Health Care For America Now

The House will likely vote on their health reform bill tomorrow evening. This will be the first time in our country's history that a full House of Congress has considered and passed a comprehensive health care bill.

To refresh your memory, the bill being considered in the House:

• Creates an Exchange where individuals and small businesses can purchase health care
• Gives tax credits to those in the Exchange to help them afford coverage
• Includes a national public health insurance option in the Exchange to keep the insurance industry honest and lower prices
• Strengthens employer-based coverage and asks employers to provide good coverage for their employees
• Regulates all insurance plans to outlaw denials for pre-existing conditions, charging more if you're a woman, and a host of other bad practices
• Strengthens Medicare and fully closes the Medicare Part D donut hole over time
• Provides access to coverage for those uninsured in the interim before the entire program is up and running

For more information, Majority Leader Steny Hoyer has an interactive map that will show you how this bill will affect you.

Actors Martin Sheen and Stockard Channing, who have a bit of "experience" with politics, have a message for health reform supporters today:

Click here to call your Representative and urge them to vote YES on this historic occasion.

NEWS

Health Bill Garners Endorsements - Wall Street Journal

AARP and AMA Give Backing to House Measure as Planned Saturday Vote Approaches

White House backs House bill - Politico

The White House will come out strongly in support of the House bill on Friday, an administration source tells POLITICO. The statement of administration policy will lay out the reasons that President Obama endorses the bill.

Two rallies back health-care bill - Jonesboro Sun

“We want reform. We want it now.”

That was the battle cry of about 35 health insurance reform advocates who gathered outside the Craighead County Courthouse on Wednesday at noon.

Democrats Pose Health Bill Hurdle - Wall Street Journal

Democratic Sen. Mary Landrieu says she generally backs President Barack Obama's health-care overhaul efforts. But she'd like to see a few items in the bill before voting for it, including bigger federal Medicaid payments for her home state of Louisiana, extended health coverage for her pet cause of foster children, and help for teaching hospitals in her state.

Health care opponents intensify late attack - Boston Globe

The sweeping health care overhaul package before Congress is under an 11th-hour attack over a pair of emotional issues, abortion and immigration, that are complicating Democrats’ efforts to piece together the coalition they need to pass the bill.

As It Turns Out, Republicans Don't Want Americans To Have Health Care After All - Media Matters

After months of blustering and bluffing, the Republicans have finally released their health care reform proposals.  And while the legislation costs less than the Democratic plan, the Republicans failed to write any language that would ensure coverage for more Americans, ease the financial burden for families, or even prevent insurance companies from denying coverage to those with pre-existing conditions.

CBO numbers are in [pdf] on the Republican health care bill and guess what? It'll do nothing!

After 10 years, the Republican health care bill will reduce the number of uninsured by a paltry 3 million, leaving 52 million uninsured. The CBO goes on, "The share of legal nonelderly residents with insurance coverage in 2019 would be about 83 percent, roughly in line with the current share."

Compare this to the Democratic health care bill coming up for a vote, which the CBO says would cover up to 96% of Americans.

And in the area of reducing the deficit, typically a Republican mainstay, the CBO says the Republican bill would do less compared to the House bill up for a vote shortly.

Republicans will claim that the CBO says their bill will reduce premiums. The question, as Jon Cohn explains, is how:

By weakening or removing requirements that insurance cover certain services–everything from cancer screenings to mental health–the Republican bill would likely result in people getting insurance that covers less. That is, based on a quick canvassing of people who have read the report, the meaning of this passage:

The second source of change in average insurance premiums is changes in the average extent of coverage purchased. … With other factors held equal, insurance policies that cover more benefits or services or have smaller copayments or deductibles have higher premiums, while policies that cover fewer benefits or services or have larger copayments or deductibles have lower premiums. Provisions in the amendment that would reduce insurance premiums by affecting the amount of coverage purchased include the State Innovations program, which would encourage states to reduce the number and extent of benefit mandates that they impose, and provisions that would  allow individuals or affiliated groups to purchase insurance policies in other states that have less stringent mandates.

So, yes, the Republican health care bill will lower premiums overall. But many people in poor health will see their premiums go up. And many people will get lower premiums only because they’re getting inferior coverage.

Of course, as noted yesterday, the CBO implies the House bill will reduce premiums as well, while providing better coverage, though they haven't examined the question directly.

So let's review. The Republican bill would do nothing to change the number of uninsured in this country. It would reduce the quality of coverage you get, and sick people would pay more, to say nothing of continued denials for pre-existing conditions. And the bill would do less to reduce the deficit than the Democratic bill.

The Republican bill: 219 pages of wasted paper, all to preserve the status quo. And that's great news for the insurance industry.

NEWS

House expected to vote on health bill Saturday - Washington Post

House leaders put in motion the machinery to hold a rare Saturday vote on the most far-reaching expansion of the health-care system in more than 40 years.

Budget analysts say GOP bill would do little to expand health insurance coverage - Washington Post

The long-awaited Republican entry in the health care debate received its assessment late Wednesday from congressional budget analysts, who concluded that the proposal would barely dent the ranks of the uninsured.

Dems want to seize historic moment - Politico

Health care is big for House Democrats: big like Social Security in the ’30s and civil rights in the ’60s, big like the war stories retold now in party caucuses as lawmakers grapple with the floor vote that is just days away.

AP sources: Dem Health bill to get AARP backing - Washington Post

In a coup for House Democrats, AARP will endorse sweeping health care overhaul legislation headed for a history-making floor vote, officials told The Associated Press on Wednesday.

Michele Bachmann to protesters: 'Scare' Congress - Politico

In a conference call Wednesday night with bloggers and activists for the advocacy group Americans for Prosperity, Rep. Michele Bachmann (R-Minn.) called on protesters to “scare” members of Congress into killing the proposed health care reform bill.

60 Plus Ad Uses The Greatest Generation's Achievements To Scare People Into Opposing Reform - Media Matters

The right-wing seniors' group 60 Plus has put together a new ad opposing health care reform.  Instead of providing seniors with the correct information that health care reform will benefit them and their families, 60 Plus chose to use scare tactics to inspire America's seniors to fight progressive health care reform.

Our health care system is broken, nobody disputes that, and yet even in our broken system, people like me have it much better. Why? Because I'm a man.

Women are charged more for insurance. They can be denied coverage if they're been a victim of domestic violence, or if they've had a C-Section. Many insurance plans don't cover the full range of care they need. Maternity care, in particular, is hard to find. And women statistically end up spending more of their money out-of-pocket on health care, and thus are more likely than men to be uninsured.

The abuses women suffer at the hands of our health care system can be staggering:

Today a woman testified before the Senate because she was denied health insurance as a result of a c-section — unless she wanted to permanently sterilize herself:

Today, at Sen. Mikulski's HELP Committee hearing "What Women Want: Equal Benefits for Equal Premiums," we met Peggy Robertson. Peggy is a mother of two young boys, living in Colorado with her husband. Over the past few years, Peggy and her family have faced not one but two shocking cases of insurance company abuse. First, in 2007, Peggy was denied coverage by Golden Rule insurance, a subsidiary of UnitedHealth Group (the largest insurance company in the US), because of a previous c-section birth. What happened next is shocking (Sen. Mikulski called it "bone-chilling" and "morally repugnant"): Golden Rule said they would cover Peggy if she agreed to be sterilized. Watch the video of her story on the SEIU Blog.

One of Health Care for America Now's principles for reform is equity in health care, and that means these disparities have to end.

That's why we're joining with our coalition partner, the National Women's Law Center, to speak out today about this issue. They've put together a phenomenal site where you can contact Congress and make sure women are treated equally by our health care system, along with an excellent widget to take action:

The House bill that will be voted on shortly gives women equality in health care. So does the Senate bill. But its imperative your representatives in Washington know this issue is important to you, no matter if you're a man or a woman. It's a simple matter of equality.

Last week, after the House health care bill was unveiled, the CBO released their analysis of the bill. In it was a few paragraphs on the public health insurance option that seemed noteworthy and puzzling:

Roughly one-fifth of the people purchasing coverage through the exchanges would enroll in the public plan, meaning that total enrollment in that plan would be about 6 million.

That estimate of enrollment reflects CBO’s assessment that a public plan paying negotiated rates would attract a broad network of providers but would typically have premiums that are somewhat higher than the average premiums for the private plans in the exchanges. The rates the public plan pays to providers would, on average, probably be comparable to the rates paid by private insurers participating in the exchanges. The public plan would have lower administrative costs than those private plans but would probably engage in less management of utilization by its enrollees and attract a less healthy pool of enrollees. (The effects of that “adverse selection” on the public plan’s premiums would be only partially offset by the “risk adjustment” procedures that would apply to all plans operating in the exchanges.)

This analysis confirms a lot of what I've been saying about the insurance industry. Even with regulation, they will continue to seek out younger, healthier people they can make money on, while dumping older, sicker people they lose money on. Risk adjustment mechanisms (such as those built into the House bill) can help mitigate some of this, and surely, stronger risk adjustment mechanisms may be necessary. But as usual, the CBO is obscuring the real story.

Jonathan Gruber, MIT health care economist, has put together a fuller picture of the CBO's analysis of the public health insurance option:

In a letter released today, the Congressional Budget Office (the official government scoring agency) reported that they estimated the cost of an individual low-cost plan in the exchange to be $5300 in 2016. This is a plan with an "actuarial value" (roughly, the share of expenses for a given population covered by insurance) of 70%. In their September 22nd letter to the Senate Finance Committee, the CBO projected that, absent reform, the cost of an individual policy in the non-group market would be $6000 for a plan with an actuarial value of 60%. This implies that the same plan that cost $6000 without reform would cost $4540 with reform, or almost 25% less.

In other words, Gruber says the CBO has confirmed that even though the public option premiums themselves may be slightly higher than private premiums within the Exchange, the public health insurance option will act to keep overall premium levels down.

The CBO's analysis of the House health care bill seems to confirm this, saying [pdf]:

"[The House bill] would also include a public plan that CBO estimates would place some downward pressure on the premiums of private plans operating in the exchanges.

While it's hard to accurately predict what's going to happen eight or ten years from now, the overall picture is clear. Put together, the conclusion by the CBO is that the public option works. Not only does it save money - $25 billion, less than a public option with negotiated rates, but still a chunk of change - but it holds down private premiums as well.

NEWS

Democrats file final House health bill; Friday vote possible - The Hill

The vote on the House's healthcare reform legislation will not be held until Friday evening at the earliest.

House Republicans angry about leak - The Hill

House Republican leaders were furious that their healthcare reform alternative was leaked to the media on Tuesday.

Senate moderates flex muscle on health-care bill - Washington Post

Moderate lawmakers are exerting their outsize influence in the divided Senate to secure changes to health-care reform legislation, potentially adding more delays to a bill that has already missed several announced deadlines.

G.O.P. Counters With a Health Plan of Its Own - New York Times

House Republicans have come up with an answer to Speaker Nancy Pelosi, drafting an alternative health care bill that would reward states for reducing the number of uninsured, limit damages in medical malpractice lawsuits and allow small businesses to band together and buy insurance exempt from most state regulation.

Harkin asks big health insurers to explain their rate practices - Des Moines Register

Sen. Tom Harkin said Tuesday he was launching an investigation into health insurance pricing, asking four major insurers to justify their pricing practices.

Why Health Insurance Charges Are Going Up - Forbes

Nancy Pelosi may be the HMOs' Grinch this year, continuing to push a public option that could eventually damper profits, but at the moment, the industry is looking healthy.

Democrats whipping on abortion compromise to save health bill - The Hill

Democratic House leaders have developed a compromise they hope will resolve an intra-caucus dispute about whether the health bill allows tax dollars to subsidize abortions, and they’re surveying abortion-rights opponents in the caucus to gauge support.

THE INFLUENCE GAME: Liberals targeting moderates - Associated Press

Get on the health overhaul bandwagon, or don't count on our help in your re-election.

Why do private, for-profit, Wall Street-run health insurance companies deny your care? Why do they drop your coverage if you get sick? Why do they raise your rates and limit your doctor-recommended treatments?

So they can make money.

One measure of how much money these private plans make is their "medical loss ratio," the amount of money they spend paying for the health care of their customers vs. the amount of money they pocket as profit. Obviously, if they pocket more money and spend less on care, they make larger profits and their Wall Street investors approve.

Since the insurance companies defeated health care reform last time around in 1993, their medical loss ratio has plummeted. As our premiums have skyrocketed, and we face more denials and rejections, the amount of your premiums private insurance companies spend on your care has dropped almost 15 points, from 95% to 81%. Compare that to Medicare [pdf], which has always spent almost 98% of the money it takes in on care:

This is just one of the many problems with private insurance. The relentless drive for profits and a lower medical loss ratio makes private insurers deny more care and find any way they can to spend less money on you and give more to their Wall Street investors.

This chart points to one of the advantages of a public health insurance option: More of the money you pay to it in premiums will go towards your care, seeing as the public option, like Medicare, won't need to lower its medical loss ratio to make a profit for Wall Street, not to mention increasing competition and improving everyone's care.

The Wall Street Journal, of all places, had the most accurate headline on the new Republican health care bill set to be unveiled by John Boehner, after months of waiting. The headline was: "GOP Health Bill Gives Insurers More Leeway."

The Wall Street Journal apparently thought that headline was too honest, and the article has subsequently dissapeared from their website, but the Internet has preserved it for us, in a slightly edited form, and the facts speak for themselves:

A House Republican health-care bill wouldn't seek to prevent health insurance companies from denying sick people insurance, Minority Leader John Boehner (R., Ohio) said Monday.

…

The bill would allow insurance firms to sell policies across state lines, permit small businesses to pool together to bring down costs they face, implement changes to medical malpractices, and give state governments more flexibility to pursue rule changes in their states.

…

Boehner also said Monday that the Republican plan wouldn't include tax credits for people who buy insurance individually rather than through their employer. He cited the cost of providing those credits as a reason why they wouldn't be included.

Apparently, the forthcoming GOP health care bill operates on the principle that if it's good for insurance companies, it must be good for us.

The Republican bill runs the table on provisions that will increase insurance company profits.

• Make more money by denying care? Check.
• Make more money by ending insurance policies when someone gets sick and actually needs to use the care they paid for? Check. (At least according to the original version of the Wall Street Journal article.)
• Allowing insurers to move to the least-regulated states and sell their junk insurance to the rest of the country? Check.

There's no attempt to expand coverage to people who are dying without it, that would be too costly. And no attempt to shield people from insurance company abuses like denial of care.

I'm not sure what this bill does do, beyond funnel more money to insurance companies. As Speaker Pelosi's blog illustrates, in comparison to the plan on the table in the House, this new plan is just a bunch of no:

The Republican health care plan: Where the insurance companies win and you lose.

NEWS

Senate Pressing Insurers on the Amount of Premiums They Spend on Care - The New York Times

The health insurance industry likes to cite figures showing that 87 cents of every dollar in premiums is spent on medical claims.

GOP Health Care Bill WON'T Prevent Insurance Companies From Denying Sick People - Huffington Post

Republicans are preparing to unveil their own health bill in the next few days. Minority Leader John Boehner (R., Ohio) said Monday that the plan wouldn't seek to prevent health-insurance companies from denying sick people insurance — a key plank of the Democrats' legislation.

Reid reassures left Lieberman on board - The Hill

Sen. Joe Lieberman has reached a private understanding with Majority Leader Harry Reid that he will not block a final vote on healthcare reform, according to two sources briefed on the matter.

Democrats Say House Bill Cuts Premiums for Many - New York Times

As the House moved toward climactic votes on legislation to remake the health care system, the Congressional Budget Office said Monday that middle-income families might be required to pay 15 percent to 18 percent of their income on insurance premiums and co-payments under the proposal.

As votes near, insurers make last stand - Politico

When the insurance industry launched the first full-scale attack on key provisions of health reform, the Democrats’ response was swift, brutal and aimed squarely at Karen Ignagni, a former Democratic Capitol Hill aide who is now the industry’s top lobbyist.

Pelosi picks up centrist ‘yes’ votes - The Hill

Centrist Democrats in the House are moving toward the “yes” column on healthcare reform, triggering optimism among leadership officials that they will soon have the votes to pass their $894-billion measure.