Health Reform Lawsuit to Move Forward

Yesterday a federal judge in Florida ruled that multi-state challenges against the individual mandate and Medicaid expansion under the new health reform law can move forward.  Florida Northern District Judge Roger Vinson did not rule that he agrees with the assertion that the law is unconstitutional, but only that it won't be dismissed outright, as the Obama administration had requested.  However, four other counts related to taxation and requirements that states enforce the law were thrown out by Vinson.

The challengers argue that the individual mandates seeks to regulate "inactivity" because it would penalize people for not buying health insurance.  In his ruling, Vinson appears open to this line of reasoning, quoting a 16 year old Congressional Budget Office (CBO) report concluding that "A mandate requiring all individuals to purchase health insurance would be an unprecedented form of federal action.  The government has never required people to buy any good or service as a condition of lawful residence in the United States."  Though, Vinson added a disclaimer in which he adds, "Of course, to say that something is 'novel' and 'unprecedented' does not necessarily mean that it is 'unconstitutional' and 'improper.'  There may be a first time for anything.  But, at this stage of the case, the plaintiffs have most definitely states a plausible claim with respect to this cause of action."

The White House, though, remains optimistic that the law will hold.  The administration's response, via The White House blog, can be found by clicking here.

Vinson's ruling can be found by clicking here.
The story, as reported by The Hill, can be found here.

March 18 Health Reform Deadline in Question

House Majority Leader Steny Hoyer (D-MD) yesterday pushed back against the President's insistence that an "up or down vote" on health reform be made before Mr. Obama leaves for an overseas trip on March 18th. In a story in The Hill newspaper, Hoyer is reported as claiming that the March 18th deadline imposed by the White House will be difficult to meet, but is not by any means an absolute deadline.

For more, click here.

GOP Brown Victorious in Massachusetts

In a special election to fill the late Senator Ted Kennedy's US Senate seat, Republican Scott Brown, formerly a little-known Massachusetts state senator, claimed victory in a tight, momentum-shifting race late Tuesday night. Claiming 52 percent of the vote, Mr. Brown now will head to Washington, DC to be sworn in as Massachusetts's junior Senator and will be faced with a number of issues pressing not only GOPs, but the entire Senate, most notably health care reform. Displacing Democrats' fillibuster-proof 60 votes, Mr. Brown now forces the White House and a Democrat-controlled Congress to figure out how and when they will pass what stands to be President Obama's signature domestic policy initiative, historic health reform legislation. As Washington anxiously, or soberly, awaits Mr. Brown's arrival into the Senate, news outlets are reporting that Democratic leaders are now scrambling to salvage health reform before it gets torn and tattered by GOPs, misguided by midterm election concerns, or other pressing policy issues.

To read more on Mr. Brown's landmark victory, click on the following major media outlet links:

The Hill - Brown Snags Massachusetts Senate Seat in Stunning Upset Win for Republicans
The New York Times - GOP Takes Massachusetts Senate Seat
The Wall Street Journal - GOP Victory Upends Senate
Kaiser Health News - Republican Brown Wins Senate Seat

Congressional & Administration Leaders Close to Health Care Deal

Throughout the week, top White House officials, Congressional Democratic leaders, and Democratic committee chairmen have been furiously working on negotiating a final health care reform bill. At issue and receiving significant mainstream media attention are, among other things, disagreements over the role of states in health insurance exchanges, subsidy levels to make insurance more affordable for middle-class Americans, an excise tax on high-priced insurance plans, the ability of the bills to contain overall health costs, and the Massachusetts special election to replace the late Sen. Ted Kennedy.

On Thursday, January 14th, media outlets reported that House Democrats had issued statements that a deal on the financing portions of the bill had been struck. The revised bill is slated to be sent to the Congressional Budget Office on Saturday to receive a cost analysis. Congressional Democrats are increasingly feeling a sense of urgency over next week's special election in Massachusetts. Republican State Senator Scott Brown, as of today, holds a slight lead, albeit within the margin of error, over his Democratic opponent, Massachusetts Attorney General Martha Coakley. Mr. Brown has indicated that if elected and present for the vote on the health bill, he would vote against it, thereby foiling Democrats' hopes of passing historic health reform.

To read more, click here for the story from The Hill.

Late Thursday, labor leaders reported that a deal had been struck on the proposal to tax high-priced "Cadillac plans". According to The New York Times, in a conference call with reports, AFL-CIO President Richard Trumka provided additional details:

• The threshold for the tax would be $24,000 for families and $8,900 for individuals. The Senate bill called for a threshold of $23,000 for families and $8,500 for individuals.
• The threshold would be increased each year by the amount of the rise in the Consumer Price Index plus 1 percent — that’s the same rate of indexation called for in the Senate bill.
• The formula will be adjusted for inflation from 2010 to 2013. The initial inflation threshold period will be adjusted upward if inflation increases above current assumptions.
• For high risk professions, the threshold would increase to $27,000.
• There would also be adjustments creating higher thresholds for employee groups whose health premiums are higher because the groups contain a disproportionate percentage of older workers and women. Those two groups tends to have higher health premiums than other workers. There would also be adjustments for those living in high-cost states.
• As of 2015, dental and vision costs would not be counted toward the threshold.
• Collective bargaining plans were to have been excluded from the exchange. Starting in 2017, collective bargaining agreements at all levels will be able to participate in the exchanges.

The New York Times also reports that "workers covered by collective bargaining agreements, as well as state and local employees, will be exempted from the tax until 2018."

For more on this, click here to access The New York Times story.

Tax on "Cadillac" Plans Likely to Survive

The Hill reports that labor leaders have conceded that the excise tax on "Cadillac", or high-cost, health plans will survive negotiations between the House and Senate on their respective health reform bills. Andy Stern, president of the Service Employees International Union (SEIU), along with other union and labor leaders have lambasted the proposed 40% tax on the cost of insurance policies worth greater than $8,400 for individuals and $23, 000 for families.

Vocal opposition to the tax has emerged as of late and some see the proposed tax as a broken promise to the American people. In his presidential campaign, Mr. Obama asserted that he would not raise taxes on anyone making less than $250,000. Others worry that including the tax in the final bill would give Republicans political ammunition, something that Democrats want to avoid in this mid-term election year.

For more on this, visit The Hill.

Additional information on this issue can be found by clicking here (Roll Call) and here (New York Times).

Senate Passes Health Bill

Thursday morning, as expected and as promised by Senate majority leader Harry Reid (D-NV), the Senate approved their version of health reform legislation by a vote of 60-39. The bill now heads to Conference Committee to hash out differing provisions of the two bills. The public option, for instance, is included in the House bill, but was rejected during debate in the Senate. Financing reform is another contentious issue that both chambers will have to resolve.

For additional coverage from major U.S. newspapers, click on the following links:

The Hill
The Wall Street Journal
The New York Times
CQ Politics

Health Bill Set to Pass Out of Senate and Into Conference Committee with House

Senate Democrats are poised to pass historic health care reform legislation out of their chamber and into Conference Committee with the House Thursday morning at 7:00am. The final procedural hurdle was passed Wednesday when a cloture vote of 60-39 ended debate on the underlying bill. All 58 Democrats and two Independents have remained united throughout the week and are expected to do the same on Christmas Eve. Unlike procedural votes aimed at ending filibusters, Thursday's vote requires only a simple majority of 51 yeas. Thursday's roll call will mark the 25th straight day the Senate has been in session, only one day short of matching the record of 26 set in 1917 as Congress, and the country, prepared to enter World War I.

The vote was originally scheduled for 7:00pm Thursday, but was eventually moved to the morning to allow Senators and their staffs time to make it home for the Christmas holiday. On Wednesday, the Senate rejected a number of points of order, one of them questioning the bill's constitutionality, introduced by Republicans and designed to stall the process even further.

To read more, click for articles from The Hill, The Wall Street Journal, and The New York Times.

Senate Votes to Adopt Manager's Amendment and Limit Debate on Substitute Amendment - 3 Down, 3 to Go

Early Tuesday, the Senate voted twice, both times along party lines, to move health care reform legislation closer to passage. First, they voted to adopt the manager's amendment introduced by majority leader Harry Reid (D-NV) last Saturday. Second, casting aside another parliamentary delay maneuver, Democrats voted to invoke cloture, or limit debate, on a substitute amendment, thus clearing the way for the final three votes that need to pass if Democrats want to pass health reform legislation by Christmas Eve. The next vote is scheduled for 1:00pm Wednesday, with the final vote slated to occur around 7:00pm Christmas Eve.

To read more, visit a related article from The Hill.

CQ Politics also reports on the votes in this article.

Senate Democrats Cut a Deal; Reach 60 Votes

Early Saturday morning, Senate majority leader Harry Reid (D-NV) released a 383-page manager's amendment to the Senate health insurance reform proposal, indicating that he has secured the 60 votes needed to pass the legislation by Christmas. Senate Republicans immediately invoked the first of many delay tactics by requiring the Senate Clerk to read the entire bill aloud. Appeasing the last Democratic holdout, Sen. Ben Nelson (D-NE), Mr. Reid modified language that does not require or forbid health insurance plans from covering abortion services, but does include an exemption that allows states to prohibit abortion coverage in the insurance markets or the exchanges, where most plans would be sold. Nebraska will also receive, under the amendment, a substantial increase in federal matching dollars that support the state's Medicaid program - the federal-state entitlement program that provides coverage to the poor.

This version of the Senate bill will cost, according to an analysis by the nonpartisan Congressional Budget Office, $871 billion and reduce the federal deficit by $132 billion over ten years, The Hill reports. Costing $22 billion more than its original version, the bill is predicted to cover an additional 31 million Americans.

The complete manager's amendment can be found on the Senate Democrats' website or by clicking here.

Coming only a day after a public opinion poll released by the Kaiser Family Foundation indicated that public support for reform is weakening, Mr. Reid has scheduled six votes to pass the legislation by Christmas. The first one, the next move in the process, is a 1:00am vote early Monday morning to end debate on the manager's amendment. All six procedural moves can be found at a post to the New York Times Prescriptions Blog or by clicking here.

A New York Times article discussing the changes made to key components of the legislation can be found by clicking here.

Reid Unveils Senate Health Bill

Yesterday evening, Senate majority leader Harry Reid (D-NV) released the Senate's version of a health reform bill, the "Patient Protection and Affordable Care Act". A cost analysis from the Congressional Budget Office (CBO) puts the price tag of the bill at $848 billion over 10 years while expanding coverage to an additional 31 million Americans and is expected to reduce projected federal budget deficits by $130 billion over a decade.

Now, Senator Reid is faced with the task of moving the bill to debate on the full Senate floor through a procedural move called a "motion to proceed", which is expected to happen on Saturday. This motion, along with passage of the bill itself, requires 60 votes. Senators Joseph Lieberman (I-CT) and Bernard Sanders (I-VT) are two Independents who caucus with the Democrats, but have not yet confirmed their support of the bill. If Lieberman and Sanders do not vote for the bill, Democrats will fall short of the required 60 votes by 2.

Full articles on the bill are available by clicking on the following links:

• New York Times
• Wall Street Journal
• The Hill

The full bill text can be found by clicking here. And, a searchable version of the bill, courtesy of the New York Times, is available here.

A talking points look at the Joint Committee on Taxation's revenue analysis can be accesses by clicking here.

The CBO score is available here.

CMS Actuary Releases Cost Analysis of House Health Bill

The health reform bill recently approved by the House will cost $289 billion over the next ten years, according to the chief actuary at the Centers for Medicare and Medicaid Services (CMS). This analysis, however, is not an apple-to-apples comparison of the Congressional Budget Office and Joint Committee on Taxation's cost analyses because CMS doesn't take into account the various tax provisions baked into the legislation.

Additionally, the report claims that the bill falls short of house Democrats' reform goals:

"With the exception of the proposed reduction in Medicare... the provisions of H.R. 3962 would not have a significant impact on future healthcare cost growth rates."

Read the complete story at The Hill by clicking here.

The report from CMS's Chief Actuary can be found by clicking here.

House Democrats Unveil Health Reform Bill

Yesterday, House Democrats released their 1,990-page version of health reform legislation. With the Senate bill set to be released soon, both chambers of Congress are now preparing set for a heated and momentous debate. The non-partisan Congressional Budget Office (CBO) estimates that the House bill will provide coverage to 36 million people, cost $1.05 billion over 10 years, and cut the budget deficit by $104 billion over ten years. Of note, the public option plan, if passed in its current form, will negotiate rates with providers instead of using Medicare reimbursement rates and imposes an income tax surcharge on families making over $1 million.

The Hill reports on more details of the bill here.

The following articles provide more detailed information:

• New York Times
• Wall Street Journal
• The Hill
  

Health Care Reform - House Bill to Reach Floor Soon

House Majority Leader Steny Hoyer (D-Md.) is reportedly set to introduce the health care reform bill that will make it to the full House floor, according to The Hill newspaper. House Democrats want to bring it to the floor so it can be voted on next week. Because they pledged to give 72 hours notice to review the bill, House leaders are expediting their progress. Hill staffers indicate however that a CBO score of the bills need to be released before a bill could formally be introduced.

Read the complete story here: http://thehill.com/homenews/house/64941-house-dems-on-verge-of-bringing-health-bill-to-floor