The Political Bridge

"The Affordable Health Care for America Act:” After the Tumult and Shouting Subside, Will the House Divide and Fall? By DrTed

When Speaker Pelosi announced passage of the Affordable Health Care for America Act (H.R. 3962), Democrats in the House of Representatives erupted in cheers and high fives.

 

Across the aisle, the Republicans watched glumly.

 

Afterwards, the Democratic and Republican House Leaders made predictable claims about H.R. 3962.

 

John Dingell (D- Michigan), the Act’s sponsor, trumpeted its passage by declaring that the “House Makes History on Health Reform:  For the first time in U.S. history, the House votes to provide quality, affordable health insurance for all Americans.”

 

John Boehner(R-Ohio), the House Minority Leader, warned that “Speaker Pelosi’s Government Takeover of Health Care Will “Dim the Light of Freedom.”

 

In all this tumult and shouting, little has been said about the impact of the proposed health care reforms upon the 50 states. This might be one of the most contentious and divisive issues in reforming America’s health care system.

 

Implementing any enacted health care reform (H.R. 3962, S. 1796 or a conciliatory measure) will be costly to the states. Nearly everybody agrees.

 

The Congressional Budget Office(CBO) has a $39 billion increase in state spending over the next ten years as a consequence of implementing H.R. 3692. This projection is based upon mandated changes in state laws governing Medicaid and Children’s Health Insurance Program (CHIP) enrollment requirements. An unforeseen  number of working poor might also be added to these rolls, because they will be unable to either purchase the required health insurance or pay the fine for not having insurance(Reuters). 

 

The Reuters’ analysis of H.R. 3692 indicates still further costs to the states. Several states anticipate allocating millions of dollars for the technology needed to administer the proposed health-care exchange system.

 

With Medicaid expenditures and state budgets currently headed toward a fiscal precipice ( Download 8001), what are the states to do about the forecasted H.R. 3962-related costs?

 

Raise taxes?  Not a good option for state officials who want to remain in office.

 

Cut core services?  Many states have already done that, and cutting more services would only compound their troubles.

 

Devising tougher Medicaid and CHIP eligibility requirements?  This, I believe, is not permissible under H.R. 3962, which prescribes a more standardized and less stringent eligibility requirements that the current Medicaid and CHIP regulations demand.   

 

Opting out of the federally mandated Medicaid and CHIP Programs? Going down this road could lead to a constitutional crisis on the question of states’ rights versus the federal government.

 

Several notable Republicans have talked about invoking state sovereignty (the Tenth Amendment  to the U.S. Constitution). Governor Tim Pawlenty (R-Minnesota), for instance, has suggested that Minnesota might cite this Amendment as a reason for not implementing portions of the (eventually) enacted federal health care program.

 

While Governor Pawlenty has been backtracking from this threat, there is a burgeoning state sovereignty (self-determination) movement in America. Nine states from conservative Georgia to liberal Washington have introduced bills or resolutions declaring self-determination under the Tenth Amendment.  A dozen (mostly red) states have been contemplating similar legislation.  

 

This recent self-determination movement has been most clearly manifested in health-related matters.  As of July, 2009, 17 (mostly blue) states have either enacted and or have been moving towards comprehensive health care reform. The medical use of marijuana has become legal in 13 states.

 

An enactment of H.R. 3692 of S.1796, or a compromise measure will then most likely give a huge boost to the state-sovereignty movement.  

 

I fear this development because Americans fought a bloody civil war to become the United States of America rather than these United States.

 

I believe that President Lincoln was right in waging that war—a house divided cannot stand.

Harold Meyerson of the the Washington Post: The House's Health Care Plan is the Better Plan

 

For families who buy their insurance on the exchanges that both bills establish, for instance, the House bill includes more generous subsidies -- on average, $1,000 more, according to the Congressional Budget Office. The House bill also offers a lot more assistance to Medicare recipients by reducing the cost of their prescriptions. While the bill that emerged from the Senate Finance Committee renews the Bush administration's mega-bucks gift to the drug companies by continuing to prohibit Medicare from negotiating drug prices with them, the House bill authorizes those negotiations.  

To Read More: Click Meyerson

Senator Olympia Snowe's Next Step for Main Street Credit Availability Act of 2009 (Introduced in Senate)

From Thomas.com

A BILL

To amend the Small Business Act and the Small Business Investment Act of 1958 to stop the small business credit crunch, and for other purposes.

Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

This Act may be cited as the `Next Step for Main Street Credit Availability Act of 2009'.

SEC. 2. MAXIMUM AMOUNTS FOR 7(a) LOANS.

Section 7(a)(3)(A) of the Small Business Act (15 U.S.C. 636(a)(3)(A)) is amended by striking `$1,500,000 (or if the gross loan amount would exceed $2,000,000' and inserting `$4,000,000 (or if the gross loan amount would exceed $5,000,000'.

SEC. 3. REFINANCING EXISTING 7(a) LOANS.

(a) In General- Section 7(a) of the Small Business Act (15 U.S.C. 636(a)) is amended by adding at the end the following:

`(34) REFINANCING EXISTING LOANS- A borrower that has received a loan under this subsection may refinance the balance of the loan by applying for a loan from the lender that made the original loan or with another lender.'.

(b) Technical Amendment- Section 7(a) of the Small Business Act (15 U.S.C. 636(a)) is amended by striking `(32) INCREASED' and inserting `(33) INCREASED'.

SEC. 4. MAXIMUM LOAN AMOUNTS UNDER 504 PROGRAM.

Section 502(2)(A) of the Small Business Investment Act of 1958 (15 U.S.C. 696(2)(A)) is amended--

(1) in clause (i), by striking `$1,500,000' and inserting `$4,000,000';

(2) in clause (ii), by striking `$2,000,000' and inserting `$5,000,000'; and

(3) in clause (iii), by striking `$4,000,000' and inserting `$5,500,000'.

SEC. 5. MAXIMUM LOAN LIMITS UNDER MICROLOAN PROGRAM.

Section 7(m) of the Small Business Act (15 U.S.C. 636(m)) is amended--

(1) in paragraph (1)(B)(iii), by striking `$35,000' and inserting `$50,000';

(2) in paragraph (3)(E), by striking `$35,000' each place it appears and inserting `$50,000'; and

(3) in paragraph (11)(B), by striking `$35,000' and inserting `$50,000'.

SEC. 6. ONLINE LENDING PLATFORM.

It is the sense of the Congress that the Administrator of the Small Business Administration should establish a website that--

(1) lists each lender that makes loans guaranteed by the Small Business Administration and provides information about the loan rate of each such lender; and

(2) allows prospective borrowers--

(A) to compare rates on loans guaranteed by the Small Business Administration; and

(B) to apply online for loans guaranteed by the Small Business Administration.

 

Are President Obama's New Small Business Adminstration's(S.B.A.) Initiatives Intended as a Political Plum for Senator Olympia Snowe?

 The New York Times, October 21, 2009

What is striking about the S.B.A. initiatives is not just the size of the increases but whom they appear meant to impress. The new loan limits closely track increases proposed by Olympia Snowe, the senator from Maine (who was the only Republican to vote for the Baucus Health-Care Bill...

In August, Ms. Snowe introduced legislation titled the “Next Step for Main Street Credit Availability Act of 2009.”

(Click Senator Snowe to read more about this Act)

A Lexington Herald-Leader Editorial: The Baucus Health Care Plan Falls Short

The Baucus plan does some good things, including requiring insurance companies to sell all customers the same policy and ending industry practices that deny care for spurious reasons.

It falls short in holding down insurance costs because there's no public option to compete with private insurers.

... It seems to us, though, that the public option is a more streamlined way to achieve reform's goals than a new bureaucracy to police 50 state insurance markets to be sure that insurers aren't illegally denying coverage and cherry-picking customers.

To read the entire editorial click Lexington Herald-Leader.

The Unlikely Alliance among the Obama Administration, Pharmaceutical Manufacturers and the American Medical Association

The Politico, October 16, 2009 (an indepdent and well-respected source of congressional and political news)

At a meeting last April with corporate lobbyists, aides to President Barack Obama and Sen. Max Baucus (D-Mont.) helped set in motion a multimillion-dollar advertising campaign, primarily financed by industry groups, that has played a key role in bolstering public support for health care reform

(This meeting resulted) in a somewhat unlikely alliance between an administration that came into power criticizing George W. Bush for his closeness to Big Business and groups such as the Pharmaceutical Research and Manufacturers of America and the American Medical Association.