FixHealthCarePolicy

Congressional Micromanagement of Health Care: Messing Up The FEHBP

While Congressional leaders are feverishly plotting to jam the hugely unpopular Senate health bill through the House of Representatives the moment Speaker Pelosi thinks she has the votes, House liberals are also tinkering around with the Federal Employee Health Benefits Program (FEHBP). This is the program that covers federal workers and retirees; it is a consumer-driven program of competing private health plans. Through more regulation, Congressional liberals would like to make it look a lot more like Obamacare.

Historically, the success of the FEHBP as a consumer-driven and competitive system of private health plans has been largely attributable to its wide range of personal choice, relatively light regulation, and the hands-off approach the Office of Personnel Management (OPM) in its administration. That can change, of course, depending upon who is running the White House.

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Tags: FEHBP, Medicare, ObamaCare, Office of Personnel Management, Senate Health Bill

Health Reform That Breaks the Bank

During last month’s Blair House health care summit, President Barack Obama was forced to change the subject after Rep. Paul Ryan (R-WI) Blair House thoroughly refuted the President’s claim that his health care plan would reduce the deficit. It took over a week for the White House to respond to Ryan, but last Thursday they finally produced this blog post by OMB director Peter Orszag followed by a Washington Post op-ed Friday titled: Health reform that won’t break the bank. Ethics and Public Policy Center fellow James Capretta responded to the White House that same day at NRO:

“Orszag and DeParle start by agreeing with Ryan that delaying the start date of an entitlement expansion is a tried-and-true budget gimmick, designed to push the full cost of the additional spending outside of the ‘budget window’ covered by a cost estimate.” (more…)

Tags: bend cost curve, double-counting, Health Care Summit, health insurance exchange, high-cost insurance plans, Medicare, Rep. Paul Ryan

A Post-Health Summit Warning: Is Incremental Control Next for Obamacare?

In the wake of the White House’s health care summit, reconciliation is still seen as the likely route that congressional leaders and their liberal allies will take to jam Obamacare through Congress. Congressional Democrats and President Barack Obama already are using the summit as a public relations vehicle to help fast-track the Senate health care bill through a parliamentary process used primarily for budgetary issues.

But beware Plan B — the more “modest” plan. There’s a surer, well-worn path that the Clinton Administration took after the collapse of Hillarycare in 1994: A careful, well-coordinated, step-by-step march to the Left on federal health care policy.

The Republican congressional victory in 1994, even though it reflected public revulsion at the Clinton Administration’s proposed takeover of the private health care system, did not change the fundamental direction of federal health policy. It only changed the degree and velocity of liberal policy success. The Clinton team started taking baby steps to expand federal control over health care financing and delivery, lulling often clueless congressional Republicans into cooperation with long-term consequences for doctors and patients. In some cases, the GOP majority enacted provisions of the Clinton health bill word for word. (more…)

Tags: ClintonCare, Health Care Summit, HIPPA, Medicaid, Medicare, ObamaCare, reconciliation, schip, start over

Video: Paul Ryan Destroys Obamacare’s Deficit Reduction Claims

Yesterday at the Blair House health summit, Rep. Paul Ryan (R-WI) directly challenged the White House’s deficit reduction claims. From the transcript:

“Look, we agree on the problem here, and the problem is health inflation is driving us off of a fiscal cliff. Mr. President, you said health care reform is budget reform. You’re right. We agree with that. Medicare right now has a $38 trillion unfunded liability. That’s $38 trillion in empty promises to my parents’ generation, our generation, our kids’ generation. Medicaid is growing at 21 percent this year. It’s suffocating state’s budgets. It’s adding trillions in obligations that we have no means to pay for it.”

“Now, you’re right to frame the debate on cost and health inflation. And in September when you spoke to us in the well of the House, you basically said — and I totally agree with this — ‘I will not sign a plan that adds one dime to our deficits either now or in the future.’” (more…)

Tags: budget reform, CLASS Act, deficits, doc fix, Medicare, ObamaCare, Ponzi scheme, Rep. Paul Ryan

Obama’s Health Plan – Taxes, Taxes Everywhere

The White House recently released President Obama’s health care reform proposal. The plan incorporates a mixture of the many tax increases passed by the House and Senate, hiking taxes by almost $750 billion over ten years. This is on top of $1.3 trillion in other tax increases the President recently proposed in his 2011 budget. Not that there is ever a good time to raise taxes, but doing so as the economy is still emerging from a deep recession is particularly ill-advised and will likely prolong full recovery. Moreover, the President’s proposal deviates from his stated goal to address the soaring spending and debt problem the nation faces by piling on massive new spending and taxes.

Payroll tax hikes: Obama accepted the Senate’s plan to break long-held policy by raising the Hospital Insurance (HI) portion of the payroll tax on high-income earners to pay for a new and unrelated health care entitlement. He then doubled-down on this dangerous new precedent by separately applying the HI tax to investment income for the first time. The tax code already taxes investment too much. Higher taxes still on dividends, interest and business income increases the cost of capital which will further depress investment and thus job creation. Ironic to propose this at the very time the President wants employers to create jobs.

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Tags: Cadillac tax, Medicare, ObamaCare, payroll tax hikes, President's proposal, tax increases

Obama’s Health Plan Has Dangerous New Taxes

The health care plan President Obama recently released is mostly a combination of the different plans passed by the House of Representatives and the Senate. But in one major way it breaks with long-standing precedent, proposing a fundamental wrong-headed change to both entitlement policy and tax policy. He proposes for the first time to tax capital income to support entitlement programs.

Payroll taxes have always applied just to wages and salaries and the revenue those taxes raise has gone solely to pay for entitlements like Social Security and Medicare. The deal has always been that we pay payroll taxes during our working years and receive the benefits they fund after we retire. President Obama’s health care plan would shatter this compact forever.

The Hospital Insurance (HI) portion of the payroll tax is 2.9 percent on all wages and salary that is paid half (1.45 percent) by workers and half (the remaining 1.45 percent) by employers. It is supposed to pay only for the hospital insurance portion of Medicare benefits that retirees receive. President Obama’s plan adopts this break with long-held policy and doubles down by further severing the link between HI and Medicare benefits. Obama’s plan not only increases the HI tax on wages and salaries for high-income earners similar to the Senate bill, it also applies the HI tax to investment income for the first time. Obama’s unprecedented plan would levy the current 2.9 percent HI tax on what the administration obnoxiously refers to as “unearned” income, which includes capital gains, interest, dividends, annuities, royalties and rents for families earning more than $250,000 a year ($200,000 for single filers). (more…)

Tags: entitlements, Hospital Insurance, Medicare, Medicare payroll tax, President's proposal, Social Security

Morning Bell: Can They Make Obamacare Worse? Yes They Can!

Flacking for President Barack Obama’s “new” health care plan, White House Press Secretary Robert Gibbs told reporters assembled for yesterday’s press briefing: “The president posted ideas of his on the White House website today. We hope Republicans will post their ideas either on their website, or we’d be happy to post them on ours, so that the American people could come to one location and find out the parameters of what will largely be discussed on Thursday.” And this might have been a small bit of successful Obama administration gamesmanship on health care and transparency in government except for one small problem: reality. Not only do House Republicans already have their own health care plan, not only is it already available online, but the White House’s own website already links to it!

And speaking of the President’s behind-closed-doors plan, don’t believe any of those headlines showing a $950 billion price tag. That is an Obama administration-created number that should not be afforded any more credibility than Gibbs’ grasp of the contents of his own website. In fact, the independent Congressional Budget Office (CBO) published this about the President’s new plan yesterday:

“Preparing a cost estimate requires very detailed specifications of numerous provisions, and the materials that were released this morning do not provide sufficient detail on all of the provisions. Therefore, CBO cannot provide a cost estimate for the proposal without additional detail, and, even if such detail were provided, analyzing the proposal would be a time-consuming process that could not be completed this week.”

In other words, even with over a year to prepare for the moment they would finally release their own plan, the White House could only manage to obtain an “incomplete” grade from the official budget scorekeeper in Washington. So every time you hear the President say “my plan is paid for” or “my plan reduces the deficit,” just remember you are going to have to take his word for it.

And where the President’s plan is more firm than fuzzy, it only makes the scheme worse: (more…)

Tags: CBO, Cornhusker Kickback, Medicaid, Medicare, ObamaCare, President's proposal, price controls

Obamacare Bends the Cost Curve Up: Here Is How to Bend It Down

President Obama often says that bending the curve in health spending downward is one of the main objectives of his health care reform agenda. There is indeed a consensus that health costs are growing at a rapid rate, and that reformers should work to slow the rising tide of spending.

But as Heritage’s Robert A. Book, Ph.D, and Jason D. Fodeman, M.D. point out, the big picture is not so simple. In order to successfully reduce health care spending, legislators must address what is causing expenses to rise in the first place. The big House and Senate bills are based on faulty assumptions.

According to Book and Fodeman, “The House and Senate bills appear to be based on a fundamental misunderstanding of the basic factors driving health care spending upward. As a result, instead of restraining these basic factors, the bills neglect some and reinforce others, driving spending upwards instead of downward.”

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Tags: consumer centered health care, Medicaid, Medicare, ObamaCare, third-party payer

Sen. Nelson Says “No” to Public Option A Bit Too Late

In the wake of widespread public backlash over his eleventh-hour deal to get increased federal taxpayer Medicaid funding for his vote, Sen. Ben Nelson (D-Neb.) has been hitting the media circuit, assuring reporters that he won’t vote for any merged health care bill that funds abortions with taxpayer dollars or has a government-run health insurance plan.

“There is zero chance (of a public option),” he said to The Chadron Record. “I’ve made it so clear. It isn’t going to happen.” But Sen. Nelson has already allowed a “public option” to flourish by voting for the Senate version last month.

Medicare, for example, is the quintessential public plan. Instead of the Medicare bureaucracy contracting with private carriers to provide health coverage, as it does today, the latest Senate bill turns that responsibility over to the Office of Personnel Management (OPM), the agency that runs the federal civil service and the popular Federal Employees Health Benefits Program (FEBHP). Under the Senate bill, OPM would sponsor two “multi-state” health plans —one of which must be nonprofit — to compete against private plans in the country.

In other words, there could be health plan competition on a national level in every state, but only the federal government would field these national health plans. These government-sponsored health plans would have an exclusive franchise: No private health plans would be able to compete in the same way as the selected health plans sponsored by OPM. In effect, the Senate bill creates a set of “public options” that are thinly disguised as private health plans.

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Tags: FEBHP, Medicare, Office of Personnel Management, public option, Sen. Ben Nelson

Morning Bell: Obama’s Other Broken Health Care Promises

When Speaker Nancy Pelosi (D-CA) emerged from a closed-door meeting with top House Democratic leaders yesterday, the press asked her about C-SPAN CEO Brian Lamb’s request that she permit cameras to televise the final health care negotiations between the House and Senate. After Pelosi first demurred, a reporter reminded Pelosi about President Barack Obama’s frequent promises to the American people throughout 2008 that he would ensure C-SPAN was allowed to televise exactly such negotiations, to which Speaker Pelosi quipped: “There are a number of things he was for on the campaign trail.”

Speaker Pelosi is right: President Obama’s broken health care promises are legendary. According to reports, Speaker Pelosi wasn’t even referring to Obama’s whopper from last month that he never campaigned on the public option. No, Speaker Pelosi is apparently most upset with Obama’s support for the Senate’s tax on high cost health plans, which she believes is a violation of Obama’s promise not to raise taxes on the middle class. But really, President Obama’s current health care plan breaks so many of his previous health care promises, there is no need for Pelosi to have to name just one. Here are just some of the other major promises President Barack Obama has broken:

Individual Mandate: There were not a lot of actual policy fights in the 2008 Democratic Presidential primary, but one of the few major policy disagreements between then-Sen. Hillary Clinton (D-NY) and then-Sen. Barack Obama (D-IL) was over the individual mandate. Clinton was for it and Obama was against it. On January 31, 2008, Obama made the case against mandates in a Los Angeles, CA, debate: “Now, under any mandate, you are going to have problems with people who don’t end up having health coverage. I think we can anticipate that there would also be people potentially who are not covered and are actually hurt if they have a mandate imposed on them.” Both the House and Senate bills now contain an individual mandate. According to the President’s own Centers for Medicare and Medicaid Services, under the Senate plan, 19 million Americans would pay $29 billion in taxes/fines and still receive no health care in return.

You Will Not Lose Your Doctor: On June 15, 2009, President Obama promised the American people: “No matter how we reform health care, we will keep this promise to the American people. If you like your doctor, you will be able to keep your doctor, period. If you like your health care plan, you’ll be able to keep your health care plan, period. No one will take it away, no matter what.” Again, the President’s own Centers for Medicare and Medicaid Services confirms that the current Senate health bill breaks this promise. Seventeen million Americans will be forced out of their existing health insurance. Worse, the CMS explains that continued Medicare cuts will encourage more doctors to stop seeing Medicare patients entirely, and the 18 million people added to Medicaid will also make it next to impossible for those already on Medicaid to find a doctor who will treat them.

No Tax Hikes for People Making Less than $250,000: On February 24, 2009, President Barack Obama promised the American people: “if your family earns less than $250,000 a year, you will not see your taxes increased a single dime. I repeat: not one single dime.” Speaker Pelosi believes the Senate bill’s excise tax on insurance plans breaks this promise, and she is right. But it is not the only way that Obamacare shatters the President’s no-middle-class-tax-hike pledge. There are a slew of new taxes in the Senate bill, many of which will hit the middle class, including taxes on medical devices, tanning beds, insurance user fees, and brand name drugs (not to mention the individual mandate which is enforced by a tax or the employer mandate which kills jobs and punishes the poor).

Your Health Premiums Will Be $2,500 Lower: On October 15, 2008, then-Sen. Barack Obama (D-IL) promised the American people: “The only thing we’re going to try to do is lower costs so that those cost savings are passed onto you. And we estimate we can cut the average family’s premium by about $2,500 per year.” According to the Congressional Budget Office, Americans in large-group employer-sponsored plans would, on average, see their premiums remain flat, while individuals who purchase insurance in the non-group market would see much higher premiums in 2016 under Obamacare than they would under current law. And many believe those estimates are optimistic. According to the Lewin Group, once fully implemented, health care spending per worker will increase for all employers who do not currently offer coverage — $316 per worker under the Senate bill and $800 increase per worker under the House bill.

Health Reform Reduces the Deficit: On September 10, 2009, President Barack Obama promised the American people: “I will not sign a plan that adds one dime to our deficits – either now or in the future. Period.” Even the President’s most ardent supporters are now admitting the Senate bill is full of budget gimmicks to make it appear Obamacare will reduce the deficit. When the true cost of Obamacare is considered, the final tab comes to $2.5 trillion with an honest accounting of Medicare reimbursement rates netting a $765 billion deficit all by itself.

Tax Payer Funded Abortion: On September 10, 2009, President Barack Obama promised the American people: “No federal dollars will be used to fund abortions.” While the House bill’s Stupak amendment language fulfills this promise, the Senate’s Nelson compromise does not. If the Senate language were to become law, it would overturn the precedent set by the Hyde Amendment, the FEHBP (Federal Employees Health Benefits Plan), Military insurance through TRICARE, and the Indian Health Service. Your taxdollars most definitely would be paying for elective abortions.

No one expects a President to fulfill 100% of his promises. But when the failures to live up to your past pledges pile so high, it shouldn’t be any surprise that the American people have turned so strongly against President Obama’s health care plan.

Tags: C-SPAN, campaign promises, closed-door negotiations, House Speaker Nancy Pelosi, Medicaid, Medicare, ObamaCare, transparency