An update on the Democrats’ Healthcare Reform Bill Fast Shuffle and the Big B Files’ Responses to McCaskill’s Reply

An update on the Democrats’ healthcare reform bill fast shuffle and the Big B file responses to McCaskill’s reply is the subject of this Big B file.

 

    First, the update on that Democrats’ health care reform bill. It was passed by a 60 to 40 vote margin on Christmas Eve. Since then, one dramatic event has occurred. That event was the election of State Sen. Scott Brown in Massachusetts to fill the seat left vacant by the death of Sen. Ted Kennedy. With Scott Brown being elected to the Senate, the Democrats no longer had the 60 seat supermajority that they had for the last year.

This means that the likelihood of passage of health care reform legislation is very low for now with the normal methods of passing bills in Congress. It does not mean they are trying to look at other ways to get it passed without a supermajority by options such as reconciliation on a “nuclear option” or the “Slaughter Solution”, which Pelosi, Reid, Durbin, Schumer and other are considering right now. The Heritage Foundation explains the two options this way:

  • Deeming Resolution (Slaughter Solution): Step 1 of the latest strategy to get health care reform across the finish line is to use a “deeming resolution” to deem the Senate-passed version of Obamacare passed in the House. House members would technically never vote on the bill–instead they would vote on a resolution that deems the bill passed. This is completely unconstitutional and an all-out attack on the rule of law.
  • Reconciliation: Once the House passes the Senate-passed bill, step 2 would be for both chambers to then pass a reconciliation bill with the changes they want. Reconciliation is a complicated procedure normally used for budgetary matters and therefore requires only a simple majority of votes to pass instead of the usual 60. Liberals are trying to use reconciliation to get around the filibuster in the Senate and put in some last-minute special provisions that can’t pass in the Senate using regular procedure.

 

If either option on is invoked, it would mean that all is required for passage if a simple majority of 51 senators voting yes. This Big B File is the Big B Files’ response to Sen. McCaskill’s reply to the letter I sent the senator back in December 2009.

The letter that is shown below is the reply to the latter that I sent to Senator McCaskill in December 2009 in regards to the Democrats’ health-care reform legislation:

 


Date: Tue, 12 Jan 2010 19:07:23 -0500
From: senator@mccaskill.senate.gov
To: Bryan Hewing
Subject: Reply from Senator McCaskill

January 12, 2010

 
Dear Mr. Hewing,

 

 Thank you for contacting me regarding health care reform.  I welcome the opportunity to update you about what is contained in the Senate health care bill and clear up some wide-spread misinformation. 

According to independent analyses of the bill, including the non-partisan Congressional Budget Office, the recently-passed Senate health care reform legislation will reduce the deficit, protect Medicare, and stabilize healthcare costs for over 90% of Americans.  This reform is necessary because the soaring cost of medical care is crippling our economy, bankrupting our nation’s families, and becoming an unsustainable financial burden for American employers.  In the last eight years, health care premiums have grown four times faster than wages, and insurance companies have made millions of dollars in profits while routinely denying coverage. 

On November 18th, 2009, Senate Majority Leader Reid introduced The Patient Protection and Affordable Care Act.  On December 24th, after five weeks of debate, I voted for the Patient Protection and Affordable Care Act, embodied in H.R. 3590, which passed by a vote of 60 to 39.  The Senate bill (H.R. 3590) and the previously passed House bill (H.R. 3962) must now go through a reconciliation process.

I want you to know that I have read The Patient Protection and Affordable Care Act thoroughly and plan to read all of the provisions in a final, reconciled health reform bill before casting my vote on final passage.  If you would also like to read the full text of the legislation, you can find the complete text of the Patient Protection and Affordable Care Act at http://democrats.senate.gov/.  While there has been an unprecedented amount of transparency during this debate, including hundreds of televised hours of committee work and debate, I disagree with the decision not to have a conference committee to resolve the differences between the House and Senate legislation. I believe that those negotiations should be open to the public.

I supported the Patient Protection and Affordable Care Act because it would expand health care coverage to more than 94 percent of Americans, curb skyrocketing healthcare costs, and ensure patient choice of care, all while significantly reducing the government deficit.  The bill would also stop insurance company abuses that prevent people from getting the health care they need, such as denying coverage based on pre-existing conditions.  In addition to consumer protections, the bill establishes state-based health insurance exchanges where individuals and small businesses can compare and purchase insurance plans online at more competitive prices.  

I have heard from some Missourians who have concerns regarding certain provisions in the Senate bill.  The Senate bill upholds current federal law which requires that no federal funds can be used to pay for an abortion except in the case of rape, incest, or danger to the life of the mother.  To ensure this, the measure requires insurance plans to keep federal funds completely separate from private premium dollars, and further requires that anyone purchasing abortion coverage do so with a separate private payment.

The bill also expressly exempts illegal immigrants from any of the health care programs and the ability to participate in the health insurance exchange.  Some non-citizens who lawfully reside in the United States and pay taxes on their earnings may be eligible to purchase health insurance in the exchange, provided they meet prescribed eligibility requirements. 

In addition, there are provisions that will strengthen seniors’ Medicare benefits and significantly reduce fraud, abuse, and inefficiencies in the program, which could extend the life of the Medicare Trust Fund beyond 2022.  Let me emphasize that none of these changes would reduce the guaranteed benefits that seniors are entitled to under the Medicare program.

Finally, the bill requires that Members of Congress and their staffs buy their insurance on the same exchange that will be available to those who don’t get insurance from their employer.  In other words, Members of Congress will be required to be part of the new insurance exchange that we are creating.

I am opposed to any special deals in this bill for particular states.  This earmarking process is an ingrained culture in Washington, where every year members go into back rooms and negotiate special deals for their states.  This is a problem on both sides of the aisle and I find it hypocritical that some of the same Senators who are criticizing the earmarks in the health care bill were in line for special deals for their states in the annual spending bills passed just a few weeks ago.  I’m proud that I am one of the few Senators of either party that refuses to participate in this flawed earmarking process.  I’m hopeful that some of these special earmarks will be removed from the bill before our final vote.

This bill is not perfect, but in the end, I supported this legislation because it will reduce the federal deficit and contain health care costs.  With one out of every six dollars in our economy going toward health care in the United States, it is imperative that our government work to rein in the soaring cost of health care.  The bill will not only reduce the cost of insurance for families but also decrease the national deficit in the long term.  In fact, the Congressional Budget Office estimates that the bill would reduce the federal deficit by $130 billion over the next decade, followed by another $650 billion cut in the deficit in its second decade.

Health care reform holds the promise of lowering government budget deficits, curbing unsustainable health care costs, and expanding access to health coverage.  As the health care debate continues, I will continue to work with my colleagues on both sides of the aisle to find meaningful solutions to these difficult and complex problems.

Again, thank you for contacting me. Please do not hesitate to contact me in the future if I can be of further assistance to you on this or any other issue.

 Sincerely,

Claire McCaskill
United States Senator

P.S. If you would like more information about resources that can help Missourians, or what I am doing in the Senate on your behalf, please sign up for my email newsletter at www.mccaskill.senate.gov.

Let us begin by taking a look at the first paragraph of her letter, which says “Thank you for contacting me regarding health care reform.  I welcome the opportunity to update you about what is contained in the Senate health care bill and clear up some wide-spread misinformation.” As far as the Big B Files can determine, Sen. McCaskill’s entire latter is almost all misinformation and contradictions… we’ll get to those in just a moment.

The Big B Files is never seen such contradictions and misinformation before, the same misinformation and contradictions that have been covered by every single United States Sen. that is supporting the health care reform legislation, commonly referred to as “Obama care”. Now, the Big B Files will dissect and analyze Sen. McCaskill’s letter paragraph by paragraph beginning with the second paragraph. Let’s take a look at the second paragraph which says the following:

“According to independent analyses of the bill, including the non-partisan Congressional Budget Office, the recently-passed Senate health care reform legislation will reduce the deficit, protect Medicare, and stabilize healthcare costs for over 90% of Americans.  This reform is necessary because the soaring cost of medical care is crippling our economy, bankrupting our nation’s families, and becoming an unsustainable financial burden for American employers.  In the last eight years, health care premiums have grown four times faster than wages, and insurance companies have made millions of dollars in profits while routinely denying coverage”

The first sentence of Sen. McCaskill’s letter is apparently not true. The Big B Files through a simple web search found the following in a Fox News Channel story from last fall:

“Budget analysts say that the early revenue cannot be fenced off, much like Social Security money is spent despite a trust fund for that purpose. The funding gets absorbed into the general federal budget, presumably to go toward reducing the deficit on a yearly basis. 

However, this creates the possibility that Congress could spend that money twice, by using the up-front savings as fun money for new projects and then having to pay the bill for health care reform down the road. Holtz-Eakin called this a worst-case scenario. 

“The government’s incapable of segregating funds. You can’t put the money in a cigar box and bury it behind the Treasury Department,” said Michael Tanner, senior fellow with the libertarian Cato Institute. 

Tanner pointed to two other “gimmicks” that make the price seem smaller than it is. 

One deals with the so-called “doctor fix,” which would be an act of Congress to ensure Medicare doctors don’t face steeps cuts in federal reimbursements. This would cost at least $210 billion over 10 years, and it’s “fix” that Democrats are trying to separate from the health care reform bill. 

That alone erases the $130 billion in deficit savings claimed by the CBO’s latest health care estimate. 

Tanner also pointed to the CLASS Act, a long-term care program in the bill that takes in billions in revenue early on but does not pay out in any significant way until the next decade. 

“If you use honest accounting … then this bill’s not paid for,” Tanner said. “It’s smoke-and-mirrors accounting.” 

The Budget Committee document estimating the actual cost to be $2.5 trillion over years five through 14 of the program also showed $126 billion in deficit reduction in that period. It estimated even more down the road. 

But Holtz-Eakin called that “fiction,” since it relies on more than $1 trillion in cuts to Medicare and Medicaid. 

He said there’s no way the government can sustain and increase those cuts and expect the program to work”

  • Senate Health Bill Price Tag, Rosy Deficit Estimate Assailed as ‘Fantasy’
  • Fox News Channel – November 19, 2009

    The remainder of the first paragraph of the letter, the Big B Files was able to find proof that this is false as well. Just take a look at Hans F. Sennholz; Professor Emeritus Grove City College is an Adjunct Scholar of the Mises Institute, said in an article in 2006:

    “A few writers believe that the primary reason for rapidly rising costs of health care is a massive expansion of medical insurance which foots doctors and hospital bills. They like to use an inordinate terminology that diverts the reader from the actual causes. They broaden the concept of insurance to encompass Medicare and Medicaid, which are government programs providing medical care for the aged and needy, and then hint at insurance as the driving cost factor.

    In reality, the number of Americans with health insurance actually is declining; rising health-care costs and a declining number of employer-sponsored benefits are steadily reducing the number of insured Americans. At the present, some 47 million Americans are bereft of any coverage.

    Few observers dare to state that spiraling health-care costs are the inevitable consequence of a 1965 Social Security amendment molding Medicare and Medicaid. It provided a basic welfare program that covers most persons aged 65 and older as well as all needy individuals. Soon after its passage some four million patients rushed to seek treatment and some 18 million Americans registered to have 80 percent of doctor and surgeon bills paid by the new system.

    By now, in 2006, Medicare provides health benefits for 41 million elderly and disabled persons, and Medicaid, joint federal-state program, serves some 50 million poor beneficiaries. It is the fastest-growing item in most state budgets and accounts for some 20 percent of total state spending.”

    • Hans F. Sennholz
    • Mises Daily: Tuesday, August 22, 2006

By the way, Sen. McCaskill by law to look at a report from 2080 by the American medical Association (which has thrown its support behind Obama care) stating that Medicare had the highest percentage of medical claims denied of any insurer in the United States. (Click here to see the News Busters piece and click here to see the AMA report itself)

Sen. McCaskill, a few paragraphs later, says “While there has been an unprecedented amount of transparency during this debate, including hundreds of televised hours of committee work and debate, I disagree with the decision not to have a conference committee to resolve the differences between the House and Senate legislation. I believe that those negotiations should be open to the public.” The only part of the program that is true is the last sentence. The reason for this is that the final version of House Bill and the Senate Bill were both written behind closed doors… no C-SPAN, no media cameras, no citizens sitting in the audience… nothing. period!

The Big B Files like to refer you to the example cited above as to why the following paragraph is files and misleading as well:

“I supported the Patient Protection and Affordable Care Act because it would expand health care coverage to more than 94 percent of Americans, curb skyrocketing healthcare costs, and ensure patient choice of care, all while significantly reducing the government deficit.  The bill would also stop insurance company abuses that prevent people from getting the health care they need, such as denying coverage based on pre-existing conditions.  In addition to consumer protections, the bill establishes state-based health insurance exchanges where individuals and small businesses can compare and purchase insurance plans online at more competitive prices. ”

Another problem with the insurance exchanges is that they, according to The Heritage Foundation:

“In reality, the result would be a massive erosion of private health insurance. According to a recent analysis by the Lewin Group, the nation’s most prominent health policy econometrics firm, assuming full implementation of the House bill, 103.9 million Americans would be covered under the public plan, and 83.4 million people would no longer be covered by private health insurance.[3] Moreover, a federally designed health insurance exchange would consolidate federal control over the financing and delivery of Americans’ medical services.

Initially, Americans may respond positively to the idea of a national health insurance exchange, but they are almost certainly unclear about its functions, how it would affect them, or which health policy problems it would solve. The maddeningly elastic language used in the health care debate can conceal as much as convey the true meaning of proposals embodied in the complex provisions of the mammoth House and Senate health care bills.

One of the paragraphs the Big B Files had no problems proving that was false the following paragraph from Sen. McCaskill’s letter:

“I have heard from some Missourians who have concerns regarding certain provisions in the Senate bill.  The Senate bill upholds current federal law which requires that no federal funds can be used to pay for an abortion except in the case of rape, incest, or danger to the life of the mother.  To ensure this, the measure requires insurance plans to keep federal funds completely separate from private premium dollars, and further requires that anyone purchasing abortion coverage do so with a separate private payment.”

The evidence that the above paragraph is false comes from the official statements of the United States Conference of Catholic Bishops (USCCB), whom said the following in a fact sheet released on March 4, 2010:

The Senate bill uses federal power to force Americans to pay for other people’s abortions even if they are morally opposed. The bill mandates that insurance companies deciding to cover elective abortions in a health plan “shall… collect from each enrollee in the plan (without regard to the enrollee’s age, sex, or family status) a separate payment” for such abortions. While the bill states that one plan in each exchange will not cover elective abortions, every other plan may cover them — and everyone purchasing such a plan, because it best meets his or her family’s needs, will be required by federal law to fund abortions. No accommodation is permitted for people morally opposed to abortion. This creates a more overt threat to conscience than insurers engage in now, because in many plans receiving federal subsidies everyone will be forced to make separate payments solely and specifically for other people’s abortions. Saying that this payment is not a “tax dollar” is no help if it is required by the government.”

 

The USCCB President, Cardinal Francis George of Chicago, IL said the following:

What do the bishops find so deeply disturbing about the Senate bill? The points at issue can be summarized briefly.  The status quo in federal abortion policy, as reflected in the Hyde Amendment, excludes abortion from all health insurance plans receiving federal subsidies. In the Senate bill, there is the provision that only one of the proposed multi-state plans will not cover elective abortions – all other plans (including other multi-state plans) can do so, and receive federal tax credits. This means that individuals or families in complex medical circumstances will likely be forced to choose and contribute to an insurance plan that funds abortions in order to meet their particular health needs.

Further, the Senate bill authorizes and appropriates billions of dollars in new funding outside the scope of the appropriations bills covered by the Hyde amendment and similar provisions. As the bill is written, the new funds it appropriates over the next five years, for Community Health Centers for example (Sec. 10503), will be available by statute for elective abortions, even though the present regulations do conform to the Hyde amendment. Regulations, however, can be changed at will, unless they are governed by statute.

Additionally, no provision in the Senate bill incorporates the longstanding and widely supported protection for conscience regarding abortion as found in the Hyde/Weldon amendment. Moreover, neither the House nor Senate bill contains meaningful conscience protection outside the abortion context. Any final bill, to be fair to all, must retain the accommodation of the full range of religious and moral objections in the provision of health insurance and services that are contained in current law, for both individuals and institutions.

This analysis of the flaws in the legislation is not completely shared by the leaders of the Catholic Health Association. They believe, moreover, that the defects that they do recognize can be corrected after the passage of the final bill. The bishops, however, judge that the flaws are so fundamental that they vitiate the good that the bill intends to promote. Assurances that the moral objections to the legislation can be met only after the bill is passed seem a little like asking us, in Midwestern parlance, to buy a pig in a poke.

  • Cardinal Francis George of Chicago,
  • President of the United States Conference of Catholic Bishops

Senator McCaskill’s only true statement in the entire reply letter comes in the following paragraph:

 

The bill also expressly exempts illegal immigrants from any of the health care programs and the ability to participate in the health insurance exchange.  Some non-citizens who lawfully reside in the United States and pay taxes on their earnings may be eligible to purchase health insurance in the exchange, provided they meet prescribed eligibility requirements. 

Take a look at the following paragraphs from Senator Claire McCaskill’s reply letter to the Big B Files:

In addition, there are provisions that will strengthen seniors’ Medicare benefits and significantly reduce fraud, abuse, and inefficiencies in the program, which could extend the life of the Medicare Trust Fund beyond 2022.  Let me emphasize that none of these changes would reduce the guaranteed benefits that seniors are entitled to under the Medicare program.

Finally, the bill requires that Members of Congress and their staffs buy their insurance on the same exchange that will be available to those who don’t get insurance from their employer.  In other words, Members of Congress will be required to be part of the new insurance exchange that we are creating.

I am opposed to any special deals in this bill for particular states.  This earmarking process is an ingrained culture in Washington, where every year members go into back rooms and negotiate special deals for their states.  This is a problem on both sides of the aisle and I find it hypocritical that some of the same Senators who are criticizing the earmarks in the health care bill were in line for special deals for their states in the annual spending bills passed just a few weeks ago.  I’m proud that I am one of the few Senators of either party that refuses to participate in this flawed earmarking process.  I’m hopeful that some of these special earmarks will be removed from the bill before our final vote.

This bill is not perfect, but in the end, I supported this legislation because it will reduce the federal deficit and contain health care costs.  With one out of every six dollars in our economy going toward health care in the United States, it is imperative that our government work to rein in the soaring cost of health care.  The bill will not only reduce the cost of insurance for families but also decrease the national deficit in the long term.  In fact, the Congressional Budget Office estimates that the bill would reduce the federal deficit by $130 billion over the next decade, followed by another $650 billion cut in the deficit in its second decade.

Health care reform holds the promise of lowering government budget deficits, curbing unsustainable health care costs, and expanding access to health coverage.  As the health care debate continues, I will continue to work with my colleagues on both sides of the aisle to find meaningful solutions to these difficult and complex problems.

As for the special deals, why did you vote for the bill when the “Cornhusker Kickback,” the “Gator-Aid,” and the “Louisiana Purchase” backroom deals were in there at the time and you still push the bill when they are still in the bill now. As for the Medicare costs and benefits, according to the Heritage Foundation:

Increased Medicaid Costs for States: Eventually the states would be forced to pick up the costs of the largest expansion of the Medicaid program in history. This unfunded mandate would likely require state tax hikes, more cuts to Medicaid providers (further lowering the quality of care for those on the program), or a push by the states to have the federal taxpayers bail them out once again.

. . . . Despite the potential constitutional questions of “deeming” a bill passed, the Senate Parliamentarian has signaled that the House would have to pass–and the President would need to sign into law–the Senate version of Obamacare before a reconciliation bill could be considered in the Senate. Thus, any changes proposed in reconciliation may never be signed into law.

    In regards to the expanding of healthcare coverage, Dr. Milton R. Wolf, a radiologist in Kansas and President Barack Obama’s second cousin once removed says in a Washington Times OP-ED from Thursday, March 11, 2010:

The justification for Obamacare has been to control costs, but the problem is there is little in Obamacare that will do that. Instead, there are provisions that will ration care and artificially set price. This is a confusion of costs and price.

As one example, consider the implications of Obamacare’s financial penalty aimed at your doctor if he seeks the expert care he has determined you need. If your doctor is in the top 10 percent of primary care physicians who refer patients to specialists most frequently – no matter how valid the reasons – he will face a 5 percent penalty on all their Medicare reimbursements for the entire year. This scheme is specifically designed to deny you the chance to see a specialist. Each year, the insidious nature of that arbitrary 10 percent rule will make things even worse as 100 percent of doctors try to stay off that list. Many doctors will try to avoid the sickest patients, and others will simply refuse to accept Medicare. Already, 42 percent of doctors have chosen that route, and it will get worse. Your mother’s shiny government-issued Medicare health card is meaningless without doctors who will accept it.

Obamacare will further diminish access to health care by lowering reimbursements for medical care without regard to the costs of that care. Price controls have failed spectacularly wherever they’ve been tried. They have turned neighborhoods into slums and have caused supply chains to dry up when producers can no longer profit from providing their goods. Remember the Carter-era gas lines? Medical care is not immune from this economic reality. We cannot hope that our best and brightest will pursue a career in medicine, setting aside years of their lives – for me, 13 years of school and training – to enter a field that might not even pay for the student loans it took to get there.

  • Wolf: Obama family health care fracas – A doctor savages his cousin Barack’s reform plan
  • Washington Times – March 11, 2010

As for the budget deficits, the Heritage Foundation refutes McCaskill’s statement with the following:

According to the Congressional Budget Office (CBO), by 2019, the legislation would cost (PDF) $196 billion annually and still leave 24 million Americans uninsured.

The fact that 24 million people remain would uninsured with enactment of the Senate health bill is remarkable. Under current law, there would be 55 million uninsured Americans in 2019.  That means that over 43 percent of the projected uninsured would be unaffected by the legislation, continuing to go without coverage ten years from now.  Yet according to research by Heritage expert James Capretta, the bill would cost well over $1 trillion over the next ten years.  Capretta shows that the true ten year cost of the plan is more likely to be close to $1.2 trillion, but even this estimate significantly underestimates the true long term cost of the plan.  Capretta further points out that this estimate includes ten years of new revenues, but only 6 or 7 years of new spending, skewing the Congressional Budget Office’s ten-year cost analysis to make the bill appear less expensive than it really is.  He says that a true ten year estimate would put the price tag closer to $2.3 trillion.

  • Health Coverage for All Americans? Not Under the Senate Health Bill
  • The Heritage Foundation – March 17, 2010

 

The Big B Files would like to leave you with the beginning of Dr. Wolf’s Opinion piece when he said, “Primum nil nocere.”First, do no harm. This guiding principle is bedrock of medical care. Sadly, those politicians who would rewrite our health care laws do not live in the same universe as do the doctors and health care professionals who must practice it.”

 

And that’s the Big B Files. Click on the “Comments” Link below and tell me what you think . . . .I’m Bryan Hewing.

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