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Archive for the ‘Health Care’ Category

Obamacare and Reconciliation

Sunday, July 1st, 2012

When we wrote “Obamacare Repeal: For Show or For Real?” back in January, the point was that House Republicans were making a great show of trying to repeal Obamacare, but there was no chance their bill was going to pass. Their hopes for getting rid of the new national health care regulations were in the Supreme Court.

But Chief Justice Roberts found Obamacare constitutional as an exercise of Congress’s power to tax. (If you’re interested in the Court’s internal politics, the linked article is a good one.)

So now the only hope for Obamacare‘s opponents is Republican victories at the polls this November, delivering a new president and a Republican Senate.

But even that doesn’t guarantee a repeal. Under long-standing Senate traditions, bills can be held up if they don’t have 60 (out of 100) votes. Plenty of bills that could win a majority don’t go through the Senate because of a thing called the “cloture” rule.

There are some votes in the Senate that don’t require a cloture vote, though. “Reconciliation” is part of the annual budget process in which Congress marries up its new budget plan with the programs the government has running. You can get to a final vote on a reconciliation bill with a simple majority, not the 60 votes you need for other bills. It says so right there in 2 USC § 641(e)(2)!

Now, substantive law changes aren’t supposed to go on reconciliation bills—just budget stuff. You can change the level of spending on a government program, for example—that’s budgetary—but you couldn’t outlaw the possession of a rare breed of snake. That kind of thing doesn’t affect the budget.

Obamacare’s opponents are starting to see a silver lining in the cloud of the Supreme Court’s ruling. It makes pretty clear—Obamacare being a tax program—that it is something Congress can deal with on reconciliation. (Democrats used reconciliation in the process of passing Obamacare, the Reconciliation Act of 2010, specifically, so the goose and gander may cook in the same juice.)

That means Republicans don’t need to reach the impossible goal of having 60 senators in the next Congress. They just need to get to a majority. Oh, and they need the presidency, of course.

That’s the way to get rid of Obamacare. When the House passed H.R. 2, the “Repealing the Job-Killing Health Care Law Act” earlier this year, it was just for show. The real show is at the polls this November.

If Republicans win the presidency and the Senate, while keeping the House, watch for them to move legislation to repeal the Obamacare mandate as part of the budget process. You would think that a procedure with the name “reconciliation” would be about everyone getting along, but it might be the most explosive procedure the Senate ever uses.

The Latest Repeal Bill

Friday, June 29th, 2012

Hot on the heels of the Supreme Court’s approval of Obamacare, also known as Public Law 111-148, the Patient Protection and Affordable Care Act, there’s another bill in Congress to repeal it. Another bill would defund it.

These might be just for show.

Republicans’ Health Care Approach

Sunday, June 10th, 2012

With a Supreme Court ruling on Obamacare coming down the pipeline, it’s a good idea for the two sides of the debate to have something to say about health care. The Republicans showed their hand last week when the House passed H.R. 436, the Health Care Cost Reduction Act of 2012. You can’t really call it a health care “plan.” The idea is more to let people plan their own health care. So it’s all about tax cuts.

The bill the House passed combines several bills that already existed, a confusing, but common, practice. First, there was the idea in the original version of H.R. 436, which was previously called the “Protect Medical Innovation Act.” The original version repealed an excise tax on medical devices that was scheduled to take effect in January 2013. That tax increase was going to collect a whopping $29 billion dollars over the next ten years. Getting rid of that tax makes medical devices cost that much less for the next ten years.

The content of H.R. 1004, the Medical FSA Improvement Act of 2011 was also rolled into H.R. 436. FSA stands for “flexible spending account.” That’s a tax-advantaged account that allows an employee to set aside a portion of earnings to pay for qualified expenses as established in a cafeteria plan. They’re usually used for medical expenses, but often for dependent care or other expenses. Money deducted from an employee’s pay into an FSA is not subject to payroll taxes, which can save big money. But funds not used by the end of the plan year are lost to the employee. This is known as the “use it or lose it” rule. H.R. 1004 and now H.R. 436 get rid of the “use it or lose it” rule, which leaves about $4 billion with people to spend on health care, dependent care, and so on.

The next thing rolled into H.R. 436 is the content of H.R. 5842, the Restoring Access to Medication Act. That bill repeals provisions of the Internal Revenue Code that were added by the Patient Protection and Affordable Care Act (“Obamacare”). Those provisions limited payments for over-the-counter medications from health savings accounts, medical savings accounts, and flexible spending arrangements. Only prescription drugs or insulin can be paid from these accounts currently. That would allow people to spend about $4 billion more of their money.

Finally, there’s a provision in H.R. 436 that would require collections of certain overpayments of health insurance subsidies. (Apparently, they have to pass a law to prevent overpayments.) That would bring in about $12 billion over the next ten years.

The net result is about $450 in savings per U.S. family. That’s money left with people to spend as they choose (on health care and dependent care), and money that doesn’t get spent by the government. It would also lower the national debt by about $40 per U.S. family. (That’s a small part of the $156,000 every family owes, but it’s something.)

Below are the current votes on H.R. 436 and the two bills that have been rolled into it. Click to vote, comment, learn more, or edit the wiki articles about the bills.

You’re Fat

Wednesday, April 25th, 2012

So H.R. 4604 would provide for a national program to conduct and support activities toward the goal of significantly reducing the number of cases of overweight and obesity among individuals in the United States. …Fatty.

New Petition: Moms Matter

Wednesday, July 27th, 2011

Take a look at this new petition: Moms Matter. If you agree, sign on!

A bill it relates to is H.R. 894, the Maternal Health Accountability Act of 2011. Take a look at that, too, and vote your conscience.

What the Framers Had in Mind When They Wrote the Constitution

Tuesday, July 19th, 2011

S. 1381 would expand Federal efforts concerning the prevention, education, treatment, and research activities related to Lyme and other tick-borne disease, including the establishment of a Tick-Borne Diseases Advisory Committee

Think Congress Doesn’t Do Enough?

Wednesday, June 15th, 2011

They’re now looking at your prostate.

H.R. 2159 and S. 1190 would “reduce disparities and improve access to effective and cost efficient diagnosis and treatment of prostate cancer through advances in testing, research, and education, including through telehealth, comparative effectiveness research, and identification of best practices in patient education and outreach particularly with respect to underserved racial, ethnic and rural populations and men with a family history of prostate cancer, … establish a directive on what constitutes clinically appropriate prostate cancer imaging, and … create a prostate cancer scientific advisory board for the Office of the Chief Scientist at the Food and Drug Administration to accelerate real-time sharing of the latest research and accelerate movement of new medicines to patients.”

Oppose This if You Hate Good Things

Monday, June 13th, 2011

H.R. 2104 is called “The Consistency, Accuracy, Responsibility, and Excellence in Medical Imaging and Radiation Therapy Act of 2011.” How could you possibly be against that? Anyone opposing it must want inconsistent, inaccurate, irresponsible, and totally non-excellent medical imaging and radiation therapy.

That’s why bills have names like this.

I Kinda Thought This Was Already Illegal

Tuesday, May 17th, 2011

S. 1002 would prohibit theft of medical products.

Let the Acupuncturists Have Some

Saturday, April 2nd, 2011

H.R. 1328 would provide for coverage of qualified acupuncturist services under part B of the Medicare Program and under the Federal Employees Health Benefits Program.