Health Care Insurance

From BarackObama.com: "Just as he criticizes federal health reform based on the law he passed in Massachusetts, Mitt Romney is attacking the President for providing women with the same access to contraception and preventive health care services Romney did as governor. Our new infographic takes a look at how contraception coverage compares under the Affordable Care Act and the Massachusetts law Romney stood behind."

It's good to see Republicans like Birther Tim Jones, Auditor Tom Schweich, Sen. Tom Dempsey and richperson Sam Fox finally come out in support of a health insurance mandates.  

Tax incentives to increase health coverage used to be pretty standard fare for conservative politicians -- former Sen. Kit Bond cosponsored legislation in the 1990s with a health insurance mandate.But intellectual honesty isn't exactly in vogue in GOP circles these days. 

See, for example, candidate Mitt Romney on just about any issue that matters. 

We interrupt your extended Ronald Reagan birthday party to bring you this video of the Gipper's Solicitor General, Harvard Law Professor Charles Fried, explaining to the Senate Judiciary Committee his thoughts about the Affordable Care Act's health insurance mandate.  "I am quite sure that the health care mandate is constitutional," he told the committee. "The mandate is necessary to the accomplishment of the regulation of health insurance."

It isn't exactly earth-shattering news that conservative legal scholars affirm the constitutionality of the bill -- Sen. Kit Bond, for instance, co-sponsored legislation in the 1990s that featured an individual health insurance mandate.  But facts haven't exactly gotten in the way of Republican grandstanding on the issue, as you know. 

Watch some of Friend's testimony, as posted by ThinkProgress:

The Hill: "A federal judge in Virginia on Tuesday rejected a legal challenge to the healthcare reform law, the second time the law's mandate that people buy insurance has been ruled constitutional. The lawsuit was brought by Liberty University, which also argued that the law violates the First Amendment by requiring people to buy insurance that could cover abortions."

A new McClatchy poll finds that a majority wants to keep the health care reform law or expand it, and that voters support provisions like stopping insurers from denying coverage for pre-existing conditions by a two to one margin.

A majority of Americans want the Congress to keep the new health care law or actually expand it, despite Republican claims that they have a mandate from the people to kill it, according to a new McClatchy-Marist poll.

The post-election survey showed that 51 percent of registered voters want to keep the law or change it to do more, while 44 percent want to change it to do less or repeal it altogether.

Driving support for the law: Voters by margins of 2-1 or greater want to keep some of its best-known benefits, such as barring insurers from denying coverage for pre-existing conditions. One thing they don't like: the mandate that everyone must buy insurance.

At the same time, the survey showed that a majority of voters side with the Democrats on another hot-button issue, extending the Bush era tax cuts that are set to expire Dec. 31 only for those making less than $250,000.

Pretty funny -- and effective -- stuff from Health Care for America Now. 

More at www.StopSpewman.com/

Politico's Ben Smith: "A federal judge in Michigan just now upheld this year's health care legislation in the first significant challenge to its constitutionality. Ruling against a lawsuit brought by the conservative Thomas More Law Center, Judge George Steeh, a Clinton appointee to the Eastern District of Michigan, found that the Commerce Clause applies to health care, and that penalties imposed on people who don't buy insurance aren't an unconstitutional 'direct tax.'"

The full decision is online here, and embedded below the jump.

Todd Akin wants you to know that he feels your pain. You may think that he doesn't understand what it's really like to make ends meet because he makes $174,000 every year from the government (the same government he tells you is destroying your life), and because he receives fabulous health care benefits that are heavily subsidized by taxpayers. 

But this morning on KWMU's St. Louis on the Air, Akin told host Don Marsh that his compensation package isn't actually all that grand. In their conversation about health care policy, Akin said that one of the things our health care system really needs is an increased reliance on charity. And Marsh, in a delicate NPR kind of way, asked him to get real. 

AKIN: I believe that charity is a legitimate way -- Americans are very generous people -- but we've come to believe that government is going to take care of it all, and therefore we just sort of dust our hands to say, you know...

HOST: Would you like to give up your Congressional health insurance for -- and rely on charity?

AKIN: Well, I wouldn't rely on charity.  I'd try and save my money and buy health insurance.  Yeah. No, I mean, I think you have to be, people have to be responsible. If we don't take responsibility for the decisions that we make, then the country doesn't work.

HOST: You probably have the best health insurance in the country though. I think [chuckle] Members of Congress, it's pretty much conceded they have a wonderful health insurance.

AKIN: No, I wouldn't agree to that at all.  No.  I mean, people say that, but I don't think it's true.  I had health insurance as a state rep, and I can guarantee you that was not very good health insurance. Because I could never see the doctor.  And it turned out when I got the Capitol when I was first elected to Congress, I marched in to get my first physical in years.  They said, yeah Todd, you're doing great except a little detail. You have got cancer.  And that's something that if I had good insurance, it might have, there would have been incentive to get that physical every couple of years.

HOST: And if you'd had no insurance...?

AKIN: Yeah. It -- and again, it's expensive to try to find somebody to do it.

Back here on Planet Earth, we know that Members of Congress and their staffs do have great health insurance benefits.  They also "get special treatment at Washington's federal medical facilities and, for a few hundred dollars a month, access to their own pharmacy and doctors, nurses and medical technicians standing by in an office conveniently located between the House and Senate chambers."  (Government-run health care, oh my!)  Also note that seconds after Akin says his Congressional benefits package isn't that hot, he tells the story of how said insurance paid for his cancer treatment. 

Which charity is in charge of reconnecting Todd Akin with the real world?  

Judy Baker, the former state representative, 2008 candidate for Congress in the Ninth District and now a Regional Director for the U.S. Department of Health & Human Services, has a great op-ed posted to KansasCity.com today (though it may have been printed a day or two ago) about the benefits of the new health care law that have already taken effect.  An excerpt:

Six months after Congress passed and the president signed the new health reform law, Americans are already seeing the benefits.

Thanks to the Affordable Care Act, thousands who had been shut out of the health insurance market are now getting coverage through new pre-existing condition insurance plans. More than a million seniors and people with disabilities who have fallen into the so-called Medicare prescription-drug donut hole have received $250 checks to help them buy medications. And many small businesses are getting help too — tax credits to make it easier for them to provide coverage to workers. In Missouri, 94,300 small businesses may be eligible...

This month is reason for celebration as patients are going to be in charge of their care. The next time your coverage renews:

• Insurers will no longer be able to cancel your policy because you made a minor mistake on an application.

• Insurance firms will no longer be able to place lifetime dollar limits on your benefits that result in people losing insurance when they need it most — in the middle of a crisis.

• In many cases, insurers will no longer be able to refuse to sell you a policy to cover your child because she was born with asthma or some other pre-existing medical condition.

• Insurance companies, in many cases, will no longer be allowed to refuse to pay a doctor or hospital bill without giving you the chance to appeal to a group of outside experts.

These reforms serve as a bridge until 2014, when more important benefits kick in. New health insurance Exchanges will let individuals and small businesses purchase affordable insurance — the same coverage as Members of Congress — regardless of their health status.

The new law is not perfect. But it is already making a huge difference and we’re working with governors, state health officials, community leaders, health care providers and patient advocates to implement it effectively and, when we can, improve it.

I suppose it's not shocking from a candidate who thinks we would have been better off if Medicare and Medicaid had never been created, and who thinks that "Medicare has never done anything to make people more healthy,"  but I was still a little surprised to see this quote in the new Post-Dispatch story about the health care reform positions of Roy Blunt and Robin Carnahan.

"The health care law doesn't really take effect until 2014," said Blunt spokesman Rich Chrismer, 'so the only option Congress has at this point is to decline to allocate tax dollars for this government takeover."

While it is true that 2014 is an important milestone in the implementation of the new law -- at that point, health insurers will be prohibited from discriminating based on pre-existing conditions (something Roy Blunt used to tell voters he supported, but then failed to do anything about), and tax penalties will begin for individuals who do not purchase insurance -- Chrismer's statement demonstrates an incredible ignorance about what is actually contained in the law he claims to detest.

In fact, Roy Blunt wants to junk all of the following new provisions that are taking effect in 2010. (Perhaps because he's been so blinded by thoughtless obstruction to notice.)

• Young adults will be able stay on their parents' insurance until their 26th birthday.
• Seniors will get a $250 rebate to help fill the "doughnut hole" in Medicare prescription drug coverage, which falls between the $2,700 initial limit and when catastrophic coverage kicks in at $6,154.
• Insurers will be barred from imposing exclusions on children with pre-existing conditions. Pools will cover those with pre-existing health conditions until health care coverage exchanges are operational.
• Insurers will not be able to rescind policies to avoid paying medical bills when a person becomes ill.
• Lifetime limits on benefits and restrictive annual limits will be prohibited.
• New plans must provide coverage for preventive services without co-pays. All plans must comply by 2018.
• A temporary reinsurance program will help offset costs of coverage for companies that provide early retiree health benefits for those ages 55 to 64.
• New plans will be required to implement an appeals process for coverage determinations and claims.
• Adoption tax credit and assistance exclusion will increase by $1,000. The bill makes the credit refundable and extends it through 2011.
• A 10 percent tax will be imposed on amounts paid for indoor tanning services on or after July 1.
• Businesses with fewer than 50 employees will get tax credits covering 35 percent of their health care premiums, increasing to 50 percent by 2014.

Again, these are all 2010 provisions -- provisions that Chrismer indicates do not actually exist. Maybe if he knew more about the law, we'd see a little less demagoguery from Blunt and other Republicans? 

From the the non-partisan, non-profit Kaiser Family Foundation: "Confused about how the new health reform law really works? This short, animated movie -- featuring the "YouToons" -- explains the problems with the current health care system, the changes that are happening now, and the big changes coming in 2014."

From the Post-Dispatch Editorial Board:

In all of the overheated rhetoric that accompanied the health care debate, we rarely heard mention of the reinsurance program, the high-risk health insurance pools being set up in each state or curbs on insurance company abuses and coverage exclusions for pre-existing conditions. Yet those are major parts of health care reform.

So here's the real lesson from Proposition C vote: Like residents of Illinois, Iowa and every other state, Missourians don't want federal health care reform. We want just the parts that benefit us. Which, when you look closely at the reform law, is pretty much all of it.

Who needs Medicaid when the poorest Americans and their children can get the medical care they need by just finding a provider who will give it to them for free?

From the Center for American Progress' Wonk Room blog:

[T]oday, MIT Professor Jonathan Gruber has released a report that estimates how much more we would all be paying for health coverage, should conservative efforts to repeal the mandate and other parts of the health care law succeed:

Consider this:

Gruber writes that health reform is like a three-legged stool with insurance regulations, the mandate, and subsidies representing the separate legs. Remove one of these components and the stool (reform) falls apart.

Dave Roland of Rex Sinqefield's Show-Me Institute reacts to yesterday's approval of the "Health Care Freedom Act":

Many of the legislators and citizen groups who had worked to pass the original bill are now hailing the passage of HB 1764, implying that if the people vote to adopt this statute, it will have the same effect as the proposed constitutional amendment might have. Unfortunately, this is simply not true. Missouri voters may well use this referendum as a political statement through which they can express their opinions about the federal health care reform law, but the text that might have been legally useful as a constitutional amendment will have zero legal effect as a statute...

UPDATE: Richard's spokeperson tweets that the Speaker "was surprised" by Rupp's tweet, and that he's "already selected conferees" for negotiations, though these have not been made official yet. 

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Sources on both sides of the aisle report this morning that Speaker Ron Richard may not appoint conferees to finish this year's autism insurance bill (HB1311) in a timely manner -- or at all. 

Sen. Scott Rupp (R-Wentzville) tweets that "Hse speaker Richards [sic] is blocking autism bill AGAIN!" and the Autism Votes campaign warns that Richard is "blocking your autism insurance reform bill to death."

UPDATE: Today's vote was on a statutory change, not a constitutional change. 

The Missouri Senate today passed their version of the "Health Care Freedom Act," a proposed constitutional amendment law intended to prohibit the federal government from imposing extra taxes on people who do not purchase health insurance.

The practical effects of such a measure, apart from warm and fuzzy feelings in the hearts of sponsors Sen. Jane Cunningham and Birther Rep. Tim Jones and unnecessary legal costs for the State of Missouri, are still unclear. 

Leaving aside (for now) the facts that the latest post from Post-Dispatch's Jake Wagman

1. ignores Roy Blunt's actual record of big talk and little action for people with pre-existing conditions
2. ignores the incredible callousness of Blunt's suggestion that uninsured people with pre-existing conditions are folks "who’ve done nothing to take care of themselves," and
3. trivializes a substantive policy dispute into an opinion piece about "spin,"

I'm very intrigued by this new argument from Blunt:

He believes people will chose to go uninsured as long as they can because, according to him, the financial penalty for not having coverage is less than the cost of insurance.

“People will figure out quickly how to game this system,” Blunt said. “It’s not very complicated.”

A roundup of the stories in the last 12 hours:

• Talking Points Memo: Blunt Opposes Ending Discrimination Of Adults With Pre-Existing Conditions (VIDEO)
• ThinkProgress: Blunt rejects barring insurers from denying insurance to adults with pre-existing conditions
• The Prospect: Getting Blunt About Health Insurance.
• AMERICAblog: Missouri GOPer Roy Blunt wants to end pre-existing condition protections
• Washington Monthly: Blunt's Callous Pre-Existing Condition
• Digby: Number One Priority
• The Plum Line: Roy Blunt comes out against insuring adults with preexisting conditions
• Show Me Progress: Blunt's Flippy Floppies aren't the problem
• KC Star: Blunt opposes pre-existing medical condition protections for adults  

Greg Sargent of the Washington Post's WhoRunsGov.com:

Rep. Roy Blunt, in a video being circulated by the DSCC, appears to come out against insuring adults with pre-existing conditions, on the grounds that it would give people “every incentive” not to get insurance until they absolutely have to.

Dems point out that this is, as it happens, a pretty good argument in favor of the individual mandate.

Last June, Roy Blunt said it was very important to provide affordable coverage to people with pre-existing conditions.  In fact, it was his number one priority in a list of goals for his poorly-named "Health Care Solutions Group." He wrote:

The House Republican Health Care Solutions Group has been working for months on a plan... This process has resulted in the broad outline of a health care reform plan that the solutions group hopes will receive bipartisan support. The health care reforms outlined are designed to:

1. Make quality health care coverage affordable and accessible for every American, regardless of pre-existing health conditions.