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Obamacare 2010 a/k/a “Penalize, Overcharge, Deprive, Let 'em Die": Part 2 –- Reconciliation Roundup


[Several websites where the following info was drawn from listed at end.]

Where We are Now – A Summary

The Senate Bill will go through the “reconciliation process” with the House version that was passed in November.

Both houses will vote on it and the President will try to sign off on it by the time of the State of the Union address in late January.

The President is leaning it is said toward the Senate rather than House bill, especially in terms of the funding. [tax on middle class insurance benefits rather than on wealthy income.]

The Biggest Dispute for Reconciliation -- Funding

The House wants to increase income taxes and fund health care by taxing individuals making more than $500,000 and couples earning over $1 million. This would generate $460 billion over 10 years.

The Senate wants to tax insurance companies (which would be passed on to middle class consumers) on plans valued over $8500 for individuals and $23,000 for couples. This would raise $150 billion. [a 40% excise tax on “high value” plans will affect up to 20% of union plans in 2014, and nearly 100% of such plans by 2025. It will influence employers to reduce benefits and shift costs to employees.] [There is a Senate amendment that exempts certain “high risk” occupations, which are male-dominated. Once again, there is a gender imbalance in the bill, after the horror of the abortion rights restrictions.]

Other House Bill vs. Senate Bill Issues

Public Option:
The public option has been dropped from the Senate plan and is drastically watered down in the House plan. The Senate bill includes a provision under which the federal Office of Personnel Management would oversee at least one national, non profit plan in the exchange.

Mandated Purchasing:
The bills mandate people without insurance purchase it or be penalized.

Both bills offer subsidies to lower and middle income people but the House bill is more generous. Both bills provide subsidies to buy health insurance for people who earn up to 400 percent of the poverty level ($43,320 for an individual, or $88,200 for a family of four). The lower your income, the higher your subsidy. The subsidies in the House bill, however, are more generous than those in the Senate bill.

Both establish exchanges where some citizens can shop and compare insurance plans. The House sets up nationally run exchanges, the Senate sets up state oversight. [A national plan would give residents of less social-servicing states access to the same quality of coverage as everyone else.]

Pre-existing conditions:
Both bills ban pre-existing health conditions.

Abortion Restrictions:
They differ over how to restrict taxpayer funding for abortions. Stupak amendment in House Bill. In Senate Bill Nelson’s inclusion to allow individual states to prohibit abortion coverage in all plans offered through the exchanges. [the anti-abortion restrictions undercut union negotiations for member plans.]

Illegal Immigrants Restrictions:
They differ over whether illegal immigrants should be allowed to buy coverage in the new markets with their own money. The Senate forbids undocumented immigrants from getting low-income insurance subsidies. It demands citizenship verification so that no immigrant can purchase insurance through an exchange. The House bill forbids coverage through subsidies but allows undocumented immigrants to purchase through exchange with own money. [This Senate rule will eliminate healthy young immigrants donating to risk pool which would help raise funding, and would continue costly emergency room visits]. [empowering the Joe Wilsons in government]

Start Up Dates and Scope of Coverage:
House begins plan in 2013, Senate in 2014. The House bill covers 35 million uninsured Americans over 10 years, costing more than $1 trillion, while Senate bill, cheaper, covers 31 million. By 2014 when the bill will be in full effect, a minimum of 24 million people will remain uninsured. This is considered a minimum number destined to increase as costs escalate maybe two or three times faster than working people’s incomes. [keep in mind the premature deaths happening now and that will continue to happen through 2013 or 2014 and beyond. Right now 45,000 a year. Medicare was passed in 1964 and up and running in 1965]

Anti-trust Exemption:
The Senate sustains the insurers’ antitrust exemption, the House doesn’t. The House voted to make insurance companies subject to same anti-trust regulations of other private corporations. The Senate bill also gives insurance companies for the first time permission to sell policies across state lines. Cut-rate plans will be offered from “low regulation” states.

Medicaid Expansion:
The Senate bill expands eligibility for Medicaid and ends the disparity between states, which set their own at times grossly unjust eligibility levels. The Senate will cover 12 million people, the House 15 million.

Insurance Vouchers:
Sen. Wyden of Oregon has long advocated moving from an employer-based system and proposed an amendment that would allow people to take an insurance voucher equal to employer coverage and go to the exchange and apply it there. It is limited to certain income levels. It would be impactful if it survives the conference.

Regulation of Medicare:
The Senate bill supports a toothless version of a Medicare Commission, the House a stronger one. This independent commission would oversee Medicare if it were allowed the authority and freedom. Both houses are reluctant to cede substantial power to such a commission.

Drug Sweetheart Dealing:
In the Senate bill the pharmaceutical industry won 12 years of patent protection for certain classes of drugs, many of which were developed using public funding. The Senate rejected a proposal to allow the re-importation of prescription drugs from Canada.

Miscellaneous Advantages for the Insurance Companies

There are few provisions to keep health care affordable.

There are few provisions to prevent waste and fraud.

Insurance companies can charge more based on age.

Insurance companies can continue to rescind policies after they have been written (often using fraud or intentional misrepresentation as pretext)

Insurance companies can cherry-pick new customers and limit payments for catastrophic illnesses.

Insurance companies can refuse to allow policyholders from choosing their own doctors and hospitals.

Insurers can charge up to four times more for policies based on age plus certain conditions, double charge for people failing “wellness” programs because of diabetes, blood pressure, cholesterol, etc.

Exempting state protections passed by allowing insurers now to set up in less regulated states.

Extorted Pork and Sabotage by Senators at Eleventh Hour with Senate Bill

Senator Landrieu got $100 million in extra Medicaid funding,

Senator Ben Nelson was granted a complete exemption from Nebraska payments into enhanced Medicaid benefits

Senator Baucus won automatic Medicare eligibility for asbestos-exposed citizens of Libby, MT (after blocking expansion of Medicare everywhere else in America)

Senator Ben Nelson added anti-abortion language into the final draft that will allow individual states to prohibit abortion coverage in all plans offered through the exchanges.

Senators Baucus and Lieberman prevented a Medicare buy-in for those 55+, eliminating any trace of a public option sensibility in the Senate bill.


Peter Mahr on Single Payer:

My frustration doubles when I realize that there is a viable, efficient and affordable alternative to health care financing that could be enacted tomorrow. With a system of national health insurance, we could cover 100 percent of Americans at a dramatically reduced cost for families, businesses and our country. Under a national health insurance plan everyone pays into the insurance pool via progressive income or payroll taxes.

Let's call this our premiums. Then, when we are sick and go to the doctor or have a surgery, the doctor or hospital gets paid from the money in the pool. It is not socialized medicine: Doctors and hospitals continue treating patients as before. They remain private and autonomous.

Since a national health insurance system eliminates the profit motive, as well as the advertising and executive pay associated with private insurance and slashes burdensome and expensive administration on the doctor and hospital level, it would finance access to health care for all while reducing costs dramatically.

[Again, please help “kill the bill”. Toll-free switchboard numbers for the Senate and House: 1-800-828-0498, 1-866-338-1015, 1-866-220-0044.

Contact info for Senators or Representatives here:

To send letters:

Senate Office Building
Washington, D.C. 20510


House Office Building
Washington, D.C. 20515

Please join this vital fight now. As the adage goes, if we are not part of the solution, we are part of the problem. And consider Edmund Burke’s powerful message, also, about how evil prevails when good people do nothing.]

Informational websites:

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