Healthcare Reform Thread II

[Boris Godunov]

I know, Boris. But even if it's commonly used, its justification is questionable.

And why do you think that is?

[Boris Godunov]

Deem and pass hasn't been used for a trillion dollar bill before. And it's not clear if it's constitutional or ever was. It's simply never been challenged.

It was challenged. The House GOP defended it in Federal Court in 2007 (from Pelosi!). The court sided with the GOP, and it was upheld on appeal. It never made it to SCOTUS, no, but it did have its day in court.

[Drake Tungsten]

It was challenged. The House GOP defended it in Federal Court. The court ruled that it was a valid procedure.

Wrong. It sounds like someone has been reading too much Ezra Klein and doesn't actually know the details of the Public Citizen case, which involved "a clerk’s error with respect to one term, so the House and Senate voted on slightly different versions of the bill and the President signed the version passed by the Senate." That hardly seems applicable to our present situation, in which the House is considering knowingly avoiding a vote on the Senate bill's language. The constitutionality of "deem and pass" simply isn't clear at all.

[MrFun]

And why do you think that is?

It denies representatives the vote on an issue as paramount and substantial as this health care bill. And indirectly, thus denies the people any final say in this through their representatives.

[Ramo]

As for the "appearance" of deficit reduction, in the second decade the growth in revenues is significantly faster than the growth in expenditures, due to the excise tax.

And due to a reduction in Medicare reimbursements to doctors that is never actually going to happen. How long are you going to keep dishonestly shilling for this POS, Ramo?

With the new CBO score, even with your bull**** accounting, you're still wrong.

It decreases the deficit by $1.2 trillion over the second decade. The doc fix is $200 billion over the next decade. Unless that increases by a factor of 6 during the second decade (assuming that medical inflation is trivially related to the cost of the doc fix we're talking about a factor of 1.8), it's still a huge long term deficit reducer.

Of course, the CBO only matters if it says bad things about Democrats. We've known that for several months now.

[DanS]

Here's a fantastic vote tally by the WaPo. Through this lense, the outlook for the bill looks poor.

http://www.washingtonpost.com/wp-srv/special/politics/votes/house/finalhealthcare/?hpid=topnews

[Drake Tungsten]

It decreases the deficit by $1.2 trillion over the second decade. The doc fix is $200 billion over the next decade.

Have you really been reduced to comparing numbers from different decades and treating projections twenty years out based on questionable assumptions as gospel? Jesus Christ, dude...

A valid comparison would point out that the CBO says healthcare reform will reduce the deficit by $138 billion over the next ten years. Accepting your estimate of $200 billion over the next decade for the doc fix, the Dems' healthcare reform plans will actually add $62 billion to the federal deficit over the next ten years. This happens despite the fact that the Dems are paying for six years of benefits with ten years of revenue.

edit: "CBO: HC bills would cost $17 billion in first 4 years, $923 billion in remaining 6 years!"

[Kuciwalker]

Where's the "ten years of revenue"? Didn't the excise get postponed to 2018? Is there another revenue mechanism in the bill?

[Drake Tungsten]

Is there another revenue mechanism in the bill?

Money freed up by cuts in Medicare Advantage payments. There are other taxes in the Senate bill besides the tax on "Cadillac" plans, in addition to the penalties paid by people/businesses who fail to abide by the individual/employer mandate to purchase health insurance. I'm not sure exactly when these will all be implemented, as the revenue portions of the bill will be altered via reconciliation and are therefore still in flux. The CBO report on the reconciliation bill is a preliminary one and doesn't describe the revenue sources in detail.

edit: This site has a good overview of the various revenue provisions in the Senate, House and Presidential versions of healthcare reform...

http://healthaffairs.org/blog/2010/02/22/the-presidents-health-reform-proposal-insurance-and-revenue-provisions/

The CBO is scoring a reconciliation bill that would be similar to the Senate bill, but would include some House demands that haven't been spelled out yet.

edit 2: More info...

Revenue

Mandate penalty: $17B/10yrs
Free rider penalty: $52B/10yrs
Excise tax: $32B/10yrs
Payroll tax: $210B/10yrs

Medicare and Medicaid

Total savings: ~$493B/10yrs
Medicare Advantage: $200B/10yrs

http://wonkroom.thinkprogress.org/2010/03/18/cbo-score-comparison/

Looks like there was a significant hike in payroll taxes in the reconciliation bill, in addition to savings from college loan reform.

edit 3: Even more info...

http://keithhennessey.com/2010/03/18/understanding-health-bill-two/

[Boris Godunov]

It was challenged. The House GOP defended it in Federal Court. The court ruled that it was a valid procedure.

Wrong. It sounds like someone has been reading too much Ezra Klein and doesn't actually know the details of the Public Citizen case, which involved "a clerk’s error with respect to one term, so the House and Senate voted on slightly different versions of the bill and the President signed the version passed by the Senate." That hardly seems applicable to our present situation, in which the House is considering knowingly avoiding a vote on the Senate bill's language. The constitutionality of "deem and pass" simply isn't clear at all.

Note that I didn't say it has been deemed constitutional, as I was only pointing out it had seen a courtroom. Even the article you link to cites it as a supporting example as to why this process might indeed be given a pass by courts, esp. since previous precedent indicates that so long as the leaders of the House and Senate attest that the legislation coming out of their respective chambers was passed, there's no mechanism to challenge it.

[Drake Tungsten]

Note that I didn't say it has been deemed constitutional

"Deem and pass" is a common procedure used by both parties, it's constitutional (Even Eric Cantor admitted so today), so ANYONE complaining about it is just doing so for political purposes.

[Boris Godunov]

It denies representatives the vote on an issue as paramount and substantial as this health care bill. And indirectly, thus denies the people any final say in this through their representatives.

Who said there isn't going to be a vote? Hasn't all the news this week been about just how many votes the Dems have to get it passed?

If your objection is the Senate bypassing the 60 votes for cloture on it, well... so what? That's a procedural requirement, not a legal one. If the Senate makes it so 51 votes are all that are needed to pass it, that's its perogative. Heck, the constitution doesn't even specify that a chamber has to pass a bill by majority vote or otherwise. Technically, the House or Senate leadership could decide that 40% is enough to pass, or 30%. Not that it would be anything other than political suicide, sure... But 50% +1 seems pretty reasonable to me.

[Boris Godunov]

Alright, mea culpa. I meant to say it was considered legitimate by Congress and so even Cantor had said it was a standard House procedure, despite earlier protestations to the contrary. He agreed with Hoyer on this point. Better?

[Drake Tungsten]

Alright, mea culpa. I meant to say it was considered legitimate by Congress and so even Cantor had said it was a standard House procedure, despite earlier protestations to the contrary. He agreed with Hoyer on this point. Better?

Yes; I just wanted to make it clear that the constitutionality of deem and pass is unclear. There will be a court challenge if the Dems pass healthcare reform that way and it is not clear what the outcome of said challenge will be.

[Drake Tungsten]

I've found my silver lining in this debacle: it looks like Ben Nelson is going to lose his Cornhusker Kickback and have no chance to stop student loan reform (which hurts both Nebraska and some of his biggest donors) because he was a corrupt moron and voted for the Senate Bill. Serves him right.