MARCH 21, 2010
House Passes Healthcare Reform Measure By 219-212 Tally
In what media reports and analyses are casting as a historic development and a major win for President Obama, the House Sunday night passed the Senate-approved healthcare reform measure by 219-212. The AP (3/22) notes that after passing the bill, the House proceeded to approve "key changes" to it, "part of a prearranged agreement to guarantee passage of the historic legislation. The changes passed by a 220-211 vote. That bill now goes to the Senate for final approval, where it only requires a simple majority to pass."Most stories are describing the bill in largely favorable terms -- and the vote as a triumph of the political system as a whole. The vote, reports USA Today (3/22, Wolf, Fritze), "assured that about 32 million Americans will gain health insurance coverage, and millions more will win protections against losing theirs." The Los Angeles Times (3/22, Levey, Hook, Silva, Muskal) reports that "House Democratic leaders proved they could hold the majority caucus together," though "thirty-four Democrats opposed the bill, as did all Republicans." An AP (3/22, Woodward) story observes, "Rarely does the government, that big, clumsy, poorly regarded oaf, pull off anything short of war that touches all lives with one act, one stroke of a president's pen. Such a moment has come."
It was, Bloomberg News (3/22, Litvan, Rowley, Jensen) notes, "the most sweeping US healthcare legislation in four decades," and "the biggest victory yet for...Obama." The AP (3/22, Espo) notes that the President "watched the vote in the White House's Roosevelt Room with Vice President Joe Biden and about 40 staff aides. When the long sought 216th vote came in -- the magic number needed for passage -- the room burst into applause and hugs. An exultant president exchanged a high-five with his chief of staff, Rahm Emanuel."
The Hill (3/22, Swanson, subscription required) notes that the President addressed the nation saying, "Tonight, at a time when the pundits said it was no longer possible, we rose above the weight of our politics. ... This is what change looks like."
The Los Angeles Times (3/22, Nicholas) reports, "Rarely does a president bet everything on a single card, but...Obama did it on healthcare," and "what became clear in the...debate is that Obama is a president with a combative stubbornness, one that was not often visible in his cool, above-the-fray public demeanor."
In a front-page story, the New York Times (3/22, A1, Bernard) reports, "The uninsured are clearly the biggest beneficiaries of the legislation, which would extend the healthcare safety net for the lowest-income Americans." Meanwhile, "for people already covered by a large employer -- most Americans, in other words -- the effect would not be as significant. And yet, just about everyone might benefit from tighter insurance regulations." The Times adds, "There is no question that the legislation should benefit consumers in various ways." In a separate front-page story, the New York Times (3/22, A1, Pear, Herszenhorn) notes that "Democrats hailed the vote as historic, comparable to the establishment of Medicare and Social Security and a long overdue step forward in social justice."
McClatchy (3/22, Lightman, Douglas) says that "within a year, insurers" will "be barred from denying coverage to children because of pre-existing conditions, imposing lifetime limits on coverage and dropping people from coverage when they get sick." The bill also "provides more help with insurance premiums for lower- and middle-income consumers and expands Medicaid funding to states."
Battle Moves To Senate, Courts.
Politico's (3/22) Carrie Budoff Brown, in a blog entry, reports that "the Senate is preparing to take up the package of fixes to the Senate bill as early as Tuesday, according to Majority Leader Harry Reid's spokesman, Jim Manley." However, "Senate Democrats and Republicans still need to sit down together with the parliamentarian to review the list of potential items that could be subject to the Byrd Rule -- a step that precedes the consideration of a reconciliation bill."The New York Times (3/22, A17, Zeleny, Stolberg), meanwhile, reports, "The next chapter in the healthcare fight will play out not only in the midterm elections, but also in the courts. Attorneys general in three states -- Virginia, Florida and South Carolina -- have indicated they will file legal challenges to the measure, on the grounds that it violates the Constitution by requiring individuals to purchase insurance." In an interview, Virginia attorney general Ken Cuccinelli "said he intended to base his challenge on two grounds: that the federal bill conflicts with a newly passed state law that says no Virginian may be compelled to buy insurance and that Congress does not have authority to impose the mandate." Meanwhile, "the White House and Democrats were preparing to counter the legal arguments and coordinate a state-by-state response to any prospective challenges."
Obama To Launch "Immediate Public Relations Blitz."
The Washington Post (3/22, Shear) reports that the President "is set to begin an immediate public relations blitz aimed at turning around Americans' opinion of the healthcare bill," with the White House asserting that "Republicans have boxed themselves into a corner with unanimous opposition to the legislation and talk of a repeal." White House communications director Dan Pfeiffer tells the Post, "The Republicans have way overshot the runway in their criticism of health reform." The Post adds that "White House officials say that Obama will not make healthcare reform a daily topic during the rest of the year," but "officials said there will be several key moments before November's elections when popular parts of the healthcare legislation...will take effect. Obama will build high-profile public events around those moments, they said."On its front page, the New York Times (3/22, A1, Sanger) reports that "at the core of Mr. Obama's strategy stands a bet that the Republicans, in trying to portray the bill as veering toward socialism, overplayed their hand," and that "armed with a specific piece of legislation that offers concrete benefits to millions of people -- and that promises to guarantee insurance for many who found it unaffordable or unattainable -- the White House and Democrats...have gained the upper hand."
The New York Times (3/22, A17, Zeleny, Stolberg) also reports that "Democrats were also beginning to form a permanent campaign, of sorts, to follow the bill through its various stages. Party strategists studied the public's reaction to Medicare -- it was not immediately positive -- and were trying to create a friendlier climate for Mr. Obama when he faces voters again. "
Politico (3/22, Thrush, Lee) reports that the "win" for Obama "was a split decision for Democrats, not a knockout." While the vote "provides an immense and immediate boost" for the President, House Democrats "were more relieved than overjoyed -and many may have been casting votes, on a warm spring night, for their own political extinction."
Politico (3/22, Isenstadt) also reports that some members "may have signed their own political death warrant" by supporting the health bill: "The most immediate blowback from the votes will be felt by Democrats in marginal and conservative-minded districts. ... Members in this category include Reps. Harry Mitchell of Arizona, Chris Carney of Pennsylvania and Baron Hill of Indiana, each of whom was elected in the 2006 Democratic wave and represents a seat that George W. Bush carried twice. ... Some veterans -- among them nine-term Rep. Earl Pomeroy, who hails from solidly Republican North Dakota, and West Virginia Reps. Alan Mollohan and Nick Rahall -- will also feel the heat." Then "two first-term women...stand out for being in extreme jeopardy: Florida Rep. Suzanne Kosmas and Colorado Rep. Betsy Markey."
HHS Expected To Take Lead Role In Implementing Health Reform.
Bloomberg News (3/22, Nussbaum) analyzes how healthcare reform will be put into action, and what role the HHS will have in that. Bloomberg notes that in 2011, health insurers will "owe a rebate to customers if the insurers spend less than 80 percent on benefits for people in individual or small-group plans." According to Carl McDonald, an Oppenheimer & Co. analyst, "How heavy a burden that imposes on industry will depend on" HHS. McDonald said, "Over the next couple of years, HHS will be consistently churning out regulations and documents explaining exactly how health reform will be implemented. ... Given the stance of this administration toward health insurers over the past year, it's hard to see how much of this will be favorable." He said that HHS Secretary Sebelius "will have the final verdict."Washington Times Decries "Socialist" Healthcare Reform Measure.
The Washington Times (3/22) editorializes, "The government takeover of healthcare will go down in history as the worst piece of legislation to emerge from a Congress held in general disdain by the American people." The Times argues that the "socialist" healthcare measure is not "one of the biggest deficit reduction measures in history," as President Obama argues. Obama's statement "contradicts the chief actuary at the Centers for Medicare and Medicaid Services, who says his staff currently has no idea what the impact of the plan is 'due to the complexity of the legislation.'" The Times concludes that "once voters have a chance to tell the most irresponsible government in American history that enough is enough, the Democrats' brief reign will expire, and be deemed death by suicide."Florida Lawmakers Planning Large Changes To Medicare, Medicaid.
The Orlando Sentinel (3/21, Deslatte) reported that "Florida's Republican legislative leadership is laying the groundwork for seismic changes to how the state pays for the healthcare of the poor, sick and elderly." Some "conservatives in the Legislature think they can save $27 million by expanding a controversial Medicaid reform plan passed in 2005 from Broward County and the Jacksonville region to 19 additional counties, including Metro Orlando." The plan involves "shifting from a fee-for-service method...to managed care where patients would choose between HMO-styled plans, earn extra credit for healthy living, and theoretically spend less time in emergency rooms." The Florida Senate's budget would shift "up to 375,000 people...from their current doctors into HMOs or doctor and hospital networks known as PSNs where some services and specialties could be lost."Baltimore City Employees To Pay Part Of Prescription Drug Premium.
The Baltimore Sun (3/20, Scharper) reported that Baltimore city "employees would pay a tenth of the cost of their prescription drug plan premium under a proposal that would shave as much as $6.5 million from the city's deficit next year and twice as much in subsequent years." Baltimore budget director Andrew W. Kleine said that the "charge could offset layoffs of as many as 350 employees. ... The city is expected to pay more than $100 million for the prescription plan for the coming budget year, about a 10 percent jump from last year's cost."Rep. Giffords Asks Sebelius If Arizona Will Lose Medicaid Funding.
The Sierra Vista (AZ) Herald (3/22) reports, "US Rep. Gabrielle Giffords (D-AZ) is asking the Department of Health and Human Services for guidance about potentially devastating cuts to Medicaid as a result of the state budget approved by the Arizona Legislature and Gov. Jan Brewer (R)." Giffords requested HHS Secretary Sebelius to "clarify whether Arizona could lose $7 billion in federal funding as a result of the cuts that were signed into law on March 18." Those cuts will "eliminate KidsCare, making Arizona the first state in the nation to cancel its State Children's Health Insurance Program."Long-Term Care Provision In Health Reform Bill Discussed.
The Wall Street Journal (3/22, Mathews, subscription required) reports that now that the healthcare bill has been passed, Americans must seek to understand how the legislation will impact them. The Journal notes that many provisions of the bill will not take effect until 2014. Meanwhile, John Rother, executive vice president of AARP, says that one of the most important provisions in the bill is the long-term care benefit. Consumers will not be able to select this option until 2011 at the earliest, and then they must pay premiums for a minimum of five years before they can qualify for benefits. Rother also points out that the measure will not provide 24-coverage; therefore, insurers will likely develop some sort of gap insurance for users of long-term care.Many Patients Found To Be Hitting Healthcare Costs Caps.
The Chicago Tribune (3/20, Gabler) reported on patients with "the increasingly common predicament of having too little insurance to cover [their] healthcare costs." Currently, "many health insurance plans have annual or lifetime caps, and medical costs can easily exceed the limits after a diagnosis of cancer or another serious illness. The health reform legislation before Congress takes aim at that shortcoming by banning plans with these caps, though some annual caps could be permitted until 2014." The Tribune focuses on the story of Jim Rudd, a patient with leukemia who has reached the $50,000 yearly cap on his healthcare costs, and must find a hospital that will ignore his annual cap.New York City Clinic Offers Unlimited Visits For $79-A-Month.
In the City Critic column in the New York Times (3/20, MB4), Ariel Kaminer described the AMG Medical Group, a New York City clinic chain that "offers a $79-a-month buffet of unlimited office visits." That fee "covers, among many other things, lab tests, vaccinations, stitches, Pap smears, X-rays and minor surgeries like mole removal and a lumpectomy." The model "is unusual enough to have attracted the attention of the New York State Insurance Department, which last year informed AMG that it could not continue to offer the $79 plan," so as a compromise, AMG "agreed to charge $33 extra for sick visits."
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