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Private Health Insurers Seek To Maintain Power By Merging Before Obamacare Takes Effect

Although Paul Ryan touts a plan for Medicare that would expand the role of private insurers, studies show the private insurance industry isn’t necessarily friendly to the American consumers who seek quality and affordable health care. A Washington Post column points out that the health insurance market, which is already set up to allow insurers to build monopolies that limit consumer choice and drive up prices, may now use mergers to maintain their outsized influence before the health reform law fully takes effect:

Now, with the health insurance industry near the top of its profit cycles and Obamacare about to add tens of millions of new people to the insurance pool and another wave of consolidation hitting the industry, [Coventry Chairman Allen Wise] has decided it’s time to do what he meant to do all along: sell Coventry to an industry giant for a 20 percent premium over the market price.

Besides delivering a bonanza for Wise and his tight-knit crew of directors and executives, the $7.3 billion purchase makes lots of sense for Aetna. The Hartford-based insurer is one of the four dominant players in the market for managing health plans for large and medium-size businesses, but it has had trouble breaking into the markets where Coventry does business: the individual and small group market plus managed-care plans under Medicare and Medicaid — the very markets that are expected to grow rapidly in coming years.

But a deal that is a boon to Coventry and Aetna shareholders is bad news for the rest of us, reducing the potential for greater competition in the health-care sector at the very time that the country is looking to competition to improve the quality of care and bring runaway costs under control.

According to a Kaiser Family Foundation study, health insurance competition is already so limited that in 30 states, the largest insurer controls more than half of the individual and small-business market — the same market that the Medicare and Medicaid programs fit into. On a national scale, the average number of serious competitors in each state is just four different insurance providers. That means hospitals are often able to negotiate prices that are 50 to 100 percent higher than the costs under Medicare and Medicaid.

The health insurance exchanges set up by the Affordable Care Act seek to enhance competition between health care providers, ultimately aiming to provide better quality of care by facilitating more choice within the market. However, big health insurers like Coventry will undermine that goal if they merge before Obamacare’s provisions fully go into effect next year. The insurance industry’s power plays underscores the need for expanding access to programs like Medicaid and Medicare. Nevertheless, Republican governors across the country have already pledged to reject federal funds to set up health insurance exchanges, despite the potentially catastrophic effects for their state’s low-income residents who already struggle to afford quality care.

NEWS FLASH

Mayors Protest Maine Governor’s Plan To Cut Medicaid | Maine Gov. Paul LePage (R) will wait until after the November election to decide if his state will expand its Medicaid program under Obamacare, but in the meantime, mayors of six cities in Maine are protesting LePage’s Medicaid cuts that will eliminate coverage for about 26,000 people in the state. The legislature passed the $20 million in cuts to MaineCare last spring. The cuts will go into effect October 1 if federal officials grant the state a waiver of Medicaid’s eligibility standards, which no state has been granted. In a letter to LePage, the mayors argue that “the elimination of insurance coverage for thousands of Maine people…presents significant hardships not just to the families affected but also to the municipalities in which they reside.”

Politics

EXCLUSIVE: Romney-Ryan Robocall Attacks Obama For ‘Changing Medicare Forever’

Even though Mitt Romney and Paul Ryan want to transform Medicare from a guaranteed benefit to a voucher-based system, essentially phasing out the existing program, their campaign is running calls claiming that President Obama is “changing the program forever”:

Some think Obamacare is the same as free health care, but nothing is free. Obama is raiding $716 billion from Medicare, changing the program forever — taxing wheel chairs and pace makers, raising taxes on families making less than $120,000. Free health care comes at a very high price. The Romney-Ryan plan will restore Medicare funding, and protect and strengthen the program for the next generation.

Listen:

The Affordable Care Act actually extends the solvency of Medicare by reallocating $716 billion spent on the program. That money has gone to lowering Seniors’ co-pays, reducing fraud and abuse, and connecting reimbursements to economic productivity.

Should Romney and Ryan repeal these changes, Medicare would become insolvent eight years before it’s currently on track to. Their plan would also force future seniors would pay $60,000 more for their care.

Justice

GOP Rep. Burgess Suggests Medicare Is Unconstitutional

Rep. Michael Burgess (R-TX)

At a panel during last week’s Republican National Convention, Rep. Michael Burgess (R-TX) strongly suggested that he believes Medicare is unconstitutional — before going on to say that its constitutionality doesn’t matter so long as it is used to achieve conservative ends. Burgess’ comment arose during a discussion of whether the Constitution permits the federal government to enact broad tort reform legislation:

The other problem that we have is the — I don’t want to say it is a problem — but the Tenth Amendment. If we do something at the federal level that changes law at the courthouse, at the state level, that is problematic. . . .

I do like the concept, and, uh, this is something I’ve talked about for a long time. Medicare is a federal system. They’ve already violated the Tenth Amendment so many times that everybody’s immune to it. So if you have, in the Medicare system, a separate liability system where doctors are covered under the Federal Tort Claims Act like they are in federally qualified health centers, you could remove that balance item off the doctor’s balance sheets.

Watch it:

To decode this a bit, tort reform has long been a major goal of conservative policy makers who claim, despite significant evidence to the contrary, that it would decrease health costs for ordinary Americans. Unfortunately for tort reformers, many of their conservative allies also believe (falsely) that federal tort reform violates the Tenth Amendment of the Constitution.

Burgess suggests squaring this circle by somehow laundering tort reform through Medicare — such as by having one set of medical malpractice laws for care paid for by Medicare and another, entirely separate system for other care. In Burgess’ words, this would avoid the Tenth Amendment problem conservatives imagine because Medicare “already violated the Tenth Amendment so many times that everybody’s immune to it.”

So there you have it. Burgess seems to think Medicare, or at least much of Medicare, is unconstitutional. But that’s okay, because Medicare can still be used to achieve unconstitutional ends, so long as those ends are conservative. The Constitution is the Supreme Law Of The Land — except when conservatives want it to say something else.

Justice

GOP Senate Candidate Supports Life Sentences For Rape Victims Who Obtain Abortions

Rep. Rick Berg (R-ND)

Rep. Rick Berg (R-ND), the candidate for Senate from North Dakota, once voted for a bill that would have made any woman who obtained an abortion guilty of a homicide crime — even if it were in the case of rape or incest. Indeed, the bill Berg supported does not even contain an explicit exception if an abortion is necessary to save the woman’s life.

In 2007, Berg was among the small number of state representatives in the North Dakota House who supported the measure. It also would have imposed penalties on doctors and anyone else who “aids, abets, facilitates, solicits, or incites” a person into an abortion:

A new section to chapter 12.1-16 of the North Dakota Century Code is created and enacted as follows:

Intentional termination of human life – Preborn children. A person is guilty of a class AA felony if the person intentionally destroys or terminates the life of a preborn child. A person that knowingly administers to, prescribes for, procures for, or sells to any pregnant individual any medicine, drug, device, or other substance with the specific intent of causing or abetting the termination of a preborn child is guilty of a class AA felony. A person that intentionally or knowingly aids, abets, facilitates, solicits, or incites a person to intentionally destroy or terminate the life of a preborn child is guilt of a class C felony. For purposes of this section, “preborn child” includes a human being from the moment of fertilization until the moment of birth.

A class AA felony carries a maximum sentence of life without the possibility of parole in North Dakota. Chapter 12.1-16 of the North Dakota Century Code is the section of that state’s law that covers homicide crimes such as murder or manslaughter.

Although one news outlet claims that Berg’s bill contains an exception “when the life of the mother is endangered” such an exception does not appear in the bill’s text. The language of the bill quoted above creates a new homicide crime without any exceptions whatsoever. It is possible that a woman who obtained an abortion to save her life could invoke a provision of North Dakota law permitting self-defense to prevent “imminent unlawful bodily injury, sexual assault, or detention,” although even this is not certain because a life-threatening pregnancy is not “unlawful.”

Berg was quick to denounce the comments of a fellow Senate Candidate, Rep. Todd Akin (R-MO), when he claimed that a woman couldn’t get pregnant from “legitimate rape.” Berg called the statement “insulting and reprehensible,” and “condemn[ed] them in the strongest terms possible.” But the assertion that a rape victim should be put in jail for not wanting to carry the child of her rapist is equally abhorrent. It is also largely unpopular — though the country is often split on abortion rights, 75 percent of Americans believe that abortion should be legal in the case of rape or incest.

NEWS FLASH

Retired Abortion Doctor Says Stigma Is Greater Now Than Pre-Roe v. Wade | Robert Livingston, a retired doctor from New Jersey, performed illegal abortions in the 1960s, but now he says there is a greater stigma attached to being an abortion doctor than there was before Roe v. Wade. “I would be afraid,” Livingston told a New Jersey newspaper. “The atmosphere is so ominous now. I wouldn’t know where to begin.” After hearing about recent controversies like Rep. Todd Akin (R-MO) referring to “legitimate rape” and the GOP’s anti-choice platform, Livingston said he wanted to talk about his experience providing abortions, but even his grown children don’t want him to talk about it out of fear it will hurt their medical practices.

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