Think Progress

Insurer Denies Life-Prolonging Treatment To Five-Year-Old Boy With Cancer

One of the worst abuses of private insurance companies is the practice of using spurious reasons to deny claims for medical treatments, which are often necessary for saving patients’ lives.

Kyler Van Nocker’s story shows that even 5-year-old kids are not exempt from this insurance company abuse. Van Nocker has neuroblastoma, which is a very rare form of childhood cancer that targets the nervous system and creates tumors throughout the body.

Due to successful treatment in 2007, Van Nocker’s cancer went into remission, giving him 12 months of pain-free life. Unfortunately, in Sept. 2008, the cancer returned, and Van Nocker was once again in need of treatment. Unfortunately, his health insurer, HealthAmerica, refused to pay for one form of treatment doctors believe could save his life (MIBG treatment) because they consider it “investigational/experimental” since it has yet to be approved by the FDA.

Yet in April 2008, the insurer approved cheaper treatment for Van Nocker that was also “experimental,” prompting Philadelphia Daily News columnist Ronnie Polaneczky to ask, “So why, pray tell, is HealthAmerica playing the ‘experimental therapy’ card in the case of the MIBG treatment Kyler now needs? Gee, money couldn’t have anything to do with the decision, could it?”

Van Nocker’s parents are suing HealthAmerica, citing the fact that the company has apparently been dishonest about its criteria for the types of treatment it will cover and is denying payment for treatment in this case because of the high cost of the procedure — $110,000 pays for only two rounds of MIBG treatment. “These companies have to be brought to the courthouse to get them to do the right thing,” says the VanNockers’s family attorney. “This child needs this treatment, or else.”

The sad truth is that Van Nocker is certainly not alone in having his claim denied by a major health insurer. The California Nurses Association (CNA), a nurses’ union and health care advocacy group, recently released a comprehensive study of claims denials across California. The study found that the six largest insurers in California rejected 47.7 million claims in the first half of 2009, nearly 22 percent of all claims submitted.

The United States is the only industrialized nation without cradle-to-the-grave, universal health care. In no other developed country would a child with cancer have to go without care because an insurance company decided it was not profitable enough to cover him.

Health Care Industry Front Group Cheers Death Of The Public Option With Large Washington Post Ad

One of the most aggressive industry front groups fighting to defeat health care reform has been the Conservatives for Patients’ Rights (CPR), run by disgraced hospital executive Rick Scott and represented by the same public relations (CRC Public Relations) firm that brought us the Swift Boat Veterans For Truth.

The group’s main target was the public option. CPR fear-mongered that President Obama wanted to bring scary, ineffective, socialized Canadian and British health care to the United States. It ran dishonest public relations campaign, even tricking British and Canadian citizens into appearing in an anti-government-run health care ad. While portraying itself to the public as an honest broker in the health care negotiations with President Obama, the industry was simultaneously pouring massive funds into front groups like CPR to kill reform.

Yesterday, Scott released a statement claiming credit for the defeat of the public option and saying he would be taking a “breather”:

Accordingly, we’re stepping back from the debate and taking a breather. In the meantime, and consistent with our mission, CPR will remain focused on promoting the Four Pillars of Free-Market Health Care Reform — Choice, Competition, Accountability and Personal Responsibility — pillars that will lead to lower costs and better patient outcomes.”

Today, CPR has a large, nearly full-page ad in the Washington Post cheering the public option’s death. The top of the ad has a tombstone reading, “PUBLIC OPTION PLAN R.I.P. January 27, 2010.” More text from the ad:

In his State of the Union Address, the President didn’t doom his Public Option health care plan with faint praise, he simply BURIED it with deafening silence. [...]

Finally, those of us who opposed your government-run Public Option plan can close this chapter.

By educating on the perils of your government-run Public Option plan, we achieved our goals to protect patients’ rights and stop a government takeover of our health care choices. Today, we join with our fellow Americans concerned with protecting patients’ rights to celebrate that our months of hard work finally paid off.

ThinkProgress spoke to CPR spokesman Brian Burgess of CRC Public Relations, who said that the ad was running only in the Washington Post.

CPR was not reflecting the views of most “fellow Americans” in its campaign. Over the summer, there was actually strong public support for the public option. Through an aggressive campaign, the health care industry spread misinformation to create opposition.

Woman Who Was Denied Insurance Due To Pre-Existing Condition Looking To Get Married For Health Care

One of the worst abuses of the private insurance industry is its practice of excluding people with certain pre-existing conditions from coverage, effectively denying them the right to get adequate health care coverage because covering them is not profitable enough.

45-year-old mother and divorcee Terri Carlson knows what life is like with a pre-existing condition. She has a rare genetic disease called C4 Complement Deficiency, that involves the immune system having “inadequate levels of complement proteins,” which leaves the body more prone to infections. “[It] makes me unable to process bacteria and viruses efficiently and my body attacks itself. It’s very similar to lupus,” Carlson explained to the press.

Because she recently divorced, she has “one year left under COBRA health coverage, but after that she will have nothing to pay for numerous doctors appointments and dozens of medications.” Due to the fact that Complement Deficiency is considered a pre-existing condition by many health insurance companies, Carlson has been unable to find anyone willing to cover her following the expiration of her COBRA coverage. “I’ve looked, I’ve searched, there is absolutely no stone that I’ve left unturned. And there are no other options for me,” she told a reporter.

After fruitlessly searching for months for a way to get health coverage, Carlson decided that she had only one way to get affordable coverage: She would get married. She has set up a website called WillMarryForHealthInsurance.com and is offering to marry someone whose health insurance will cover her as well. “You know, I am not happy I was delt this deck of cards in my life. However, if I don’t fight for myself nobody will. While the goverment fights over healthcare reform people like me suffer … as drastic as it sounds, I will marry for health insurance,” she writes on the site.

CBS News interviewed Carlson today. She told the news network that she can’t afford to care what her future husband looks like — “The lower the co-pay, the sexier you are to me!” Watch it:

Carlson told CBS that some people have accused her of being part of a left-wing conspiracy by using her case to illustrate the need for health reform, but that she doesn’t mind the charge: “I’m just like every other middle American that’s suffering with a pre-existing condition and caught in the middle. And if that makes me the poster child for President Obama, I’m happy to do it.”

It is worth noting that the United States is the only developed country without a universal, cradle-to-the-grave health care system. In no other developed country would a woman feel like she was forced to marry someone, even if she didn’t love them, just to be able to get decent health care coverage.

Demoralizing His Supporters, Obama Calls Nukes, Coal, And Oil Drilling ‘Clean Energy Jobs’

President Barack Obama’s discussion of energy policy in his first State of the Union address pandered to corporate interests while demoralizing his progressive supporters. Though Obama made a strong case that real investments in clean energy such as solar technology, advanced batteries, high-speed rail and efficiency are critical to job creation and international competitiveness, he also offered sops to established corporate polluters. Republicans, who spent much of the address refusing to applaud Obama’s call for economic reforms, ecstatically applauded his praise of polluting industry. Embracing the language of the John McCain campaign, Obama described nuclear power, offshore oil and gas drilling, and coal as “clean energy jobs”:

But to create more of these clean energy jobs, we need more production, more efficiency, more incentives. And that means building a new generation of safe, clean nuclear power plants in this country. It means making tough decisions about opening new offshore areas for oil and gas development. It means continued investment in advanced biofuels and clean coal technologies. And, yes, it means passing a comprehensive energy and climate bill with incentives that will finally make clean energy the profitable kind of energy in America.

Watch a compilation of Obama’s address and the Republican reaction:

Although Republicans lauded Obama’s praise of heavily subsidized, polluting industries, they scoffed at energy legislation that would address climate change. Unlike Rudy Giuliani, Rep. David Dreier (R-CA), Mitt Romney, Sen. Mitch McConnell (R-KY), and Rep. Jeb Hensarling (R-TX), Obama’s actual supporters were dismayed.

About 12,000 MoveOn members participated in a “live online dial-test of President Obama’s State of the Union speech.” While Obama’s mentions of clean energy innovation were some of his most popular moments, his paean to polluters was by far his worst moment with progressive activists:

Nukes, oil, and coal just aren’t clean. If Obama really is committed to “tough decisions,” he’ll take on the coal companies who are tearing up the Appalachian mountains, the nuclear companies who want taxpayers to take all the risk for accidents and waste, and the oil companies who are burning up the planet for their own profit. And that’s something the people who put him into office could support.

Cross-posted on The Wonk Room.

Why Is Nelson OK With Using Reconciliation For Tax Cuts For Millionaires But Not For Health Care For Americans?

Following the election of Sen. Scott Brown (R-MA) in the Massachusetts special election, Democrats have been discussing ways to pass a comprehensive health care bill that will not be killed by a GOP-led filibuster. One idea that has been floated is for the House to pass the Senate’s health care bill and also immediately amend the bill to make it more progressive and acceptable to members in the House via a reconciliation bill, which requires only a simple majority vote in the Senate to pass.

Sen. Ben Nelson (D-NE) rejected this path, telling the Politico that he does not support the reconciliation process and that the health care bill should be broken up and voted on “a piece at a time, as opposed to a comprehensive approach.” He explained, “We’ve tried a comprehensive approach and it’s clear that it won’t be possible.” While Nelson rules reconciliation out of the question for health care, he was singing a different tune in the past. The Nebraska senator has voted in favor of four of the five bills passed through reconciliation since he came to office in 2001, including Bush’s tax cuts for the super-wealthy:

– Nelson voted to use reconciliation to pass Bush’s 2001 tax cuts for the wealthy. The senator was one of twelve Democrats who voted for the $1.3 trillion in tax cuts contained in the Economic Growth and Tax Relief Reconciliation Act of 2001, which included billions of dollars of tax cuts for the super-wealthy. [5/26/2001]

– Nelson voted to use reconciliation to pass Bush’s follow-up tax cuts for the wealthy in 2003. The senator was one of only two Democrats who voted for the The Jobs and Growth Tax Relief Reconciliation Act of 2003, which contained an additional $330 billion in tax cuts. The tax cuts would not have passed without Nelson’s vote. [5/23/2003]

– Nelson voted to use reconciliation to pass an extension of the reduced tax rates on capital gains. The senator was one of three Democrats to vote to shield wealthy investors from an increase in their capital gains tax with a vote in the affirmative for the Tax Increase Prevention and Reconciliation Act of 2005 . [5/11/2006]

– Nelson voted to use reconciliation to pass a bill helping students afford college tuition. The senator joined the rest of the Democratic caucus to vote for the College Cost Reduction Act of 2007 [9/7/2007]

Given the fact that three out of four of the reconciliation bills Nelson has supported mostly benefited the wealthiest Americans, the logical question to ask is why the reconciliation process he has supported in the past is apparently appropriate for siphoning wealth to the richest Americans but not to get health care for tens of millions of Americans who lack it.

Passing Health Reform Would Contribute To Obama’s Deficit Reduction Goals

This morning, Sen. Evan Bayh (D-IN) appeared on MSNBC’s Morning Joe to (unsurprisingly) endorse President Obama’s new proposal to institute a discretionary spending freeze for two years. “The freeze would affect $447 billion in spending, or 17% of the total federal budget,” but it would “exempt security-related budgets for the Pentagon, foreign aid, the Veterans Administration and homeland security, as well as the entitlement programs that make up the biggest and fastest-growing part of the federal budget: Medicare, Medicaid and Social Security.”

Bayh supported Obama’s new approach but criticized him for spending too much time on health care reform. “We can have progressive government in this country, but you’ve got to take it a step at a time. You’ve got to be in touch with the times you’re in,” he said:

And going with the large bill in the middle of the worst recession since the 1930s and a major new expenditure at a time we were running a $30 trillion deficit just didn’t resonate real well. Monday morning quarterbacking is not something I’m into, but you’ve gt to learn from these sorts of things, and going forward let’s do what we can in a common sense way.

Watch it:

Bayh is wrong to suggest that health care reform is antithetical to reducing the nation’s $1.4 trillion deficit. After all, according to the Congressional Budget Office (CBO) the Senate health care bill would reduce the deficit by $132 billion over 10 years (or up to $409 billion over 10 years according to a Commonwealth study) and lower Medicare spending per beneficiary from 8% growth rate to 6% growth rate. As Christina Romer, chairwoman of the Council of Economic Advisers, explained in December, reform would slow the growth rate of cost by 1 percentage point per year” and have “a dramatic impact on where we are relative to otherwise we would have been.”

Health care reform would compliment the administration’s new focus on deficit reduction by slowing the fastest growing part of the deficit. In yesterday’s interview with Diane Sawyer, Obama reiterated his commitment to “keep on pushing” “on the big issues” and said, “We are going to have to be serious about the deficit in ways that we haven’t been before.” Obama didn’t say if he would urge Congress to pass comprehensive health care reform as party of his effort “to be serious about the deficit,” but taking a strong position on reform certainly demonstrate that he is “not backing off the need for us to tackle these big problems in a serious way.” As he told Congress during his address in February, “Put simply, our health care problem is our deficit problem. Nothing else even comes close. Nothing else.”

Cross-posted on The Wonk Room.

Poll Confirms Massachusetts Election Was Not A Rejection Of Health Care Reform

Following the surprise victory of Sen.-elect Scott Brown (R-MA) in last week’s special election, conservatives have attempted to paint the election as a rejection of healthcare reform and progressive policies more generally.

Appearing on ABC’s This Week yesterday, Sen. Jim DeMint (R-SC) said, “what happened in Massachusetts” shows that “people are alarmed and angry about the spending, the debt, the government takeovers [including health care].” Conservative Washington Post columnist George Will said on This Week that Massachusetts “really was a health care election.” “This was a referendum on a particular piece of legislation that is the signature legislation of the administration, and the people of Massachusetts and the country are hotly angered over its substance,” Will said.

Senate Minority Leader Mitch McConnell (R-KY), on Meet the Press yesterday, said, “the message in Massachusetts was absolutely clear. The exit polls that I looked at said 48 percent of the people in Massachusetts said they voted for the new senator over health care.” McConnell added: “The people are telling us, ‘Please don’t pass this bill.’”

This “referendum” on health reform meme has become near-conventional wisom, with the media and even some Democrats echoing it. But a new Washington Post/Kaiser/Harvard poll undermines this assertion. The poll suggests that while the election was a “protest of the Washington process,” it was not a rejection of progressive policy. Only 11 percent of voters, including 19 percent of Brown voters, want Brown to “stop the Democratic agenda:”

- 70 percent of voters think Brown should work with Democrats on health care reform, including 48 percent of Brown voters.

- 52 percent of voters were enthusiastic/satisfied with Obama administration policies.

- 44 percent of voters believe “the country as a whole” would be better off with health care reform, but 23 percent believe Massachusetts would be better off.

- 68 percent of voters, including 51 percent of Brown voters approve of Massachusetts’ health care reform.

- 58 percent of all voters, including 37 percent of Brown voters, felt “dissatisfied/angry” with “the policies offered by the Republicans in Congress.”

A different poll, from Rasmussen Reports, cast doubt on the notion that Brown voters were primarily motivated by opposition to health care reform. The poll found that 52 percent of Brown voters said health care was their top issue, while an even greater percentage of people who voted for state Attorney General Martha Coakley (D) — 63 percent — placed it first.

And as the Wonk Room’s Igor Volsky noted, Brown “doesn’t make a very convincing messenger for opposing the policy behind health reform,” considering he voted for his state’s health reform legislation in 2006. “He promised to be the 41st vote against reform because Massachusetts had already passed its own health reform bill, arguing that the state shouldn’t pay for the national effort,” Volsky added.

More at the WonkRoom here, here and here.

Matthews Tells Congressman Grayson That He Doesn’t Represent ‘The Real World Of Congress’

As Congress enters the final stretches of the health care debate, members are looking for the best way forward following the election of Sen. Scott Brown (R-MA) to the U.S. Senate. One path being suggested is for the House to pass the Senate bill as is and then later use the reconciliation process — which requires only a simple majority vote in the Senate — to amend the bill and make it more progressive and acceptable to members of the House.

This evening, Rep. Alan Grayson (D-FL) appeared on MSNBC’s Hardball With Chris Matthews to advocate for this plan. As Grayson floated the idea, the MSNBC host repeatedly attacked the congressman, claiming that Grayson is part of the “outside world represented by the netroots” that doesn’t understand how Congress operates:

MATTHEWS: This is the problem, Congressman. Every night we deal with two worlds, the real world of Congress that has to do things and get things passed, and this outside world represented by the netroots and people like yourself, who play this game.

GRAYSON: What are you talking about? I sit in meetings with the Democratic caucus with meetings every week! I’m telling you, this is what we’re talking about. This is what the leadership is telling us.

MATTHEWS: We’ll make a side bet that it’s not going to happen. Congressman Alan Grayson, a true believer that you can get things done by willing it to get done! [laughs]

Watch it:

It is true that Grayson embraces the netroots, with an active Daily Kos account and multiple issue campaign websites. But unlike Chris Matthews, Grayson is also a member of Congress and has a vote.

Democrats Need To Pass A Comprehensive Health Care Bill

In the Battle of Waterloo, Democrats are prepared to surrender. After Sen. Jim DeMint (R-SC) issued his battle cry to the Democrats in August, President Obama aptly responded by noting “this isn’t about me,” but rather, it’s about “a health care system that is breaking America’s families.” “We can’t afford the politics of delay and defeat when it comes to health care — not this time, not now,” Obama added. But today, Democrats — just inches from the goal-line — are prepared to take a knee, run out the clock, and renege on their promise of seeing health care reform through completion.

Learning the wrong lessons from a Massachusetts election, Democrats are finding difficulty motivating their solid majorities in the House and Senate to finish what they started. The outcome in Massachusetts didn’t change the basic fundamental questions: Can we afford the status quo, and is the current reform bill better than doing nothing at all?

Last year, Senate and House Democrats pledged to fix the broken health care system and put the nation on a sustainable economic path by repeatedly voting for change. If they’re still committed to that goal, then passing the Senate health care bill alongside a reconciliation package to improve the underlining legislation and address popular concerns is the only way to achieve the change voters demanded in 2008.

Trying to pass a scaled-back version of reform would drag out the process, fail to substantially lower costs or improve access, and do so without any assurance that it will be any more popular in Congress. Democrats therefore have two choices: pass an improved version of the Senate health care bill or abandon the effort altogether. If Democrats chose the latter, millions more Americans would go without health care and health care costs would continue to skyrocket. Politically, the Democratic Party will be ridiculed for talking a big game but delivering no results. They will lose their progressive base and outsource their agenda to the Republican minority — all simply because their supermajority of 60 shrank to 59.

Democrats are hesitant to vote again for an unpopular health care bill. They fear that the Massachusetts elections are a bellwether of the upcoming midterms. Change of the magnitude envisioned by health care reformers certainly does not come easily. As Obama said in March, “To kick these problems down the road for another four years or another eight years would be to continue the same irresponsibility that led us to this point. That’s not why I ran for this office. I didn’t come here to pass on our problems to the next President or the next generation — I came here to solve them.”

The Democrats have an opportunity to improve health care for millions of Americans. They will regret squandering this moment if they cannot regroup now.

Cross-posted on The Wonk Room.

Update Tom Toles provides this illustration:

Will Brown Give Back The Federal Money That Subsidized Health Reform In Massachusetts?

Senator-elect Scott Brown (R-MA) supports Massachusetts’ 2006 health care reform but opposes the near-identical Senate health care bill. During the campaign, Brown promised to provide the 41st vote for any national reform effort that required states like Massachusetts to finance reform elsewhere:

Thank you for the question, the health care plan is not good for Bay State Health Center here in Springfield, I worked on that health care bill, the problem with it is that we have 98% of our people insured and we have to look at pricing it’s getting out of control – but the Federal plan, taking a half trillion from Medicare, why would we go and subsidize the failure of other states – not only would we be paying for our plan, we’d be paying for everyone else – and look at the back door deals – I think people have lost confidence – and I think that we need to go back – I’d work on it – why do we need a one size fits all government approach we already did it.

Watch it:

But if Brown believes that Americans should not have to finance other states’ reform efforts, he should return the federal dollars that subsidize Massachusetts’ Medicaid expansion. After all, the state’s 2006 health care reform legislation included an expansion of Medicaid for children up to 300% of the federal poverty level and increased enrollment caps on existing Medicaid programs for adults. Massachusetts relied “very heavily on federal Medicaid funds to finance the plan, including $385 million in annual federal Medicaid payments that would have been lost in the absence of a plan to reduce the number of uninsured.”

Massachusetts used federal funds because, like all states, it lacked the economic capacity to invest in something as big as health care reform. Only the federal government can fix the systematic problems plaguing the health care system and improve the system in an equitable manner. Brown’s insistence that states can do reform on their own, is just a back door way for preserving the status quo that denies millions of Americans the kind of reforms that they’re financing in Massachusetts.

Senator Of Katrina-Ravaged Louisiana Collaborates To Block Climate Action

Today, Sen. Mary Landrieu (D-LA) announced that she is the previously unnamed Democrat joining Sen. Lisa Murkowski (R-AK) in her campaign to prevent Clean Air Act regulation of greenhouse gas pollution. Because she “believes the Clean Air Act is not meant to be applied to carbon dioxide emissions,” Landrieu is collaborating to craft what environmentalists are calling the Dirty Air Act:

“I am considering that right now,” Landrieu said when asked whether she backed Murkowski’s plan. “I have been working with her on it.”

Landrieu, like Louisiana’s Republican governor Bobby Jindal and Senator David Vitter, has pledged allegiance to the pollution interests who have given her over $1.5 million instead of her own people. Last month, Jindal “filed objections with EPA Administrator Lisa Jackson” over the proposed climate rules, claiming the standards would have “profound negative economic impacts on the state of Louisiana.” In September, Vitter submitted an amendment to block funding for centers that study and prepare for the impacts of climate change.

Landrieu’s actions are quite simply morally indefensible. The Mississippi Delta is under extraordinary threat from global warming, as seas rise and storms intensify. According to a recent analysis published in Nature, “an additional 2 degrees of global warming” — to which our business as usual commits the planet — would cause “6 to 9 meters (20 to 30 feet) of long-term sea level rise,” which would “permanently submerge New Orleans and other parts of southern Louisiana.”

This is not just a future threat. Climate change significantly intensified Hurricane Katrina, which cost this nation $80 billion, killed thousands, and displaced a million people. As hurricane scientist Kerry Emanuel has explained, “Probably if Hurricane Katrina had happened in 1980, the levees would have held.”

Cross-posted on The Wonk Room.

Brown’s Victory Wasn’t A Referendum On National Health Reform Legislation

While House Speaker Nancy Pelosi (D-CA) is insisting that Democrats “don’t (think) a state that already has health care should determine whether the rest of the country should,” several prominent Democrats are misinterpreting Senator-elect Scott Brown’s (R-MA) surprise victory in Massachusetts as a referendum on national health care reform and are urging Congressional leaders to slow down the process:

– Sen. Jim Webb (D-VA): “In many ways the campaign in Massachusetts became a referendum not only on health care reform…I believe it would only be fair and prudent that we suspend further votes on health care legislation until Senator-elect Brown is seated.”

– Sen. Evan Bayh (D-IN): “There’s going to be a tendency on the part of our people to be in denial about all this, [but] if you lose Massachusetts and that’s not a wake-up call, there’s no hope of waking up.” “Whenever you have just the furthest left elements of the Dem party attempting to impose their will on the rest of the country — that’s not going to work too well.”

– Rep. Barney Frank (D-MA): If Martha Coakley had won, I believe we could have worked out a reasonable compromise between the House and Senate health care bills…. But our respect for democratic procedures must rule out any effort to pass a health care bill as if the Massachusetts election had not happened.

– Rep. Anthony Weiner (D-NY): “It’s not the end of the world. Look, we can come back to healthcare.” “It wouldn’t be the worst thing in the world to step back and say, look, we’re going to pivot to do a jobs thing. We’re going to try to include some healthcare pieces in it.”

Public hostility towards health reform certainly helped propel Brown to victory, but as economist Austin Frakt explains, “[t]he real lesson seems to be less about policy and far more about politics.” After all, Brown doesn’t make a very convincing messenger for opposing the policy behind health reform. As a state senator, Brown voted for Massachusetts 2006’s reform law which, like the Senate and House bills, includes an individual health insurance mandate, insurance exchanges, government affordability credits and insurance regulations. As a result of the law, 98% of Massachusetts residents have health insurance and 79% want the law to continue. Unlike voters in more conservative states, Massachusetts residents don’t fear national reform because it would result in a government take over of health care — they’ve already benefited from the provisions in the Senate health care bill and they support them.

Brown’s campaign tapped into voter frustration with skyrocketing premiums (unlike the national bills, Massachusetts reform did not include cost containment) and the political sausage making process to cast the national reform as an unnecessary effort that could only increase costs for Massachusetts residents. “[W]hy do we need a one size fits all government approach we already did it?” Brown asked voters during a debate with Coakley. “[T]he Federal plan, taking a half trillion from Medicare, why would we go and subsidize the failure of other states – not only would we be paying for our plan, we’d be paying for everyone else – and look at the back door deals – I think people have lost confidence – and I think that we need to go back – I’d work on it,” he said. Brown localized the reform issue. He stripped it of its policy clothes and presented the effort as a hindrance to the state’s successful program. He promised to be the 41st vote against reform because Massachusetts had already passed its own health reform bill, arguing that the state shouldn’t pay for the national effort?

It’s unclear how many voters voted for Brown because of his opposition to the national health reform effort, but at least one poll suggests that enthusiasm for reform was greater than the movement against it. According to Rasmussen Reports election night poll, 63% of Coakley voters said health care was the most important issue in determining their vote, while 52% of Brown voters said it was their top issue.

Since national dissatisfaction with reform coincided with the Senate’s effort to water-down the bill, Democrats shouldn’t distill the legislation further or put it off altogether. “If the Democrats run for cover, if we become pale carbon copies of the opposition, we will lose–and deserve to lose,” Ted Kennedy once said. “The last thing this country needs is two Republican parties.”

Cross-posted on The Wonk Room.

Gingrich: Republicans ‘Will Run On An Absolute Pledge To Repeal This Bill’

Yesterday, Minority Leader Mitch McConnell (R-KY) refused to acknowledge that Republicans would campaign in future elections on a platform of repealing health reform, but former House Speaker Newt Gingrich predicted that Republicans would exploit the bill’s late implementation date to “run on an absolute pledge to repeal the bill“:

I suspect every Republican running in ‘10 and again in ‘12 will run on an absolute pledge to repeal this bill. The bill–most of the bill does not go into effect until ‘13 or ‘14, except on the tax increase side; and therefore, I think there won’t be any great constituency for it. And I think it’ll be a major campaign theme.

Watch it:

While the exchanges don’t go into effect until 2014, the Senate health care bill spends approximately $10 billion between 2011 and 2014 on interim benefits. The bill immediately prohibits insurers from rescinding coverage, imposing life-time or annual limits or denying coverage to children with pre-existing conditions. Applicants who are unable to find insurance in the individual market, can purchase catastrophic coverage and young adults can stay on their parents’ policies until their 27th birthday. Small businesses that provide health coverage will also be eligible for tax credits beginning in 2010.

The bill requires health insurers to spend 80 to 85 percent of all premium dollars on medical care and reduces the size of the coverage gap in Medicare Part D “by $500 in the first year.” The bill also guarantees “50 percent price discounts on brand-name drugs and biologics purchased by low and middle-income beneficiaries in the coverage gap.”

These benefits could also improve as the Senate bill moves into conference. Several House progressives have pledged to push the conference committee to move up the implementation date of the exchanges in the final bill and front load more benefits into the interim period of the final legislation.

Catholic Hospitals Endorse Senate Abortion Compromise

The Catholic Health Association — which represents hundreds of Catholic hospitals across the country said in a statement that it was ‘encouraged’ and ‘increasingly confident‘ that the abortion compromise in the Senate health care bill “can achieve the objective of no federal funding for abortion.’” The announcement represents a break from the the United States Conference of Catholic Bishops’ strong opposition to the Senate’s less stringent restrictions and provides critical political cover for pro-life Democrats who are hesitant to vote for a bill opposed by Catholic organizations. Under the Senate measure, women are required to purchase abortion services with private premiums and pay for the care with a separate transaction. States could also prohibit insurers in the exchange from offering abortion services.

The NYT explains the theological underpinnings of the endorsement:

“The Catholic Health Association seems to be using traditional principles of cooperation with evil,” said Prof. M. Cathleen Kaveny of the Notre Dame University Law School. Such principles, she said, could permit support for “imperfect legislation,” as long as one’s intent was not to “further abortion,” one made every effort to “minimize the harm,” and one achieved “an extremely important good that can’t be achieved any other way.”

In contrast, she said, “some bishops have adopted a prophetic stand against abortion that wants to eliminate any form of cooperation with evil no matter how remote.”

Catholic hospitals (like any hospital) hope to minimize the number of uninsured patients who receive uncompensated care and achieve the “extremely important good” of expanding health care coverage to everyone. Earlier this month, Ellen-Marie Whelan and Jessica Arons analyzed the Catholic Bishop’s criteria “that they set as priorities to be included in health reform legislation” and concluded that health care reform meets these self-imposed goals:

As our analysis shows, there are a number of ways both bills would achieve the Bishops’ “pro-life” goals: they would save the lives of thousands each year, reduce the suffering of millions, and increase the dignity with which people are treated when ill. Moreover, providing quality health care to women and families in need is a much more effective and humane way to reduce the number of abortions than restrictions on funding ever have been. In the United States, as throughout the world, restrictions on abortion make the procedure more expensive and less safe; they do not make it less common.

The question before any pro-life Catholic organization is this: “Is it worth jeopardizing legislation that would provide nearly universal access to health care, improve quality, be much more affordable, assist the poor and low income, reduce fraud and waste, protect the conscience of providers, and so much more simply because it would preserve the status quo on public funding for abortion but not impose new restrictions on private coverage?” Fortunately, the Catholic hospitals have decided that it is not.

Rep. Bart Stupak (D-MI), meanwhile, has responded to the hospitals’ endorsement by reiterating his opposition to the Senate language, arguing that he has commitments from at least 10 Democrats who voted for House health care bill to oppose the final bill if it doesn not reflect the House bill’s compromise.

Cross-posted on The Wonk Room.

Conservatives Attack Health Bill Passage As A ‘Gift That Keeps On Taking,’ Threaten To Take Down X-Mas Tree

Early this morning, the Senate passed comprehensive health care reform legislation by a vote of 60-39 — with Sen. Jim Bunning (R-KY) not voting — ending more than four weeks of acrimonious floor debate. “This morning is not the end of the process,” Senate Majority Leader Harry Reid (D-NV) reminded progressives dissatisfied with the Senate bill. “It’s only the beginning.” Sen. Robert Byrd (D-WV), the longest serving federal lawmaker in U.S. history, cast his vote saying, “Mr. President, this is for my friend Ted Kennedy. Aye.” Watch highlights compiled by Igor Volsky at the Wonk Room:

As CAP President and CEO John Podesta noted, health care reform “would extend health care coverage to a record 31 million Americans who are currently uninsured, bringing the total insured population to 94 percent.” However, every single Republican opposed the legislation. RNC Chairman Michael Steele immediately put out a statement blasting the legislation as a “gift that keeps on taking”:

This morning, as millions of Americans prepared to gather with their families in celebration of Christmas, President Obama and Harry Reid gathered with their liberal allies in celebration of government. Mr. Reid and company honored President Obama’s Christmas wish for increased federal control and passed their government-run health care experiment out of the Senate. [...]

As we move forward, America can look forward to watching Nancy Pelosi conduct the arm-twisting needed to convince her most liberal colleagues that the Senate version is the best Trojan horse possible to hide a true single payer system, which is what this debate has always been about. This Christmas, the Democrats and President Obama have given America the one gift that keeps on taking.

Conservatives have been aggressively trying to portray health care reform as an assault on Christmas and Christian values. Fox News even said that senators voting against reform are doing so because they understand “the true meaning of Christmas.” Today on the floor, Sen. Kit Bond (R-MO) said that Americans would be getting “a lump of coal” this Christmas. Apparently, this meme is catching on. TPM notes that today on C-SPAN, a caller — “Bunny” from Kansas — was so upset over the health care bill’s passage that she said she would be taking down all her Christmas decorations. “I have taken my Christmas wreath off my house. I have taken all the lights down,” she said. “This is supposed to be a nation under God, and it isn’t. They absolutely have ruined Christmas.” Watch it (at approximately 45:00):

After the passage of the historic bill, President Obama said, “As I’ve said before, these are not small reforms; these are big reforms. If passed, this will be the most important piece of social policy since the Social Security Act in the 1930s, and the most important reform of our health care system since Medicare passed in the 1960s. And what makes it so important is not just its cost savings or its deficit reductions. It’s the impact reform will have on Americans who no longer have to go without a checkup or prescriptions that they need because they can’t afford them; on families who no longer have to worry that a single illness will send them into financial ruin; and on businesses that will no longer face exorbitant insurance rates that hamper their competitiveness.”

Nelson Insists Carve-Out Isn’t ‘A Special Deal For Nebraska,’ Promises To Remove If The Governor Requests

Yesterday, Sen. Ben Nelson (D-NE) took to the Senate floor to defend a provision in the Senate health care bill that requires the federal government to fully fund Nebraska’s Medicaid expansion. Nelson insisted that the deal “lay down” a marker “so that every state could object to this manner of unfunded mandates.” “There is no carve out. Each state between now and 2017…will have an opportunity to come back in and get this bill changed”:

As a governor — and my colleague is a former governor — we fought against federal unfunded mandates. And as a senator back here, I’ve also fought against unfunded and underfunded federal mandates. And this was in fact exactly that. While we weren’t able to get in this legislation an actual opt-out or opt-in for a state-based decision, what we did get was at least a line, if you will, so that in the future other states are going to be able to come forward and say, hey, either the federal government pays for that into the future or the state will have the opportunity to decide not to continue that so that we don’t have an unfunded federal mandate.

Watch it:

Nelson read from his correspondence with Nebraska Governor Dave Heineman, in which the governor asked that the state be protected from the unfunded mandate but later criticized the matching fund proposal. “On the 20th of December I again wrote to the governor,” Nelson explained. “I pointed out that within hours after the amendment was filed, my colleague from Nebraska objected to the inclusion of these funds. ‘As a result, I’m prepared to ask that this provision be removed from the amendment in conference if it’s the governor’s desire,” Nelson said.

Last night, Heineman told Fox News, “We’re embarrassed by what’s going on. We’re very surprised. Nebraskans are angry and upset about what occurred. And so they need to set this straight.”

Baucus: Not A Single Republican Senator Has The ‘Courage’ To Work Together To Pass Health Reform

In an uncharacteristically impassioned and frank speech on the Senate floor, Sen. Max Baucus (D-MT) challenged “courageous” Republicans to “break from their leadership” and “work together to pass health care reform.” Baucus argued that the Republican party was more interested in winning seats during the 2010 election than offering sensible alternatives to the health care crisis. He also accused the Republican leadership of pressuring members of ‘Gang of Six’ to abandon bipartisan negotiations.

Sens. Olympia Snowe (R-ME), Mike Enzi (R-WY), and Chuck Grassley (R-IA) “wanted to pass health care reform,” Baucus insisted. “They asked very good questions,” but “one by one by one they started to drift away. They wanted to pass health care reform, they wanted to act in a bipartisan basis but they were pressured, pressured from their political party not to do it.”

At one point, Sen. Roger Wicker (R-MS) tried to argue that so-called “Gang of Six” members wanted to support a compromise, but “it dawned on them that my friends on the outer side of the aisle wanted to Europeanize the health care system of the United States of America.” Baucus responded angrily. “I want to tell this Senator that is not what happened,” he shouted, waiving his index finger at Wicker:

BAUCUS: I want to tell the Senator that that is not what happened. I was in the room constantly, constantly. I talked to those Senators many many times. That is not what happened. I”ll tell you what did happen. Your leadership pressured them, pressured them, pressured them not to work together. There is no European style effort in that room, that is a totally untruthful statement. Totally untruthful statement. None whatsoever….That assertion of working towards a European solution is entirely untrue. It’s entirely false.

Watch it:

“I just want the public to know that we worked very hard to get a bipartisan bill that side of the aisle started working with us but gradually they began to bleed politically,” Baucus said. They realized “that they would do a better chance in the 2010 elections by just not working with us, but just attack attack attack attack attack and try to score political points to defeat any honest effort to get health care reform.”

Cross-posted on The Wonk Room.

FLASHBACK: Obama Repeatedly Touted Public Option Before Refusing To Push For It In The Final Hours

In recent days, there has been an uproar in the progressive community over the Senate’s decision to drop the public option from its health care bill in order to reach the crucial 60 votes needed to break a filibuster. Given that many liberals backed a single-payer, Medicare-for-all system, the public option was seen as a political compromise.

“I didn’t campaign on the public option,” President Obama told the Washington Post. But he touted the public option on his campaign website and spoke frequently in support of it during the first year of his presidency, citing its essential value in holding the private insurance industry accountable and providing competition:

– In the 2008 Obama-Biden health care plan on the campaign’s website, candidate Obama promised that “any American will have the opportunity to enroll in [a] new public plan.” [2008]

– During a speech at the American Medical Association, President Obama told thousands of doctors that one of the plans included in the new health insurance exchanges “needs to be a public option that will give people a broader range of choices and inject competition into the health care market.” [6/15/09]

– While speaking to the nation during his weekly address, the President said that “any plan” he signs “must include…a public option.” [7/17/09]

– During a conference call with progressive bloggers, the President said he continues “to believe that a robust public option would be the best way to go.” [7/20/09]

– Obama told NBC’s David Gregory that a public option “should be a part of this [health care bill],” while rebuking claims that the plan was “dead.” [9/20/09]

Despite all this overt advocacy for the public option, it appears that Obama was reticent to apply the political pressure necessary to get the plan in the final hours of congressional negotiation. Sen. Joe Lieberman (I-CT) — who threatened to filibuster the creation of any new public plan or expansion of Medicare — told the Huffington Post that he “didn’t really have direct input from the White House” on the public option and was never specifically asked to support it.

Sen. Russ Feingold (D-WI), one of the most ardent backers of public insurance, blamed the demise of the public option on a “lack of support from the administration.” Rep. Anthony Weiner (D-NY) — perhaps the most visible defender of the public option in the entire health care debate — went even further, saying that Obama’s lack of support for congressional progressives amounted to him being “half-pregnant” with the health insurance and drug industries.

Dean No Longer Urging Dems To ‘Kill’ The Bill: ‘Let’s See What They Add To This Bill And Make It Work’

This morning, Howard Dean walked back from earlier statements encouraging Democrats to “kill” the Senate health care bill. On Thursday, Dean wrote that “this bill would do more harm than good to the future of America,” but during his appearance on Meet The Press, Dean argued that yesterday’s manager’s amendment significantly improved the legislation. “I would let this thing go to conference committee and let’s see if we can fix it some more,” Dean said:

Well, let’s start with the positive things. Over the last week, there were things that were improved. There were some cost containment mechanisms that were gutted. They got restored. I would certainly not vote for this bill if this were the final product, but there are, the House bill is quite a good bill. This bill has improved over the last couple of weeks, I would let this thing go to conference committee and let’s see if we can fix it some more…so there are a lot of things that need to be fixed, but if they are fixed you may actually get the foundation of a bill, coming out of the House. If most of the House provisions survive, then we can have a bill that we could work with….I hope this isn’t the compromise that’s been achieved. I think we have yet to see the compromise that we could achieve.

Watch a compilation:

Dean didn’t advocate for pushing the bill through the reconciliation process or restarting reform after the midterm elections, as he had suggested several days earlier. Instead, the former Vermont governor expressed optimism that the bill could be improved in conference, going so far as to say that some of the goals of the public option could be accomplished through regulatory means.

“Here is the major problem,” Dean said. “We have committed to go down a path in this country where private insurance will be the way that we achieve universal health care. That means we’re going to have a 30-year battle with the insurance industry every time we try to control costs and try to get them to do things.” “My position is let’s see what they add to this bill and make it work, if they can make it work without a public option, I’m all ears. I don’t think that’s possible,” he said.

DailyKos founder Markos Moulitsas, who strongly opposed the Senate bill, also appeared to soften his position. “This, this is not a done deal, we still have reconciliation to go to,” he said during a round table following Dean’s appearance.

Cross-posted on The Wonk Room.

Ben Nelson To Provide 60th Vote For Senate Health Bill

This morning, Sen. Ben Nelson (D-NE) held a press conference to announce that he would provide the 60th vote for cloture on the Senate bill with the manager’s amendment.” Nelson praised the Obama administration and Majority Leader Harry Reid (D-NV) for addressing his concerns but warned his colleagues, “I reserve the right to vote against cloture vote if there are material changes to this agreement in the conference report. ”

Abortion and Medicaid expansion may have been the largest sticking points to winning over Nelson’s votes, but Nelson dodged a question about the extra Medicaid matching funds that are provided for his state and instead highlighted the amendment’s changes to flexible savings accounts (FSA), rural hospitals, and a new report that would study successful malpractice reforms “to find out more information out about it,” Nelson said.

The abortion language — which allows states to prohibit abortion in their exchanges and requires strict segregation of private and public funds — may be the most significant alteration. In the video below, Nelson lays out the compromise:

First of all there are 12 states that have banned abortion in public plans and there are 5 states that have banned abortion in both private and public plans. We wanted to make sure in this legislation that it was clear that there was no preemption of the right of states to continue to make those bans.

Watch Nelson explain how the funds would be segregated:

“My chief of staff and I basically developed this idea,” he said. “We already agreed how to account for the money, the premium dollars so finding then the mechanism for coverage was the next. And this we just stumbled on to,” Nelson admitted before confirming that abortion was the last unresolved issue.

Cross-posted on The Wonk Room.