Another Obamacare Setback: Patient Out-Of-Pocket Caps Waived Until 2015

[Bill Peckham]

Sorry Rocker, your memory of "open" negotiations does not line up with the historical account. The left wing DEMs even shut out the moderate and conservative "blue-dog" DEMS who made a formal complaint against that.

http://www.nytimes.com/2009/05/12/us/politics/12dems.html?adxnnl=1&ref=us&adxnnlx=1242133580-BAMJSJYbmjbBoEQASz72Zg&_r=0

ObamaCare came to us through back room politics from one sided left wing DEMS who had the votes in the House and Senate. Pelosi put enormous pressure on her troops to hold the line and vote. Pelosi told the public we have to pass it so we could find out what is in the bill. You call this an "open" debate.

http://www.youtube.com/watch?v=hV-05TLiiLU

Rocker, where did I state that single payer was in the ACA. Not what I stated at all. I stated that the goal of the ACA is to lead to a single payer system, not that it contained a single payer clause. Interestingly, Harry Reid so stated a few days ago that that is their goal. Sorry that this is news to you, but that has been apparent for a long time to those who oppose Obamacare. The government-sponsored commercial insurance policy was opposed simply because it was as a direct step towards a single payer system that even the DEMS couldn't pass since that is not what the majority of Americans want.

There was a year long election campaign - addressing the perverse health insurance system was one of the main issues that Obama campaigned on, I remember this because i was I was alive at the time. Obama and his agenda won by a large margin. The Democrats picked up seats in the House and in the Senate because the American People supported their policy preferences. You can unskew polls all you want but you can't unskew elections.


The Pelosi quote is a typical out of context talking point that has meaning only to pure partisans on the right. The full speech is available. This was March of 2010. Pelosi was referencing the Senate Bill, which had yet to pass the House, which the Republicans were making spurious claims about for instance that there would be death panels or that their objection was about abortion or that it was a job killer or that it would increase the deficit. Pelosi was saying that until the House passed the Bill you couldn't argue the details, that the House had to agree on a bill before you could say what exactly the details were - it's a ordinary observation since legislation can be amended at any time durning the process. Once the Senate Bill was passed by the House with an agreement to make changes - higher subsidy levels, different kinds of taxes to pay for them, nixing the Nebraska Medicaid deal - you could point to the language and say that no there are no death panels, there isn't support for undocumented patients, there isn't support for abortion, it lowers the deficit.

If the whole ACA process has taught you anything it would be that no one person gets what they want. It doesn't matter if Harry Reid, in his heart, wants single payer, the Senate Majority leader can only pass legislation with the support of 59 other Senators. It is true though that by insisting that the Federal Government set up exchanges throughout red state America (with exceptions, Idaho for instance) there will be a different payment level available, aside from Medicare, on which to base a single payer system. I think it will depend how badly republicans can sabotage the implementation of the ACA, if they do as a good a job as they wish a single payer system may be the only viable option available, because Price's mandate-less plan would not work and Switzerland has a mandate so that approach is not acceptable to Republicans too apparently. You have to solve the free rider problem in a way that doesn't leave people dying from a lack of care, because that wouldn't be a solution. For some reason Republicans have decided the free rider issue can't be addressed by mandating people take responsibility for their health insurance. And I have not heard another approach that could work.

[Hemodoc]

Sorry Bill, a couple of things to correct as well. Obamacare would have died in the Senate with the election of Brown in MA but Harry Reid pulled an end run by using the "reconciliation" process  which many believed was unconstitutional.

Many Republicans are saying at this point give the people Obamacare in full right now so that people will finally find out what is really in that bill, but Obama protecting his interests in the 2014 midterm election is holding several key provisions that could adversely effect the Senate democratic majority. At present prior to the midterm election, many GOP say put it into effect and the ACA will sabotage itself.

Lastly, it is no knew story that Obama himself has a goal of single payer system. Obamacare will cause folks to demand a single payer system down the road after he completely ruins what we have today and Obamacare itself fails as it shall. It is a train wreck coming our way so let it come at this point. Why is Obama afraid of his own legislation to fully implement it now as was scheduled?

[Bill Peckham]

Sorry Bill, a couple of things to correct as well. Obamacare would have died in the Senate with the election of Brown in MA but Harry Reid pulled an end run by using the "reconciliation" process  which many believed was unconstitutional.

Many Republicans are saying at this point give the people Obamacare in full right now so that people will finally find out what is really in that bill, but Obama protecting his interests in the 2014 midterm election is holding several key provisions that could adversely effect the Senate democratic majority. At present prior to the midterm election, many GOP say put it into effect and the ACA will sabotage itself.

Lastly, it is no knew story that Obama himself has a goal of single payer system. Obamacare will cause folks to demand a single payer system down the road after he completely ruins what we have today and Obamacare itself fails as it shall. It is a train wreck coming our way so let it come at this point. Why is Obama afraid of his own legislation to fully implement it now as was scheduled?

That is not what happened - check the Congressional record if you must but Wikipedia is accurate and succinct http://en.wikipedia.org/wiki/Patient_Protection_and_Affordable_Care_Act#Legislative_history

On December 23, the Senate voted 60–39 to end debate on the bill (a cloture vote to end the filibuster by opponents). The bill then passed by a vote of 60–39 on December 24, 2009, with all Democrats and two independents voting for, and all Republicans voting against except one (Jim Bunning (R-KY), not voting).[218] The bill was endorsed by the AMA and AARP.[219]

After Brown's election the Senate could not have voted on the House version and risked going to committee. The only option left was for the House to pass the Senate Bill as it was, as it was written when it got 60 votes through normal order. This ties directly to Pelosi's comment because she was referencing the negotiations that were going on at the time which as I said included an agreement to make changes - higher subsidy levels, different kinds of taxes to pay for them, nixing the Nebraska Medicaid deal which was a normal reconciliation Bill having to do with funding and as such requires only 50 votes. Peter you've internalized a history that is false.

[Hemodoc]

Not true at all Bill, you have left out the final act of the ACA which WAS passed by reconciliation with only 56 senators. Even your link so states:

Health Care and Education Reconciliation Act of 2010

Obama signed the Patient Protection and Affordable Care Act into law on March 23, 2010. The Health Care and Education Reconciliation Act of 2010 was passed by the House of Representatives on March 21, 2010, by a vote of 220–211, and on March 25, after having two minor provisions stricken under the Byrd Rule, passed the Senate by a vote of 56-43. A few hours later, the amended bill was passed by the House 220-207. President Obama signed the health care reconciliation bill into law on Tuesday, March 30, at Northern Virginia Community College.[3

https://en.wikipedia.org/wiki/Health_Care_and_Education_Reconciliation_Act_of_2010

Obama signed the ACA (the Senate bill) into law on March 23, 2010.[236] The amendment bill (the Health Care and Education Reconciliation Act) was also passed by the House on March 21, then by the Senate via reconciliation on March 25, and finally signed by President Obama on March 30.

http://en.wikipedia.org/wiki/Patient_Protection_and_Affordable_Care_Act#Legislative_history

Since these bills are supposed to originate in the House and go to the Senate, approving the Senate version instead of the House version was felt to be inappropriate by many but who cares what the constitution states anyway. The Senate version ran into another issue with the conservative House DEMS because the Stupak amendment was not included in the Senate version and Obama had to issue an executive order to get the Senate version passed in the House. Since they no longer had a super majority, they could not take the House bill and pass it again in the Senate as is the usual process. So, by executive order and the Health Care and Education Reconciliation Act of 2010, they did an end run around the legislative process for the ACA.

[Bill Peckham]

Not true at all Bill, you have left out the final act of the ACA which WAS passed by reconciliation with only 56 senators. Even your link so states:

Health Care and Education Reconciliation Act of 2010

Obama signed the Patient Protection and Affordable Care Act into law on March 23, 2010. The Health Care and Education Reconciliation Act of 2010 was passed by the House of Representatives on March 21, 2010, by a vote of 220–211, and on March 25, after having two minor provisions stricken under the Byrd Rule, passed the Senate by a vote of 56-43. A few hours later, the amended bill was passed by the House 220-207. President Obama signed the health care reconciliation bill into law on Tuesday, March 30, at Northern Virginia Community College.[3

https://en.wikipedia.org/wiki/Health_Care_and_Education_Reconciliation_Act_of_2010

Obama signed the ACA (the Senate bill) into law on March 23, 2010.[236] The amendment bill (the Health Care and Education Reconciliation Act) was also passed by the House on March 21, then by the Senate via reconciliation on March 25, and finally signed by President Obama on March 30.

http://en.wikipedia.org/wiki/Patient_Protection_and_Affordable_Care_Act#Legislative_history

That's exactly what I said.

You stated that

"Obamacare would have died in the Senate with the election of Brown in MA but Harry Reid pulled an end run by using the "reconciliation" process  which many believed was unconstitutional."

 That's not what happened, as evidenced by your most recent quote. The Bill, the two thousand page bill, the ACA, is the Senate Bill. It passed with 60 votes. It was signed on March 23, 2010. Harry Reid got the Bill through with 60 votes - the Bill that is law today was passed by the Senate with 60 votes.

Then through normal order, a second Bill which was negotiated between the House and the Senate prior to the House passing the Senate version of the ACA. The Health Care and Education Reconciliation Act of 2010 amended some of the tax and spend provisions in the ACA. It's a short bill, thick with edits to the ACA but it can be summerized completely in three pages  http://www.dpc.senate.gov/healthreformbill/healthbill61.pdf 

The Bill that is the law of the land, the  Patient Protection and Affordable Care Act went through full Senate committee vetting, hundreds of hours of hearings and testimony and received a supermajority vote. The House had a similar Bill that went through the entire House vetting process of committee hearings and testimony. In the end the House bill never received an up or down vote because the politics of he Senate made it moot. But to say that the ACA passed through reconcilliation is factually not the legislative history.

[Hemodoc]

Yes, it would have died because the senate would have had to pass the House Bill after considering the Senate bill and passing their own version. Instead, Obama put an executive order to satisfy the lack of the Stupak amendment in the Senate bill and then the Reconciliation bill gained the votes in the House for the senate version which is backwards from the usual process and then the Senate passed this bill by a 56 vote margin. You did not give the full story Bill. Without reconciliation in the senate, the House would not have passed the Senate bill due to blue dog DEMS opposed to the senate bill.

[rocker]

At present prior to the midterm election, many GOP say put it into effect and the ACA will sabotage itself.

Who?  Any actual national Republican political figure saying that?

Lastly, it is no knew story that Obama himself has a goal of single payer system. Obamacare will cause folks to demand a single payer system down the road after he completely ruins what we have today and Obamacare itself fails as it shall. It is a train wreck coming our way so let it come at this point. Why is Obama afraid of his own legislation to fully implement it now as was scheduled?

Keep fighting to preserve a system that kills tens of thousands of American citizens every year.  They probably weren't important.

[Hemodoc]

At present prior to the midterm election, many GOP say put it into effect and the ACA will sabotage itself.

Who?  Any actual national Republican political figure saying that?

Lastly, it is no knew story that Obama himself has a goal of single payer system. Obamacare will cause folks to demand a single payer system down the road after he completely ruins what we have today and Obamacare itself fails as it shall. It is a train wreck coming our way so let it come at this point. Why is Obama afraid of his own legislation to fully implement it now as was scheduled?

Keep fighting to preserve a system that kills tens of thousands of American citizens every year.  They probably weren't important.

Rand Paul for one.

Who says I want the status quo. Perhaps some day you will actually read my posts instead of making up what you think I say.

[Bill Peckham]

Yes, it would have died because the senate would have had to pass the House Bill after considering the Senate bill and passing their own version. Instead, Obama put an executive order to satisfy the lack of the Stupak amendment in the Senate bill and then the Reconciliation bill gained the votes in the House for the senate version which is backwards from the usual process and then the Senate passed this bill by a 56 vote margin. You did not give the full story Bill. Without reconciliation in the senate, the House would not have passed the Senate bill due to blue dog DEMS opposed to the senate bill.

Yeah, I didn't give the full story 

I think I have a pretty clear memory of what happened and why - at the time the push to get coverage for the life of the transplant was in play and the actual process that the ACA took to become law was what undercut the transplant community's stabbed in the back narrative. While it seems as if you are reconstructing the ACA's history via Google to fit your preferred political position.

[Hemodoc]

Yes, it would have died because the senate would have had to pass the House Bill after considering the Senate bill and passing their own version. Instead, Obama put an executive order to satisfy the lack of the Stupak amendment in the Senate bill and then the Reconciliation bill gained the votes in the House for the senate version which is backwards from the usual process and then the Senate passed this bill by a 56 vote margin. You did not give the full story Bill. Without reconciliation in the senate, the House would not have passed the Senate bill due to blue dog DEMS opposed to the senate bill.

Yeah, I didn't give the full story 

I think I have a pretty clear memory of what happened and why - at the time the push to get coverage for the life of the transplant was in play and the actual process that the ACA took to become law was what undercut the transplant community's stabbed in the back narrative. While it seems as if you are reconstructing the ACA's history via Google to fit your preferred political position.

Oh baloney Bill, the Senate ACA version would not have passed the House without the Executive order covering the Stupak amendment and the Reconciliation bill to amend the ACA since the senate could not pass an updated house version without using reconciliation after Brown was elected. No reconstruction, just plain facts. They could not take the senate and house versions to conference and pass again in House and Senate once again without reconciliation. That is the plain facts whether you like it or not Bill.

[Bill Peckham]

Yes, it would have died because the senate would have had to pass the House Bill after considering the Senate bill and passing their own version. Instead, Obama put an executive order to satisfy the lack of the Stupak amendment in the Senate bill and then the Reconciliation bill gained the votes in the House for the senate version which is backwards from the usual process and then the Senate passed this bill by a 56 vote margin. You did not give the full story Bill. Without reconciliation in the senate, the House would not have passed the Senate bill due to blue dog DEMS opposed to the senate bill.

Yeah, I didn't give the full story 

I think I have a pretty clear memory of what happened and why - at the time the push to get coverage for the life of the transplant was in play and the actual process that the ACA took to become law was what undercut the transplant community's stabbed in the back narrative. While it seems as if you are reconstructing the ACA's history via Google to fit your preferred political position.

Oh baloney Bill, the Senate ACA version would not have passed the House without the Executive order covering the Stupak amendment and the Reconciliation bill to amend the ACA since the senate could not pass an updated house version without using reconciliation after Brown was elected. No reconstruction, just plain facts. They could not take the senate and house versions to conference and pass again in House and Senate once again without reconciliation. That is the plain facts whether you like it or not Bill.

The ACA received 60 votes in the Senate. The ACA was the subject of hundreds of hours of testimony in several different Senate Committees. The ACA passed through normal order. The ACA was available for anyone to read for nearly three months before the House voted on it.

Because people read the Bill the House required some changes and some political cover to come to a compromise with the Senate, like every other Bill that ever passes the Senate and needs to go through the House.

What is the point you are trying to make? That no one knew what was in the Bill? Not true. That the ACA passed through some novel legislative process? Not true. That some democrats in the House were worried about their political careers if they supported the ACA? That's true. That's called political courage, something today's Republicans in the House sorely lack.

[duncan reamhiar]

not for nothing but Bill quoting Wikipedia is not really a good place to get your info.. ANYONE can add or change info on Wikipedia... if i decided to make any kind of changes to it.. it would read as I wanted it to. so i find Wikipedia to NOT be an accurate source of info... i am a moderator on another site and have found much wrong with many things gotten from there

[Bill Peckham]

not for nothing but Bill quoting Wikipedia is not really a good place to get your info.. ANYONE can add or change info on Wikipedia... if i decided to make any kind of changes to it.. it would read as I wanted it to. so i find Wikipedia to NOT be an accurate source of info... i am a moderator on another site and have found much wrong with many things gotten from there

Like I said:
check the Congressional record if you must but Wikipedia is accurate and succinct http://en.wikipedia.org/wiki/Patient_Protection_and_Affordable_Care_Act#Legislative_history

On December 23, the Senate voted 60–39 to end debate on the bill (a cloture vote to end the filibuster by opponents). The bill then passed by a vote of 60–39 on December 24, 2009, with all Democrats and two independents voting for, and all Republicans voting against except one (Jim Bunning (R-KY), not voting).[218] The bill was endorsed by the AMA and AARP.[219]

And I would note that those numbers in brackets are citations. The ACA passed the Senate on December 24, 2009 by a vote of 60 to 39. That is a fact of history.

Just because Wikipedia's Lady Gaga article contains misinformation does not mean Wikipedia is not a good place to get information.

[Hemodoc]

Still not telling the story of how the House passed the Senate bill without amendments since an amended House bill could not pass again in the Senate WITHOUT reconciliation after Brown was elected in MA.

They did pass the Senate version but the amendments were in a Reconciliation bill. Yes, reconciliation was used in the ACA to get the vote in the House whether you wish to admit it or not.

[Bill Peckham]

Still not telling the story of how the House passed the Senate bill without amendments since an amended House bill could not pass again in the Senate WITHOUT reconciliation after Brown was elected in MA.

They did pass the Senate version but the amendments were in a Reconciliation bill. Yes, reconciliation was used in the ACA to get the vote in the House whether you wish to admit it or not.

Political compromise, what a concept.

[Hemodoc]

Actually Bill, many of those who engaged in your so called political compromise found out it was actually political suicide like lemmings jumping off a cliff just before the midterm  election.

[Bill Peckham]

Actually Bill, many of those who engaged in your so called political compromise found out it was actually political suicide like lemmings jumping off a cliff just before the midterm  election.

So elections validate your policy positions (2010) except when the elections don't go your way (2012).

[duncan reamhiar]

who the cripes is Lady Gaga and what does she have to do with any of this? my point being only that ANYONE can make changes to Wikipedia so it is not a good place to use to prove a point..

[Bill Peckham]

my point being only that ANYONE can make changes to Wikipedia so it is not a good place to use to prove a point..

Sure that's called vandalism and it happens all the time but there is a reason Wikipedia is the most used information source in the world - it has an effective system that removes vandalism. And it has a system that rates articles so that even a novice user can understand the article's importance and completeness. If, for instance, someone went to this article which has a low importance in the eyes of the community and is reckoned to be of "B" quality it is still being followed and checked. So if one were to edit the article and write that support of the war would have collapsed had people known that in 70 years American citizens would be expected to carry health insurance, that claim would be removed within minutes because it is farcical. However, if you happened to come across the page in the few minutes that the claim was active there are a number of ways to judge for yourself if the claim is not supported by the people who care about this particular article (36 people are watching it) or to judge for yourself if the claim lacks factual support. For instance you could note that the claim does not provide a citation, that should raise a red flag and/or you could see that hte claim is new and has not been a part of the article for more than minutes.

Wikipedia is a very useful information source but as with all things there is a base level of understanding needed to use it well.

[Hober Mallow]

who the cripes is Lady Gaga and what does she have to do with any of this? my point being only that ANYONE can make changes to Wikipedia so it is not a good place to use to prove a point..

And his point, which was crystal clear, is that the numbers are cited from their sources which you're free to check.

[Jean]

Just feel that I have to ask this question. Here in California, we have "County" Hospitals. If you have no insurance or can't pay your bill, they either qualify you for Med-Cal or there is no bill. Don't your states have that? There is no reason for some one to die for lack of care, I guess unless they don't know about it.

[Hober Mallow]

Just feel that I have to ask this question. Here in California, we have "County" Hospitals. If you have no insurance or can't pay your bill, they either qualify you for Med-Cal or there is no bill. Don't your states have that? There is no reason for some one to die for lack of care, I guess unless they don't know about it.

Well, there *is* a bill, whether the patient pays it or not. Someone has to pay for the care. It's not free.

Second, that would be all well and good if you need to go to an ER, but what if you need to see a specialist? A nephrologist? An oncologist? What if you need ongoing care? An organ transplant? Do the County Hospitals pay for all that? What about medication? People in the U. S. do indeed die from lack of care.

[Jean]

Yes Hober Mallow, they do pay for all of it. Hubby and I got stuck between jobs, and he was diagnosed with Cancer. They covered every single thing, since our only income was my unemployment. The County Hospitals here have all kinds of specialists. Of course, you are right about it is not free, as some one pays the bill and it is actually the residents of the County.  I did work in that hospital for nearly a year and they treated all kinds of people, from the mildly ill to the terminally ill. Of course, there are people who are too proud to go to a "county" hospital and I suppose people could die that way.