In what could be a blow to ‘no’ votes Sens. Olympia Snowe and Susan Collins, Maine has released a report showing that the health care law “will save the state tens of millions of dollars a year after it is fully implemented in 2014″:

“This is a far-reaching projection and it assumes what we know today,” Department of Health and Human Services Commissioner Brenda Harvey said. “There are also some policy decisions that will need to be made that will impact these estimates.”

If the state adopts all of the changes assumed in the analysis, which was conducted by DHHS, the net savings to the state in 2014 is an estimated $31.8 million.

Contrary to the complains of many states, Maine — which has already expanded coverage for adults to at least 100 percent of the FPL prior to enactment of health reform — will receive transitional federal funding to help pay for some of the adults that it’s currently financing with state dollars.

“Under the new law, the federal government will pay 98 percent of the cost,” the state notes. “Expanding Medicaid to cover all childless adults under the new federal health law increases the state’s match rate for those Mainers and would save the state over the current program that caps enrollment. The estimated savings in 2014 are $14.6 million.”

Maine will benefit more than other states from reform because it’s gone further in meeting the goals of the bill and expanding coverage to its residents, Snowe and Collins however, seem to have other priorities.

If there are any death panels in health care reform, then they may have very well killed the American Medical Association, which suffered another loss in the Senate this afternoon after Majority Leader Harry Reid (D-NV) failed to secure enough votes to patch the 21% pay cut coming to physicians participating in the Medicare program.

In 2009, the AMA lent its support to the health law after receiving assurances that Congress would scrap the existing SGR formula to avoid future cuts, but now, as Democrats continue to look for 60 votes, Republicans are letting it be known that there is a price to pay for bucking the grand old party:

– SEN. TOM COBURN (R-OK): “I don’t blame the AMA for being upset, but they kind of walked into this themselves by embracing, and then not embracing, and then embracing” the reform bill, he said. “It didn’t have an SGR fix and it didn’t have liability fix. The two goals that every doctor that’s associated with AMA wants—they want payment reform and they want liability reform—they got none of it.”

– SEN. JOHN CORNYN (R-TX): “For some inexplicable reason, I think the AMA has kind of burned all its bridges. It just makes absolutely no sense to me.”

– SEN. JOHN THUNE (R-SD): “That’s why a lot of Republicans right now are looking at this issue and saying: ‘Yeah, we want to help you. We want to fix this. We thought it should have been fixed a long time ago.’ But [they] are not particularly sympathetic to their sense of urgency about getting a 10-year fix in place given the fact that it should have been done in the health care debate.”

The AMA’s trouble counting Republican votes began as early as last year, when Senate Majority Leader Harry Reid (D-NV) attempted to pass a $245 billion 10-year doc fix. The legislation wasn’t offset and failed to garner a single Republican vote, despite AMA assurances to the contrary. “We were told by the American Medical Association and others, that we would get help by the Republicans to take care of senior citizens so they could have doctors to take care of them,” Reid lamented. The vote represented a defeat for the group, which had spent some $2 million dollars lobbying for the SGR in the weeks before the vote.

Doctors — the organization’s supposed bread and butter — are also turning their backs on the organization. While it theoretically represents all physicians, the AMA’s current paying membership comprises somewhere between 15 to 18% of doctors, declining almost 3.4% in 2009 to 228,000 — itself about a 2% decline from the 241,000 reported for 2007. (The 2007 figure is notable in that it marked the first time in seven years that membership increased, about a 1% jump. But that boost was achieved by giving away 8,577 free memberships for first-year residents who had been student members the previous year.)” Consequently, the dues accounted for just 16% of AMA revenue. The rest of its funds come from things like billing codes, CMS payment negotiations, and other non-membership-related operations.

Now, the group is on record as supporting an unpopular health care law and remains powerless in preventing the pending reimbursement cuts. Its hemorrhaging membership problem and its political decline will create an opportunity for other physicians’ group to fill the leadership void. Whether they’ll be more successful in completely reforming SGR and guiding the country’s transition through health reform however, is a different question altogether.

Uwe Reinhardt makes a smart point about the GOP’s new-found outrage that individuals would lose their employer-based coverage and have to enroll in individual plans through the exchanges:

I would not be surprised at all if the health-reform bill, once implemented, will trigger some and perhaps quite a bit of migration from the employment-based health-insurance platform onto the individually-insured platform based on health insurance exchanges. The White House would be well advised to acknowledge that possibility and to defend it, as can easily be done.

Indeed, if memory serves me accurately, Stuart Butler or John Goodman would not mourn the erision of the employment-based health insurance system either. Would they not favor a system of truly protable, individually purchased insurance policies in place of a system that tied individuals to particular jobs and offered ephemeral coverage? Why should small business be saddled with the problem of health insurance?

That’s right. Conservatives have been arguing for years that we should eliminate the tax subsidy for employer based insurance and give everyone the choice of purchasing insurance through the individual market. Sen. John McCain’s (R-AZ) campaign plan provided Americans with tax credits to purchase coverage on their own and some of the party’s brightest thinkers still believe that placing the individual in charge of his or her own health insurance plan is the way to go. If you don’t believe me, you should listen to Gov. Mitch Daniels’ (R-IN) solutions for reforming health care at yesterday’s AEI event.

The health care bill that Congress passed and the President signed would take small and gradual steps towards that direction (albeit with far greater regulation of the individual insurance product) without blowing up the employer health care system. After the first 10 years, the Congressional Budget Office estimates that “the number of people obtaining coverage through their employer would be about 3 million lower in 2019 under the legislation.” The Center of Medicare and Medicaid Services estimated that just 1.4 million would move out of employer coverage.

So what conservatives are criticizing is actually slow crawl towards their own ultimate goal. But rather than attacking the pace of reform, they’re characterizing the very idea of losing employer-based insurance as a failure in the new law. If that’s the case, then what does it say about their own health proposals?