Senate Democratic leaders have amended their newly released health reform bill to include a contentious provision allowing some workers to receive cash vouchers toward exchange coverage in lieu of enrolling in employer-based plans.
Wyden's office describes the proposal thusly (emphasis added):
Under the Senate legislation as it is currently written, Americans with employer-provided coverage, whose income is below 400 percent of the federal poverty level and whose premiums are between 8 and 9.8 percent of their total income will be exempt from having to purchase health coverage but will not be able to access the exchange to qualify for government assistance to purchase insurance. The agreed to amendment will make it possible for these individuals to convert their tax-free employer health subsidies into vouchers that they can use to choose a health insurance plan in the new health insurance exchanges. The Congressional Budget Office estimates a previous version of this provision will expand coverage to more than a million Americans.
Given that only about one million people will be impacted, this isn't a radical policy shift, but it does represent an important first step in opening health insurance exchanges to more Americans and creating more health insurance options for the public.
Perhaps more importantly, it's an example of the kinds of things that legislators will need to continue doing once health care reform is passed. Although the health reform bills do establish a framework for reform -- with both insurance exchanges and a public option in addition to subsidies and new insurance regulations -- the bills don't go as far as they should. But because they do put a framework for progress in place, they can be continually improved, allowing us to whittle away at the problems in our system with pieces of legislation like Wyden's.
So Fox conducts a poll on whether or not Americans approve of President Obama's bow while meeting the Emperor of Japan. Given that they attacked President Obama mercilessly over the bow on Monday, it's likely they wanted to excoriate him once again, this time using poll results showing how much America hated the bow.
But there's a problem for Fox: it turns out their very own poll shows Americans don't have a problem with bow-gate. Indeed, 67% said they think it is appropriate for the American president "to bow to a foreign leader if that is the country's custom" and only 26% felt it was "never appropriate for the president to bow to another leader."
Perhaps the most notable thing is not just that Fox failed to manufacture outrage over bow-gate, it's that as I can tell, Fox never put their poll on the air. I've searched through their transcripts and watched much of their coverage since the poll was released in a PDF on their website, seen by approximately 5 people from their target audience of conservatives.
Perhaps Fox should change their slogan: we report and you decide, but only if it's something that we think will make you hate President Obama.
Senator John McCain’s future in the U.S. Senate may be a little less assured than previously thought.
A new Rasmussen Reports telephone survey of likely 2010 Republican Primary voters in Arizona finds the longtime incumbent in a virtual tie with potential challenger J.D. Hayworth. McCain earns 45% of the vote, while Hayworth picks up 43%.
Former Minuteman leader Chris Simcox gets four percent (4%) support, while two percent (2%) prefer some other candidate and seven percent (7%) are undecided.
It should be fun to watch McCain embrace his inner-teabagger in the coming months. Of course the burning question is, will Palin come down and campaign for him?
The good news on the Senate version of the public option is (beyond the fact that there is one included in the bill, making conference that much easier) that it uses the essential components of the HELP version of the public option, with a few minor changes. The core of the public option remains pretty decent, with a single national plan set up and run by the Secretary of HHS, who has the authority to negotiate reimbursement rates with providers. Not as good as Medicare +5, but could be worse.
The bad news, of course, comes with the opt-out provision of the bill, which makes the public option less than national. When first proposed, the idea was that states would automatically be included, and would have to take action to opt-out sometime after implementation of the program. Unfortunately, that's not how it worked out in the actual language [Sec. 1323, part (a)(3)]
(3)STATE OPT OUT.— (A) IN GENERAL.—A State may elect to prohibit Exchanges in such State from offering a community health insurance option if such State enacts a law to provide for such prohibition. (B) TERMINATION OF OPT OUT.—A State may repeal a law described in subparagraph (A) and provide for the offering of such an option through the Exchange.
There's no requirement of a waiting period before states can opt out, which in this political environment means the battle is taken directly to the states, because insurers will have until 2014 to get state legislatures to pass those laws. That could lead to as much as a third of country being left out, according to CBO estimates [pdf] (h/t Jon Walker).
CBO’s analysis took into account the probability that some states would opt not to allow the public plan to be offered to their residents. Rather than trying to judge which states might opt out, CBO applied a probability recognizing that public opinion is divided regarding the desirability of a public plan and that some states might have difficulty enacting legislation to opt out. Overall, CBO’s assessment was that about two-thirds of the population would be expected to have a public plan available in their state.
You know who the third is going to be--those who need it the most. Check out this map from the most recent Census data, via TWI's Mike Lillis.
(Click on image to enlarge.)
In Texas, for example, the uninsured rate in 2008 was the highest in the nation at 24.1 percent, while just 4.1 percent of Massachusetts residents lacked health coverage, representing the country’s lowest rate, the Census data revealed.
There’s nothing new or unusual about these distinctions. States have their own laws, and some have simply put greater emphasis on getting health coverage for residents. What’s interesting in the context of the insurance reforms working their way through Congress is how the highest uninsured rates are largely concentrated in the South and the Mountain West, where the lawmakers tend to be more conservative — and more likely to oppose the Democrats’ health reform plans.
Changing the opt-out date is an amendment waiting to happen when this bill hits the Senate floor (probably) early next week, and a barring a fix there, a priority for conferees when we finally get to that point.
They just don't make them any crazier than Glenn Beck:
Transcript (new line signals edit point):
What's in this legislation? The end of America as you know it, I believe.
We are taking about massive, sweeping change. American's showed up by the hundreds of thousands at various tea parties to demand the opposite of this: stop spending money. But look at these bills. Look at this. This is a fundamental transformation of America.
Massive changes to the way you live your life. The Senate plans to pass this mess before Christmas.
I don't want to believe the things I believe about what's happening in Washington, but we have a President who has surrounded himself not with free-market system lovers. These are people that don't want to increase America's prosperity, they are spending us into oblivion for their own purposes.
Obama is trying to overwhelm the system right now with massive new government takeover programs. I mean look at these bills. This is just for health care. Stimulus. This is insanity.
Obama is insisting on this all at once. His entire transformation America package all with twelve months of his administration.
We are talking here America about the end of our way of life.
This is not some wild conspiracy tale.
They already control our banks.
They control the auto industry.
Control the temperature inside of your home.
Control of one-sixth of the economy.
Taking over the internet in the name of neutrality.
They are moving at the speed of light and we've got to get up off of our couches and get into their offices.
If we don't stop this insanity now, they will fundamentally transform America. It must end. You must make a choice. This, or this.
...I meant in the election, not necessarily in life. That is for others to debate. What can be said now definitively, however, is that in the election held two-plus weeks ago, Democrat Bill Owens was properly elected to the U.S. House of Representatives, while de facto GOP nominee Doug Hoffman has officially run out of chances (scroll down for the vote totals):
It's over. Rep. Bill Owens, D-Plattsburgh, leads by 3,105 votes with 3,072 absentee ballots left to be counted.
With 58.6 percent of all absentees counted, Mr. Hoffman has gained 71 votes on Mr. Owens so far.
It is also worth noting that one of Bill Owens' best counties on Election Day (Saint Lawrence County) has not yet counted its absentees, meaning that Owens lead may well stretch further before all is said and done.
For his part, Hoffman has not backed off of his bizarre and unsubstantiated claim that some shadowy coalition made up of ACORN, organized labor, and the Democratic Party somehow successfully schemed to deny him his victory. It is a truly bizarre claim, but Dave Weigel of the Washington Independent might be spot on with the motivation behind Hoffman's absurd claims:
So what is defeated Conservative Party candidate Doug Hoffman doing by casting doubt on the results of the NY-23 special election? The most obvious answer, suggested by that letter, is fundraising. It was an expensive race, and Hoffman put some of his own cash on the line.
Indeed, Hoffman did loan his own campaign a fair amount of cash. The best way to recoup some of that lost spare change is to give people a reason to part with their cash well after the election is over. The most effective way to do that is to give the prospective donor the sense that the election, despite all evidence to the contrary, is not really over.
Weigel also comes up with the best explanation to date for Hoffman's quick concession (yes...it is better than Hoffman's "I was forced into it" rationale from Wednesday):
Why did Hoffman concede in the first place? That I’d credit to the campaign’s overconfidence. They went into election day planning for a clear victory. Hoffman bragged to me, and to other reporters, that he hadn’t even talked to Dede Scozzafava, the ousted GOP candidate, because he’d “win without her.” When votes started coming in far, far below their expectations, they lost hope very quickly.
So a political neophyte who had grown convinced that his victory was assured, and that he was the new conservative superstar, learns instead that the voters of the 23rd district do not share the fervor for him found within the teabagger crowd.
Shellshocked, and no doubt more than a little embarrassed, he coughs out a quick and painful statement of concession, wanting to leave the stage as quickly as possible.
When the usual adjustments to the vote count make the race more competitive (but far from actually competitive--there were eleven elections in 2008 for Congress that had closer margins by percentage of the vote than this one), Hoffman loses composure again and makes that strange "un-concession" with Glenn Beck.
Then, when math gets in the way and it becomes clear that there is no need to call in Al Michaels for another "Do You Believe In Miracles?" moment, Hoffman has few places to go. So that is when he turns to the absurdity of the stolen election claim, with a chain of evidence rivalled only by the slashed tires claim on Election Day that wound up being the work of a broken bottle.
For a guy who has said in the past few weeks that he might be interested in seeking public office again in the near future, Hoffman's antics are more likely to shovel dirt on that proposition rather than give it life.
The first floor vote on the Senate HCR bill will happen Saturday evening, after a long day of speechifying, but without having to hear bill read aloud. Chances are pretty good the 60 will be there to at least allow the bill to be considered.
Sen. Tom Coburn (R-Okla.) has agreed to relent on his demand for Senate clerks to read aloud the 2,074-page bill and allow the chamber to take a critical test vote, said the aide. Reading the bill on the Senate floor was estimated to take as many as 30 hours or longer, raising the possibility of the Senate staying in session into next week....
The Senate will vote at 8 pm Saturday to cut off debate on a motion to proceed to the healthcare reform bill. If 60 senators support the motion, the chamber would automatically adopt the motion to proceed to the bill and then depart. The Senate would begin amending the bill after the Thanksgiving recess.
None of which is to suggest that the next several weeks will go smoothly. Reid doesn't have his 60 votes, although even if he did, he wouldn't say so publicly. And he's certainly not going to get the recalcitrant Ben Nelson to say he's on board. In face, Senator Nelson now says that the abortion provisions just aren't good enough, despite the fact that yesterday he said they were a "good faith effort" to address his concerns. If Nelson gave in now, no one would want to interview him anymore, so expect to see plenty of vacillation from him in the coming weeks.
Also prepare yourself for the brilliance of Tom Carper, this time with added burnish from Olympia Snowe, as he continues his quest for the triggered co-op.
"Tom and I have been working on it, we've had discussions and so on, but, you know, we haven't got down in concrete terms, and he'd like to have my affordability language and so on," Snowe said. "But nevertheless it's still going to require 60 votes so I don't know when that would happen, and frankly I would have preferred that to happen at the outset of this process, rather than going through this convoluted procedural gymnastics."
There's a slight improvement in Carper's vision of the trigger over Snowe's. In Carper's plan, the standard for affordability of plans would have to be et at teh time the exchanges start, not at some date afterward. But it's still even less of a real public option than the opt-out, and it should still cause a revolt on the part of progressives, unless they were just talking when they told Reid they've compromised enough. Reid says no reconciliation, but he sure as hell better be keeping it in his back pocket if he doesn't want this whole effort to be forced down the drain, subsumed by abortion and triggers.
While fallout from the breast cancer panel continues to be felt, here are two of the best and most thoughtful posts on the topic I have come across in the last few days (post more if you see them):
New guidelines for cervical cancer screening say women should delay their first Pap test until age 21, and be screened less often than recommended in the past.
The advice, from the American College of Obstetricians and Gynecologists, is meant to decrease unnecessary testing and potentially harmful treatment, particularly in teenagers and young women. The group’s previous guidelines had recommended yearly testing for young women, starting within three years of their first sexual intercourse, but no later than age 21.
