Universal Health Care for America

February 20, 2010

From time to time, Congress makes use of a special procedure outlined in the Congressional Budget Act known as “reconciliation.” This procedure was originally designed as a deficit-reduction tool, to force committees to produce spending cuts or tax increases called for in the budget resolution. However, it was used to enact tax cuts several times during the George W. Bush Administration, thereby increasing projected deficits.

* What is a reconciliation bill? A reconciliation bill is a single piece of legislation that typically includes multiple provisions (generally developed by several committees) all of which affect the federal budget — whether on the mandatory spending side, the tax side, or both. A reconciliation bill, like the budget resolution, cannot be filibustered on the Senate floor, so it only requires a majority vote to pass.

* How does the reconciliation process work? If Congress decides to use the reconciliation process, language known as a “reconciliation directive” must be included in the budget resolution. The reconciliation directive instructs a committee to produce legislation by a specific date that meets certain spending or tax targets. (If they fail to produce this legislation, the Budget Committee Chair generally has the right to offer floor amendments to meet the reconciliation targets for them, a threat which usually produces compliance with the directive.) The Budget Committee then packages all of these bills together into one bill that goes to the floor for an up-or-down vote, with only limited opportunity for amendment. After the House and Senate resolve the differences between their competing bills, a final conference report is considered on the floor of each house and then goes to the President for his signature or veto.

* Constraints on reconciliation: the “Byrd rule.” While reconciliation enables Congress to bundle together several different provisions affecting a broad range of programs, it faces one major constraint: the “Byrd rule,” named after Senator Byrd of West Virginia. This Senate rule makes any provision of (or amendment to) the reconciliation bill that is deemed “extraneous” to the purpose of amending entitlement or tax law vulnerable to a point of order. If a point of order is raised under the Byrd rule, the offending provision is automatically stripped from the bill unless at least 60 senators vote to waive the rule. This makes it difficult, for example, to include any policy changes in the reconciliation bill unless they have direct fiscal implications. Under this rule, authorizations of discretionary appropriations are not allowed, nor are changes to civil rights or employment law, for example. Changes to Social Security also are not permitted under the Byrd rule.

In addition, the Byrd rule bars any entitlement increases or tax cuts that cost money beyond the five (or more) years covered by the reconciliation directive, unless these “out-year” costs are fully offset by other provisions in the bill. This is one reason that Congress made the 2001 tax cuts expire after ten years, rather than making them permanent.

In short, the annual federal budget process begins with a detailed proposal from the President in February; Congress next develops a blueprint called a budget resolution that sets limits on how much each committee can spend (or reduce revenues) over the course of the year; and the terms of the budget resolution are then enforced against individual appropriations, entitlement bills, and tax bills on the House and Senate floors. In addition, Congress sometimes uses a special procedure called “reconciliation” to facilitate the passage of deficit reduction legislation or other major entitlement or tax legislation. Finally, a companion PAYGO rule helps ensure that tax cuts and entitlement increases are paid for and do not add to the deficit.

February 20, 2010

s The White House Crafts A Reconciliation Bill, Senate Democrats Have Called Using The Procedure For Health Care “An Outrage,” “A Nonstarter,” “A Real Mistake,” “Very Ill-Advised,” “The Worst”

WHITE HOUSE WRITES “RECONCILIATION” HEALTH CARE BILL: “Democratic officials said the president’s proposal was being written so that it could be attached to a budget bill as a way of averting a Republican filibuster in the Senate. The procedure, known as budget reconciliation, would let Democrats advance the bill with a simple majority rather than a 60-vote supermajority.” (“Obama To Offer Health Bill To Ease Impasse As Bipartisan Meeting Approaches,” The New York Times, 2/19/10)

18 Senate Democrats On The Record Opposing Reconciliation For Health Care

SEN. HARRY REID (D-NV): “I’m Not Using Reconciliation.” (“Reid On Passing Health Care: 'I'm Not Using Reconciliation',” TPMDC, 11/19/09)

SEN. KENT CONRAD (D-ND): “I Don't Believe Reconciliation Was Ever Intended For The Purpose Of Writing This Kind Of Substantive Reform Legislation Such As Health Care Reform.” “I have said publicly and privately what I believe. I don't believe reconciliation was ever intended for the purpose of writing this kind of substantive reform legislation such as health care reform, such as climate change.” (Sen. Conrad, Congressional Record, S.3957, 3/30/09)

SEN. ROBERT BYRD (D-WV): Reconciliation On Healthcare “An Outrage That Must Be Resisted.” “I was one of the authors of the legislation that created the budget ‘reconciliation’ process in 1974, and I am certain that putting health-care reform and climate change legislation on a freight train through Congress is an outrage that must be resisted.” (“The End Of Bipartisanship For Obama’s Big Initiatives?” The Washington Post, 3/22/09)

SEN. JAY ROCKEFELLER (D-WV): “Reconciliation Is A Nonstarter … It Doesn’t Work. ... It Opens Itself Up To An Endless, Unstoppable Number Of Amendments, Which They Will Have Lined Up, 800 Amendments, Whatever It Is.” (“Rockefeller Dismisses Reconciliation As An Option For Health Care Reform,” Roll Call, 11/17/09)

SEN. BLANCHE LINCOLN (D-AR): “I Will Not Accept Any Last-Minute Efforts To Force Changes To Health Insurance Reform Issues Through Budget Reconciliation, And Neither Will Arkansans.” (“Dem Impasse On Health Bill Continues,” Politico, 1/27/10)

SEN. BYRON DORGAN (D-ND): “We Shouldn't Stretch Reconciliation For … Health Care.” “Sen. Byron Dorgan (D-N.D.), an appropriator, said today it would be ‘highly unusual’ to use reconciliation for climate change or health care legislation. ‘We shouldn't stretch reconciliation for climate change or health care,’ he said. ‘It would be very hard to justify.’” (“Democratic Senators Not Ready To Embrace Reconciliation,” CongressNow, 3/17/09)

SEN. JOE LIEBERMAN (I-CT): “I Think It's A Real Mistake To Try To Jam Through The Total Health Insurance Reform, Health Care Reform Plan That The Public Is Either Opposed To Or Of Very, Very Passionate Mixed Minds About.” (CNN’s “State Of The Union,” 8/23/09)

MARY LANDRIEU (D-LA): “Was Intended For Deficit Reduction, And It Should Not Be Used For Other Things.” (“Why The Democrats Can't Govern,” The New Republic, 4/15/09)

SEN. EVAN BAYH (D-IN): “Very Ill-Advised.” (“Nelson, Bayh Warn Against Reconciliation,” Politico, 1/26/10)

SEN. MAX BAUCUS (D-MT): “It’s Not A Good Idea.” “‘Reconciliation tends to be partisan,’ Senate Finance Chairman Max Baucus said. ‘It's not a good idea.’” (“Dems Resistant To Using Reconciliation For Climate Bill,” Congress Daily AM, 3/11/09)

SEN. RUSS FEINGOLD (D-WI): “It Wasn't Appropriate Then; It Isn't Appropriate Now.” “Reconciliation is intended for legislation that reduces the deficit. I have strongly opposed past efforts to use reconciliation to address policy matters, such as drilling in the Arctic National Wildlife Refuge. It wasn't appropriate then; it isn't appropriate now.” (Sen. Feingold, Congressional Record, S.4289, 4/2/09)

SEN. CLAIRE MCCASKILL (D-MO): “Missouri Sen. Claire McCaskill Said … She Was ‘Not Open’ To Using The Maneuver For A Comprehensive Fix To The Senate Bill. And regarding the more narrow, two-step process envisioned by Democratic leaders, McCaskill said: ‘I don’t think it’s a good idea.’” (“Dem Impasse On Health Bill Continues,” Politico, 1/27/10)

SEN. TOM HARKIN (D-IA): “That Would Probably Be The Worst Thing We Could Do Right Now because of deadlines and dates, if this were to go to reconciliation now, it would not be written by my committee -- which is a very progressive committee -- it would be written by the Budget committee.” (“Harkin Calls Reconciliation The 'Worst Thing' Liberals Could Want,” The Hill, 11/19/09)

SEN. FRANK LAUTENBERG (D-NJ): “New Jersey Democratic Sen. Frank Lautenberg, Who Is Not A Member Of The Group, Said That While He Opposes Using Reconciliation As A Vehicle For Healthcare and climate-change legislation, he thinks the centrists will fall in line with the rest of their party when requested.” (“Lincoln, Pryor Pan Speedy Budget Idea Arkansans Warn Against Hastiness,” Arkansas Democrat-Gazette, 3/23/09)

SEN. ARLEN SPECTER (D-PA): “That Is Undesirable.” (Fox’s “Fox News Sunday,” 8/23/09)

SEN. MARK PRYOR (D-AR): “I’m Not Real Wild About Using That Procedure That Way.” (“Dem Impasse On Health Bill Continues,” Politico, 1/27/10)

SEN. BEN NELSON (D-NE): “Sen. Ben Nelson, A Democrat, Said Sunday That He Would Vote Against Using A Tactic Called Reconciliation To Push Through A Health Care Bill.” (“Nelson: Bipartisanship A Must,” Omaha World Herald, 9/28/09)

Q: “Will You Commit To Supporting Efforts To Bring Up Important Legislation Under Budget Reconciliation Rules Even If Other Moderate Democrats Try To Stop That?” SEN. MARK BEGICH (D-AK): “I’ll Tell You, Rachel, The Answer Is Probably No.” (MSNBC, 3/19/09)

February 20, 2010

I bet it still has the provision excluding unions in there still.

The democrats WILL be committing political suicide with that game.

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s The White House Crafts A Reconciliation Bill, Senate Democrats Have Called Using The Procedure For Health Care “An Outrage,” “A Nonstarter,” “A Real Mistake,” “Very Ill-Advised,” “The Worst”

WHITE HOUSE WRITES “RECONCILIATION” HEALTH CARE BILL: “Democratic officials said the president’s proposal was being written so that it could be attached to a budget bill as a way of averting a Republican filibuster in the Senate. The procedure, known as budget reconciliation, would let Democrats advance the bill with a simple majority rather than a 60-vote supermajority.” (“Obama To Offer Health Bill To Ease Impasse As Bipartisan Meeting Approaches,” The New York Times, 2/19/10)

18 Senate Democrats On The Record Opposing Reconciliation For Health Care

SEN. HARRY REID (D-NV): “I’m Not Using Reconciliation.” (“Reid On Passing Health Care: 'I'm Not Using Reconciliation',” TPMDC, 11/19/09)

SEN. KENT CONRAD (D-ND): “I Don't Believe Reconciliation Was Ever Intended For The Purpose Of Writing This Kind Of Substantive Reform Legislation Such As Health Care Reform.” “I have said publicly and privately what I believe. I don't believe reconciliation was ever intended for the purpose of writing this kind of substantive reform legislation such as health care reform, such as climate change.” (Sen. Conrad, Congressional Record, S.3957, 3/30/09)

SEN. ROBERT BYRD (D-WV): Reconciliation On Healthcare “An Outrage That Must Be Resisted.” “I was one of the authors of the legislation that created the budget ‘reconciliation’ process in 1974, and I am certain that putting health-care reform and climate change legislation on a freight train through Congress is an outrage that must be resisted.” (“The End Of Bipartisanship For Obama’s Big Initiatives?” The Washington Post, 3/22/09)

SEN. JAY ROCKEFELLER (D-WV): “Reconciliation Is A Nonstarter … It Doesn’t Work. ... It Opens Itself Up To An Endless, Unstoppable Number Of Amendments, Which They Will Have Lined Up, 800 Amendments, Whatever It Is.” (“Rockefeller Dismisses Reconciliation As An Option For Health Care Reform,” Roll Call, 11/17/09)

SEN. BLANCHE LINCOLN (D-AR): “I Will Not Accept Any Last-Minute Efforts To Force Changes To Health Insurance Reform Issues Through Budget Reconciliation, And Neither Will Arkansans.” (“Dem Impasse On Health Bill Continues,” Politico, 1/27/10)

SEN. BYRON DORGAN (D-ND): “We Shouldn't Stretch Reconciliation For … Health Care.” “Sen. Byron Dorgan (D-N.D.), an appropriator, said today it would be ‘highly unusual’ to use reconciliation for climate change or health care legislation. ‘We shouldn't stretch reconciliation for climate change or health care,’ he said. ‘It would be very hard to justify.’” (“Democratic Senators Not Ready To Embrace Reconciliation,” CongressNow, 3/17/09)

SEN. JOE LIEBERMAN (I-CT): “I Think It's A Real Mistake To Try To Jam Through The Total Health Insurance Reform, Health Care Reform Plan That The Public Is Either Opposed To Or Of Very, Very Passionate Mixed Minds About.” (CNN’s “State Of The Union,” 8/23/09)

MARY LANDRIEU (D-LA): “Was Intended For Deficit Reduction, And It Should Not Be Used For Other Things.” (“Why The Democrats Can't Govern,” The New Republic, 4/15/09)

SEN. EVAN BAYH (D-IN): “Very Ill-Advised.” (“Nelson, Bayh Warn Against Reconciliation,” Politico, 1/26/10)

SEN. MAX BAUCUS (D-MT): “It’s Not A Good Idea.” “‘Reconciliation tends to be partisan,’ Senate Finance Chairman Max Baucus said. ‘It's not a good idea.’” (“Dems Resistant To Using Reconciliation For Climate Bill,” Congress Daily AM, 3/11/09)

SEN. RUSS FEINGOLD (D-WI): “It Wasn't Appropriate Then; It Isn't Appropriate Now.” “Reconciliation is intended for legislation that reduces the deficit. I have strongly opposed past efforts to use reconciliation to address policy matters, such as drilling in the Arctic National Wildlife Refuge. It wasn't appropriate then; it isn't appropriate now.” (Sen. Feingold, Congressional Record, S.4289, 4/2/09)

SEN. CLAIRE MCCASKILL (D-MO): “Missouri Sen. Claire McCaskill Said … She Was ‘Not Open’ To Using The Maneuver For A Comprehensive Fix To The Senate Bill. And regarding the more narrow, two-step process envisioned by Democratic leaders, McCaskill said: ‘I don’t think it’s a good idea.’” (“Dem Impasse On Health Bill Continues,” Politico, 1/27/10)

SEN. TOM HARKIN (D-IA): “That Would Probably Be The Worst Thing We Could Do Right Now because of deadlines and dates, if this were to go to reconciliation now, it would not be written by my committee -- which is a very progressive committee -- it would be written by the Budget committee.” (“Harkin Calls Reconciliation The 'Worst Thing' Liberals Could Want,” The Hill, 11/19/09)

SEN. FRANK LAUTENBERG (D-NJ): “New Jersey Democratic Sen. Frank Lautenberg, Who Is Not A Member Of The Group, Said That While He Opposes Using Reconciliation As A Vehicle For Healthcare and climate-change legislation, he thinks the centrists will fall in line with the rest of their party when requested.” (“Lincoln, Pryor Pan Speedy Budget Idea Arkansans Warn Against Hastiness,” Arkansas Democrat-Gazette, 3/23/09)

SEN. ARLEN SPECTER (D-PA): “That Is Undesirable.” (Fox’s “Fox News Sunday,” 8/23/09)

SEN. MARK PRYOR (D-AR): “I’m Not Real Wild About Using That Procedure That Way.” (“Dem Impasse On Health Bill Continues,” Politico, 1/27/10)

SEN. BEN NELSON (D-NE): “Sen. Ben Nelson, A Democrat, Said Sunday That He Would Vote Against Using A Tactic Called Reconciliation To Push Through A Health Care Bill.” (“Nelson: Bipartisanship A Must,” Omaha World Herald, 9/28/09)

Q: “Will You Commit To Supporting Efforts To Bring Up Important Legislation Under Budget Reconciliation Rules Even If Other Moderate Democrats Try To Stop That?” SEN. MARK BEGICH (D-AK): “I’ll Tell You, Rachel, The Answer Is Probably No.” (MSNBC, 3/19/09)

February 22, 2010

Let's wait and see until what happens Thursday at the Blair House. The President is inviting Republicans and Democrats to discuss the stagnation of Health Care reform.

February 22, 2010

The President will bring a comprehensive proposal to the bipartisan meeting this Thursday that builds on the progress Congress has already made and aims to give the American people and small business owners more control over their health care choices.

Over the past year the House and the Senate have been working on an effort to provide health insurance reform that lowers costs, guarantees choices, and enhances quality health care for all Americans. Building on that year-long effort, the President has now put forth a proposal that incorporates the work the House and the Senate have done and adds additional ideas from Republican members of Congress. The President has long said he is open to any good ideas for reforming our health care system, and he looks forward to discussing ideas for further improvements from Republicans and Democrats at an open, bipartisan meeting on Thursday.

The proposal will make health care more affordable, make health insurers more accountable, expand health coverage to all Americans, and make the health system sustainable, stabilizing family budgets, the Federal budget, and the economy:

* It makes insurance more affordable by providing the largest middle class tax cut for health care in history, reducing premium costs for tens of millions of families and small business owners who are priced out of coverage today. This helps over 31 million Americans afford health care who do not get it today – and makes coverage more affordable for many more.

* It sets up a new competitive health insurance market giving tens of millions of Americans the exact same insurance choices that members of Congress will have.

* It brings greater accountability to health care by laying out commonsense rules of the road to keep premiums down and prevent insurance industry abuses and denial of care.

* It will end discrimination against Americans with pre-existing conditions.

* It puts our budget and economy on a more stable path by reducing the deficit by $100 billion over the next ten years – and about $1 trillion over the second decade – by cutting government overspending and reining in waste, fraud and abuse.

Key Provisions in the President’s Proposal:

The President’s Proposal builds off of the legislation that passed the Senate and improves on it by bridging key differences between the House and the Senate as well as by incorporating Republican provisions that strengthen the proposal.

One key improvement, for example, is eliminating the Nebraska FMAP provision and providing significant additional Federal financing to all States for the expansion of Medicaid. For America’s seniors, the proposal completely closes the Medicare prescription drug “donut hole” coverage gap. It strengthens the Senate bill’s provisions that make insurance affordable for individuals and families, while also strengthening the provisions to fight fraud, waste, and abuse in Medicare and Medicaid to save taxpayer dollars. The threshold for the excise tax on the most expensive health plans will be raised from $23,000 for a family plan to $27,500 and will start in 2018 for all such plans. And another important idea included is improving insurance protections for consumers and creating a new Health Insurance Rate Authority to review and rein in unreasonable rate increases and other unfair practices of insurance plans.

http://www.whitehouse.gov/sites/default/files/summary-presidents-proposal.pdf

February 22, 2010

Policies to Crack Down on Waste, Fraud and Abuse

The House and Senate health reform bills contain an unprecedented array of aggressive new authorities to fight waste, fraud and abuse. The President’s Proposal builds on those provisions by incorporating a number of additional proposals that are either part of the Administration’s FY 2011 Budget Proposal or were included in Republican plans.

Comprehensive Sanctions Database.

The President’s Proposal establishes a comprehensive Medicare and Medicaid sanctions database, overseen by the HHS Inspector General. This database will provide a central storage location, allowing for law enforcement access to information related to past sanctions on health care providers, suppliers and related entities. (Source: H.R. 3400, “Empowering Patients First Act” (Republican Study Committee bill))

Registration and Background Checks of Billing Agencies and Individuals.

In an effort to decrease dishonest billing practices in the Medicare program, the President’s Proposal will assist in reducing the number of individuals and agencies with a history of fraudulent activities participating in Federal health care programs. It ensures that entities that bill for Medicare on behalf of providers are in good standing. It also strengthens the Secretary’s ability to exclude from Medicare individuals who knowingly submit false or fraudulent claims. (Source: H.R. 3970, “Medical Rights & Reform Act” ( Kirk bill))

Expanded Access to the Healthcare Integrity and Protection Data Bank.

Increasing access to the health care integrity data bank will improve coordination and information sharing in anti-fraud efforts. The President’s Proposal broadens access to the data bank to quality control and peer review organizations and private plans that are involved in furnishing items or services reimbursed by Federal health care program. It includes criminal penalties for misuse. (Source: H.R. 3970, “Medical Rights & Reform Act” (Kirk bill))

Liability of Medicare Administrative Contractors for Claims Submitted by Excluded Providers.

In attacking fraud, it is critical to ensure the contractors that are paying claims are doing their utmost to ensure excluded providers do not receive Medicare payments. Therefore, the President’s Proposal provision holds Medicare Administrative Contractors accountable for Federal payment for individuals or entities excluded from the Federal programs or items or services for which payment is denied. (Source: H.R. 3970, “Medical Rights & Reform Act” (Kirk bill))

Community Mental Health Centers.

The President’s Proposal ensures that individuals have access to comprehensive mental health services in the community setting, but strengthens standards for facilities that seek reimbursement as community mental health centers by ensuring these facilities are not taking advantage of Medicare patients or the taxpayers. (Source: H.R. 3970, “Medical Rights & Reform Act” (Kirk bill))

Limiting Debt Discharge in Bankruptcies of Fraudulent Health Care Providers or Suppliers.

The President’s Proposal will assist in recovering overpayments made to providers and suppliers and return such funds to the Medicare Trust Fund. It prevents fraudulent health care providers from discharging through bankruptcy amounts due to the Secretary from overpayments. (Source: H.R. 3970, “Medical Rights & Reform Act” (Kirk bill))

Use of Technology for Real-Time Data Review.

The President’s Proposal speeds access to claims data to identify potentially fraudulent payments more quickly. It establishes a system for using technology to provide real-time data analysis of claim and payments under public programs to identify and stop waste, fraud and abuse. (Source: Roskam Amendment offered in House Ways & Means Committee markup)

Illegal Distribution of a Medicare or Medicaid Beneficiary Identification or Billing Privileges.

Fraudulent billing to Medicare and Medicaid programs costs taxpayers millions of dollars each year. Individuals looking to gain access to a beneficiary’s personal information approach Medicare and Medicaid beneficiaries with false incentives. Many beneficiaries unwittingly give over this personal information without ever receiving promised services. The President’s Proposal adds strong sanctions, including jail time, for individuals who purchase, sell or distribute Medicare beneficiary identification numbers or billing privileges under Medicare or Medicaid – if done knowingly, intentionally, and with intent to defraud. (Source: H.R. 3970, “Medical Rights & Reform Act” (Kirk bill))

Study of Universal Product Numbers Claims Forms for Selected Items and Services under the Medicare Program.

The President’s Proposal requires HHS to study and issue a report to Congress that examines the costs and benefits of assigning universal product numbers (UPNs) to selected items and services reimbursed under Medicare. The report must examine whether UPNs could help improve the efficient operation of Medicare and its ability to detect fraud and abuse. (Source: H.R. 3970, “Medical Rights & Reform Act” (Kirk bill), Roskam Amendment offered in House Ways & Means Committee markup)

Medicaid Prescription Drug Profiling.

The President’s Proposal requires States to monitor and remediate high-risk billing activity, not limited to prescription drug classes involving a high volume of claims, to improve Medicaid integrity and beneficiary quality of care. States may choose one or more drug classes and must develop or review and update their care plan to reduce utilization and remediate any preventable episodes of care where possible. Requiring States to monitor high-risk billing activity to identify prescribing and utilization patterns that may indicate abuse or excessive prescription drug utilization will assist in improving Medicaid program integrity and save taxpayer dollars. (Source: President’s FY 2011 Budget)

Medicare Advantage Risk Adjustment Errors.

The President’s Proposal requires in statute that the HHS Secretary extrapolate the error rate found in the risk adjustment data validation (RADV) audits to the entire Medicare Advantage contract payment for a given year when recouping overpayments. Extrapolating risk score errors in MA plans is consistent with the methodology used in the Medicare fee-for-service program and enables Medicare to recover risk adjustment overpayments. MA plans have an incentive to report more severe beneficiary diagnoses than are justified because they receive higher payments for higher risk scores. (Source: President’s FY 2011 Budget)

Modify Certain Medicare Medical Review Limitations.

The Medicare Modernization Act of 2003 placed certain limitations on the type of review that could be conducted by Medicare Administrative Contractors prior to the payment of Medicare Part A and B claims. The President’s Proposal modifies these statutory provisions that currently limit random medical review and place statutory limitations on the application of Medicare prepayment review. Modifying certain medical review limitations will give Medicare contractors better and more efficient access to medical records and claims, which helps to reduce waste, fraud and abuse. (Source: President’s FY 2011 Budget)

Establish a CMS-IRS Data Match to Identify Fraudulent Providers.

The President’s Proposal authorizes the Centers for Medicare & Medicaid Services (CMS) to work collaboratively with the Internal Revenue Service (IRS) to determine which providers have seriously delinquent tax debt to help identify potentially fraudulent providers sooner. The data match will primarily target certain high-risk provider types in high-vulnerability areas. This proposal also enables both IRS and Medicare to recoup any monies owed to the Federal government through this program. By requiring the Internal Revenue Service (IRS) to disclose to CMS those entities that have evaded filing taxes and matching the data against provider billing data, this proposal will enable CMS to better detect fraudulent providers billing the Medicare program. (Source: President’s FY 2011 Budget)

Preventing Delays in Access to Generic Drugs.

Currently, brand-name pharmaceutical companies can delay generic competition through agreements whereby they pay the generic company to keep its drug off the market for a period of time, called “pay-for-delay.” This hurts consumers by delaying their access to generic drugs, which are usually less expensive than their branded counterparts. The Federal Trade Commission (FTC) recently estimated that this could cost consumers $35 billion over 10 years. The President’s proposal adopts a provision from the bipartisan legislation that gives the FTC enforcement authority to address this problem. Specifically, it makes anti-competitive and unlawful any agreement in which a generic drug manufacturer receives anything of value from a brand-name drug manufacturer that contains a provision in which the generic drug manufacturer agrees to limit or forego research, development, marketing, manufacturing or sales of the generic drug. This presumption can only be overcome if the parties to such an agreement demonstrate by clear and convincing evidence that the pro-competitive benefits of the agreement outweigh the anti-competitive effects of the agreement. The proposal also requires the Chief Executive Officer of the branded pharmaceutical company to certify to the accuracy and completeness of any agreements required to be filed with the FTC.

February 22, 2010

The president’s plan, however, does not resolve insurance coverage of abortions. You cannot remove Senate language on abortion using the parliamentary process of budget reconciliation. Obama just does not understand that this a HUGE issue with Conservative Democrats. We will not budge on life.

February 22, 2010

You can also call or write to the President that you do not support funding abortions:

The White House

1600 Pennsylvania Avenue NW

Washington, DC 20500

Please include your e-mail address

Phone Numbers

Comments: 202-456-1111

Switchboard: 202-456-1414

FAX: 202-456-2461

TTY/TDD

Comments: 202-456-6213

Visitors Office: 202-456-2121

February 23, 2010

Linda Douglas, White House Office of Health Reform Communications Director, discusses President Obamas Proposal for Health Care Reform.

February 23, 2010

Senator Chris Dodd (D-CT) issued the following statement today on President Obama’s health care reform proposal, which was released to the public today. On Thursday, Dodd will join Democratic and Republican Senate and House leaders at the Blair House for a health reform summit.

"With the release of the President’s health care plan, we are now closer than ever before to achieving meaningful and comprehensive health care reform. This proposal incorporates a lot of the hard work of the Senate and the House over the last year, and many bipartisan reform elements. The final bill will be the result of more than 100 bipartisan meetings and more than 20 days of markup held by both the HELP and Finance Committees. In the HELP Committee alone, more than 287 amendments were considered, and 161 Republican amendments were ultimately accepted.

I am looking forward to meeting with the President and leaders from both parties on Thursday to finish our job of crafting health care reform that will guarantee all Americans access to stable, quality, and affordable health care.”

February 23, 2010

Sen. Scott Brown yesterday warned the Obama administration against using the "nuclear option" of ramming through Congress a revised $1 trillion health-care bill outlined yesterday by the White House.

February 24, 2010

I am pleased the President remains committed to passing a comprehensive health insurance reform bill that will give millions more Americans access to health insurance, while improving quality and keeping costs down for everyone. Not only do tens of millions of Americans lack health insurance, but under the current system, insurance companies can actively discriminate against sick people, and American families are driven into bankruptcy every day by medical expenses. These escalating health costs and the erosion of insurance protection are unsustainable and threaten the health security of everyone.

Working with Democrats and Republicans, the President has outlined meaningful proposals that bring good ideas from both parties to the table. The White House proposal includes a system to prevent unfair and excessive premium rate increases through federal and state oversight of the health insurance industry, expansion of coverage to dependent children up to age 26, and employee wellness programs.

The President’s proposal recognizes the importance of introducing choice and competition into the health insurance market. Last year I introduced legislation to repeal the federal antitrust exemption enjoyed by the health insurance industry. Surely we can all agree that increasing competition can help reduce costs to consumers. The House is expected to vote on a similar repeal later this week, and I am committed to working with Senator Reid to ensure that it is signed into law. I also believe that meaningful reform must include additional choices for consumers by including a public option, and I will continue to push for its inclusion in health care reform.

President Obama has already signaled his support for fighting the scourge of health care fraud, through which billions of dollars are lost every year. I have also focused the Judiciary Committee’s attention on the issue of health fraud losses, working closely with Senator Ted Kaufman of Delaware, and I am pleased that the White House’s proposal includes aggressive measures to crack down on Medicare and health care fraud, which will ultimately save taxpayer money and return hard-earned money to the pockets of struggling American families.

Now is our opportunity to act. Health care reform is too important to be sidelined by partisan motives. I look forward to moving ahead on health insurance reform and providing all Americans with access to affordable, high-quality health insurance.

February 24, 2010

Right on cue

A Massachusetts doctor pleaded guilty to one count of health care fraud stemming from accusations that he faked research for a dozen years in published studies that suggested after-surgery benefits from painkillers including Vioxx and Celebrex. Dr. Scott Reuben, an anesthesiologist, also agreed to repay $361,932 of research grants and forfeit assets worth at least $50,000 as penalty for his conduct during yesterday’s plea hearing at the US District Court in Boston. Federal prosecutors have recommended up to 10 years imprisonment. Sentencing is set for May 24. Prosecutors allege the former chief of acute pain at Baystate Medical Center in Springfield sought and received research grants from pharmaceutical companies but never performed the studies. His attorney says Reuben was suffering from a serious but undiagnosed bipolar disorder and had no financial motive.

February 24, 2010

Will the Republicans Post Their Health Plan… and When?

The President believes strongly that Thursday's bipartisan meeting on health insurance reform will be most productive if both sides come to the table with a unified plan to start discussion – and if the public has the opportunity to inspect those proposals up close before the meeting happens.

That's why yesterday the White House posted online the President's proposal for bridging the differences between the Senate- and House-passed health insurance reform bills. The proposal puts American families and small business owners in control of their own health care. It makes insurance more affordable by providing the largest middle-class tax cuts for health care in history, it ends discrimination based on pre-existing conditions, holds insurance companies accountable, and reduces our deficit by $100 billion over the next 10 years.

February 24, 2010

Watch Virginia Delegate Bob Marshall claim at an anti-Planned Parenthood press conference that disabled children are God's punishment for abortion.

February 24, 2010

Congressman John Shadegg (AZ-03) issued the following statement regarding President Obama’s new health care pre-conditions:

“Today, President Obama unveiled the same playbook for a government takeover of health care that Americans have been rejecting for months. What I had hoped might be an opportunity to share ideas at Thursday’s summit, is turning out to be a mockery before it even happens.

“The President’s request for Republican ideas is disingenuous. In fact, HHS Secretary Kathleen Sebelius wrongly claimed that Republicans have not come to the table with any sort of proposal. Nothing could be further from the truth. Republicans have offered comprehensive plans and have put forth solutions that end lawsuit abuse, allow Americans to purchase health insurance across state lines, and provide coverage to Americans with pre-existing conditions through high-risk pools. Her claim is absolutely groundless and was obviously made to mislead and confuse the public. Secretary Sebelius is playing politics with an issue too important for politics.

“Based on the structure of the President’s summit, it is clear that he is also playing politics. The fatally flawed bill already rejected by the American people will be the starting point for Washington Democrats as they try to ram through a government takeover of health care. Thursday’s summit should be a chance to start with a clean sheet of paper. That’s exactly what the public is demanding. It’s time to stop playing politics with this issue and get something done for the American people.

“On the other hand, Republicans and their leadership have not demanded pre- conditions. Instead, we’ve been putting good, reasonable ideas for incremental reform on the table since the get-go, and we deserve to have a real discussion about the merits of our proposals as well. The President owes it to the American people to consider all options. President Obama’s refusal to start over shows he's not interested in compromise or bipartisanship. Where is the ‘change we can believe in’ that he promised?”

February 24, 2010

Jul 14, 2009, Congressman John Shadegg (AZ-03) joined with several Republican Members of Congress including: Congressman Rob Bishop (UT-01), Congresswoman Marsha Blackburn (TN-07), Congressman Michael C. Burgess, M.D. (TX-26), Congressman Phil Gingrey, M.D. (GA-11) and Congressman Pete Hoekstra (MI-02) to introduce The Improving Health Care for All Americans Act which will reform America’s health care system making health care services more personal, more affordable and ensure that all Americans receive the care they need.

The bill includes:

IF YOU LIKE IT YOU CAN KEEP IT.

Approximately 83% of Americans are satisfied with the health care they currently receive through their employer. Under this plan, Americans with employer-provided care can keep it without any change. Unlike other proposals, this bill will NOT tax your employer-sponsored plan to pay for a government takeover of health care. And, unlike the Democrats plan, it will not force you to give up the health care coverage you currently have if you choose to keep it!

ALL AMERICANS GET CHOICE AND COVERAGE.

The bill allows Americans who don’t have employer-sponsored care or those not satisfied with their employer-sponsored plan to buy their own plan on the same tax-advantaged basis their employer enjoys. Americans who pay income taxes get a dollar for dollar reduction in their tax bill up to $2500 for individuals and $5000 per family. Americans who don’t pay income taxes get the same amount from the government to buy a policy of their choice; $2500 for individuals and $5000 per family.

PROVIDES POOLING MECHANISMS AND GROUP PLAN CHOICES FOR EVERYONE.

This legislation creates expanded options for the purchase of low-cost health care from new pooling mechanisms. Today, the only health insurance pool available to Americans is their employer’s pool. Americans not in an employer-sponsored pool buy in what is called the “individual market.” The Improving Health Care for All Americans Act dramatically expands the insurance pools Americans can select to join by allowing churches, alumni associations, trade associations and other civic groups to set up new insurance pools and offer affordable health care packages to their members. Instead of having only one group policy to choose from, under this bill, every American will be able to choose from a number of “group plans.” This will make health care more affordable and portable while not locking individuals into staying at a job simply to keep their health coverage. Families should not be forced to choose between leaving their employer and having health care.

PRE-EXISTING AND CHRONIC CONDITIONS COVERED AT AFFORDABLE RATES.

Our fragmented health care system makes it difficult for Americans with pre-existing conditions and chronic illnesses to find affordable coverage. No American should go bankrupt because they get sick. The Improving Health Care for All Americans Act strengthens, expands and creates new avenues for affordable health care for the sickest Americans through high-risk pools and reinsurance mechanisms. The sick and those with chronic conditions will be able to buy coverage at competitive rates.

CONTROLS COST AND PROVIDES COVERAGE FROM THE BOTTOM UP, NOT THE TOP (GOVT.) DOWN.

The Improving Health Care for All Americans Act takes a radically different approach in contrast to what has been discussed by President Obama as well as Democrats in both chambers. It gives people choice and places American families back in control of their plans and their health care. This legislation will reduce the cost and improve the quality of health care while expanding access and portability.

February 24, 2010

President Obama released a new health care plan today, which CBO admits cannot be scored due to lack of sufficient details. House Republicans have had a health care plan for months. It was scored by CBO in November. Yet, Democrats refuse to consider it as a viable option.

You can find all the details about our health care plan here.

http://www.gop.gov/solutions/healthcare

February 24, 2010

Pro-life Congressman Bart Stupak (D-Mich.) released a statement on Tuesday morning, calling President Obama's latest health care proposal “unacceptable” on the issue of abortion.

Rep. Stupak, who has been outspokenly opposed to abortion during his political tenure, said on Feb. 23 that he “was pleased to see that President Obama’s health care proposal did not include several of the sweetheart deals provided to select states in the Senate bill.”

“Unfortunately, the President's proposal encompasses the Senate language allowing public funding of abortion,” the Michigan representative stated. “The Senate language is a significant departure from current law and is unacceptable,” he added.

“While the President has laid out a health care proposal that brings us closer to resolving our differences, there is still work to be done before Congress can pass comprehensive health care reform.”

Rep. Stupak stepped into the national political spotlight when he introduced an amendment to the House health care reform bill that maintained the Hyde Amendment ban on using federal funds to pay for abortions. The Stupak Amendment passed in the House by a vote of 240-194 last November.

President Obama's health care proposal comes at a time when congressional leaders are still divided on the issue. The recent election of Republican Senator Scott Brown to an historically Democratic seat in Massachusetts has added to the complexity of the situation and has caused some to claim it unlikely that there are enough votes to pass health care reform legislation in either the House or the Senate as it currently stands.

February 24, 2010

Any member of Congress who votes for the final legislation proposed by President Obama will be voting for direct federal funding of elective abortion through Community Health Centers, and also an array of other pro-abortion federal subsidies and mandates.

The health bill passed by the Senate in December (H.R. 3590) had become, by the conclusion of the Senate amendment process, the most expansively pro-abortion bill ever brought to the floor of either house of Congress since Roe v. Wade. The Senate bill, as passed, contained seven distinct problems pertaining to abortion policies. (The bill passed earlier by the House, H.R. 3962, contained none of these pro-abortion components, thanks to adoption of the Stupak-Pitts Amendment on the House floor on November 7, 2009, by a vote of 240-194.) President Obama today proposed "a targeted set of changes to" the Senate-passed bill. None of President Obama's proposed changes diminish any of the sweeping pro-abortion problems in the Senate bill, and he actually proposes to increase the funds that would be available to directly subsidize abortion procedures (through Community Health Centers) and to subsidize private health insurance that covers abortion (through the premium-subsidy tax credits program).

If all of the President's changes were made, the resulting legislation would allow direct federal funding of abortion on demand through Community Health Centers, would institute federal subsidies for private health plans that cover abortion on demand (including some federally administered plans), and would authorize federal mandates that would require even non-subsidized private plans to cover elective abortion.

Here is one problem, offered for illustration: The Senate bill, due to a last-minute amendment, provides $7 billion for the nation's 1,250 Community Health Centers, without any restriction whatever on the use of these federal funds to pay directly for abortion on demand. (These funds are entirely untouched by the "Hyde Amendment" that currently covers Medicaid.) Obama today proposed to increase that figure to $11 billion, but without adding a prohibition on the use of the funds for abortion. (The House-passed bill would provide $12 billion, but in the House bill the funds would be covered by the Stupak-Pitts Amendment.) Two pro-abortion groups, the Reproductive Health Access Project and the Abortion Access Project, are already actively campaigning for Community Health Centers to perform elective abortions. In short, the Senate bill would allow direct federal funding of abortion on demand through Community Health Centers. A memorandum documenting this issue in further detail is posted here: http://www.nrlc.org/AHC/NRLCmemoCommHealth.pdf

The abortion-related differences between the House-passed and Senate-passed bills are far, far greater than one would gather from reading superficial summaries such as those published repeatedly in the mainstream news media. These thumbnail sketches have tended to focus exclusively and superficially on certain provisions associated with Senator Ben Nelson. NRLC believes that the Nelson provisions are unacceptable, but the pro-abortion problems in the Senate bill go far beyond the flawed Nelson provisions. A letter from NRLC to U.S. House members, explaining the multiple pro-abortion components of the Senate-passed bill, is posted here: http://www.nrlc.org/AHC/HouseLetteronAbortionProvisions.html

The U.S. Conference of Catholic Bishops (USCCB) produced a 13-page memorandum that throws the many unacceptable provisions of the Senate bill into stark relief, which is posted here: http://www.usccb.org/healthcare/life_conscience.pdf

A substantial number of pro-life Democrats in the House, including some lawmakers whose names have not been mentioned on the various published lists, have told their constituents that they are not going to vote for the Senate-passed bill because of the abortion problems. For pro-life Democrats, President Obama's proposal only makes matters worse. The only thing that would fix the Senate bill on abortion is permanent, bill-wide language that is functionally identical to the Stupak-Pitts Amendment adopted in the House on November 7, 2009.

The Obama proposal also would force rationing of lifesaving medical treatment, a matter that will be the subject of separate comment by the National Right to Life Committee.

February 24, 2010

Officials investigating an abortion business in Philadelphia after a woman died from a botched legal abortion last November have made a grisly discovery. The found dozens of apparently late-term unborn children who were killed in abortions as long as 30 years ago.

The "Shop of Horrors" case involves the West Philadelphia abortion center Women's Medical Society run by Kermit Gosnell.

Authorities were prompted to investigate Women's Medical Society after an abortion patient died last November. Massive amounts of drugs found in the victim's system led authorities to suspect Gosnell was illegally prescribing pain-killers.

Officials also suspected the woman died from the botched abortion in part because she had been treated by unlicensed personnel.

The State Board of Medicine says Gosnell had the unlicensed staff member vaginal exams and administer the drugs Demerol, Promethazine and Diazepam. He was eventually fined $1,000 for the violations.

Yesterday, for the second time in four days, according to a CBS 3 report, local police along with State Licensing officials and DEA agents, searched the Women's Medical Society.

They found the dozens of unborn children killed in abortions who were frozen for decades. CBS 3 indicates they are now determining whether or not they may have been victims of illegal late-term abortions.

CBS 3 also reported that records from 1995 show Gosnell was publicly reprimanded by the State Licensing Board which found he ''employed a physician's assistant that was not certified ... saw at least one patient and treated him."

So far, as a result of the abortion death, Gosnell's medical license has been temporarily suspended, but he has not yet been charged with anything illegal. His abortion center is temporarily closed while the investigation proceeds.

Troy Newman, the president of the pro-life group Operation Rescue, told LifeNews.com that the suspension order described "deplorable and unsanitary" conditions at the clinic, indicating that "there was blood on the floor, and parts of aborted fetuses were displayed in jars."

The order declared Gosnell to be "an immediate and clear danger to the public health and safety."

Newman says the notion that legalizing abortion made it safer for women is fiction.

"This is not the exception to the rule in our nation's abortion clinics. It is standard operating procedure," he said. "This clinic is no better than a back alley abortion mill, and in fact may be worse."

"Collecting the remains of dead babies over a 30 year time frame is reminiscent of the actions of deranged serial killers who keep body parts as trophies. It doesn't get much sicker than that," he added.

http://www.lifenews.com/state4838.html

February 24, 2010

Briefing by White House Press Secretary Robert Gibbs, 2/23/10

James S. Brady Press Briefing Room

Q Robert, a lot of members of your own party on the Hill are wondering how aggressive the President is going to get in selling this latest, last-ditch effort at comprehensive reform. So what are his plans? Is he going to talk to the public? Are we going to hear him talking frequently about the need to do this? What’s the sort of rollout campaign for his plan?

MR. GIBBS: Well, look, I'm not going to get too far ahead of the next thing that's on the calendar, and that's the importance of – important events of Thursday in –-

Q Democrats are saying that this kind of an effort would be just as important as sitting down around the table. You also have to sell it to a public that’s skeptical and to Democrats on the Hill who are skeptical.

MR. GIBBS: Well, but I think before we get there the President has wanted to and will sit down with Democrats and Republicans to discuss their ideas, to go through the plans that had been put forward and to find agreement where that's possible. I think that's the next step, and I don't think the President wants to get too far ahead on that process.

Q But how are they -- I don't see how they have to be separate from one another. Why do you have to separate one out from the other?

MR. GIBBS: I'm not discussing whether or not they're separate. The President is not focused on Friday. The President ultimately is focused on Thursday.

Q But Democrats are saying he needs to be focused on Friday if there's any chance of this thing succeeding.

MR. GIBBS: Well, we have been focused on getting health care reform this far. We're focused on getting it done. And we look forward to what we hope is a robust exchange of ideas on Thursday. The President --

Q I hate to drag this out even further, but it sounds like what you're -- it sounds like you're not willing to say that he's going to make an aggressive sales effort --

MR. GIBBS: You want to take this in a different direction. The President is focused -- the President is focused on Thursday.

Q Can you tell us a little bit more about this statement of administration policy regarding the antitrust exemption? Why specifically now? How long has the President been planning on coming out in favor of this? He's been hinting about it for quite some time.

MR. GIBBS: Well, the House is considering in their legislative vehicle -- this legislation goes to the Rules Committee today; as my understanding, goes to the floor either tomorrow or the day after that. We typically weigh in at this part -- point in the process with a statement of administration policy. It's been evaluated by a number of departments throughout government, and believe that this -- removing this exemption will allow appropriate enforcement and examination of potential policies that might prove uncompetitive, might stifle competition, and we think this better promotes affordability and innovation through greater choice and less market concentration.

Q I think it was either a few weeks ago or a few months ago the President said, I think in one of the weekly addresses, that it was time for Congress to consider repealing the antitrust exemption. Do you have evidence that there is any, as you put it, bid rigging or price fixing? Is that why he came out more solidly in favor of this?

MR. GIBBS: We do know this, Jake, that the AMA studied the market concentration of health insurers and found that 94 percent of the U.S. health insurance markets were highly concentrated, meaning one or only a few health insurers offering policies in, as I said, almost all the markets in the country. This allows DOJ and FTC the ability to look into, in complement with state insurance regulations, to ensure competitiveness.

Q Okay. And about Thursday's summit, it doesn't really seem like it's shaping up right now to seem all that bipartisan on Thursday. You have Republicans saying it's going to be a Democratic infomercial. The fact that the President posted his plan on whitehouse.gov is indicative of a lack of sincerity on his part, they say, because he's -- and then, for your guy's part, the bill that you've posted is not just a bill the President supports; it's also a vehicle to get this through Congress without any Republican support.

MR. GIBBS: Again, Jake, the bill is a starting point for what Congress had spent many months considering. What we get out of Thursday will be, as I said yesterday, based on the willingness of those participating to come in with an open mind and discuss the ideas and the plans that they have.

Was it disappointing that Senate Republicans appear to have decided not to post their plan on the Internet for discussion, or for Republicans to come with a more consensus plan? Sure, that's disappointing. I hope that doesn't wipe away their willingness to actively discuss the ideas that they have to cut costs for those that are drowning -- small businesses and families -- government budgets, and those that are being discriminated against by the practices of insurance companies.

Q But doesn’t the fact that you’ve posted it in the form that you’ve posted it, which is not just a list of principles or a statement of legislation –

MR. GIBBS: Well --

Q -- but, I mean, look, we all know that --

MR. GIBBS: No, no. In fairness --

Q -- for reconciliation if it comes to that.

MR. GIBBS: Jake, in fairness, I can assume if we would have simply posted principles they would have said, why isn't there more information?

Look, semantics aside, the President looks forward to discussing actively for several hours with members of his administration, Democrats and Republicans, their ideas for health care reform. I think -- again, I can't stress enough, I think the product, the output of six hours of discussion will be based on every participant's willingness to come and have an honest and frank discussion.

I don't think it does any good if somebody says, we're not going there to offer our ideas, we're just going there to help people understand how bad the other guys' ideas are. That's not what the American people are looking for. They're looking for Democrats and Republicans who are willing to sit around a table and work together to provide solutions to problems like health care, the rising cost of health care. That's what the President sees as his hope for what happens on Thursday.

Q Just to follow on Jake's question, is the White House optimistic that on Friday health care will be in a different place than it is right now, that something will actually --

MR. GIBBS: Hopefully Thursday afternoon. Again, I think the President wants to sit down and discuss ways to move forward, ideas of common interest.

Q -- from Republicans are you confident, are you optimistic that this --

MR. GIBBS: I am, because, look, I think this is -- you always have a little bit of pre-game chatter. I think the -- again, the willingness of individuals and groups to discuss these ideas I think will change when the -- I think the American people want to see that two parties can sit around a table and coherently discuss solutions to the problems that the American people face. I think that's what the American people want to see as well.

Q One other question. Yesterday after the jobs bill, the Republicans supporting the jobs bill, did the President directly reach out to them, thank them for --

MR. GIBBS: I don't know that the President made any calls. Obviously you saw our statement. Look, I think this is a good example and a good lead-in to Thursday, and that is there's a willingness for members to put aside partisan games and to move ahead with what we know is important for the American people and for the growth and the stabilization of our economy.

My sense is that this will pass fairly overwhelmingly either later today or tomorrow. And I think that's an important step on the road to each party working together on solutions for the American people.

Chip.

Q On the health care, supporters of the public option are making another push in preparation for Thursday's meeting to try to get it back on the agenda. By not including it in the President's proposal, is the President saying as far as he's concerned it's dead?

MR. GIBBS: Well, look, I think that we have seen obviously -- and I talked about this some yesterday -- that there are some that are supportive of this. There isn't enough political support in a majority to get this through. The President wanted to find -- took the Senate bill as a base, and looks forward to discussing consensus ideas on Thursday.

Q What do you make of the characterizations of Thursday as "last best hope," "last ditch" on health care reform?

MR. GIBBS: Look, I think it is -- I think this is an important avenue for each party to get together and seek consensus. I think it's easier to fire away at each other when you're not in the same room and you're not having to sit down and talk to each other. So I think this provides an important avenue for us, for members of Congress, and, quite frankly, for the American people to see us work together, and I think that's what the President hopes to see on Thursday.

Q Is it the last avenue?

MR. GIBBS: I hope not.

Q And what can you tell us about the negotiations -- or are there negotiations -- on format, on table size, on cameras? Who's making the calls on this? It almost sounds like a G8 summit negotiation with sherpas or something.

MR. GIBBS: No, I have -- you know, I can't imagine that we couldn't find a few tables to put together and somebody can write out some rudimentary name cards and we can all find places to sit. Look, I mean, I -- you know --

Q That's not the House being --

MR. GIBBS: Is it being characterized as something far more complex than that?

Q Oh, yes.

Q Seems like it.

MR. GIBBS: How so?

Q Well, the shape of the table has changed --

MR. GIBBS: Let me tell you, if the biggest thing that we debate on Thursday is the shape of the table, then I could understand the utter disgust and contempt that the American people might have.

Q Chalkboard or PowerPoint?

MR. GIBBS: Look, I think that the American people will see that we can get past discussing -- I don't know who's discussing the size and the shape of the table. I think that is somewhat immaterial to the solutions that will be discussed. The President is not -- the President is interested in having a balanced conversation and hearing from Republicans and Democrats. I don't know what the shape of the table was in Baltimore. That seemed to be a process that worked quite well for --

Q I don’t think there was a table.

MR. GIBBS: There wasn't a table. Maybe we'll just -- you know, maybe those little desks they give you in like elementary school that would otherwise be uncomfortable and hard to fit into might be the best way forward.

Q Is there going to be a lunch break? (Laughter.)

Q Maybe no desks, no chairs?

Q Recess?

MR. GIBBS: You know, just sitting on the floor and figuring it all out.

Q Crisscross, apple sauce?

Q Robert, can the White House point to any evidence for its optimism that this ball -- health care ball is going to get moved by the end of Thursday? And what would that be?

MR. GIBBS: Well, look, I can't prejudge what happens on Thursday. I take any member that wants to come and have an honest discussion -- you take them at their word that that's what they want to do. We'll get a chance to see the motivations behind any participation on Thursday.

I sent this out Thursday. I think many of you all saw that the Republican ideas that are included in the President's proposal -- the President is open to discussion on issues relating to cost and insurance reforms to how we save money for the federal government as it relates to our deficit, and to improving -- to coverage. So those are roughly -- to get back to some of the formatting questions, there will be discussions on each of the four of those things as the President -- or as the administration outlined in their letter to Congress that I think we'll spend a good amount of time discussing. And, again, the President is looking forward to hearing from members and having an honest discussion.

Q Does the President buy into the conventional wisdom that with each passing day, as the midterm elections come around, doing some heavy lifting like this health care legislation becomes harder?

MR. GIBBS: Look, obviously I think when we get later into the summer that's probably likely the case. But I think we understand that there's a number of things that we have on our plate that are going to have to get done before -- and what the President wants to see get done before those elections in November, including not just health care but continued effort on jobs and employment, financial reform, and other important things that have to get done between now and November.

Q So no deadline for congressional -- and on the antitrust exemption, does the President think that that can be a stand-alone action that takes care of some of the health insurance problems, or does it have to be a part of the larger package?

MR. GIBBS: Well, look, I think this certainly complements what -- this will ultimately complement health care reform in ensuring the changes that you make in the market -- that the ability to look into potential anti-competitive practices, that that's not, quite frankly, illegal to do. This is not in lieu of something to make broader changes in the insurance market. This is a complementary step along the way.

Q Finally, as I understand it, the participants are going to have lunch on site on Thursday. Does the President --

MR. GIBBS: I have no idea what they're going to eat. (Laughter.)

Q -- planning to join them?

Q Something healthy. A box lunch? Is it going to be in a bag?

MR. GIBBS: I think there was some discussion of a box lunch.

Q Will the President participate?

MR. GIBBS: I will check on that.

Q Yes, is he staying the whole time or is he dipping in and dipping out?

MR. GIBBS: He'll be there.

Q The whole time?

MR. GIBBS: Yes.

Q Okay.

Q Robert, I'd like to give you a chance to respond to a couple things that House Republicans said today. First, Eric Cantor, quoting him directly, "They say the definition of insanity is continuing to do the same thing and expect a different result. And the President clearly seems to be trying to prove that that is true." That's Eric Cantor. John Boehner, regarding the President: "He has basically crippled the summit that's expected on Thursday by coming in with a rerun of the same failed bill that couldn't pass the House or the Senate." Could you respond to those two --

MR. GIBBS: Well, the bill passed -- one bill actually did pass the House and one bill actually did pass the Senate. This is a -- in many ways a consensus plan around those ideas. Look, again, as I likened a minute ago, you can put your -- tape your quotes up on the locker room wall and put on your --

Q It’s locker room material?

MR. GIBBS: I think it is. I think it's -- you hit my shoulder pads, I'll hit yours, and we'll go running off through the tunnel.

Q But that's on the same team, though, Robert.

MR. GIBBS: I know. They're all going to --

Q Among themselves?

MR. GIBBS: Yes, that's the --

Q Oh, I see.

MR. GIBBS: I lost you on the football analogy, didn't I? (Laughter.) It was very clear up here, Major, it just apparently didn't get --

Q He’s mourning LT. (Laughter.)

MR. GIBBS: So I read. But, again, look, we can play games about the President's proposal --

Q So they're just trying to hype themselves up in anticipation?

MR. GIBBS: Look, I think -- if the President hadn't put anything on there, wouldn't you guess, Major, that we would hear, well, is the President not bringing any ideas to the summit? I mean, are we not going to -- do we not have a document with which we're working on to start this proposal? Of course you would have.

Q Are you saying that no matter what you did, Republicans will criticize?

MR. GIBBS: I mean, it is hard to say -- I will say this, it is hard to take into -- it is hard to listen to, on one hand, “I can't believe they're prejudging the outcome of this by laying out a plan,” and then in the next breath saying, “the plan doesn't have enough detail to be scored by the CBO.” How do you rationalize -- I don't know how they rationalize it. It's probably taped up somewhere in the locker room.

Q It’s irrational.

MR. GIBBS: It appears to be.

Q When the President came here about a week and a half ago, he said that what shouldn't happen is this shouldn’t all go back to the congressional committees for rewrites, the health care legislation. So what I'm curious about is, let's just say for the sake of argument something miraculous happens Thursday and you get something that's akin to a deal. Who writes it? I mean, does it go back to committee? Do you go straight to the House floor, the Senate floor? I mean, these kinds of things are not insignificant to achieving a health care result.

MR. GIBBS: No, they're not insignificant, but I'll be honest with you, Major, leaving the table and the lunch structure aside, I think if we come out of there with an agreement on some ideas --

Q Which you would probably concede would be near miraculous.

MR. GIBBS: Not necessarily. Again, I don't want to prejudge the outcome based on people's willingness to come in there with an open mind. But I don't think the largest impediment to getting something done is, is does the Legislative Counsel for the Ways and Means Committee write down our final ideas or do we send it to larger -- I think those are -- well, again, once we get past the size of the table, I think we can come to -- I think we can come to an agreement and an understanding of that. I think what we lack right now appears to be, based on some of the quotes that you just read me, is a willingness to come and discuss these issues.

Q Let me give you a chance to answer a question on the minds of some progressives. If you are open to the idea of reconciliation, why not put public option in it and go all the way?

MR. GIBBS: Well, again, the President simply believes that we ought to have an up or down vote on health care. Again, I'm not going to get into the structure of how things would look. The President is focused on what he hopes will be a productive conversation on Thursday.

Q Can I ask on the -- not to prolong the table/boxed lunch questions, but the President will be out on national television for hours and hours and hours. Usually, when a President goes out that long, there is some sort of preparation for that. Is there any kind of rehearsal or discussion or briefing or any kind of practice?

MR. GIBBS: Well, look, he and Nancy-Ann have gone through ideas and proposals. He's gotten a longer memo on what ideas are out there and -- in hopes of, again, finding some common agreement on this.

Q But would you do any kind of mock session in which somebody would say, "Sir, somebody might ask you -- what would you respond?”

MR. GIBBS: I'm not going to say that. (Laughter.) I don't know of any structure like that.

Q Whatever it was, please say it.

MR. GIBBS: Yes. (Laughter.)

Yes, ma'am.

Q I have a question just to --

Q Wait, I'm sorry, I'm sorry --

Q Oh, sorry, go ahead.

Q One last one, sorry. On the President's exemption part, a lot of Democrats would like that to be in the bill you posted yesterday, and yet it's not. Why support it separately and not as part of it?

MR. GIBBS: Well, again, this was going through a House process. We had certainly known for I don't know how long, but we've known that this was going to Rules Committee today. Typically the administration weighs in with a statement on administration policy at this point.

Q -- propose it yesterday?

MR. GIBBS: Yes, I mean, I think it's -- I think there's a belief that we can get a bipartisan majority that can support ensuring that type of competition without putting it into legislation.

Mara.

Q Robert, just to follow up on Jennifer's question, when you first got your plan the leadership in Congress was fairly non-committal. They said they wanted to take a look at it and discuss it with their members. Now it's been more than 48 hours. What in the --

MR. GIBBS: Well, not 48.

Q I'm sorry, 24.

MR. GIBBS: Right.

Q What indication do you have that at least in the House of Representatives there is support for -- majority support for this?

MR. GIBBS: Look, I don't want to get ahead of announcing for them where all of their members are. I know they're -- as I understand it, they're going to have a caucus today to discuss some of these ideas, and they also met last night, and --

Q You haven't gotten any feedback in the --

MR. GIBBS: Look, I got to tell you, I thought the statements yesterday by a number of members were indeed quite positive.

Q Do you think this could pass the House of Representatives?

MR. GIBBS: I'm not a vote counter on Capitol Hill, but I do believe that this represents among Democratic ideas a good starting point based on where the Senate was, with some tweaks in that legislation. Again, this is a starting point for our discussions on Thursday that we hope will be fruitful.

Q But doesn’t it go to Congress after that? I mean, don't you want them to do something with it, even if there's not some kind of bipartisan miracle? I mean, you're --

MR. GIBBS: Again, I know it's only Tuesday and I'm focused on Thursday and we want to look beyond Thursday. I'm focused on Thursday; I know that's where the President is focused on. Our intention is to have an honest discussion and hopefully find continued support for ideas on both sides of the aisle.

Q I’m just talking about your side of the aisle.

MR. GIBBS: I understand. I know there's -- again, there's a willingness to want to get well ahead of the process. The President is focused on Thursday. As I said earlier, the bill wasn’t sent to CBO to get scored because our hope is that we're going to add ideas from both sides of the aisle that have common support. I think there are overlaps if people come with a willingness to make progress on an issue.

Q Let me try another way. (Laughter.) Have you had conversations with Democrats since you put this thing online?

MR. GIBBS: Yes, we've briefed Congress.

Q What's been the response?

MR. GIBBS: Again, I don't -- Mara, you guys are normally quite good at getting quotes from them. I've seen many positive quotes on this. Again, our focus is not on what happens Friday, next week, two weeks from now or what have you. Our focus is on a starting point --

Q It has to be, Robert --

MR. GIBBS: But it's not.

Q The White House does not sit still and wait for Friday to come before --

MR. GIBBS: We're focused on Thursday. We're focused on --

Q But that doesn’t make any sense. Don't you want to pass a bill?

MR. GIBBS: And that's why we're doing this on Thursday.

Q I mean, if this is an urgent need for the American public to address all sorts of things -- economic, regulatory and everything else, all the things you have said a hundred times if not more from this podium -- how could you not be thinking past Thursday?

MR. GIBBS: Major, I'm not going to prejudge the outcome of Thursday by telling you what's going to happen Friday based on an outcome of Thursday that I don't know about, based on the fact that I think the willingness -- or the product that ultimately comes out of 4:00 o’clock on Thursday will be based on people's willingness to come with an open mindset. That's what the President --

Q -- not to say you don't have contingency plans?

MR. GIBBS: I'm focused on Thursday; the White House is focused on Thursday; the President is focused on Thursday. As luck would have it, you all probably have a chance to ask me questions on Friday, and we can get to Friday.

Q But Leg Affairs might be focused on a different day.

Q Is there a plan A, plan B, plan C, possibly?

MR. GIBBS: We're focused on Thursday.

Q Is there a plan A, plan B, plan C, possibly?

Q What if nothing comes out of Thursday that --

MR. GIBBS: Then you could ask me that on Friday.

Q All evidence out there points to them showing up and not wanting to make this deal. But is it not naïve to think that -- if your overall goal --

MR. GIBBS: No.

Q -- but it just seems naïve to think --

MR. GIBBS: Can I just say this? I don't know -- I get one question that says, I can't believe by putting out a plan you've completely prejudged and corrupted and polluted the process of what's going to happen on Thursday. So if I then start describing what's going to happen on Friday, based on what may happen on Thursday, aren't you going to certainly -- aren't certainly people going to come back and say you've already prejudged the outcome of Thursday by discussing what's going to happen on Friday?

Q Robert, we're not asking you about Friday. We're asking you if you feel confident that you will have Democratic support for this plan today or tomorrow?

MR. GIBBS: We have discussed this plan with Democrats. I know that they're evaluating parts of the legislation.

Q But you said -- there was a bill that passed the House and a bill that passed the Senate, but if I understood your answer to Mara correctly --

MR. GIBBS: No, I said that -- apparently I said that to Congressman Boehner, who didn't think that happened.

Q But if I understand your answer to Mara, you can't say now if this proposal of the President could even pass the House, which is the first step to getting a bill --

MR. GIBBS: No, I said I wasn't a vote counter and I don't have --

Q Do you have some confidence it could pass the House?

MR. GIBBS: I have confidence that, based on the quotes that I've seen, this has been received warmly by Democrats on Capitol Hill.

Q -- 39 Democrats who voted no for the House health care bill back in November indicated that they'd vote yes the next go-round?

MR. GIBBS: I don't know the answer to that question. One of you ask a question.

Q Okay. I'll go first. This is health care-related, but going back to August, just clarifying some Sunday talk show chatter --

MR. GIBBS: I guess -- yes. I don't know what the resistance is to talking about now. (Laughter.)

Go ahead.

Q You said that the -- "the President's clear commitment is not to raise taxes on those making less than $250,000 a year.” The President's proposal out yesterday actually would raise the Medicare payroll or hospital insurance tax on households making less than $250,000. Wouldn't that --

MR. GIBBS: I'd have to look through the proposal. I'm not sure that's correct.

Q Thank you, Robert. Excuse me. This morning Governor Daniels of Indiana was asked about reconciliation which comes up with regulatory here, and he said that when the tax cuts were passed in the previous administration, where he served as OMB director, it was meant to be applied only to taxes and budget matters, but never to matters such as revolutionary changes in policy that would affect 16 percent of the government -- or 16 percent of the economy.

MR. GIBBS: How much does -- $1.35 trillion worth of tax cuts in 2001, $350 billion in tax cuts in 2003 -- for $1.65 trillion in tax cuts over two votes, is what measure of -- that's a price tag that exceeds what the President is talking about. And differently than that, the proposal that the President has is indeed paid for.

Q But --

MR. GIBBS: I knew there was a "but" in there. I just had to get my broader --

Q Right. It did deal with tax and budget matters, which under --

MR. GIBBS: Again, there --

Q -- which was with reconciliation --

MR. GIBBS: Welfare was another example of something that had passed based on reconciliation. I can certainly get a list of, I think many of you can get a list of, ideas that have gone through the process of that that up until recently didn't seem to be abnormal.

Q Robert, one on the public option. You say that it's not in this, but are there any components of the public option that will be taken and transplanted into this proposal that the President has for Thursday?

MR. GIBBS: Again, this is a debate that was largely ended with the notion that it's not going to make it through the legislative process. The proposal that the President put online was where he believed was a good starting point at the end of the debate that had been had on Capitol Hill. We think that the way exchanges are structured and other components of the legislation will increase the amount of choice and competition that people have in picking health insurance.

Only a partial list of attendees has been released, but it is clear the room will be full. Among the participants: Republican Sens. John McCain (Ariz.) and two doctor-lawmakers, Tom Coburn (Okla.) and John Barrasso (Wyo.); Democratic Sens. Harry M. Reid (Nev.), Charles E. Schumer (N.Y.), Max Baucus (Mont.), Christopher J. Dodd (Conn.) and Patty Murray (Wash.); and Democratic Reps. Charles B. Rangel (N.Y.), John D. Dingell (Mich.), Henry A. Waxman (Calif.), Xavier Becerra (Calif.) and Jim Cooper (Tenn.)

February 24, 2010

This week at www.healthtransformation.net, we are hosting The American People's Online Health Summit.

Like the White House's summit, our online health summit will feature voices from both parties, including Republican Sen. Tom Coburn and former Democratic Majority Leader Tom Daschle.

And like their summit in Washington, D.C., our online health summit will feature some of the country's foremost experts on healthcare, including Julie Gerberding, M.D., former director of the Centers for Disease Control, and Scott Serota, president and CEO of Blue Cross and Blue Shield.

But unlike the White House summit, which will be totally dominated by politicians, The American People's Online Health Summit has a seat for you at the table.

We're discussing common sense, market-oriented solutions to America's healthcare challenges, including steps to stop fraud, creating incentives for better health outcomes, and lawsuit reform to reduce the cost of defensive medicine. According to a Gallup poll released Monday and commissioned by Jackson Healthcare, doctors estimate that one-in-four healthcare dollars are spent on defensive medicine. That's over $650 billion a year we could be saving!

Today we are discussing how health information technology will help cut the waste and inefficiency of a paper-based system and allow us to better analyze health data to determine what hospitals and providers provide the best outcomes and value for your dollar.

Visit www.healthtransformation.net to participate today.

February 24, 2010

WELLPOINT RAISING RATES BY DOUBLE DIGITS IN AT LEAST 11 STATES: This month, health insurance giant WellPoint announced that it planned to raise premiums by 39 percent on individual policyholders of its California subsidiary.

President Obama called the news "jaw-dropping" and said the hikes underscore the need for comprehensive reform. "As bad as things are today, they'll only get worse if we fail to act," Obama said.

Indeed, a new survey by the Center for American Progress Action Fund shows that California is not alone.

"[D]ouble-digit hikes have been implemented or are pending in at least 11 other states among the 14 where WellPoint's Blue Cross Blue Shield companies are active," the report finds.

In Maine, for instance, "where WellPoint-owned Anthem Blue Cross and Blue Shield is by far the largest insurer, the company is seeking to raise individual rates an average of 23 percent this year." This comes "after five consecutive years of double-digit premium increases."

In Indiana, some WellPoint individual policyholders will face rate increases of "up to 50 percent."

The White House health care proposal, released Monday, includes a provision that would "allow the federal government to review and deny excessive, unreasonable or discriminatory health insurance premium increases" like WellPoint's. There are other protections in the bills that passed the House and Senate, but this new measure "would go a step further by federalizing the states' traditional and somewhat uneven role in monitoring insurance rate increases."

Many states have "some form of a prior approval process for premium increases," but state governments often lack the resources or political will to keep insurers in check. Under the White House proposal, insurers would have to justify "unreasonable" premium increases to the Health and Human Services Secretary, who would have the ability to deny or modify unjustified hikes. Insurers claim rate increases are necessary to stave off losses, but the five largest companies actually increased their profits by 56 percent in 2009.

Luke_Wilbur · February 25, 2010

PRES. OBAMA’S HEALTH CARE SUMMIT: LIVE ON THE C-SPAN NETWORKS

Wednesday

Pres. Obama hosts members of Congress at Blair House on Thursday in an effort to reach a compromise on health care legislation.

Live C‑SPAN coverage begins at 9:45am ET on C‑SPAN3, C‑SPAN.org andC‑SPAN Radio. Also follow our live coverage on Twitter, Facebook andthe C‑SPAN Radio iPhone App.

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