Karen Tumulty at Swampland at Time:
Multiple sources are now reporting that Nebraska’s Ben Nelson, the last Democratic holdout, is now saying he will support the latest version of the health care bill. That makes 60 votes, enough to overcome a fillibuster.
So what’s actually in this bill? And what did it take to get the last votes? I’m still going through it, and will file more as I figure that out, but you can see some highlights here. A senior Democratic aide says this:
The manager’s amendment builds upon the strong bill we already have.
Protects our good coverage, cost, and affordability numbers
· Reduces Deficits – estimated to save over $130 billion first ten and roughly $650 billion second ten
· Expands Coverage – over 94 percent of Americans under 65 years of age, including over 31 million uninsured
· Reduces Costs – most Americans will see their health care costs reduced relative to projected levels
Makes health care more affordable for Americans by expanding small business tax credits
· $12 billion increase
· Begins in 2010
· Expands wage thresholds for tax credits
Demands greater accountability from insurance companies/ creates more choice and competition
· Medical Loss Ratio 85/80 percent – Insurance companies will be forced to spend more money on care and less money padding their bottom line.
· Starting immediately children cannot be denied health coverage due to pre-existing conditions
· Insurance companies who jack up their rates will be barred from competing in the exchange.
· Give patients the right to appeal to an independent board if an insurance company denies a coverage claim
· Health insurers will offer national plans to Americans under the supervision of the Office of Personnel Management, the same entity that oversees health plans for Members of Congress.
· Provides significant resources for Community Health Centers
Nelson has recently complained that the proposed expansion of Medicaid to those earning below 133% of the Federal Poverty Line (FPL) would burden his state of Nebraska and suggested that states should be able to opt-in to the program.
Under the current merged legislation (the version unveiled on November 18th), the federal government fully finances care for the expanded population for two years and increases its matching funds (known as FMAP) thereafter. Page 98 of the managers amendment specifically identifies Nebraska for higher federal matching funds, fully funding its expansion for an additional year:
‘‘(3) Notwithstanding subsection (b) and paragraphs (1) and (2) of this subsection, the Federal medical assistance percentage otherwise determined under subsection (b) with respect to all or any portion of a fiscal year that begins on or after January 1, 2017, for the State of Nebraska, with respect to amounts expended for newly eligible individuals described in subclause (VIII) of section 1902(a)(10)(A)(i), shall be determined as provided for under subsection (y)(1) (A) (notwithstanding the period provided for in such paragraph)
Subsection (y)(1)(A) refers to page 399 of the original merged Senate legislation which fully funds state Mediciad expansions for the first two years. The manager’s amendment also provides 2.2% increase in FMAP to help states finance their existing Medicaid programs.
That will be worth at least hundreds of millions of dollars in federal cash for Nebraska … for the first three years. After that, Nebraskans get as screwed as the rest of the country. And what about that abortion coverage? Nelson caved, as one can read in the published version,
Part of what Ben Nelson seems to have gotten in exchange for his vote is an arbitrary extra year of federal Medicaid funding for Nebraska. There’s no conceivable policy justification for this, but it’s a small price to pay for the support of a crucial senator. But when I say it’s a “small price to pay” I mean that quite literally—the amount of money involved is tiny. The ability to do this mostly underscores how ridiculous Nelson’s Medicaid objections were to begin with.
Kathryn Jean Lopez at The Corner:
I’m holding out hope for Jim Webb or someone to be the profile in courage in this Senate story. (No, I’m not holding my breath. But I’m happy to be thanking Webb on Christmas eve.)
Carol Platt Liebau at Townhall:
Bargaining behind closed doors, Democrats have prevailed upon Ben Nelson to provide the 60th vote for a health care bill that no one — besides, apparently, 60 Senate Democrats — really wants.
No one really knows what’s in the bill and no one really knows how much it will cost.
People from the left, right and center have made their opposition clear.
But in the greatest act of legislative arrogance of my lifetime, Democrats have pressed on.
Now, in typical Democratic fashion, we will probably get the bill to conference, have a couple more weeks of acrimonious debate, pass the bill, get a bill with some meaningful reform and some decidedly bad things, and then spend the next year fighting a civil war and convincing ourselves that the bill is horrible and Obama hates the base.
being a Republican was SOOO much easier. Obligatory Will Rogers reference.