Yes, Virginia, There Is Health Care Reform, or, What Would Jesus Repeal?

Health insurance reform has passed Congress and been signed into law by President Obama, ushering in the most sweeping overhaul of health care in over a generation. So what happens now? I think it is instructive to look at two questions. First, Republicans are loudly clamoring for repeal. Can it happen? Second, what parts of this law are so egregiously un-American and unconstitutional that they would merit immediate repeal lest the Nation fall by sundown?

Republicans are already banging the drum to repeal the new health insurance reform law. Reps. Steve King (R-IA) and Michele Bachmann (R-MN) have introduced one-page bills to repeal the entire Act. Six senators and forty-six representatives have already signed the Club for Growth’s repeal pledge, along with almost 200 congressional candidates. Republican presidential hopeful Mitt Romney is even calling for repeal – an interesting pivot from signing a very similar law when governor of Massachusetts. But is this real, or just bluster?

Firstly, it will not happen before 2011 in this Congress, because if you don’t have the votes to stop something from becoming law, then you don’t have the votes to repeal it. Secondly, after such a battle to pass the law, any partial or full repeal would be vetoed by President Obama, and Republicans and lack the votes to override a veto. Gaining enough votes in Congress to override a veto before the end of Obama’s first term would require Republicans to pick up 25 Democratic seats in the Senate plus Sen. Joe Lieberman (I-CT), or 26 seats without him. As there are only 16 Democrats up for re-election in the Senate in 2011, this is an impossible feat. Further, Republicans would have to win over at least 113 seats in the House in 2011, a number not approached since the Republicans lost 100 seats in the 1932 election at the end of the disastrous Hoover administration.

But now that it is clear why repeal won’t happen, let us humor Republicans for the moment and imagine that it could. Just what parts of this bill are so socialist, Marxist, communist, or any other -ist that they pose a threat to freedom, democracy, apple pie, baseball, and the future of America?

• Alabama’s PACT (Pre-pay a Child’s Tuition) college funding program is on the verge of collapse. The jobless rate for college-age veterans is over 21%, and for other college-age adults is 16.6%. Many young adults are still living at home or depending on their families as they try to pay for college or find a job. Does Rep. Parker Griffith (R-AL 05) want to repeal the right to keep their children on their family insurance until they turn 26 for the thousands of middle class families in his district – many of whom rely on the Defense Department for their livelihoods?
• Nearly 15% of the residents of northwestern North Carolina are “lacking the resources to meet the basic needs for healthy living; having insufficient income to provide the food, shelter and clothing needed to preserve health.” Many of them rely on the help of six community health care centers that care for the poor and medically underserved. Does Rep. Virginia Foxx (R-NC 05) want to repeal the nearly $8 million in federal assistance for community health centers?
• More than one-fifth of the residents of Florida’s 16^th district are Medicare beneficiaries. Currently, these 171,000 seniors and other Medicare-eligible residents are responsible for $4,550 in true out-of-pocket prescription drug expenses before catastrophic coverage kicks in. Does Rep. Thomas Rooney (R-FL 16) want to repeal the elimination of the Medicare Part D doughnut hole over the next decade, costing the seniors of his district millions of dollars out of pocket, and forcing them to continue to decide between medicine, food, and other necessities?
• Millions of Americans are uninsured and have pre-existing conditions like cancer and heart disease, including 16,000 residents of northwest Texas. For-profit insurance giants will not provide coverage to these citizens because there isn’t any money to be made in caring for them. As a result, some of these uninsured adults and children cannot get the care they need, and they die. Does Rep. Randy “Baby Killer” Neugebauer (R-TX 19) want to repeal guaranteed coverage for individuals with pre-existing conditions, or does he want private for-profit insurers to continue to have the right to deny care, allowing uninsured individuals, including babies, to die?
• More than half a million residents of Minnesota’s 6^th district are insured through their employers or have purchased their own insurance. While this district has one of the highest rates of insurance in the country, its citizens are still subject to lifetime coverage limits, rescissions, rejections for pre-existing conditions, and wasteful private insurer spending. Does Rep. Michele Bachmann (R-MN 6) want to repeal prohibitions on annual and lifetime coverage limits, and prohibitions on rescissions when policy holders get sick and need their insurance the most, and prohibitions on denials for pre-existing conditions, and limits on company administrative spending and profits?
• Hundreds of thousands of families face financial ruin every year, having to file for bankruptcy because of uncovered health care costs. Part of this is due to policies of for-profit insurers, raising premiums by a third or more annually, and dropping policyholders when they get sick. Around 1,700 of these bankruptcies were in Nevada’s 2^nd district, comprising most of the state outside of Clark County. Does Rep. Dean Heller (R-NV 2) want to repeal caps on annual out of pocket costs for those insured in exchanges or through private business, and bans on annual and lifetime limits?
• New deficit hawks who have suddenly seen the light now that Iraq is occupied and George Bush is out of office – Republicans like Texas’ Jeb Hensarling (R-TX 5) – are beside themselves with glee at the political points to be scored from Obama’s deficit spending. They never mind the fact that the spending is necessitated by the circumstances of the country created by eight years under Bush. So if he really cares about the deficit, does Rep. Hensarling want to repeal health insurance reform that helps millions, improves lives, keeps families together and healthy, while reducing the deficit by $130 billion in the next ten years, and by over a trillion dollars in the next twenty years (depending on GDP growth)?

So which of these will it be?

Remember when Trigger was just a horse?

The health insurance reform bill changes so often and so quickly, even within the same day, that an overwhelming sense of déjà vu has set in. Ideas that we thought were dead and buried are back again, making us wonder - is this a new idea, or haven't we heard this one before. Today, from McClatchy, it is the trigger:

Senate Majority Leader Harry Reid, D-Nev., last week said he'd move ahead with a plan that allows states to opt out within the first year, but that's failed so far to stir the eight to 12 moderates whose votes are crucial.

Gaining support is the idea of a "trigger," where the public option only would be permitted if private insurers fail to lower costs. There are lots of other ideas, however.

Only if they fail to lower costs? Kaiser Family Foundation:



In the decade just ended, premiums increased 131%, and worker contributions increased 128%, compared against a 28% rate of inflation or 38% wage increases over the same time period.

In the United States, we spend more money per person on health care than any other nation in the world. And yet, in measure after measure, we trail most industrial nations and many developing nations in health outcomes. Without government intervention, there is nothing to stop insurance companies from continuing to loot the pockets of American workers. They have shown no willingness or ability to lower premiums year after year over a long period of time. So why should we wait even longer for them to show even more years of incompetence and avarice before a government-mandate intervention can be triggered?

In fact, public insurance companies have billions - yes, billions - of reasons to continue pushing premiums up, paying executive performance bonuses, and make no efforts to cut costs or ease the pressure on working Americans.

Company	Enrollment	Outstanding Shares
UnitedHealth Group	30,300,000	1,162,420,963
WellPoint	35,300,000	484,639,194
Aetna	17,700,000	442,800,000
Humana	8,400,000	169,657,445
CIGNA	11,900,000	272,704,706
TOTAL	103,600,000	2,532,222,308

These billions of shares have to receive dividends - profits on the backs of the diseases, disorders, illnesses, and deaths of other Americans. We don't need a trigger. We don't need to wait for more evidence that these health insurance companies are unwilling and incapable of controlling costs. We can see the problem clear as day. But too many people in power are too weakened by money and corruption to do the right thing.

Exhibit A: Sen. Blanche Lincoln (D-AR). She is facing a tough re-election fight in a rare reddening state. When she is not busy being the pawn of Wal-Mart or Tyson (which is not often), she has the freedom to choose for herself what is best for her re-election chances - er, the people of Arkansas. Here is what those people told her this week - Progressive Change Campaign Committee (MOE 4%):

QUESTION: Would you favor or oppose the government offering everyone a government administered health insurance plan -- something like the Medicare coverage that people 65 and older get -- that would compete with private health insurance plans? (Wording of NYT poll)

	FAVOR	OPPOSE	NOT SURE
ALL	56	37	7

QUESTION: If Blanche Lincoln votes against a public option as part of health care reform, will that make you more likely or less likely to vote for her in the 2010 general election or would it have no real effect on your vote?

	MORE	LESS	NO EFFECT
ALL	16	29	55

QUESTION: If Blanche Lincoln joined Republican senators in filibustering and killing a health care reform bill because it had a public health insurance option, would that make you more likely or less likely to vote for her in the 2010 general election or would it have no real effect on your vote?

	MORE	LESS	NO EFFECT
ALL	15	32	53

A clear majority of Arkansans favor a plan like Medicare for all. And when it comes to the question of whether Lincoln should oppose a public option (-13) or join Republicans in "filibustering"* (-17), the affect on voters is similar enough to fall within the margin of error. Yet in this rare alignment of planets - the right thing to do AND the will of the electorate - Lincoln still seems to be in search of her spine. (So does her colleague Mark Pryor - he's not even up for re-election this time, but is still saying he will be guided by what Lincoln does.)

[* - until "filibusters" look like this again, I'll be using the quotation marks.]

And why is Lincoln still searching for her spine? Because in the 2009-2010 election cycle, only two people in the entire country have taken more from the health industry than Blanche Lincoln's $427,950 - Sen. Harry Reid (D-NV) and Senate candidate and former governor Charlie Crist (R-FL).

Blanche - get off the fence and out from in front of the cameras, and do the right thing. Who knows? It might just get you re-elected.