AP sources: Dems reach deal to drop gov't-run plan

http://finance.yahoo.com/news/AP-so...iaWw5BHBvcwMxBHNlYwN0b29scwRzbGsDcHJpbnQ-?x=0

AP sources: Dems reach deal to drop gov't-run plan

AP sources: Democrats reach tentative deal to drop government-run plan from health bill

By David Espo, AP Special Correspondent
On 10:45 pm EST, Tuesday December 8, 2009

WASHINGTON (AP) -- After days of secret talks, Senate Democrats tentatively agreed Tuesday night to drop a full-blown government-run insurance option from sweeping health care legislation, several officials said, a concession to party moderates whose votes are critical to passage of President Barack Obama's top domestic priority.

In its place, officials said Democrats had tentatively settled on a private insurance arrangement to be supervised by the federal agency that oversees the system through which lawmakers purchase coverage, with the possibility of greater government involvement if needed to ensure consumers of sufficient choices in coverage.

Additionally, the emerging agreement calls for Medicare to be opened to uninsured Americans beginning at age 55, a significant expansion of the large government health care program that currently serves the 65-and-over population.

At a hastily called evening news conference in the Capitol, Majority Leader Harry Reid, D-Nev., declined to provide details of what he described as a "broad agreement" between liberals and moderates on an issue that has plagued Democrats' efforts to pass health care legislation from the outset.

With it, he added with a smile, the end is in sight for passage of the legislation that Congress has labored over for months.

The officials who described the details of the closed-door negotiations did so on condition of anonymity, saying they were not authorized to discuss them publicly. Several officials stressed that so far, Democrats had technically agreed only on submitting proposals to the Congressional Budget Office for their impact on the bill's cost and other analysis.

At its core, the legislation would expand health care to millions who lack it, ban insurance companies from denying coverage on the basis of pre-existing medical conditions and rein in the rise of health care spending nationally.

The developments followed a vote on the Senate floor earlier in the day in which abortion opponents failed to inject tougher restrictions into sweeping health care bill, and Democratic leaders labored to make sure fallout from the issue didn't hamper the drive to enact legislation. The vote was 54-45.

Taken together, the day's developments underscored the complexity that confronts the administration and Reid as they seek the 60 votes needed to overcome Republican opposition and pass a bill by Christmas. Despite their reluctance, some senators had talked openly and in detail earlier in the day about the progress of the negotiations.

The provision in the legislation to be dropped under the emerging agreement provides for a government-run insurance option to be available to consumers, with individual states permitted to drop out. Liberals have long sought such as arrangement, as a means of forcing competition on insurance companies.

One participant in the talks, Sen. Tom Harkin, D-Iowa, referring to a deal among the negotiators, told reporters he didn't like it, but added, "I'm going to support it to the hilt" in hopes of securing passage of the health care bill.

Another senator involved, Sen. Russ Feingold, D-Wis., issued a statement saying, "I do not support proposals that would replace the public option in the bill with a purely private approach. We need to have some competition for the insurance industry to keep rates down and save taxpayer dollars." But he did not rule out voting for the measure.

The White House quickly applauded the developments. "Senators are making great progress and we're pleased that they're working together to find common ground toward options that increase choice and competition," said a spokesman, Reid Cherlin.

In his comments to reporters, Reid said the emerging compromise "includes a public option and will help ensure the American people win in two ways: one, insurance companies will face more competition, and two, the American people will have more choices."

It wasn't clear what he meant by a "public option," the Medicare expansion or a fallback in case private insurance companies declined to participate in the nationwide plan envisioned to be overseen by the Office of Personnel Management. One possibility was for the agency to set up a government-run plan, either national in scope or on a state-by-state basis.

Under the tentative agreement, liberals lost their bid to expand Medicaid, the federal-state program that provides health care for the poor, elderly and disabled. But they prevailed on the Medicare expansion, and the negotiators appeared ready to maintain a separate health care program for children until 2013, two years longer than the bill currently calls for, according to officials familiar with the details.

Additionally, there was consensus support for a requirement long backed by Sen. Jay Rockefeller, D-W.Va., and other liberals for insurance companies to spend at least 90 percent of their premium income providing benefits, a step that supporters argue effectively limits their spending on advertising, salaries, promotional efforts and profits.

Reid -- the chief architect of the health care bill as well as an abortion opponent -- played a prominent role in the debate over attempts by conservatives to toughen restrictions in the Senate measure. "No one should use the health care bill to expand or restrict abortion," he said, arguing that abortion foes were attempting to do just that. "And no one should use the issue of abortion to rob millions of the opportunity to get good health care."

The current legislation would ban the use of federal funds to pay for abortion services under insurance plans expected to be offered in a new health care system, except in cases of rape, incest or when the life of the mother is in jeopardy.

Individuals who receive federal subsidies to purchase insurance under the plans would be permitted to use personal funds to pay for abortion services -- the point on which the two sides in the dispute part company.

"Segregation of funds is an accounting gimmick," said Sen. Ben Nelson, D-Neb., the chief Democratic supporter of tightened restrictions. "The reality is federal funds would help buy coverage that includes abortion."

Abortion rights supporters, Senate Democratic women most prominently, countered heatedly.

Sen. Dianne Feinstein, D-Calif., said abortion opponents were driven by ideology, and Sen. Jeanne Shaheen, D-N.H., called the proposed changes "a very far-reaching intrusion into the lives of women."

The amendment that Nelson, Sen. Robert Casey, D-Pa, Sen. Orrin Hatch, R-Utah, and numerous Republicans proposed would also have barred insurance plans from covering abortions except in the three categories if any of their policyholders received federal subsidies. It also would have required insurance companies that offer no-abortion plans to make available a policy that offers such services.

In all, 50 Democrats, two Republicans and two independents voted to kill the abortion proposal. Thirty-eight Republicans and seven Democrats favored it.

Associated Press writers Ricardo Alonso-Zaldivar and Erica Werner contributed to this report.

 

http://www.reuters.com/article/idUSTRE5B807720091209?feedType=RSS&feedName=topNews&rpc=22&sp=true

Democrats reach deal on health bill

7:11am EST
By John Whitesides

WASHINGTON (Reuters) - Senate Democratic healthcare negotiators said they agreed on Tuesday to replace a government-run insurance option with a scaled-back non-profit plan and would seek cost estimates on the deal.

"We have a broad agreement," Senate Democratic leader Harry Reid told reporters, refusing to provide details of the healthcare proposals to be sent to the Congressional Budget Office.

A team of 10 Senate Democrats -- five liberals and five moderates -- had worked for days to find a substitute to the government-run "public" insurance option included in the Senate healthcare bill after moderates voiced concerns about it.

The government-run plan has been one of the biggest hurdles for the healthcare overhaul, which is President Barack Obama's top domestic priority.

Democratic Senate sources said the substitute would create a non-profit plan operated by private insurers but administered by the Office of Personnel Management, which supervises health coverage for federal workers.

One of the liberal negotiators, Democratic Senator Russ Feingold, said he had concerns about the direction of the talks on the public insurance option, which was designed to create more choice for consumers and competition for insurers.

"I do not support proposals that would replace the public option in the bill with a purely private approach," Feingold said. "We need to have some competition for the insurance industry to keep rates down and save taxpayer dollars."

The negotiators also sought cost estimates on an expansion of the Medicare health program for the elderly, which is now available at age 65, to Americans as young as 55 who could "buy-in" to the coverage, a Democratic source said.

That proposal, designed to create more affordable insurance options for older workers, had been pushed by liberal Democrats in exchange for dropping their support for the public option.

"I've got a smile on my face," Democratic Senator John Rockefeller, who has been advocating the Medicare expansion since 2001, told reporters after the talks broke up.

'MORE COMPETITION'

"Insurance companies will certainly have more competition," Reid said of the deal, which he said would be enough to bring the bill to final passage. "The American people will certainly have more choices."

The Democrats met in Reid's office late into Tuesday, their fourth consecutive day of negotiating, and afterward Reid said the deal could lead to final passage of the bill.

Democratic Senator Tom Carper said once the cost estimates were received from CBO "then we'll take it up and decide what we can afford."

The other potential hurdle to the healthcare overhaul was abortion, and the Senate on Tuesday rejected an attempt to tighten restrictions on abortion coverage -- a vote that could threaten a crucial Democrat's support for passage of the bill.

Democratic Senator Ben Nelson's amendment to tighten the bill's restrictions on the use of federal funds for abortions, identical to a provision approved by the House of Representatives last month, was killed on a 54-45 vote.

Without the abortion language, Nelson had threatened he would not back the final healthcare bill when it came to a vote. If he followed through, Democrats would be one vote short of the 60 they need to pass the measure.

But after his amendment failed, Nelson softened his stance slightly. "It makes it harder to be supportive. We'll see what happens," he told reporters.

Reid said he was willing to keep working with Nelson to add language to the bill that would resolve the concerns on both sides of the divisive issue.

"If in fact he doesn't succeed here, we'll try something else," Reid said of Nelson before the vote. Nelson said he was not looking to negotiate a compromise.

The amendment would have blocked people who receive federal subsidies from buying insurance plans that cover abortions and prohibited a proposed government insurance plan from offering abortion coverage in most circumstances.

The Senate was on its ninth day of debate on the bill, which would extend coverage to 30 million uninsured people and halt industry practices like refusing coverage to those with pre-existing medical conditions.

Senators are racing the clock to meet a self-imposed end-of-year deadline for the bill's final passage. It would still need to be reconciled with the House version in January.

(Additional reporting by Donna Smith; Editing by Sandra Maler)

 

Don't you love it how whichever party is in control, they're so horribly corrupt and in the pockets of big business?

The Democrats aren't making their own base happy - they want a single payer system.

I've been accused of being a right wing conservative, yet I've been arguing for a pure socialized medicine scenario as the govt. option. Yes folks, I've been arguing FOR a govt. option.

There's 3 basic forms a health care system can take:
1) Fully private (insurance companies, independent doctors and hospitals)
2) Single payer (private doctors and hospitals, bills payed by the govt.)
3) Socialized (govt. owns the hospitals, doctors and staff are govt. employees)

What I've proposed is a hybrid of #1 and #3. The govt. becomes an HMO and competes with the private sector. It has the ability to control its costs because it can pay doctors what it sees fit, negotiate for drug purchases in volume, only pays for services provided instead of insurance premiums, and doesn't need to run a profit.

My proposal provides competition, which should help drive the cost of care down. It doesn't represent a massive takeover of a large chunk of the private sector. It's nowhere near as expensive as the plan that's about to be rammed down our throats for political gain (vs. merit).

For the cost of the missile defense shield that Obama cancelled ($11B/year), the govt. could build 100 fully modern hospitals and numerous clinics throughout the country over a 10 year period (and why stop after 10 years?). For the cost of a republican highway bill (when they were in control, ~$300B over 10 years), the govt. could build 300 additional hospitals.

I see clinics as being hugely important. They provide the triage for who goes to the hospitals. Most people don't need a hospital for things like a broken leg or back pain or the flu. You don't have to build a building to set one up - there's plenty of medical and commercial properties around. They can be distributed widely so people in rural areas might have one close by.

The govt. doesn't need to spend enormous amounts of money on this. The post office has been break even or profitable until recently. The bus systems in major cities don't need much from government to provide a service. The thing is that there's no free lunch. People have to pay their bus fare, or in my proposal, for their clinic visits or for some sort of monthly buy in cost that covers the costs of operations.

What about the people who can't afford it? I don't see how most people couldn't afford it - if it's pay as you go, $200-$300 a year vs. many thousands for insurance. And we have hundreds of programs already to provide assistance to people who aren't able to provide such things for themselves.

A $1T bill is a travesty. I want to see it stopped. It's not about victory for Obama and Democrats, it's about doing the right and pragmatic thing as a matter of public policy.

I'll close by saying that I would cover abortions.

 

My objective is to cut out the insurance companies from being tied to govt. payments, while providing a manageable setup for the govt. to run.

I absolutely don't want the private sector to be eliminated! When those death squads decide you aren't worth spending time and money and medicine on, you should be able to find a doctor who will at your own expense.

 

In case you missed it, I'm making fun of the right wingers who make it out to be like they're death squads.


But the point remains - you should be able to pay out of your pocket to have whatever care you choose and can afford.

 

Like I said, the bill is terribly expensive and most of the money goes into the pockets of the insurance companies. I can't in good conscience say there's much good about this bill.

 

BTW, if they went with my proposal, they could use all of medicare funds for the program and provide services to medicare recipients through the govt. clinics/hospitals, etc.

I was figuring $1B per hospital, just to build it and supply it with equipment.

 

I can only repeat what is true about the bill. They removed health care spending from it to make it look like it's profitable, and they frontload the taxes so they can afford the payments down the road for a while.

What do I mean by removed spending? They cut out both medicare spending and various programs that pay doctors. With a nod and a wink to the doctors that they'll restore the spending in a separate bill. The medicare spending will have to be put back in place, too.

Fuzzy accounting at its best.