Plouffe: Pass the Healthcare Bill Now

David Plouffe wrote an op-ed for the Washington Post:

Pass a meaningful health insurance reform package without delay. Americans' health and our nation's long-term fiscal health depend on it. I know that the short-term politics are bad. It's a good plan that's become a demonized caricature. But politically speaking, if we do not pass it, the GOP will continue attacking the plan as if we did anyway, and voters will have no ability to measure its upside. If we do pass it, dozens of protections and benefits take effect this year. Parents won't have to worry their children will be denied coverage just because they have a preexisting condition. Workers won't have to worry that their coverage will be dropped because they get sick. Seniors will feel relief from prescription costs. Only if the plan becomes law will the American people see that all the scary things Sarah Palin and others have predicted -- such as the so-called death panels -- were baseless. We own the bill and the health-care votes. We need to get some of the upside. (P.S.: Health care is a jobs creator.) WaPo

The democrats are mulling over health care:

Sen. Charles Schumer (D-N.Y.), a member of the leadership team, said deciding on the process should not take long. “That doesn't mean we're going to sit here and twiddle our thumbs for weeks and weeks and weeks, but it'll take a few days to figure out what the best solution is,” he said. The Hill.

Plouffe also says republicans shouldn't be lecturing on spending. I'm convinced that Americans could care less who drove up the nation's debt. They simply don't want to see the deficit any higher, which is why healthcare scares the wits out of them. But if anyone doubts what will happen if GOP is back in power, consider John Boehner's reaction to the recent SCOTUS decision on giving corporations people power:

"I think the Supreme Court decisions today are a big win for the First Amendment and a step in the right direction," said House Republican leader John Boehner of Ohio. In his view, the Constitution's protection of free speech extends to campaign contributions. No organization — business, union, whatever — should be limited by the government, Boehner said. NPR

Plouffe:

Don't accept any lectures on spending. The GOP took us from a $236 billion surplus when President Bush took office to a $1.3 trillion deficit, with unpaid-for tax cuts for the wealthy, two wars and the Medicare prescription drug program. Republicans' fiscal irresponsibility has never been matched in our country's history. We have potent talking points on health care, honest budgeting and cuts in previously sacrosanct programs. Republicans will try to win disingenuously by running as outsiders. We must make them own their record of disastrous economic policies, exploding deficits, and a failure to even attempt to solve our health care and energy challenges.

During the campaign, who will be whispering in Republican ears? Watching GOP leaders talking about health care the past few days, it was easy to imagine lobbyists and big health insurance executives leaning over their shoulders, urging death to health insurance reform. When it comes to cracking down on the banks and passing tough financial regulatory reform, GOP leaders will be dancing to the tune of Wall Street lobbyists and opposing tougher oversight, as if the financial crisis never happened. We need to lay it out plainly: If you put the GOP back in charge, lobbyists and huge corporate special interests will be back in the driver's seat. Workers and families will get run over, just like they did in the past decade.

CBS' Mark Knoller says Obama will be seeking Plouffe's advice more often, but not as an official paid government employee:

In the wake of the GOP Senate win in Mass., Pres. Obama will be looking to his former campaign mgr David Ploufe for more political advice.

Obama: Seat Brown First

Update: Harry Reid said healthcare won't move forward until after Brown is seated.

This pleases me. A lot. Obama gets it. Also, Scott Brown could be an ally on a new healthcare bill. This comes from a preview of Obama's interview tonight with George Stephanopoulos (watch a preview here):

President Obama said today that Democratic leaders in Congress should not try to “jam” the health care bill through in the coming days, saying that lawmakers should wait to move forward on the legislation until Republican Senator-elect Scott Brown of Massachusetts is seated.

“Here’s one thing I know and I just want to make sure that this is off the table: The Senate certainly shouldn’t try to jam anything through until Scott Brown is seated,” Mr. Obama said in an interview with ABC News. “The people of Massachusetts spoke. He’s got to be part of that process.”

He added, “It is very important to look at the substance of this package and for the American people to understand that a lot of the fear mongering around this bill isn’t true.”

The president said lawmakers should “move quickly to coalesce” around “core elements” of the legislation that are less controversial, including efforts to reduce costs of health insurance.
......
Here’s my assessment of not just the vote in Massachusetts, but the mood around the country: the same thing that swept Scott Brown into office swept me into office,” Mr. Obama said, according to excerpts released by the network. “People are angry, they are frustrated. Not just because of what’s happened in the last year or two years, but what’s happened over the last eight years.”

The president also struck an unusual tone, expressing an air of contrition as he opens his second year in office.

“If there’s one thing that I regret this year,” Mr. Obama said, “is that we were so busy just getting stuff done and dealing with the immediate crises that were in front of us that I think we lost some of that sense of speaking directly to the American people about what their core values are and why we have to make sure those institutions are matching up with those values.”
NYT

Axelrod and Gibbs on Brown Win

Update from Andrea Mitchell on Twitter:

more Axe- says he agrees with Webb shouldnt try and circumvent Scott Brown. will link to interview soon.

See what Jim Webb had to say about waiting here.

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CHUCK TODD: Republican Scott Brown's stunning victory means the Democrats' eight month super majority in the Senate is now gone. Is the President's health care bill gone with it?

Robert Gibbs is the White House Press Secretary. David Axelrod is the President's Senior Advisor. They're here now for a DAILY RUNDOWN exclusive, together. We believe it's your first joint interview since you've been in that lucky --

DAVID AXELROD, SENIOR ADVISOR TO PRESIDENT OBAMA: It may be our last. Let's see how it goes.

ROBERT GIBBS, WHITE HOUSE PRESS SECRETARY: We may take it on the road, Chuck. We may be making , you know, a few cities.

TODD: Fair enough. So, David, I'm going to put this first question to you.

How much responsibility does the White House accept for Martha Coakley's -- for the Democratic Party's loss in Massachusetts?

AXELROD: Look, Chuck, there's an unbecoming habit in this town of trying to defray a responsibility, point in other directions. And so let me say it was Robert's fault and I'm bitter about it.

Read the rest of the transcript

Eight Hour Talks on Health Care

After 8 hours, health care talks just let up today, according to CBS White House reporter Mark Knoller:

White House health meeting with Congressional Democratic leadership just ended - after 8 hours.

Obama has apparently brought down the hammer, trying to reach an agreement on health care.

Prodded by President Barack Obama, senior Democratic lawmakers held lengthy talks at the White House on Wednesday as they searched for a final compromise on overdue health care legislation.

Several officials said numerous details remained to be settled, including the size of the subsidies that would go to lower-income Americans who require help in affording insurance.

It was not clear what progress, if any, the day's negotiations yielded. "I don't know whether they'll get through discussing all that they need to today," said White House press secretary Robert Gibbs. MSNBC

Labor Leaders Not Happy With Cadillac Tax

Everyone is so precious. No one wants to make any sacrifices for the common good. Labor leaders, who Obama met with yesterday, are saying labor won't come out to vote if their Cadillac plans are taxed because they don't view their health plans as a Cadillac.

How many people have robust benefits such as this:

The proposed 40 percent tax would affect family plans worth more than $23,000 and those worth $8,500 for individuals and could raise $149 billion in new tax revenues over 10 years.

Obama may consider fixes to Labor's complaints, such as raising the threshold. Kaiser Health news has summaries from various news outlets on Obama's meeting with Labor:

Labor leaders were invited to the White House to discuss negotiations to merge the House- and Senate-passed health overhaul packages.

The Washington Post: "The final bill will not include the House's government-run insurance plan, or 'public option'; it will probably include the Senate's new tax on high-cost health plans that could affect many union members; and its penalties for employers who do not provide insurance coverage will probably be closer to the more lenient terms in the Senate bill." Earlier in the day, AFL-CIO President Richard Trumka warned at the National Press Club that Democrats risk a replay of the "Democratic blowout in the 1994 elections, when, after the passage of NAFTA and other disappointments to unions, "'there was no way to persuade enough working Americans to go to the polls when they couldn't tell the difference between the two parties'" (MacGillis, 1/12).

The New York Times: During a private session designed to "search for a sort of compromise," President Barack Obama told the union leaders "that he remained committed to taxing high-cost insurance policies as a way to drive down health costs. But he also signaled that he was willing to amend the proposal to 'make this work for working families,' a senior administration official said."

The proposed 40 percent tax would affect family plans worth more than $23,000 and those worth $8,500 for individuals and could raise $149 billion in new tax revenues over 10 years. Read more at KHN

Obama Speaks on Health Reform's Benefits in 2010

Obama talks about that elusive good job with a good wage, and then delves into the immediate benefits of healthcare. See a health reform timeline of benefits and when they start here.

Uninsured Americans with a pre-existing illness or condition will finally be able to purchase coverage they can afford.

Children with pre-existing conditions will no longer be refused coverage, and young adults will be able to stay on their parents’ policy until they’re 26 or 27 years old.

Small business owners who can’t afford to cover their employees will be immediately offered tax credits to purchase coverage.

Early retirees who receive coverage from their employers will see their coverage protected and their premiums go down.

Seniors who fall into the coverage gap known as the donut hole will receive discounts of up to 50 percent on their prescriptions as we begin to close that gap altogether.

And every patient’s choice of doctor will be protected, along with access to emergency care.

Here’s what else will happen within the first year. Insurance plans will be required to offer free preventive care to their customers – so that we can start catching preventable illnesses and diseases on the front end. They’ll no longer be allowed to impose restrictive annual limits on the amount of coverage you receive or lifetime limits on the amount of benefits you receive. They’ll be prohibited from dropping your coverage when you get sick and need it most. And there will be a new, independent appeals process for anyone who feels they were unfairly denied a claim by their insurance company.

In short, once I sign health insurance reform into law, doctors and patients will have more control over their health care decisions, and insurance company bureaucrats will have less. All told, these changes represent the most sweeping reforms and toughest restrictions on insurance companies that this country has ever known. That’s how we’ll make 2010 a healthier and more secure year for every American – for those who have health insurance, and those who don’t.

Transcript

Obama's Interview With Jim Lehrer Dec. 23

Full transcript.
An excerpt:

JIM LEHRER: Are you going to actually participate with -

PRESIDENT OBAMA: We are - we are - we hope to have a whole bunch of folks over here in the West Wing, and I'll be rolling up my sleeves and spending some time before the full Congress even gets into session, because the American people need it now. I mean, something that's gotten lost, Jim, during the course of this debate - because this is how Washington works - it ends up being, well, did the president win on that one or did he lose on that one? What's Joe Lieberman doing today, and what's Mitch McConnell doing tomorrow?

Right now there are families who don't have health insurance and, as a consequence of somebody getting sick in their family, have been bankrupt. Right now there are small businesses who've been doing the right thing by their employees and just got a notice from their insurance companies that their premiums went up 25, 30, 40 percent; and that business owner's having to make a decision, do I start dropping coverage for my employees or do I have to lay off one employee to keep coverage for everybody else?

Those kinds of decisions are happening right now. And so, you know, I intend to work as hard as I have to work, especially after coming this far over the course of the year, to make sure that we finally close the deal.

Obama Did NOT Campaign on Public Option

As someone who has watched every media interview and campaign speech and every Obama speech once he was elected President (all of his speeches are posted on this blog), I know that Obama didn't campaign on the public option, contrary to Ezra Klein's opinion:

Oy. I'll defend the argument that the health-care bill that looks likely to pass is structurally similar to the health-care proposal released by the Obama campaign. But it's impossible to defend Obama's statement that "I didn't campaign on the public option." For one thing, it was in his campaign plan, which is to say, he campaigned on it. The proposal (pdf) assured voters that Obama's plan will "establish a new public insurance program available to Americans who neither qualify for Medicaid or SCHIP nor have access to insurance through their employers." WaPo

Klein is violating the spirit of Obama's intentions. The "public insurance program" in Obama's campaign PDF is not the same as today's current public option. Media people like to manipulate information to meet their preconceived notions. In this case, Klein is trying to give an example as to why the left is losing faith in Obama:

And it's a good example of why the left is losing its trust in Obama.

I am so tired of the manipulations by the left and right media. Ideology, people set in their ways, is why things don't get done in Washington. As someone who doesn't subscribe to any ideology, it's easy to see what's going on here. A lot of people on the left propped Obama up to be what they wanted him to be. Same for the right. The wingnuts are just in outer space with their far out preconceived ideas.

In fact, Obama's never advocated strongly for the public option in its current form because he saw it as ONE way to meet his goals, not the only way. He has received a lot of criticism for not insisting on the public option as we know it. I think Obama recognized early on that the public option in its current form would be a political football between the left and the right. If so much attention hadn't been paid to the public option, health care might be further along. But as usual, the left and the right decided to make political mincemeat of it, which served as a distraction. Here we are with the left-most media still politicizing the public option.

Final Healthcare Bill in February?

Issues that need to be reconciled between the House and Senate bills: the public option, abortion coverage and how to pay for healthcare:

The White House privately anticipates health care talks to slip into February — past President Barack Obama’s first State of the Union address — and then plans to make a “very hard pivot” to a new jobs bill, according to senior administration officials.

Obama has been told that disputes over abortion and the tight schedule are highly likely to delay a final deal, a blow to the president, who had hoped to trumpet a health care victory in his big speech to the nation. But he has also been told that House Democratic leaders seem inclined, at least for now, to largely accept the compromise worked out in the Senate, virtually ensuring he will eventually get a deal.

Internally, White House aides are plunging into a 2010 plan calling for an early focus on creating jobs, especially in the energy sector, along with starting a conversation about deficit reduction measures, the administration officials said. Politico

McCaskill Says She's Pretty Sure the Grinch is a Republican

Claire McCaskill says democrats are united thanks to the republicans.

McCaskill says when she explains the bill to Missourians, they understand. She says there's been a lot of misinformation about health care and the horrible economic year has made people mistrustful. She says health care turned into a political food fight. McCaskill is one of the few Senators I trust. I think it was the way she handled the unruly town halls this summer.

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Why is There a Mandate in Senate Health Bill?

Because if everyone is paying into the insurance premium pool, then we can take care of people with pre-existing conditions. This episode of Talk of the Nation explains some of the pieces of the healthcare bill, including cost. The more I hear about the bill, the more I like it and the more I'm actually enjoying hearing republicans whine.

I still think Ben Nelson is an unethical creep though.

Obama's Remarks on Healthcare Bill and Government Efficiency

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Ben Nelson is an Unethical Terd

Apparently, these kinds of trades, bribes, or whatever you want to call it, happen all the time. But getting a special exception for his state makes Sen. Ben Nelson of Nebraska look like a real terd.

It's very unethical of Nelson to demand free Medicaid, something that other states won't get, in exchange for a vote. What if every democrat did what he did? Plus, he made demands on abortion too.

Clearly, politicians don't have much of a conscience. Even if I was a Nebraskan, I'd be disappointed with such an immoral deal. Still, I'm happy that healthcare is almost certain to pass the Senate.

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Obama's Schedule Dec. 21

Obama will speak at 11:30 am eastern on effective government. It will probably be live streamed at WhiteHouse.gov.
Now that the manager's amendment (changes to the Senate healthcare bill) passed (late last night), the next vote will be on the substitute amendment and then a vote on the whole bill, which will probably happen on Christmas eve, when a simple majority of 51 votes are needed. Then the House bill and the Senate bill have to be reconciled.

Obama Announces Funding for Community Health Centers

Obama announced $500 million of stimulus funding for community health centers across the nation. He also said $88 million will help them migrate medical records from paper to digital. See a list of which centers will get the grants and how much they'll receive here. The community centers competed for the money much like schools are competing for federal education grants.

Obama also thanked Congress for sticking with healthcare and says the tentative new compromise is another step in the right direction.

Here's the release from the White House:

WASHINGTON - Today President Obama announced nearly $600 million in American Recovery and Reinvestment Act (Recovery Act) awards to support major construction and renovation projects at 85 community health centers nationwide and help networks of health centers adopt Electronic Health Records (EHR) and other Health Information Technology (HIT) systems. The awards are expected to not only create new job opportunities in construction and health care, but also help provide care for more than half a million additional patients in underserved communities. The President also announced a new demonstration initiative to support the delivery of advanced primary care to Medicare beneficiaries through community health centers.

“Together, these three initiatives – funding for construction, technology and a medical home demonstration project – won’t just save more money, and create more jobs, they’ll give more people the peace of mind of knowing that health care will be there for them and their families when they need it,” said President Obama. “Ultimately, that’s what health reform is really about.”

“One of the first investments we made through the Recovery Act was in supporting our nation’s community health centers – and today we build on that progress by funding new construction and improvement projects at more than 80 facilities nationwide,” said Vice President Biden. “This is what the Recovery Act is all about – providing immediate assistance for hard-hit families, improving our nation’s infrastructure and creating new opportunities for stable, well-paid work.”

To qualify for funding, a health facility must be a Federally Qualified “Community” Health Center. Grants of $508.5 million will be provided through the Facility Investment Program (FIP) program to address pressing health center facility needs. Also, as much as $88 million will be available to help Health Center Controlled Networks improve operational effectiveness and clinical quality in health centers by providing management, financial, technology and clinical support services.

The new Recovery Act funds are the latest in a series of grants awarded to community health centers, which deliver preventive and primary care services at more than 7,500 service delivery sites around the country to patients regardless of their ability to pay. Health centers serve more than 17 million patients, about 40 percent of whom have no health insurance.

Both programs will be administered by the Health Resources and Services Administration (HRSA), an agency of the U.S. Department of Health and Human Services (HHS).

President Obama directed the Department of Health and Human Services to implement a demonstration initiative designed to evaluate the impact of the advanced primary care practice model on access, quality and cost of care provided to Medicare beneficiaries served by community health centers.

This model, known as the “medical home,” promotes accessible, continuous, and coordinated family-centered care. Developed and administered by the Centers for Medicare and Medicaid Services (CMS), the demonstration will last three years. CMS anticipates that up to 500 health centers will participate.

“Because community health centers already provide comprehensive health care to people who face the greatest barriers to accessing care, these demonstration projects have the potential to support and improve the care delivered not only to Medicare beneficiaries, but also to others who rely on community health centers for primary care,” said HHS Secretary Kathleen G. Sebelius.

HRSA has received a total of $2 billion through the Recovery Act to expand health care services to low-income and uninsured individuals through its health center program. To date, nearly $1.9 billion of these funds have been awarded to community-based organizations across the country.

Harry Reid's Report on Today's Meeting With Obama

Harry Reid says he asked five progressive dems and five moderates to get together and work out their differences.

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Mitch McConnell Complains About Being Left Out

Mitch McConnell has gall. Republicans have been standing against the wall whining.
Obama called democrats together today to push healthcare. The Senate voted down an amendment by the smarmy John Ensign. If I were Ensign, I would've resigned.
Harry Reid says in the future people will look back at what this Congress accomplished:

Witness this fine piece of criticism by John Cornyn--a healthcare "gulag." Come on. Really?

Carly Fiorina Pulls a Sarah Palin

In the GOP weekly address, Senate candidate and former HP exec Carly Fiorina talks about her cancer.
She also talks about the mammogram recommendations from the task force, or what Sarah Palin would call the "death panel." Republicans exploded the conversation on new scientific information from the task force into the realm of the irrational. Then the media got a hold of it and it spiraled out of control.
This debate is maddening. We lack the ability to analyze new information, without it getting twisted from various world views. Most people today are fed information.
The simple fact is republicans aren't interested in health reform, except when it benefits the industry. Carly does what Sarah couldn't do. She puts a pleasant spin on "death panels:"

I, for one, took note of the new recommendations. Dr. Susan Love, an expert on breast cancer, is the most clear voice in the debate:

This brings us to the current task force which again went through a thorough review of the data supporting screening young women. They found that although there is a reduction in mortality by 15% in this group, it does not appear until the women are followed 11-20 years, in other words until they are over 50. The risks of getting mammography early in life include extra radiation. One estimate of the cumulative radiation risk for women 40-50 is that as many deaths could be caused versus prevented with yearly screening. Other risks include false positives or finding abnormalities that require investigation and even biopsy but do not turn out to be cancer. Finally, there is the over treatment risk from finding lesions that may look like precancerous lesions but in fact would never develop into cancer.

Are these new guidelines an example of rationing? You bet. They are an example of exactly how we need to ration health care, based on science. It is exactly this approach, health care standards by popularity rather than science that raise the cost of medical care in this country. The lack of a "comparative effectiveness" body to come up with recommendations and then enforce them, means that it is the third party payers willingness to pay for procedures that determines the standard of care. The absence of a government run screening program means that the uninsured cannot get screened at any age unless they are poor enough to qualify for a CDC program. The best way to improve the health care of all women and to prevent deaths from breast cancer is not supporting screening that is not effective but rather a health care reform that covers all with evidence based medicine. HP

Orrin Hatch to Introduce Abortion Amendment to Healthcare Bill

The Senate begins debate on healthcare tomorrow. Both republicans and democrats will be offering amendments. If healthcare passes, Harry Reid is the King. If it's going to pass, there has to be a lot of give and take.

The Senate is set to begin debate on its health-overhaul bill Monday, with Democrats and Republicans planning to offer amendments on divisive subjects such as abortion and taxes that could hamper passage of the bill.

The debate is expected to last at least several weeks. Democrats would like to pass a bill by Christmas, but have yet to find a formula that can win 60 votes, the number required to conclude debate.

Complicating the situation, lawmakers from both parties are planning to introduce dozens of amendments, addressing issues from a government-run health-care plan to medical malpractice lawsuits to abortion and taxes. The aim isn't just to shape the bill but also to make political points.

Any of the amendments will also likely require 60 votes to pass, because opponents can threaten to filibuster any amendment that has less support. That sets a high bar, but even unsuccessful amendments can send a message.

Sen. Orrin Hatch (R., Utah), for example, is expected to offer an amendment to insert tough abortion restrictions in the bill, mirroring language in the bill that narrowly passed the House Nov. 7. Republicans are also likely to offer at least one amendment limiting medical malpractice lawsuits.

Obama's Press Conference on Cabinet Meeting Nov. 23