The more Liberals defend the HCR Bill that passed the Senate

[Tom Rinaldo]

...the less leverage Liberals and Progressives will have in the House/Senate Conference Committee, and the less pleased Liberals and Progressives will likely be with the final HCR legislation.

[librechik]

1. could you pls keep it on the DL how much influence libs have?

we are trying to use a little strategy here. (I hope)

[ProSense]

2. Screaming fact-free claims isn't likely to improve progressive leverage either.

Every Senator who has stated what's right in the bill is written off as a sellout. That's a great way to gain leverage, huh?

[Tom Rinaldo]

5. I stand by my statement as written

There is a difference which you are fully aware of between defending the HCR process and defending the Senate HCR Bill. There is also a difference between saying the Senate Bill should be killed and saying that one is hopeful that it can be improved in the Conference Committee. Negotiations are ongoing and there are still those who hope to push the final bill toward the Right as much as possible. They have done well at that so far by pointedly withholding their support until they get to see the final product that will come to a vote. There seems to be a correlation between centrist skeptics expressing skepticism about a bill in progress and further progress than shifting in a more conservative direction.

[Duke Newcombe]

17. What's "in the bill" isn't nearly enough.

When you start off negotiating against yourself, you get the crumbs. This is what happened here. Excuse us for pointing that out.

[depakid]

25. An odd thing for someone who was such a strong proponent of the public option to say...

[Hello_Kitty]

28. She was against mandates too. Once upon a time... eom

[ProSense]

32. You really can't comprehend what's going on can you?

There mandates have their pros and cons. It makes no sense to advocate mandates with exhorbitant penalities or when people can't afford the mandated product. That being said, all universal health plans include a mandate.

If you can't tell the difference between making a case to get something passed, and not making something that was never a big sticking point the basis for opposing reform, that's your problem.

[Hello_Kitty]

33. Damn sister, get some sleep.

It's only 10:25pm here. 2 hours later where you are. You aren't going to convince me, ever. Work on your neighbors. That requires early mornings and shoe leather. Your bill is a done deal. Go out and sell it!

I mean it.

[Sarah Ibarruri]

3. So you think that this is a one-time deal and there will be no modifications, ever for the history

of the United States of America, right?

God, no wonder America is such a f'd up country, with all-or-nothing thinking. FUCKED UP.

[Tom Rinaldo]

6. You forget. There isn't a deal yet.

There is still deal making going on. Not only about the Public Option, but about Abortion, about taxing mechanisms, about State vs. Federal Exchanges, about subsidy levels, about the anti-monopoly excemption that the insurance industry is currently granted, and much more.

[Sarah Ibarruri]

11. Fine, but people who are attacking Obama along with the GOP sucks and I will not stand for it nt

[tritsofme]

4. It is more an accepting of reality.

The Senate has the most leverage because they need to count to 60, and these senators have shown they have no problem letting HCR die if the Senate compromise is altered significantly.

That is the reality of this legislation.

[Tom Rinaldo]

7. The Senate's leverage is the ability of Senators to stop HCR

The same is true of the House. The original House Bill passed by a tiny margin, and that Bill had a Public Option in it.

[tritsofme]

8. Will the left really kill HCR?

I doubt it. The Liebermans and Nelsons have no problem standing with Republicans to kill reform, I doubt that is true about the more liberal members.

The compromise will win more Blue Dog votes in the House, and accepting it is the reality of the 60 vote environment that exists in the Senate.

[Tom Rinaldo]

9. I am stating a simple fact

The perception that Centrists are willing to kill HCR but that the Left is not gives centrists far more leverage in Congressional negotiations than progressives have. I believe that there was some honest uncertainty about whether Bernie Sander's vote could be counted on in the Senate for cloture, and that gave him added leverage to get changes he wanted inserted into the final Senate Bill.

For the next two weeks perceptions matter. Even the perception that there could be an at least partial Organized Labor revolt, or an at leastpartial grassroots activist revolt, and the same for feminists, if too many concessions are made to the Right and not enough to the Left by the Conference Committee.

[madfloridian]

13. I recommended, but the unrecs beat me out. I agree with you.

We are afraid to stand up for what we believe lest someone accuse us of hurting Democrats.

[Tom Rinaldo]

14. Thanks Mad

I think if enough people see this thread and actually read it knee jerk reactions will decrease. This is one of those times when I chose my words carefully. There's nothing particularly ideological about my comments; neither pro nor anti Obama either. It's just political reality.

A lot of people drag out the observaton that improvements in the Senate Bill can be made in Conferenece, and then they leave it at that. Improvements will not magically happen, there will be opposing forces clashing and hard ball played. My OP observation and a desire to improve rather than kill HCR can very much go hand in hand.

[EFerrari]

24. I do, too. n/t

[dkf]

10. There are people here happy with the amount of money health insurance cos are guaranteed to make.

Crazy huh?

[BeFree]

12. How much?

What is the guarantee? Got a dollar figure? Percentage?

[dkf]

15. 15 to 20% on entire cost

Which they keep on saying is 1/6 of GDP. Even for those who get Medicare many are double covered like retirees who get benefits from their employers. That is a lot of money

[BeFree]

16. Is that profit?

Or just administrative costs?

And won't the government be looking at the books now?

[dkf]

18. Of medical payout costs I believe.

I saw an estimate that a family of 4 making 66000 incurs almost 20000 in medical costs of which the subsidized premium is still 9000 a year. My back of napkin estimate is 3000 per family to cover admin for these plans. That looks pretty hefty to me.

Also when profits are cost plus it is an advantage to have higher costs.

[BeFree]

19. So

You don't know the guarantee?

Case point: I know someone who ran up close to a hundred thousand in bills in two years then died after paying only fifty thousand in insurance. Guess what? The insurance company and medicare lost 50 grand.

Eventually insurance companies are gonna go broke between paying the bills and overpaying executives. Now that we're reading the books, which costs do you think will be controlled first?

[dkf]

20. They have to rebate anything over 15% for large plans

And 20% for small plans. And that has nothing to do with individuals but with the collective group. So everyone else paid for your friends medical costs and the insurance cos charged them an extra 29%. That will be brought down to 15-20% under the bill but with an extra 30 million people to add to the cost plus scenario.

And don't forget many if not most states are in a monopoly type situation.

[amborin]

21. effect on Middle Class:

•The excise tax, (which is not in the House bill) which the CBO itself says will affect 19% of people with employer-provided insurance in 2016. In 2019, six years after this bill takes effect, the excise tax will affect one in five taxpayers making $50-$75,000 per year, and the average tax impact on this bracket will rise to $1,100 a year in 2019.


In addition, the Centers for Medicare and Medicaid Services (CMS, another CBO-like organization) predicts that the excise tax will actually make coverage worse for very little return in savings.

In reaction to the tax, many employers would reduce the scope of their health benefits. The resulting reductions in covered services and/or increases in employee cost-sharing requirements would induce workers to use fewer services.

Because plan benefit values would generally increase faster than the threshold amounts for defining high-cost plans (which are indexed by the CPI plus 1 percent), over time additional plans would become subject to the excise tax, prompting those employers to scale back coverage.

The savings?

This excise tax, which would reduce the quality of millions of Americans’ health insurance coverage, will technically "bend the cost curve" by just barely 0.3% in 2019. All that for a measly 0.3% reduction in national health expenditures.

To give you a comparison, CBO projects that Dorgan’s drug re-importation would reduce spending on prescription drugs roughly $100 billion over the next decade (I think the savings could easily end up 4-5 times that amount). A $10 billion reduction in prescription drug spending compared to the total NHE spending last year, which was roughly $2.4 trillion in 2008, would be a 0.4% reduction in NHE.

•The mandate remains, with a larger fine for those who don't purchase coverage attached. Perhaps that's in response to the calculations done showing that it would be cheaper for people to pay the fine than to maintain coverage under the junk insurance plans that are still going to be allowed in the newly "reformed" system. The exemption for those who can prove they can't afford coverage is maintained.

•There is no public option of any kind in the Senate bill, no opt-out, no Medicare buy-in. Just the two national private plans, one of which would be non-profit, that would be overseen by the Office of Personnel Management. The CBO says it's questionable whether "insurers would be interested in offering such plans is un

clear, and establishing a nationwide plan comprising only nonprofit insurers might be particularly difficult." Note, even should a national non-profit be set up by an insurer, it is not the equivalent of the public option.

effective they will be:

California recently dropped an attempt to enforce its anti-rescission law against a major insurer, saying that it was financially outgunned by the insurer's legal team.

The rescission law, according to the legislation, "shall not apply to a covered individual who has performed an act or practice that constitutes fraud or makes an intentional misrepresentation of material fact as prohibited by the terms of the plan or coverage."

Insurers today routinely claim that patients engaged in "fraud" or "intentional misrepresentation" when dropping them from coverage. Much depends on who defines the terms in the bill.

It won't be the federal government. There will be no federal agency tasked with overseeing the enforcement of the bill's rules. Rather, a Senate leadership aide told reporters in a briefing Saturday, individual states will police the new system.

That's a task the California Department of Managed Health Care was unable to perform when battling Anthem Blue Cross, which has rescinded 1,770 policies since 2004.

"In each and every one of those rescissions, the right to contest each, and that could tie us up in court forever," the department's director, Cindy Ehnes, told The Associated Press. A million-dollar fine was announced in March 2007, but has not been enforced.

If the enforcement for these regulations falls on the individual states, and the individual states will have to litigate them, which could take a very long time in each case. The regulations are unlikely to be uniformly enforced state to state--some of them have extremely proactive insurance commissioners and strong regulatory structures in place, others don't. And in the states that don't, don't expect insurers to end some of these practices out of the goodness of their hearts.

Bottom line, Americans are still going to be forced to buy insurance that for too many people will be unaffordable. As long as that's the case, and until there's a true alternative public option that provides people real choice, the insurance companies shouldn't get that one thing in the legislation they want: the mandate.


all from Daily Kos

[HughMoran]

29. Name one.

Name just one person here happy with what the insurance companies are going to make.

[freddie mertz]

22. I tend to agree. We could and should try to do better.

All the name-calling is not helping either.

[sabrina 1]

23. Rec'd also.

Allowing personal feelings for individual politicians and/or party loyalty to blind people to what is best for this country, is exactly what the Right did when they supported Bush's policies. Many now have regrets, but it's way too late. The dead and the maimed for life, can't take much comfort from the change of heart of those who made it all possible because of party loyalty.

That misguided support also didn't do the Republican Party much good either.

[burning rain]

26. Don't know whether this makes me a "defender" of the Senate bill or not...

but I view it as a poor bill, which, however, should pass because it improves on the even-worse status quo. Plenty of criticism is deserved, and I think potentially the most constructive approach in this critical period before the conference, is to ask House members to insist on a public option in the final bill and tell senators complaining that they can't get 60 votes for it, to toughen up and pass it via the nuclear option, thereby securing a bill that better serves the good of society, besides having more public support (a useful selling point for politicians).

[Hello_Kitty]

27. K and R. Amazing how the "roll over and accept anything" crew does not get this.

And it's not just liberals and progressives who will be displeased. The majority of the public will be as well. They want health care reform, not DLC corporate giveaway "reform".

[paulk]

30. true that

it also doesn't help that the White House, or at least their shills, are trashing the left on this and not the center. If some of our Senate "liberals" learned to play a little hardball now and then, we'd be a lot better off.

[DailyGrind51]

31. The final product still must be voted on before it is submitted to the President.

Lieberman, Nelson, et.al., could still not vote for the final package, in the event that something they object to gets added.

[jgraz]

34. Nice to see a few people get it.

[TheKentuckian]

35. For my fellow nerds, I can only paraphrase Paul Muad'Dib

The ultimate power over a thing is the ability to destroy that thing.

We have no hand because we cannot destroy the legislation, we must fight to preserve it and that being the case we will sacrifice and compromise anything to maintain it.

In the end we lost as soon as we took on a battle we weren't willing to lose. Our hands are tied from playing to win or any real hardball. The conservatives however are more than willing to blow the whole damn thing to hell and that puts them in the driver's seat to extract as much as we can stomach to allow us to help as many as they will permit.

This will be the pattern we see replay it's self over and over with every effort we attempt.

We will never score any wins in a game we are afraid to lose minus good fortune and big fortunes conspire against any random luck as much as they are against any actual effort.
The biggest problem is too many of us thought we were actually playing on the other team's side of the field, others thought we were in the red zone, and a few had tricked themselves into thinking we were on the one about to score when the reality is we're on our own goalline.

You have to call plays different in the shadow of the goalposts and I don't think enough people on our side get that while others seem to have lost track that we only get four downs to move the ball ten yards or we turn the ball over. Picking up a half a yard is progress, true enough. However, four such efforts leaves you turning the ball over on the two or three and the other side can punch it in with minimal effort.

[Tom Rinaldo]

36. Very nicely stated

I like the way you illustated that progress that is not enough progress may not be progress at all.