On March 5th of last year, firefighter Travis Ulerick, of Dublin, Indiana, introduced President Barack Obama at a White House summit on health care. Upon hearing the first rumblings of dissent about the President’s plan, Ulerick tells USA Today he thought at the time: “I definitely think it’s going to have to be a huge consensus.” It’s now 12 months later, and the only consensus that exists among the American people is strong opposition to the President’s health care plan.The White House, however, is now completely uninterested in establishing a consensus for their health care plan before they jam it through Congress. Today, in a speech from the White House, President Barack Obama will urge Congress to move swiftly to pass his health care plan by implementing a legislative tactic that can be used to pass legislation that has failed to gain broad support among the American people. It’s known as reconciliation.
Reconciliation has been used in the past, but only for procedural reasons, not because the underlying policy change was unable to muster 60-vote support. So, for example, the 1996 welfare reform law signed by President Bill Clinton was passed through reconciliation, but it also ended up getting 78 votes in the Senate (28 of them from Democrats). President Ronald Reagan also passed seven bills through reconciliation, but every single one of those bills passed through a Democratically-controlled House and won Senate votes from both parties. Never has reconciliation been used to pass any bill on purely partisan lines.
In an attempt to provide some political cover for his nakedly-partisan health care push, President Obama released a letter yesterday identifying “four policy priorities” that “I am exploring.” Specifically he is “open” to: 1) random undercover investigations of health care providers that receive reimbursements from Medicare and Medicaid; 2) $50 million in cash for states that reform medical malpractice laws in ways the White House approves of; 3) increased spending on Medicaid; and 4) language that clearly allows Health Savings Accounts (HSAs) to qualify as health insurance.
The White House has not yet released any legislative language for any of these “policy priorities.” In fact, his letter does not even promise that whatever legislation the White House does eventually offer will contain language on each of these issues. He only says he is “exploring” the issues. This is beyond a sham of bipartisanship. Details matter. The American people must be allowed to see real legislative language and they must be allowed the time to read and comment on it before any votes are taken.
Most importantly, simply adding so-called conservative ideas to the bill does not change the fundamental direction of the proposal. The bills before Congress, including the President’s new additions, would still result in a massive shift of power over health care financing and delivery of care to Washington politicians and bureaucrats. The public has spoken, and it does not want a federal take over of health care.
Julia Denton of Yorktown, Virginia, another of the Obama administration’s hand-picked March 5 health summit attendees, tells USA Today: “The legislation as proposed is so long and tough to read that people are afraid of it. Health care is such a highly personal issue. I cannot see how anyone will win if unpopular reforms are forced through over vigorous opposition.” Denton is 100% correct. The American people should not have unpopular health care reform forced down their throats in the face of strong bipartisan opposition. At a bare minimum they should have the opportunity to see actual legislation from the White House and be allowed to speak to their members about it while they are home in their districts over Easter break.
Conservatives should continue to press the Administration and leaders in Congress for bipartisan solutions that are based on elements of common ground, including letting states take the lead on health reform, tackling the tax treatment of health insurance, sensible insurance market reforms, and an honest commitment to fixing existing health care programs that the government already controls.
For real bipartisanship to work, the President must set aside the current proposals that are based on consolidating power over health care in Washington and instead embrace solutions that would give individuals and families more control over health care dollars and decisions. Simply adjusting the magnitude of the existing proposals or adding so-called conservative provisions does not change this fundamental direction.
Quick Hits:
- Twice as many Texans voted in the Republican Gubernatorial primary election than in the Democratic primary. The reverse was true in the 2008 Presidential primary.
- Ethically-challenged Rep. Charles Rangel (D-NY) is still chairman of the Ways and Means Committee, but he will be taking a “leave of absence” until the investigation is over.
- Oral arguments at yesterday’s Supreme Court hearing on a gun control case suggest the majority seems willing to extend the Second Amendment’s right to keep and bear arms to the states.
- After a slew of scandals and polls showing the number of Americans who believe that climate change is a scientific conspiracy has more than doubled since 2008, scientists now realize they are facing a crisis of public confidence.
- Privately-owned Ford Motor Co. surpassed Obama administration-owned General Motors Co. in sales last month for the first time in at least 50 years
Behind closed doors, the House and Senate leaders are trying to cobble together very different and complex provisions of their respective bills.
A key issue is the impact of the public plan, a government run health plan intended to compete against private health plans. In the House version of the bill (H.R. 3200), payment to doctors and hospitals will be pegged to Medicare rates. Specifically, the bill calls for payment for medical services to be set at Medicare payment levels with a 5 percent increase for only certain physicians.
In the aftermath of the debate on physician payment updates, much of the media focus has been on the impact on doctors. But what is often overlooked is that while doctors could lose income, there are many areas of the country where the expansion of Medicare payment for hospitals would cause many hospitals to go broke.
If millions of Americans are moved from private insurance to public coverage, with the introduction of a Medicare-like public plan and a massive Medicaid expansion, once reform is fully implemented annual reimbursements to hospitals could be reduced by $63.7 billion. Overall, if reform were to include a “strong” public option available to individuals and employers of all sizes, hospitals could see their total net income fall by $61.9 billion, which would essentially eliminate hospitals’ yearly margins. Although many hospitals would see their profits dry up, the effects would be even more pronounced in certain states.
The Maine Example. Hospitals in Maine, for example, could see their net annual income fall by $694.4 million, with hospital total margins dropping to negative 12.1 percent. This loss in hospital income in Maine would be greater than total hospital margins and it would be overwhelmingly attributable to the creation of a new Medicare-based public plan.
Today, Medicare hospital payments in Maine are 54 percent of the private payments in the state. So, the fact is this: if Congress’s health reform plan tries to expand coverage in a way that heavily relies on insufficient below-market payment levels, like the rates used in the Medicare and Medicaid programs, it would hurt—not help—most hospitals. Of course, this radically increased reliance on Medicare style administrative pricing could ultimately compromise the broad access to high-quality care that most Americans currently enjoy.
For further information on the impact of the public plan on doctors and hospitals, see http://www.heritage.org/research/healthcare/upload/lewin_public_plan_national_all.pdf