Christmas Eve Vote on Obamacare Showed Washington Still Has Shame

A decade ago this morning, 60 Senate Democrats cast their final votes approving the legislation that became Obamacare. The bill took a circuitous route to enactment after Scott Brown’s surprise victory in the Massachusetts Senate contest, which occurred a few weeks after the Senate vote, in January 2010.

Brown’s election meant Republicans gained a 41st Senate seat, giving them the necessary votes to filibuster a House-Senate conference report on Obamacare. Because Democrats lacked the 60 votes to overcome a filibuster, they eventually agreed to a process amending certain budgetary and fiscal elements of the Senate bill through the reconciliation process on a 51-vote threshold.

The grubby process leading up to Obamacare’s enactment, full of parochial politics and special interest pork, cost Democrats politically. But many Americans do not realize that such machinations occur all the time in Washington—indeed, occurred just last week. When one party participates in a corrupt process, it becomes a scandal; when both parties partake, few outside the Beltway bother to notice.

Backroom Deals

The process among Democrats leading up to the final health vote resembled an open market, with each Senator making “asks” of Majority Leader Harry Reid (D-NV). Reid needed all 60 Democrats to vote for Obamacare to break a Republican filibuster, and the parochial provisions included in the legislation showed the lengths he would go to enact it:

Cornhusker Kickback:” The most notorious of the backroom deals came after Sen. Ben Nelson (D-NE) requested a 100 percent Medicaid match rate for his home state of Nebraska. The final manager’s amendment introduced by Reid included this earmark—Nebraska would have its entire costs of Medicaid expansion paid for by the federal government forever. But the blowback from constituents and the press became so great that Nelson asked to have the provision removed; the reconciliation measure enacted in March 2010 gave Nebraska the same treatment as all other states.

Gator Aid:” This provision, inserted at the behest of Sen. Bill Nelson (D-FL), and later removed in the reconciliation bill, sought to exempt Florida seniors from much of the effects of the law’s Medicare Advantage cuts.

Louisiana Purchase:” This provision, included due to a request from Sen. Mary Landrieu (D-LA), adjusted the state’s Medicaid matching formula. Landrieu publicly defended the provision—which she said reflected the state’s circumstances after Hurricane Katrina—and it remained in law for several years, but was eventually phased out in legislation enacted February 2012.

While these three provisions captivated the public’s attention, other earmarks and pork provisions abounded inside Obamacare too—a Medicaid funding provision that helped Massachusetts; exemptions from the insurer tax for two Blue Cross carriers; a $100 million earmark for a Connecticut hospital, and health benefits for miners in Libby, Montana, courtesy of then-Senate Finance Committee Chairman Max Baucus (D-MT).

Not only did senators try to keep these corrupt deals in the legislation—notwithstanding the public outrage they engendered—but Reid defended both the earmarks and the horse-trading process that led to their inclusion:

I don’t know if there’s a senator who doesn’t have something in this bill that’s important to them. And if they don’t have something in it that’s important to them, then it doesn’t speak well for them.

It was a far cry from Barack Obama’s 2008 (broken) campaign promise to have all his health care negotiations televised on C-SPAN, “so we will know who is making arguments on behalf of their constituents, and who are making arguments on behalf of the drug companies or the insurance companies.” And it looked like Democrats didn’t really believe in the merits of the underlying legislation, but instead voted to restructure nearly one-fifth of the American economy because they got some comparatively minor pork project for their district back home.

Déjà Vu All Over Again

Democrats lost control of the House in the 2010 elections, and political scientists have attributed much of the loss to the impact of the Obamacare vote. One study found that Obamacare cost Democrats 6 percentage points of support in the 2010 midterm elections, and at least 13 seats in Congress.

But did the rebuke Democrats received for their behavior prompt them to change their ways? Only to the extent that, when they want to ram through a massive piece of legislation no one has bothered to read, they include Republicans in the taxpayer-funded largesse.

Consider last week’s $1.4 trillion spending package: Two bills totaling more than 2,300 pages, which lawmakers introduced on Monday and voted on in the House 24 hours later. Democrats wanted to repeal one set of Obamacare taxes—and in exchange, they agreed to repeal another set of taxes that Republicans (and their K Street lobbying friends) wanted gone. The Obamacare taxes went away, but the Obamacare spending remained, thus increasing the deficit by nearly $400 billion.

And both sides agreed to increase spending in defense and non-defense categories alike. Therein lies the true definition of bipartisanship in Washington: An agreement in which both sides get what they want—courtesy of taxpayers in the next generation, who get stuck with the bill.

It remains a sad commentary on the state of affairs in the nation’s capital that the Obamacare debacle remains an anomaly—the one time when the glare of the spotlight so seared Members seeking pork projects that they dared consider forsaking their ill-gotten gains. To paraphrase the axiom about casinos, in Washington, The Swamp (almost) always wins.

Gov. Jindal Op-Ed: The Liberal Left’s Misplaced Priorities

What does have against individuals with disabilities?

On first glance, it may appear an odd question to ask. But when it comes to the liberal organization’s new ad campaign attempting to persuade states to expand their Medicaid programs, it’s a sad but true statement.

Here are the facts. Obamacare contains a massive expansion of Medicaid. Until recently, the program had provided health coverage targeted towards low-income parents, children, and individuals with disabilities. But President Obama expanded Medicaid to include millions more Americans—the vast majority of whom are childless adults of working age.

The federal government provides funds to states matching their Medicaid contributions. But Obamacare includes a twist: The law provides a richer federal match for states’ coverage of childless adults than Medicaid programs receive for covering individuals with disabilities. I’ll say that again: Obamacare prioritizes Medicaid coverage of childless adults over care for persons with disabilities. That’s a case of skewed priorities if I ever heard of one.

I truly believe in a government safety net. But a vast expansion of government-run health care will jeopardize the care of the most vulnerable in our society. With more than half a million individuals with disabilities already on waiting lists for Medicaid services nationwide, we need to protect access for people with disabilities, not engage in a massive new wave of government-run health coverage.

That’s why my proposed budget for this year directs $26 million in new funding to home and community-based services for elderly individuals and persons with disabilities. We’re focused on improving the quality of care, and giving individuals with disabilities more choices. We’ve already increased the number of individuals receiving home and community-based care by 5,000, and this year’s funding increase will ultimately reduce our waiting list for services by over 4,000.

But while we’re focused on improving the quality of care provided and reducing waiting lists for persons with disabilities, Liberals would rather our state use those resources to participate in Obamacare’s Medicaid expansion. Liberal groups like won’t say one word about caring for individuals with disabilities, or how Obamacare prioritizes coverage of childless adults ahead of the most vulnerable—they just want to intimidate states into accepting Obamacare’s massive new spending programs.

Likewise, one of my state’s senators, Mary Landrieu, has decried my decision to focus on targeting resources toward individuals with disabilities rather than participating in Obamacare’s Medicaid expansion. But why did she support—and provide the critical 60th vote to enact—legislation that discriminates against individuals with disabilities, by prioritizing coverage for childless adults over the needs of the most vulnerable? And what would she say if our state devoted resources to covering thousands of childless adults through Medicaid, while leaving individuals with disabilities out in the cold? How would she fill that “Landrieu Gap?”

In the past six years, we’ve accomplished quite a lot to reform our health care system in Louisiana. We’ve privatized our antiquated charity hospital system, creating new private-public partnerships that have reinvigorated community health, and provided new services to low-income individuals across the state. We’ve revamped our Medicaid program, now called Bayou Health, to lead to better integrated and more coordinated care. And we’ve focused on covering the persons Medicaid was originally designed to serve—we’ve achieved a coverage rate for children of 95.6%, and we’re working to increase access for persons with disabilities.

We still have more work to do to improve health care in Louisiana. But I won’t accept lectures in compassion from those who would expand our safety net beyond comprehension, and jeopardize the care of our most vulnerable citizens in the process. We’ve come too far to become distracted by outside liberal groups with their own agendas, who would leave care for those with disabilities behind just to make a political point.

This post was originally published at The Ouachita Citizen.

Losing Health Insurance Due to Obamacare

Millions of Americans are finding out they will lose their current health plan due to Obamacare. Contrary to the statements made by some, Obamacare interrupts insurance for everyone, not just the Americans who purchase coverage directly in the individual market.

These sweeping changes are why the President’s proposed actions, and alternative legislative efforts like Chairman Fred Upton’s “Keep Your Health Plan Act” (H.R. 3350), Senator Ron Johnson’s S. 1617, and Senator Mary Landrieu’s S. 1642, while well intentioned, will not solve the problem. The Upton bill, for example, would allow people to enroll in plans that currently exist in the individual market for one more year. All of these efforts are temporary and, most importantly, do not roll back the many onerous Obamacare mandates that disrupt coverage for the 49 percent of Americans with employer-provided coverage.

How Obamacare Impacts Everyone’s Coverage Employer-Provided “Grandfathered” Insurance Plans: Designed for Extinction

• While the Obamacare bill included “grandfathered” plan language theoretically allowing Americans to keep plans they have and like, other sections of the legislation undermined this promise. For instance, Section 2301 of the reconciliation legislation included provisions requiring all plans, including “grandfathered” plans, to abide by some of the law’s new benefit mandates—thus making the plans different from pre-Obamacare offerings.

• Shortly after the law’s enactment, the Obama Administration released regulations further restricting individuals’ ability to keep their pre-Obamacare plans. The regulations stated that an increase in co-payments of more than $5, or an increase in the employee’s share of premiums paid by more than 5 percent, could cause plans to lose “grandfathered” status.

• The result: the percent of covered workers in “Grandfathered plans” went from 56 percent in 2011 to 36 percent in 2013. Employer-provided coverage is impacted by Obamacare in this and many other ways.

Individual Health Insurance Plans: Upending Coverage for Millions

• Because individuals who buy their own health insurance receive no employer subsidy for their health coverage, and often receive no taxpayer subsidy, they frequently shop for the most economical plan available. However, most individual plans do not comply with Obamacare’s new mandated benefits.

• Obamacare includes a list of 10 “essential benefits” that health plans must cover—including coverage of maternity services, habilitative services, and pediatric vision care.

• The law also requires that most health plans cover at least 60 percent of expected medical expenses. A study last year suggested that more than half of individual market insurance policies do not meet these so-called actuarial value requirements.

• Because they do not comply with the law’s new required benefits, one expert has concluded that as many as 85 percent of individual health insurance policies—affecting up to 16 million individuals—will be canceled due to Obamacare.

Small Business Insurance Plans: Canceled for Nonconformity

• Obamacare’s effects will not be felt only in the individual market. The Administration’s own regulations assumed that up to 69 percent of small business plans—covering as many as 41 million Americans—could be lost, because they do not comply with Obamacare’s requirements.

• For instance, Obamacare sets maximum deductibles for small business insurance plans at $2,000 for a single person. However, nearly one-third of covered workers at small firms are in plans that do not meet this requirement—meaning these individuals could face higher costs, or the loss of their current plan, or both.

• When it comes to both individual and small business insurance policies, losing one’s policy will often come with a big price tag. A Heritage Foundation analysis concluded that Obamacare’s benefit mandates will raise individual insurance premiums in 42 out of 47 states, in many cases causing rates to double.

Just as eliminating pre-Obamacare health plans was one major result of the law, so too are the higher premiums many will face upon losing their plan. It’s why the American people need relief from this unworkable, unfair, and unpopular law.

This post was originally published by The Heritage Foundation.

Democrats Keep Playing “Let’s Make a Deal”

You may have seen this story from this morning’s Politico about how Democrats are still scrambling to keep their back-room deals negotiated in secret meetings over the past several months.  In fact, Sen. Landrieu is reportedly going down to the Senate floor this afternoon to advertise her support for the $300 million “Louisiana Purchase.”

Despite promises of more legislative openness, Democrats continue to huddle behind closed doors in an attempt to resurrect their government takeover of health care – and HHS Secretary Sebelius said she could not guarantee a more transparent process going forward.  Democratic Senators have acted in a similar manner, admitting that at their retreat yesterday, they withheld their candid health care conversations until AFTER the cameras disappeared.  Are these back-room deals for special interests the reason why?