Alan Grayson's notorious description of the Republican health care plan was just one of many inflammatory statements that attracted national attention. Image: CC Mike Licht Notionscapital.com/Flickr

Former Democratic Congressman Alan Grayson tried to beat the Republicans at their own game in the midterm election and lost. He made a name for himself in his single term as a U.S. rep from Florida by trying to match right wing extremists with unabashed left wing extremism. Grayson was drubbed after running what some called a dirty campaign and blamed the Republican landslide on Democratic “appeasement.”

Alan Grayson pulls no punches

U.S Rep Alan Grayson was a rich lawyer in Orlando, Fla. when he ran for Congress in 2008. From the beginning of his term as a Democratic congressman he threw rhetorical bombs at the opposition. Some classic “Graysonisms” include a description of proposed Republican alternatives to the health care bill as “don’t get sick and if you do get sick, die quickly.” Grayson was also quoted calling a Federal Reserve adviser a “K street whore” and described Robert Gibbs, the White House press secretary, as “Bozo the spokesman” for criticizing liberal critics of President Obama.

“Taliban Dan” a gift to Grayson’s opponent

After a term in which he became a fixture for the left on the partisan MSNBC network, Grayson’s unapologetic hyper-liberalism got the better of him. He is remembered most in the 2010 midterm elections for a campaign ad characterizing his Republican opponent, Daniel Webster, a member of the Florida legislature for 28 years, as “Taliban Dan.” Apparently the ad worked better for Webster than Grayson. Grayson was defeated at the polls by a 17 percent margin.

Grayson: bipartisanship is appeasement

A week after his resounding defeat, Webster was still in the national spotlight, throwing more bombs. He contradicted the standard explanation of the Democrats 60-seat setback in the House. While most pundits are saying that the Democrats tried to do too much, Grayson said Democrats weren’t aggressive enough. He called the strategy of trying to reach bipartisan consensus “appeasement,” a term for making concessions that has come to represent weak and cowardly politics.

Sources

Politico

Miami Herald

Democracy Now

Amendments to the 1099 rule of health care reform didn't survive in the Senate, where partisan warfare is more important than good policy. Image:Wikimedia Commons

The health care bill that passed in July had an obscure provision about 1099 forms. Health care 1099 reporting isn’t obscure anymore. To raise money for health care reform, the 1099 rule aims to cut down on tax evasion. The business community says the extra paperwork will put undue strain on small companies and kill jobs. Democrats proposed loosening the 1099 rule and making up for money lost by cutting gas and oil subsidies. Republicans proposed repealing health care 1099 changes altogether, and gutting health care prevention programs to make up the difference. Neither proposal passed a Senate vote Tuesday. The 1099 requirement remains in place. Nobody wins. Welcome to the U.S. Senate.

The 1099 rule

The 1099 rule of health care reform is a tax-reporting requirement to help pay for coverage of the uninsured. The New York Times reports that congressional tax experts said the 1099 rule would generate $17 billion in the next 10 years. Health care reform requires filing 1099s for more situations. Businesses must file 1099s identifying anyone they pay $600 or more. Health care 1099 reporting is now required not just for services, but for goods or merchandise as well. Businesses will also have to send 1099s to their vendors, suppliers and contractors. Those purchases currently go unreported, and taxes related to them often go unpaid. Business groups say it would create a paperwork nightmare as companies struggle in a weak economy.

1099 rule alternatives

To alleviate the health care reform 1099 requirement, The New Republic reports that Florida Democrat Bill Nelson proposed an exemption for small businesses with 25 workers or less. Nelson’s proposal would also raise the reporting threshold from $600 to $5,000 for all businesses. The lost revenue would be recovered by cutting government oil and gas subsidies to energy companies. Nebraska Republican Mike Johanns proposed getting rid of  health care 1099 changes altogether. To pay for it, Johanns wants to eliminate the Prevention and Public Health Trust Fund, which provides money for programs like HIV prevention, cancer screening and flu vaccination.

You were expecting results?

Both amendments to reform the 1099 reporting requirements in the health care bill failed Tuesday. Ezra Klein at the Washington Post reports that in the Senate vote, Nelson got 56 votes–a majority. But since he didn’t get 60 votes, those 56 votes were worth nothing. Johanns got 46 votes. Klein points out that most Democrats weren’t willing to weaken public health. Republicans weren’t willing to cut oil and gas subsidies to free small business owners from what they call a “job-killer.” He also adds that as long as the Senate insists on super-majorities to pass anything, party-line voting is more important than making good policy.

Medical offices in some areas are becoming loan financing offices too. Image: Flickr/takomabibelot

In New York state, the attorney general has launched an investigation into medical credit cards. These high-rate credit cards are marketed to patients that need money now, often when they’re already in the doctor’s office. These cards, which offer an instant cash advance to pay off medical bills, are often marketed with allegedly deceptive practices.

How medical credit cards work

Medical credit cards are a product offered by a few financing companies. They are used to pay off medical bills, and they come with high interest rates. The medical provider is usually paid within a few days of the credit card charge and gets a rebate (aka extra money) based on how much is charged on the card.

The investigation into medical credit

For some patients, medical credit cards seem to be the easy answer. The New York Attorney General, though, is beginning an investigation into these cards because of alleged deceptive practices. Often patients are not informed of the high interest rates or payments on these cards. The Attorney General has stated that the investigation is into the deceptive marketing and kickbacks involved with these cards. By wearing the hat of both a finance adviser and a medical adviser, doctors may well be violating both their ethical and legal responsibilities.

The high cost of medical care

Though the new health care bill has several provisions that are intended to address the high cost of medical care, many changes have not yet taken effect. Health care debt is the leading cause of personal bankruptcy in the United States. These credit cards are marketed as no credit loans to help patients pay off their bills. In the end, though, they end up charging very high interest rates and fees that compound the problem. Until the high cost of medical care is addressed, paying for care will be a concern, with or without these medical credit cards.

College students already use federal student loans to pay for everything from tuition and books to housing. Image from Flickr.

Tucked inside the health care reform bill that congress passed on Sunday was a bill that will reform the student loan system. Focused mainly on how student loans are administered, the student loan bill will create $61 billion in savings over 10 years. Of those savings, $30 billion will be put back into education, while another $10 billion will go to deficit reduction. Banks and financial institutions will no longer act as the money lender on these loans — instead, the Department of Education will administer the loans.

Student loan bill changes administration

The biggest change that the student loan bill will implement is in how the student loan program operates. Currently, Congress sets eligibility rules, interest rates and most of the rules about how student loans are administered. The Department of Education then works with lenders like Sallie Mae and colleges to help students apply for the low rate personal loan.

The lending institution then distributes money to the school. The lending institution receives subsidies from the government for providing this service. The student loan bill will simply cut out government subsidies for lending institutions. Instead, the Department of Education will act as the lending institution. Just by cutting out subsidies, the government will save approximately $6.1 billion a year.

Reinvesting in education through the student loan bill

With the savings of the student loan bill, the Department of Education will be able to reinvest about $30 billion back into education. According to the student loan bill, this money will be used to increase the maximum Pell Grant, which is used to help low-income students pay for college. The bill will also reduce the monthly payments that some students have to make on their loans, which will help make college more affordable for more people.

Criticisms of the student loan bill

Even though this bill saves the government billions of dollars a year and reinvests in education, there are criticisms. The costs of college have been rising at double-digit percentages each year, and the increase in the Pell Grants will not come anywhere close to covering that increase in cost. There are also fears that by cutting out the loan industry, the government will effectively be cutting jobs. However, most estimates say that comparatively few — if any — jobs will be lost, as the government will need to hire personnel to administer the loans. Finally, some worry that interest rates on these unsecured personal loans will begin to rise. However, the student loan bill does not change the fact that Congress sets the rules, eligibility and interest rates for student loans.

Sources:

Columbia Spectator
Campus Progress
The New York Times

Joe Biden is well-known for his verbal missteps. Image from Flickr.

Nobody has ever accused Vice President Joe Biden of being the most tightly laced politician. During the press conference where Obama announced the signing of the new health care bill, though, Vice President Joe Biden added his own unique take on the moment by saying “this is a big f-ing deal” to President Obama. I’m sure Joe Biden is wishing now that he’d been able to use instant cash loans to make sure the microphones were off.

Biden drops the F Bomb

After announcing President Obama to the press corps outside the White House, Vice President Biden turned away from the microphone to welcome the President. During a quick hug, Biden said into the President’s ear “This is a big F-ing deal!” Biden’s F-bomb was captured on every microphone, video camera and camera in the area. Biden almost certainly meant this to be a private moment, but it ended up being quite public. The White House has reacted to Biden’s F-bomb with amusement more than anything, with the official U.S. Press Secretary’s Twitter account saying “And yes, Mr. Vice President, You’re right…”

See Video of Biden’s “Big Deal” moment

Joe Biden’s history of gaffes

Vice President Joe Biden is fairly well known for saying the things that many others may just be thinking. The signing of the health care bill is not the first time Biden has been caught dropping the F-bomb on live microphones. On March 13, 2009, Biden was caught saying “An hour late, oh give me a f-ing break.” The Vice President has become rather infamous for his “Bidenisms,” and there are some web sites, such as Slate’s Bidenisms, dedicated entirely to recording the Vice President’s gaffes, misspoken statements and outright mistakes.

Biden was right – health care is a big deal

The new health care bill, which President Obama signed into law today, is most definitely a big deal, as Joe Biden pointed out. The health care bill makes significant changes to the health care system over the next 10 years. To see a summary of the new health care bill, see Health Care Reform basics Part 1 and Health Care Reform basics Part 2.

Democrats have hailed the passage of the health care bill as “historic,” while Republicans such as Randy Neugerbauer and David Frum are calling the passage of the bill “tragic.”  The cost of the health care bill is hotly debated, some saying it will start the government on the path of credit repair, others claiming it will cost more than an online cash advance. Either way, Joe Biden was right – health care reform is a “big f-ing deal.”

The Bill of Rights may play a role in the "War of Constitutionality" for health care reform. (Photo: Picasa)

President Obama has signed the overhauled health care reform bill into law, but not everyone is happy. Thirteen state Attorneys General (12 Republicans and one Democrat) are now in the process of suing the federal government in order to stop the health care reform wave, claiming that it is unconstitutional in its current form. They wonder what kind of tax resolution the Fed will devise to pay for it all, among other things. Their suit targets U.S. Departments of Health, Human Services, Treasury and Labor, according to the Associated Press.

Florida AG Bill McCollum leading charge against health care reform

Other state Attorneys General against health care reform include those from South Carolina, Nebraska, Texas, Michigan, Utah, Pennsylvania, Alabama, South Dakota, Louisiana, Idaho, Washington and Colorado. More states are expected to follow suit, including Virginia, whose AG Ken Cuccinelli said he will file suit “as soon as the ink is dry” from President Obama’s signature on the bill. Various sources speculate that as many as 37 states will also sue the federal government over this health care bill (now health care law).

Why they consider new health care reform unconstitutional

There are several reasons — with the linchpin being whether the 14^th Amendment conflicts with the 10^th Amendment — that the AGs are saying the new law may actually be unconstitutional. However, constitutional experts don’t completely agree on this. Here’s an interesting blueprint for just how health care reform may be contested, as presented by one informed reader on a Yahoo! Answers board.

1. Thirty-seven states (the two-thirds required to call for a Constitutional Convention) would have to utilize the rights granted by Article 5 of the U.S. Constitution. Three-quarters of those involved would be necessary to approve a new Constitutional amendment.
2. Use the Recall Amendment (http://lugar.senate.gov/services/pdf_crs/Recall_of_Legislators_and_the_Removal_of_Members_of_Congress_from_Office.pdf) to “recall any member of the House of Representatives or the Senate according to rules however that state’s legislature deems fit.” Citizens can enact their own recall petitions, too.
3. Look to impose term limits against more than just the president. The 22^nd Amendment only applies to the Commander-in-Chief.
4. Is enacting health care reform a specific power outlined in Article 1 section 8 of the Constitution? If not, the argument is that it would be an implied power, and that a majority of states must agree. Here’s where the 10th Amendment comes in with a “largely ignored” provision: “The powers not delegated to the United States by the Constitution, nor prohibited by it to the States, are reserved to the States respectively, or to the people.”
5. Does the Incorporation clause of the 14^th Amendment violate the States’ rights provision granted by the 10^th Amendment? If so, the U.S. Constitution couldn’t be “used by the Federal Government to usurp power from the States.” Anything that is not a specifically stated power would be more of a “culture wars” issue – a state issue.

Personal Money Market is not your Constitutional Law source

In actuality, Personal Money Market is your source for easy cash loans, not lawyers or Constitutional scholars. But interesting arguments exist that the 13 states suing the federal government – as well as others that join – could use to justify their stance against health care reform.

Related Video:

http://www.youtube.com/watch?v=hbpq0HH_i28

Rep. Randy Neugebauer, aka "He Who Shouts Baby Killer." (Photo: Wikipedia)

If he indeed reflects the will of his constituents, Republican Rep. Randy Neugebauer may have just become the poster baby for why Texas should go ahead and secede from the Union: to hide public officials like Randy Neugebauer from view. Neugebauer, who has since admitted to shouting “Baby killer!” before members of the House after the health care bill passed, was supposedly objecting to what he views as pro-abortion leanings in the bill. Much like South Carolina’s Rep. Joe Wilson, who shouted “You lie!” at President Obama as he delivered a speech before Congress, Randy Neugebauer couldn’t compose himself and be a professional, working adult. It was apparent that he shouted at Rep. Bart Stupak the “baby killer!” moniker after the Michigan Democrat voiced his support for the health care bill.

Neugebauer denies having directed it specifically at Stupak

Yet Randy Neugebauer apologized to his House colleague anyway. His justification for his remarks – that the health care bill is “a baby killer” – may be his last-ditch effort to squeeze campaign dollars out of anti-abortion groups. Who knows – perhaps he was looking for some debt settlement relief?

He Who Shouts Baby Killer may be steamed over receiving less than $3,000 from the anti-abortion gallery (dollar figure taken from a Center for Responsive Politics survey). OpenSecrets.org suggests that could send anti-abortion groups into check-writing action. Those against the current health care bill are certainly steamed. Former G.W. Bush speech writer David Frum says “It’s Waterloo all right: ours.” The Fire Nancy Pelosi petition is circulating, but it’s too little too late for those who vowed to fight Democratic health care reform tooth and nail. In case you need to know, here’s a look at how the health care reform bill affects you.

Who fattens He Who Shouts Baby Killer’s war chest?

According to OpenSecrets.org, “the National Auto Dealers Association, National Association of Home Builders, Quantum Energy Partners, National Beer Wholesalers Association and National Association of Realtors” are big Randy Neugebauer bankrollers. That’s just in case you want to know.

Texas, are you proud of your elected officials?

Randy Neugebauer may represent your beliefs, but do you feel that he is scoring points for Republicans with his “He Who Shouts Baby Killer” routine? Mr. Stupak isn’t a baby killer. Emotional outbursts rarely affect cool policy decisions. They draw ridicule, not just from the media, but from people who understand adult behavior.

Shouting “Baby killer!” at grunt soldiers returning from Vietnam didn’t endear that small group of offending hippies to America, either. In both cases, perhaps a lack of information and heads swelled by some vague notion of selflessness without direction were the trouble. Randy Neugebauer would have been more endearing if he’d been more transparent. Holding up a sign begging the anti-abortion lobby for money would have been more direct, and perhaps more respectable. Payday loans with no fax are another short-term funding source, although Mr. Neugebauer would have to repay within a couple of weeks.

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David Frum has offered a Republican reaction to the new health care bill that outlines "next steps" for Congress. Image from Wikimedia Commons.

By almost any definition, David Frum is a conservative, Republican member of the political community. A conservative activist and former economic speechwriter for President George W. Bush, David Frum has written several books about the Republican right and is a well-known commentator on U.S. and Canadian politics. So when David Frum outlined in his CNN.com column today how yesterday’s health care reform vote was the “Republican Waterloo,” it raised eyebrows. A vocal opponent of payday loans for the government through deficit spending, David Frum outlines what he suggests Republicans do to “recover” from this “devastating” vote.

David Frum argues against repeal of the new health care bill

First and foremost in his column today, David Frum points out exactly how bad an idea repealing the new health care legislation would be. Any repeal would require a presidential signature, and the earliest President Obama will be out of office is two years after the next mid-term election. By the time Republicans may be able to secure a repeal vote in both houses of Congress, they are not likely to receive a presidential signature.

Repealing the entire new health care bill would be exceptionally bad politics. Repealing the health care bill would involve removing many of the new consumer protections that are very politically popular. Medicare recipients that receive prescription drug coverage, Americans with pre-existing conditions that can now get coverage, and new Medicaid recipients would combine to create a formidable political force.

David Frum’s plan for Republicans

Despite arguing against a full repeal, David Frum does outline several steps he thinks Republicans should take to respond to the new health care bill. These include changing the method of funding, possibly using carbon taxes. His plan also includes encouraging reducing the regulation of policies inside health care exchanges and removing the fine for large employers that do not purchase health care coverage.

Finally, David Frum argues that Republicans need to quit defending the employer-based health care system, pointing out that employer-based health care inherently supports a conflict of interests between employers and employees — in essence, asking employers to provide payday advances on health care they should have no hand in.

About David Frum

David Frum’s political commentary has never been limited merely to the Republican party. He has written at least six books on everything from the conservative majority to the presidency of George W. Bush and how conservatism should change. He works as a resident fellow at the American Enterprise Institute and manages a conservative group blog at FrumForum.com.

The new health care bill gives a shot in the arm to underinsured and uninsured Americans. Image from Flickr.

The new health care reform bill passed the House last night on a 219-212 vote. While the bill is not yet law, the changes of this health care reform are sweeping and will take about 10 years to fully implement. The bill will be paid for with everything from payroll loans to the government borrowing money from the national debt – but the Congressional Budget Office estimates that in the end, the bill will save the U.S. Budget a significant amount of money each year. To read more about the effects of the health care bill in 2010 and 2011, see New health care bill summary Part 1.

Summary of the new health care bill 2012-13

No major changes will occur in health care in the year 2012 under the new health care bill. In 2013, many of the new taxes and fees that will pay for the new health care bill will go into effect. This will provide funding for the 2014 fiscal year updates to the health care system.

These taxes will include new Medicare taxes on individuals who earn more than $200,000 a year. The wage tax, dividends and interest tax, and a small tax on medical devices will also be implemented. In 2013, the new health care bill will also implement a test system in Medicare in which payments are made based on the quality, rather than quantity of health care services. Health insurers will also be barred from charging different premiums to customers based on gender.

Summary of the new health care bill in 2014

In 2014, the majority of Americans will gain benefits from the new health care bill. Exchanges will be created so individuals without employer-provided health care or small business can shop for health care coverage – and insurance companies will be barred from denying coverage on the basis of pre-existing conditions. Medicare will also expand to cover all Americans with income up to 133 percent of the federal poverty level ( about $27,000 per year for a family of 4). Small businesses will also receive a tax credit to help them provide coverage to their employees. The insurance industry will also be required to pay an annual fee to help pay for the exchanges that will cover all citizens that cannot otherwise receive insurance.

In addition to providing subsidies and guaranteed coverage for most citizens, the new health care bill will also require that most people have health insurance. There will be a fine for not carrying insurance of some sort. An independent Medicare board will also be created to help curb Medicare costs if the costs rise more quickly than inflation.

Summary of the new health care bill in 2015, 2016, 2017, 2018

In 2015, the new health care bill will simply continue the new coverage, taxes and fees that are created in previous years. In 2016, the penalty for individuals who do not purchase health insurance will rise to a $695 minimum. In 2017, businesses that have more than 100 employees will be allowed to participate in the state insurance exchanges, if the state government allows it. In 2018, an excise tax will be imposed on so-called “Cadillac plans” that generally provide more than $27,500 worth of coverage for a family.

Sources:

Wall Street Journal
Lexington Clipper-Herald
My Fox Tampa Bay
Onion Kid
The Seattle Times
Wikipedia – Poverty article
Washington Post

The new health care bill injects money and regulation into the health insurance industry. Image from Flickr.

Yesterday evening in congress, the health care reform bill, HR 4872, passed the house of representatives on a 219-212 vote. An incredibly sweeping change, the new health care bill has many pros and cons. With more than 2,000 pages in HR 4872, the basics of the new health care reform bill are extensive. In short, the U.S. government will be attempting to provide health care insurance for most Americans without those individuals needing to take out a payday loan to pay for that coverage. The  effects of the new health care bill will be split over 10 years. The first two years will be covered below – to see the effects the new health care bill will have from 2012 – 2018, see Part 2.

New health care bill not yet law

The new health care bill passed the House on Sunday, but it is not yet law. First, the new health care bill must go back to the Senate for reconciliation. This means that some major provisions of the new health care bill may change – though the pros and cons of the majority of new health care bill are likely to remain the same. Once the bill is reconciled through the Senate, it will go to President Obama’s desk to be signed. At that point, the new health care bill would become law.

The timeline of the new health care bill

Because there are many details involved with the new health care bill, the timeline of implementation for the bill is currently set at 10 years. This is assuming that the new health care bill provisions are not repealed or changed in subsequent legislation. The cost of the health care bill is estimated to cost about $100 billion a year, but that cost is estimated to be more of a cash loan – the cost savings from altering the health care system are estimated by the Congressional Budget Office to be more than twice the yearly cost.

Summary of new health care bill in 2010

In the year 2010, there would be three major changes to health care. First, insurance companies would no longer be allowed to deny coverage to children with pre-existing illnesses. Second, children would be able to stay on their parent’s insurance policies until they turn 26 years old. Third, Medicare recipients who fall into a specific coverage gap will get a $250 rebate.

Other changes include an excise tax on indoor tanning, which will increase the cost of that service. Also, individuals that have not had health insurance for 6 months will receive a subsidy to enroll in high-risk insurance pools run by the states. All new insurance plans sold must exempt preventative care and screenings from deductibles. Finally, small businesses with fewer than 25 employees would receive up to a 35 percent tax credit for providing health insurance to their employees.

Summary of the new health care bill in 2011

In 2011, the new health care bill will make changes focused mostly on preparing for later updates. The new health care bill will set up a long-term care insurance program. Individuals who pay premiums into this system for at least five years will become eligible to receive support with daily living assistance.

The senior citizens that fall into the “medicare doughnut hole” – a coverage gap – will get a 50 percent discount on some drugs. In 2011, a new fee on drug makers will also be implemented to help pay for the upcoming changes. The fine on withdrawing funds from a Health Savings Account for non-medical expenses will increase by 5 to 10 percent. Employers will also need to start including the cost of health care on employee’s W-2 forms.

To read more about the continuing effects of the new health care bill, see Health Care Reform basics Part 2.

Sources:

Wall Street Journal
Lexington Clipper-Herald
My Fox Tampa Bay
Onion Kid
The Seattle Times
Wikipedia – Poverty article
Washington Post

The health care bill vote will likely take place Sunday. From Wikimedia Commons

The fight over the health care bill in the House of Representatives continues, and the bill is set for a vote on Sunday. The current bill was sent to the House by the Senate, and the House will require 216 votes in order to pass it, and that is what House Speaker Nancy Pelosi (D – CA) is gunning for. Ohio Rep. John Boccieri (D) has crossed the aisle and pledged to vote for the bill. House and Senate Republicans are bound and determined to keep the bill from passing either house, despite CBO estimates that the bill will save a lot of payday cash for consumers and the government alike.

John Boccieri says ‘Yes’ to health care bill

A freshman legislator, Rep. John Boccieri (D-OH) has, according to the Washington Post, decided to support the legislation and vote in favor of the health care bill in order to pass it through the House and send it back to the Senate.  If the bill clears the Senate without further alteration, it will be sent to the president.

Falling into line

Several other House Democrats who had previously held the bill in dubious esteem, including Dennis Kucinich (D-OH), Betsy Markely (D-CO), and Bart Gordon (D-TN) have recently also committed to voting for the bill. The bill has likely appeared more palatable because of recent Congressional Budget Office estimates that the bill, with a price tag of more than $940 billion – that’s a heck of a cash advance – will trim up to $138 billion from the deficit over the next 10 years.

Possibly not the end of the line

The success of the bill on Sunday depends entirely on getting enough votes to pass the House, and the House revised bill passing the Senate, and of course, for the President to sign it.  President Obama is deeply committed to health care reform, as health care costs are the cause of more than 60 percent of all bankruptcy filings. Medical debt has the potential to become a far greater problem in the next 30 years, as the baby boomers begin to retire.

President Obama urges action

In a recent speech, President Obama urged Congress to pass the bill as soon as possible.  The specter of health care reform is looming large over Washington, as many want something to be done and just as many oppose intrusion by government into a business as important as the health care industry.  It has become a cornerstone issue of the Obama presidency, and regardless of the outcome, it will likely be one of, if the not the, defining issue for his administration.

Before most legislation is passed, the CBO has a chance to review it. Image from Wikimedia Commons.

When any bill that affects the federal budget begins to make its way through Congress, it makes a stop that, more often than not, the public does not see. The Congressional Budget Office is an independent, non-profit governmental agency that reports to Congress, but is not controlled by Congress. The Congressional Budget Office reviews the estimated effects of all legislation – saying if the legislation will require the government to borrow money, be budget-neutral, or save money. The CBO report can make or break legislation – and the CBO report on healthcare has put an unusual spotlight on this office. So how does the CBO work, and what does the latest CBO report on health care say?

How does the Congressional Budget Office work?

The CBO was created in 1974 with the passage of the Congressional Budget and Impoundment Control Act. The Speaker of the House of Representatives and President pro tempore of the Senate jointly appoint the director of the CBO for a four-year term. It is the job of the CBO to issue periodic reports about fiscal policy, to provide projections about the current budget, and to analyze the effect proposed legislation would have on the national budget and national debt, as requested by members of Congress.

To this end, the Congressional Budget Office employs an army of accountants and fiscal analysts who study everything from tax debt to private money lenders. The CBO was created to be non-partisan and independent of Congress, so the reports it issues would not be as easily altered by the political maneuvering in Congress.

The CBO stance on health care reform

The Congressional Budget Office does not officially take political stances. Instead, it provides objective financial analysis related to the bills currently in Congress. However, the CBO is allowed to state facts as its reports see them. On the CBO Health wesbsite, the header states:

The federal budget is on an unsustainable path, primarily because of the rising cost of health care and the aging of the U.S. population.

As reported by the Washington Post, the most recent CBO report on heath care – which is due to be officially released later today – indicates that the reconciled Senate health care bill finds that that particular bill would cut the U.S. deficit by $1.3 trillion over 20 years, and would cover 95 percent of U.S. citizens.

Getting more information about the Congressional Budget Office

The CBO is a huge governmental agency that issues a number of reports, estimates, and opinions throughout the year. If you would like to get more information about the CBO, its stance on health care, or see a copy of CBO reports, you can start with the Congressional Budget Office web site. Get a copy of any CBO publication on the publications page. Full cost estimates are also available on the Cost Estimates site. To contact the Congressional Budget Office, you can email them at communications@cbo.gov or call 202-226-2602.

I'm not looking at Dennis Kucinich in this photo, either.

The battle for health care reform may be nearing a vote in the House, as President Obama has predicted. Now a major stumbling block has been removed, as Democratic Rep. Dennis Kucinich has changed his stance on the current version of the health care bill, which brings to mind credit repair – for his image.

It remains to be seen what it was that swayed the former critic of the bill, but the New York Daily News reports that pressure from the president and House Speaker Nancy Pelosi may have had a lot to do with it. They apparently put the screws to him in his home state of Ohio this week.

Dennis Kucinich says yes, but with reservations

While his vote brings Nancy Pelosi one closer to the 216 needed to pass health care reform, Dennis Kucinich won’t say that the version of the health care bill that’s on the table is perfect.

“I have taken this fight farther than many in Congress have been willing to take it,” Kucinich said in a statement to the media. “In the past week, it’s become clear that the vote on the final health bill will be very close.”

Then he said he didn’t want to be the one to deep-six the bill

That sounds like Dennis Kucinich doesn’t want to draw someone’s wrath. Who might that be? President Obama? Speaker Pelosi? His wife Elizabeth could also be a culprit.

The big question is – how will we pay for this health care bill?

Depending upon who you ask, we could either have it covered AND reduce the deficit or continue to pay for this many generations later, saddling them with tax debt. Dennis Kucinich hasn’t forgotten this part of the equation, which is most likely why he said that he has “taken a detour through supporting this bill,” and that he will continue to seek more “robust” reform. Whatever scores points with the English rose, Dennis.

(Photo Credit: http://www.flickr.com/photos/65235746@N00/ / CC BY 2.0)

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Nancy Pelosi (Photo: Wikipedia)

With the health care bill dragging into its second year of debate, there is talk from house leader Nancy Pelosi that a “procedural action” called Deem and Pass may be used to move the health care bill through the House. Half vote and half procedural action, the Deem and Pass action – otherwise known as the “Slaughter rule” – has raised blood pressures on both sides of the aisle, but unless you are a career politician, deem and pass can get more confusing than no fax payday loans very quickly. So here’s the basic primer on deem and pass for all the non-politicians out there.

What is deem and pass?

The term “deem and pass” actually refers to a rule of procedure in Congress known as “self-executing.” A full description of the rules pertaining to the self-executing rule/deem and pass is available on the house web site here. In general, deem and pass can be used as a two-for-one procedure. The house Speaker can deem amendments or changes to have passed the House, and incorporate those changes in a bill to be taken up.

Originally, deem and pass was used to expedite one chamber accepting the amendments to a bill passed by the other house. Rather than individually voting on each amendment and then on the completed bill with the amendments, which could sometimes take days, the chamber could simply “deem and pass” the amendments to move the bill into reconciliation (where the House and Senate versions of a bill are reconciled with one another before being sent to the White House).

Is Deem and Pass constitutional?

Since the suggestion that deem and pass may be used to pass the House amendments to the Senate health care package, many opponents have questioned the constitutionality of the deem and pass procedure. In The American Spectator, Representative McCotter claimed this procedure would “violate constitutionally prescribed procedures”.

However, in 2007, the United States Court of Appeals in D.C. ruled on this exact question in Public Citizen v. US District Court. The ruling is a 64-part discussion of the constitutionality of deem and pass – and it is ruled constitutional. Nancy Pelosi had actually joined Public Citizen on that case, along with Louise Slaughter. So yes, deem challenge was determined to be constitutional just a few years ago – the same place it got the name “Slaughter rule.”

Has Deem and Pass been used in the past?

Yes, deem and pass has not only been found to be constitutional, but it has been used multiple times. Deem and pass was first used in 1933 to pass a budgetary amendment and bill. Between 2005 and 2006, the American Enterprise Institute reports that the “self executing rule” – otherwise known as deem and pass – was used at least 35 times. The procedure was used for everything from federal debt consolidation to sweeping rule changes.

How will Deem and Pass be used for the health care bill?

The arguments about deem and pass are now centered on Nancy Pelosi’s plan to use deem and pass to push the health care bill through the house. It has been reported by several sources that this is “an effort to push the bill through without voting on it.” This, however, is not true. As The Atlantic explains, deem and pass will instead combine an up-or-down vote on the procedural parts of the bill with passing the House amendments on the Senate health care bill.

Code Red, Dorothy! Get in the cellar, because the health care bill may pass this week!

The United States Senate is quickly approaching a vote on the current rendition of the health care bill, and tensions are reaching the boiling point. According to Talk Radio News Service, Tea Party Patriots staged a “Code Red” rally in Washington, D.C. in which Republican speakers like Minnesota Rep. Michele Bachmann assured their faithful that that Republicans are winning the debate. However,  White House Press Secretary Robert Gibbs has gone on record as saying that a health care bill will pass the House “in a week.” If Republicans are going to “kill the bill,” they may need a last-second Hail Mary, a la Doug Flutie.

Code Red Republicans may need some Flutie-esque luck

I use the Flutie football analogy here because of something columnist George Will once said about football. He said it encapsulates two of the worst things about America: violence and committee meetings. Tea parties – as well as their counter-”patriot” equivalents – offer ample servings of both, so long as we remember that the dissemination of hate is a form of violence. That makes up for those rallies where physical violence actually fails to occur or people simply forget to bring their assault weapons. Hopefully they know that low interest loans are great for firearm safety courses.

Is there evidence in the numbers of Wall Street as to what direction the wind is blowing? Jim Cramer of “Mad Money” seems to think so. Cramer believes the current health care bill will pass, and that it will cost America dearly. We’re talking deeper recession dearly. “We have to wonder if this is one of those occasions, like in 2008, where the market doesn’t see the coming catastrophe. Or perhaps the market sees any resolution as positive,” he writes for RealMoney.

Jim Cramer sees the floodgates opening

Cap and trade, card check unionization and immigrant amnesty are on the way, claims Cramer. He cites Wal-Mart’s “inability to move even on its dividend boost” as a sign that union pressure may invade even the Walton corporate sanctuary. To pay for it all, where do you think the money will come from? Cramer says higher tax rates, including capital gains and dividend tax rates, by 2011. The massive projected costs of the current health care bill will “put the double-dip recession back on the table,” in Cramer’s estimation.

Meanwhile, Democrats are preparing to deal with Code Red tea parties

Doug Thornell, the National Press Secretary for the Democratic Congressional Campaign Committee (DCCC), sent an e-mail to “Freshman and Sophomore House Democrats” regarding “Tea Party etiquette.” Their concern is decorum, while Republicans are bracing for impact. Do you know where your fast cash loans are, in case the economic winter deepens?

(Photo Credit: http://www.flickr.com/photos/andrewaliferis/ / CC BY-ND 2.0)

Related Video:

http://www.youtube.com/watch?v=5KllrtnisU0

Throughout the recession many consumers have been using personal loans to fund their health care. There may be some relief on the way as a new health care bill is said to be on the verge of completion. Senate Majority Leader Harry Reid is confident that the bill will be passed. In a statement released earlier this week, he stated that the new revised bill should be ready for review by next week.

Part of the hold-up on the legislation came in the form of opposition mainly from Ben Nelson, the Senate’s most conservative Democrat. With his vote, the landmark health care reform bill would have the 60 votes needed for it to pass. Because his vote was so crucial, it gave him quite a bit of leverage as he met with other members of the Senate to sort through the proposed bill.

The health care bill

President Obama is hoping to insure the millions of Americans who are currently living without health care insurance. Many of them are unemployed, but not as many as was first projected by experts. Clancy Parks, analysts for MoneyMaker.com said, “It was thought that the employment rate would skyrocket the group without health care, and it did, but research has shown that there was a huge pool of uninsured prior to the recession and job loss.” Many people lived without insurance due to health care costs. When they were unable to afford health care, they cut it out of their expenses altogether. The recession caused people to scale back on all bills that were not immediately necessary, and unfortunately health care was viewed as one of them.

A reduction in the need for credit and personal loans

The health care bill is supposed to help consumers fund their health care without the use of credit or personal loans. In essence it is supposed to extend coverage to those who don’t have any health care, prohibit the industry from denying insurance due to pre-existing conditions and slow the rate of growth of medical spending throughout the US. The bill will cost about $1 trillion over the next decade and much of the funds will be spent on lowering the dollars Americans would otherwise have to come up with out of their own pockets for health care.

Legislators are working overtime

Due to the large number of uninsured in America, it’s no wonder the Senate is working aggressively to restructure health care into a workable plan. Senator Mitch McConnel said, “This massive piece of legislation that seeks to restructure one-sixth of our economy is being written behind closed doors without input from anyone in an effort to jam it past not only the Senate but the American people before Christmas.”

The future of health care

In the future, health care is hoped to be available for all insurable Americans. President Obama is working to push the legislation through quickly and see 2010 as a year when health care is available to all. It’s necessary to find a solution because thus far consumers have had to manage their own health care by whatever means necessary. Many are uninsured, many use personal loans and many use savings to fund health care costs. The President’s initiative should be ready by early 2010 and time will tell how effective it really is.

While this product makes it easier to pull a plug, the HR 3200 bill does not.

Just when I thought people were getting the story straight about section 1233, the section of HR 3200 that addresses end-of-life consultation, another round of strange interpretations and accusations has started flying around. I came across an article on LifeNews.com, a pro-life web site, that summarizes the new concerns surfacing about section 1233.

I’m not a politician or a policymaker. I’m just an average citizen who could use some cash loans like most U.S. residents. Instead of reading through all of the jargon and arguing, I’m simply going to address the claims people are making about section 1233 using common sense straight out of my own head.

Does section 1233 give financial incentive for euthanasia?

Here is a summary from LifeNews explaining one of the provisions of section 1233 of HR 3200, the bill on health care reform.

The measure would pay physicians to give Medicare patients end-of-life counseling every five years or sooner if the patient has a terminal diagnosis.

Here’s a quote, per LifeNews,  from a recent column by Charles Lane of the Washington Post Columnist:

“As I read it, Section 1233 is not totally innocuous,” Lane writes, adding that it “addresses compassionate goals in disconcerting proximity to fiscal ones.”

“Though not mandatory, as some on the right have claimed, the consultations envisioned in Section 1233 aren’t quite ‘purely voluntary,’” as backers of the bill assert, Lane adds. “To me, ‘purely voluntary’ means ‘not unless the patient requests one.’ Section 1233, however, lets doctors initiate the chat and gives them an incentive — money — to do so.”

HR 3200 introduces nothing new

What this columnist, LifeNews and anti-reformers who are squawking about section 1233 of the HR 3200 bill fail to recognize is that end-of-life consultations are not new. Doctors have always been paid to conduct these consultations. Section 1233 simply says Medicare will pay for it now instead of private insurance or individuals.

So, the financial incentive to aid terminal patients in creating a will and getting informed about their options for care has always been there. Doctors have no more reason to do it now than they did before. Section 1233 just makes it easier for patients to afford consultations on what are indeed very important life decisions.

More crazy talk

The other claim that LifeNews outlines is that physicians not only have financial incentive to do the consultations but to “formulate a plug-pulling order.” LifeNews says:

Pro-life advocates say the section opens the door to physicians pushing euthanasia or withdrawal of lifesaving medical treatment, or even basic food and water.

So, there’s a financial incentive for killing patients off? How’s that possible? Live patients spend a whole lot more money than dead ones. I’d argue that physicians have not only ethical, compassion-based reasons for keeping their patients alive as long as possible, they have financial incentives to do that as well. The longer a person stays in the hospital, the more money the hospital earns.

Closing argument

I highly doubt that the source of the funding is going to sway doctors one way or the other on whether they should pull a patient’s plug. This is just another example of a scare tactic used by groups that don’t want the HR 3200 health care bill to pass for political reasons.

What these people are truly opposed to is plug-pulling in the first place, something the HR 3200 bill neither encourages nor discourages, it just facilitates education. If these people want plug-pulling outlawed, they need to address that issue, not try to take down a huge health care bill that affects the entire country in many positive ways and could provide health coverage for 46 million Americans who don’t have insurance.

Don't believe everything you read.

There’s a lot of “news” floating around out there about House Resolution 3200. Unfortunately some of the discourse has devolved into scare tactics, misinterpretation and, in some cases, flat-out lies. Much like opponents of the people’s right to get a loan until payday call payday lenders “predatory,” opponents of the current administration are trying to twist language in the bill into meaning something it doesn’t.

It would be impossible, in one work day, for me to tackle all of the misinformation out there. Instead, I’ve picked three general misconceptions about HR 3200 to focus on.

1. The government is encouraging people to die

I chose to tackle this ridiculous claim first because it is the most offensive and the most inaccurate. In fact, the opposite is true. The bill makes sure that patients considered terminal receive proper consultation on things like creating, updating and finishing their will.

It also says that people should know their options. They will be informed about long-term care options such as hospice, nursing homes, etc. Page 429 also says that an order can be issued on the patients behalf that does the following:

“Effectively communicates the individual’s preferences regarding life sustaining treatment, including an indication of the treatment and care desired by the individual.”

I have actually encountered people who think (or say for political reasons) that this bill will allow the government “to issue an order to end a life.” The purpose of this part of the bill is to ensure that doctors don’t pull the plug unless that is specifically requested by the patient. To quote a memo by Ben Lenet, Deputy District Administrator for United States Congressman Jesse L. Jackson, Jr.:

This ensures that patients and families are given ALL the information about ALL of their options and makes sure that in all circumstances, the patient’s wishes are observed.  (This prevents Bill Frist from making medical determinations off of VHS tapes from his Senate office).

2. Government can access personal information

Rumor has it that HR 3200 gives the government access to health records, bank account information and other personal records. It is true, if HR 3200 passes, the government will have access to these things. To put it another way, these things will stay exactly the same.

The government already is allowed access to your health records and bank account information. They were granted it by a little document called the PATRIOT Act. So stop panicking. Or start panicking, but know that the government has had access to all of this information and more since 2001.

3. The government will decide what services you can get

This is sort of, a little bit true. Just as current, private insurance providers specify what treatments  your insurance plan covers, the government-run public insurance plan will have specifications on what it will cover. However, the government will not decide what makes the cut.

To quote, again, from Lenet’s memo:

This plan will establish a panel of DOCTORS who will evaluate the best practices for care.  This will eliminate physicians ordering unnecessary tests and procedures solely for the purpose of a larger reimbursement.

Also, just like private insurers, the government will have a tiered program that will allow people to choose levels of coverage or to add additional services and treatments to their health insurance plans.

You can read the complete text of HR 3200 online, thanks to The Library of Congress. Know that there are poeple out there truncating and quoting portions of the bill making the meaning sound totally different than the truth. So before you believe everything you’re told about HR 3200, check it out for yourself.

Congress is currently considering HR 3200, otherwise known as “America’s Affordable Health Choices Act of 2009.” It’s the massive health care bill that we’ve seen coming for quite some time. OpenCongress.org provides a PDF that explains HR 3200 in detail as well as the following summary:

America’s Affordable Health Choices Act of 2009

To provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes.

OpenCongress Summary:
This is the House Democrats’ big health care reform bill. Broadly, it seeks to expand health care coverage to the approximately 40 million Americans who are currently uninsured by lowering the cost of health care and making the system more efficient. To that end it includes a new government-run insurance plan to compete with the private companies, a requirement that all Americans have health insurance, a prohibition on denying coverage because of pre-existing conditions and, to pay for it all, a surtax on households with an income above $350,000.

A word from HR 3200′s sponsors

The emergency cash loans needed to fund HR 3200 will come from a mixture of sources. The PDF on OpenCongress is a document created by the House Committees on Ways and Means, Energy and Commerce, and Education and Labor. The committees, who wrote HR 3200, say:

America’s Affordable Health Choices Act provides quality affordable care for all Americans and controls health care cost growth. … The bill builds on what works in today’s health care system and fixes the parts that are broken. It provides current coverage — allowing individuals to keep the insurance they have if they like it — and preserves choice of doctors, hospitals, and health plans.

Included in HR 3200 are provisions that will offer a public health insurance option, meaning people can get health insurance through the government instead of a private insurer. As you can imagine, some people and organizations are not crazy about this idea.

Private insurance industry says “nay”

Naturally, providers and advocates of private health care are opposed to HR 3200. Kim Priestap at wizbang says:

“HR 3200 kills the private insurance industry.  … How do the private insurance companies compete with the government run health care plan? They don’t. This bill is designed to kill the private insurance industry and force people onto the government plan. …

Senator Jim DeMint remarked that Obama’s health care reform plan will be his Waterloo if the GOP can successfully stop it, and based upon what’s in HR 3200, you better hope the GOP and Blue Dogs are successful.”

Priestap dissects a few paragraphs of the bill in her commentary on wizbang. Check it out here.

Show me the money

Regarding how HR 3200 makes health care affordable to all Americans, the House Committees say America’s Affordable Health Choices Act of 2009:

• Provides sliding scale affordability credits
• Caps annual out-of-pocket spending
• Increased competition from public plan spurs efficiency and transparency
• Expands Medicaid
• Improves Medicare

The plan stresses that there must be a balance between individual, employer and government responsibility. HR 3200 also has provisions to help small employers.