The Irony of Ironies via Republican Poison Pills

H.R. 2577 is a conglomeration of a number of bills (Military Construction, Veterans Affairs, and Related Agencies Appropriations Act, 2017) that  the Senate needs to take action on failed a super-majority vote (60 votes) for cloture (the ability to be considered and voted for/against on the Senate floor).  One version of that bill was passed by the House and a different version of that/those bills passed the Senate.  Thus, it’s now gone to conference committee to work out the wrinkles between the two versions.

This conference agreement now includes the Military Construction and Veterans Affairs and Related Agencies Appropriations Act, 2017, the Zika Response and Preparedness Appropriations Act, 2016, the Zika Vector Control Act, and an unacceptable ‘division’ on funds to be rescinded from programs the Republicans don’t particularly like.  That’s what came to the floor for a cloture vote, and it failed miserably — 52-48.

Really, Senator McConnell?  It’s too difficult for the general public to understand?  I don’t think so.

It’s one thing for Republicans to short-change President Obama’s funding request.  It’s another thing to start attaching ‘poison pills’ to the proposed legislation that limit or outright prohibit women’s choices.  When you introduce a funding proposal that limits the distribution of contraceptives and that prevents family planning organizations like Planned Parenthood from participating in the effort to help women in Zika-affected areas delay pregnancy, from a disease that not just contracted from a mosquito bite, but from sexual activity with an infected male partner, did you really think that Senate Democrats would just roll over and vote for that?

When you start gutting provisions of the Federal Water Pollution Control Act, did you honestly believe that Democrats would just roll over and just vote for that?

SEC. 2. MOSQUITO CONTROL WAIVER.
Notwithstanding section 402 of the Federal Water Pollution Control Act (33 U.S.C. 1342), during the 180 day period following the date of enactment of this Act the Administrator of the United States Environmental Protection Agency (or a State, in the case of a permit program approved under subsection (b)) shall not require a permit for a discharge from the application by an entity authorized under State or local law, such as a vector control district, of a pesticide in compliance with all relevant requirements of the Federal Insecticide, Fungicide, and Rodenticide Act (7 U.S.C. 136 et seq.) to control mosquitos or mosquito larvae for the prevention or control of the Zika virus.

When you start stripping funding for the Patient Protection and Affordable Care Act (Obamacare), did you really expect Democrats to just roll over, see the light and vote your way?  Or, when you decide to fund your bill by stripping balances  from the Departments of Labor, Health and Human Services, and Education, did you really expect Democrats to go “oh yeah, that’s a great idea” and vote in favor of your bill?  Or better yet, given that we already know that you stripped a bunch of funding from the State Department for Embassy security that might have made the outcome in Benghazi drastically different, did you really expect the Senate Democrats to let you strip even more funding for the State Department and other Foreign Operations?

Are you nuts?  They certainly weren’t and neither am I.  It took me hours to sort through all the links on Congress.gov, but here’s what I found:

DIVISION D–RESCISSIONS OF FUNDS

Sec. 101.
(a) $543,000,000 of the unobligated amounts made available under section 1323(c)(1) of the Patient Protection and Affordable Care Act (42 U.S.C. 18043(c)(1)) is rescinded immediately upon enactment of this Act.

Sec. 1323. Community health insurance option. Requires the Secretary to offer a Community Health Insurance Option as a qualified health plan through Exchanges. Allows States to enact a law to opt out of offering the option. Requires the option to cover only essential health benefits; States may require additional benefits, but must defray their cost. Requires the Secretary to set geographically adjusted premium rates that cover expected costs. Requires the Secretary to negotiate provider reimbursement rates, but they must not be higher than average rates paid by private qualified health plans. Subjects the option to State and Federal solvency standards and to State consumer protection laws. Establishes a Start-Up Fund to provide loans for initial operations, to be repaid with interest within 10 years. Authorizes the Secretary to contract with nonprofits for the administration of the option.

(b) $100,000,000 of the unobligated balances available in the Nonrecurring expenses fund established in section 223 of division G of Public Law 110-161 (42 U.S.C. 3514a) from any fiscal year is rescinded immediately upon enactment of this Act.

DIVISION G–DEPARTMENTS OF LABOR, HEALTH AND HUMAN SERVICES, AND EDUCATION, AND RELATED AGENCIES APPROPRIATIONS ACT, 2008
Title I–Department of Labor
Title II–Department of Health and Human Services
Title III–Department of Education
Title IV–Related Agencies
Title V–General Provisions
Title VI–National Commission on Children and Disasters

(c) $107,000,000 of the unobligated balances of appropriations made available under the heading Bilateral Economic Assistance, Funds Appropriated to the President, Economic Support Fund in title IX of the Department of State, Foreign Operations, and Related Programs Appropriations Act, 2015 (division J of Public Law 113-235) is rescinded immediately upon enactment of this Act: Provided, That such amounts are designated by the Congress as an emergency requirement pursuant to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Control Act of 1985.

Personally, I side with Senate Minority Leader Harry Reid who declared, “It is unbelievable that somebody would have the audacity to come to the floor and say it’s Democrats’ fault. A significant amount of American women, especially young women, go to Planned Parenthood, and the Republicans want to say, ‘you can’t do that.’” Why indeed would Democrats not just prohibit Planned Parenthood from providing any services, but gut the EPA’s ability to assure clean water and harm HHS’s ability to manage health insurance options for not just Puerto Ricans, but millions of American families across our nation?  Apparently Sen. McConnell completely missed the irony of claiming to improve women’s health by prohibiting and defunding health opportunities for women altogether.


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Veto Message from the President to the Republiban re: HR3762 ACA Repeal

— by Vickie Rock, Humboldt Democrats

After the 62nd vote to repeal “Obamacare” (the Patient Protection and Affordable Care Act) which has now been upheld by the Supreme Court TWICE, the Republiban members of Congress finally managed to pass HR 3762. Inaptly named, the bill that would have done the exact opposite of its title: “Restoring Americans’ Healthcare Freedom Reconciliation Act of 2015.”  Restoring “Americans'” freedom?  Nope!  More like restoring the freedom for Insurance Corporations to give Americans the short shrift related to any hope of accessing healthcare insurance and thus health care itself.

And just so you know, each and every Nevada Republican in the House of Representatives, Rep. Mark Amodei (CD2), Rep. Joe Heck (CD3), and Rep. Cresant Hardy (CD4) voted FOR passage of HR 3762 (as well as a large number of previous bills) which would not just repeal the Affordable Care Act for millions of Americans who can barely afford health insurance as it is, but would have also revoked any and all funding received by Planned Parenthood by folks who not only can’t afford health insurance, but can’t afford health care either.  Senator Dean Heller also voted FOR passage (repeal) in the Senate in December preceding the vote in the House.

Today, at the stroke of his pen, President Obama showed us exactly HOW important it is that we have a Democratic President in the oval office as he promptly and unceremoniously vetoed their wasted efforts.  Here’s his message back to Congress:

TO THE HOUSE OF REPRESENTATIVES:

I am returning herewith without my approval H.R. 3762, which provides for reconciliation pursuant to section 2002 of the concurrent resolution on the budget for fiscal year 2016, herein referred to as the Reconciliation Act.  This legislation would not only repeal parts of the Affordable Care Act, but would reverse the significant progress we have made in improving health care in America.  The Affordable Care Act includes a set of fairer rules and stronger consumer protections that have made health care coverage more affordable, more attainable, and more patient centered.  And it is working.  About 17.6 million Americans have gained health care coverage as the law’s coverage provisions have taken effect.  The Nation’s uninsured rate now stands at its lowest level ever, and demand for Marketplace coverage during December 2015 was at an all-time high.  Health care costs are lower than expected when the law was passed, and health care quality is higher — with improvements in patient safety saving an estimated 87,000 lives.  Health care has changed for the better, setting this country on a smarter, stronger course. 

The Reconciliation Act would reverse that course.  The Congressional Budget Office estimates that the legislation would increase the number of uninsured Americans by 22 million after 2017.  The Council of Economic Advisers estimates that this reduction in health care coverage could mean, each year, more than 900,000 fewer people getting all their needed care, more than 1.2 million additional people having trouble paying other bills due to higher medical costs, and potentially more than 10,000 additional deaths.  This legislation would cost millions of hard-working middle-class families the security of affordable health coverage they deserve.  Reliable health care coverage  would no longer be a right for everyone:  it would return to being a privilege for a few.

The legislation’s implications extend far beyond those who would become uninsured.  For example, about 150 million Americans with employer-based insurance would be at risk of higher premiums and lower wages.  And it would cause the cost of health coverage for people buying it on their own to skyrocket.  

The Reconciliation Act would also effectively defund Planned Parenthood.  Planned Parenthood uses both Federal and non-federal funds to provide a range of important preventive care and health services, including health screenings, vaccinations, and check-ups to millions of men and women who visit their health centers annually.  Longstanding Federal policy already prohibits the use of Federal funds for abortions, except in cases of rape or incest or when the life of the woman would be endangered.  By eliminating Federal Medicaid funding for a major provider of health care, H.R. 3762 would limit access to health care for men, women, and families across the Nation, and would disproportionately impact low-income individuals.

Republicans in the Congress have attempted to repeal or undermine the Affordable Care Act over 50 times.  Rather than refighting old political battles by once again voting to repeal basic protections that provide security for the middle class, Members of Congress should be working together to grow the economy, strengthen middle-class families, and create new jobs.  Because of the harm this bill would cause to the health and financial security of millions of Americans, it has earned my veto.

The Republiban may have used procedural shenanigans to enable them to pass HR 3762, but to override President Obama’s veto, the Republiban would need a two-thirds affirmative vote on repeal bill.  The don’t have that.  This was all for show for the rabid GOP base heading into the November election.  But more than that, it’s a serious red-flag warning to Democrats that if we don’t overwhelm the polls this November to begin taking back Congress, and instead all the Republiban to hold onto Congress plus, take the White House, you can kiss the American Dream goodbye and buy the coffin as it will truly be dead.

522

Playing Doctor with Americans’ Lives

3Doctors400Republicans, in both the House and the Senate, are currently colluding to gut Healthcare Reform and deny actual healthcare to millions of women across our nation using a process called Reconciliation.  Reconciliation is an expedited budgetary process that offers some procedural advantages: it needs only the support of a simple majority in the Senate, and cannot be filibustered. The bill they intend pass via reconciliation is HR3762, inappropriately named, “Restoring Americans’ Healthcare Freedom Reconciliation Act” … it should be named “Butchering All Hope of Being Able to Afford Effective Healthcare Act.”

This reconciliation bill includes language to repeal key parts of Obamacare: the individual mandate, the employer mandate, the medical device tax and the ‘Cadillac tax.’ There are press posts saying that it will also end the Independent Payment Advisory Board (IPAB), but I can’t find such a provision in the bill.In addition, it would defund Planned Parenthood for one year

Defunding Planned Parenthood for a Year—

Here’s the section which specifically codifies the vilification of Planned Parenthood as a “Prohibited Entity” that just happens to provide “essential” healthcare for millions of women across our nation:

SEC. 202. FEDERAL PAYMENT TO STATES.
(a) In General.—Notwithstanding section 504(a), 1902(a)(23), 2002, 2005(a)(4), 2102(a)(7), or 2105(a)(1) of the Social Security Act (42 U.S.C. 704(a), 1396b(a)(23), 1397a, 1397d(a)(4), 1397bb(a)(2), 1397ee(a)(1)), or the terms of any Medicaid waiver in effect on the date of enactment of this Act that is approved under section 1115 or 1915 of the Social Security Act (42 U.S.C. 1315, 1396n), for the 1-year period beginning on the date of the enactment of this Act no Federal funds may be made available to a State for payments to a prohibited entity, whether made directly to the prohibited entity or through a managed care organization under contract with the State.

(b) Definition Of Prohibited Entity.—In this section, the term “prohibited entity” means an entity, including its affiliates, subsidiaries, successors, and clinics—

(1) that, as of the date of enactment of this Act—

(A) is an organization described in section 501(c)(3) of the Internal Revenue Code of 1986 and exempt from tax under section 501(a) of such Code;

(B) is an essential community provider described in section 156.235 of title 45, Code of Federal Regulations, that is primarily engaged in family planning services, reproductive health, and related medical care; and

(C) provides for abortions, other than an abortion—

(i) if the pregnancy is the result of an act of rape or incest; or

(ii) in the case where a woman suffers from a physical disorder, physical injury, or physical illness that would, as certified by a physician, place the woman in danger of death unless an abortion is performed, including a life-endangering physical condition caused by or arising from the pregnancy itself; and

(2) for which the total amount of Federal and State expenditures under the Medicaid program under title XIX of the Social Security Act in fiscal year 2014 made directly to the entity and to any affiliates, subsidiaries, successors, or clinics of the entity, or made to the entity and to any affiliates, subsidiaries, successors, or clinics of the entity as part of a nationwide health care provider network, exceeded $350,000,000.

[Emphasis mine]

Please note that the provisions to completely eliminate any funds for Planned Parenthood were proposed and recommended by the Ways and Means Committee currently led by Rep. Paul Ryan, that same Paul Ryan who will is expected to be elected as Speaker of the House next Wednesday — that is, unless the right wing extremists of the Republican Freedom Caucus renege and cast their votes for their beloved Rep. Daniel Webster instead.

Repealing the Individual and Employer Mandates —

Repealing individual mandate provisions are likely to increase, rather than decrease, the number of U.S. residents without health coverage, thus eliminating the progress that has been made in holding people responsible for their healthcare.  If the CBO forecasts are correct, the H.R. 3762 mandate repeal provisions could increase the number of uninsured U.S. residents by 55 percent to 65 percent. But, that’s okay with Republicans because for each person who doesn’t buy health insurance, the government doesn’t have to shell out $760-$815.  But they took it one step further.  To help their corporate benefactors, they also plan on repealing the mandates on employers to provide medical coverage.  Thus, ordinary Americans seeking to access affordable healthcare coverage for themselves and their families are going to rapidly find themselves up the proverbial creak, with no paddle, a leaky boat and no pail with which to bail out their boat.

The house voted on passage of HR3762 on Friday.  The vote was 240-189 with 5 Democrats not voting.  One Democrat (Peterson) voted for passage and ALL THREE of Nevada’s Congressional Republicans voted ‘AYE’ for passage! The bill is now off to the Senate, where it can be considered without a 60-vote cloture requirement (assuming the package passes muster with the Senate “Byrd Rule.”).

The Byrd Rule is a Senate rule that amends the Congressional Budget Act of 1974 to allow Senators, during the Reconciliation Process, to block a piece of legislation if it purports significantly to increase the federal deficit beyond a ten-year term or is otherwise an “extraneous matter” as set forth in the Budget Act.  It is named after West Virginia Senator Robert Byrd.

The Congressional Budget Office (CBO) assessed the effects of HR3762 on long-term deficits and direct spending as follows:

  • Including macroeconomic feedback, CBO and JCT estimate that enacting the legislation would increase net direct spending as well as on-budget deficits by more than $5 billion in one or more of the four consecutive 10-year periods beginning in 2026.
  • Excluding macroeconomic feedback, CBO and JCT estimate that enacting the legislation would not increase net direct spending by more than $5 billion in either of the first two consecutive 10-year periods beginning in 2026; however, the agencies are not able to determine whether enacting the legislation would increase net direct spending by more than $5 billion in the third or fourth 10-year period.
  • Excluding macroeconomic feedback, CBO and JCT estimate that enacting the legislation would increase on-budget deficits by more than $5 billion in one or more of the four consecutive 10-year periods beginning in 2026.

And because enacting the legislation would affect direct spending and revenues, ‘pay-as-you-go procedures‘ apply.

The President is then expected to veto, setting up the need for a veto-override vote in Congress.  In a statement promising Obama’s veto, the White House said the GOP measure “would take away critical benefits and health care coverage from hard-working middle-class families.”

However, a conservative revolt could derail the bill’s progress, as some conservative groups are opposing because the bill leaves some parts of ObamaCare intact


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Oklahoma Woman Tells GOP Lawmakers: Without Obamacare, ‘I Will Be Dead Before My 27th Birthday’

BY TARA CULP-RESSLER ON OCTOBER 7, 2013

26-year-old Kendall Brown

26-year-old Kendall Brown [CREDIT: COURTESY OF KENDALL BROWN]

As the deadline approached for Congress to pass a continuing resolution to keep the government funded, Republicans refused to strike a deal unless it defunded or delayed Obamacare. Now, a week later, GOP lawmakers still seem unwilling to compromise unless they are able to dismantle some of the health reform law. One Oklahoma resident wants them to understand the human impact of that political position.

On the eve of the looming government shutdown, 26-year-old Kendall Brown published an open letter to the lawmakers who wanted to delay Obamacare for one year before agreeing to pass a funding bill. Brown didn’t mince words. “I am dying, because of the political games you are playing right now,” her op-ed began.

The Oklahoma resident explained that she was born with Crohn’s Disease, an inflammatory bowel disease that has no cure. When Brown was in college, she was removed from her mother’s health care coverage. Since her illness prevented her from being able to take a full course load, she couldn’t meet the credit requirements to qualify as a student to remain on the plan. During that time, she could only afford a limited student health plan, and she accumulated thousands of dollars in medical debt.

Once Obamacare allowed young adults to remain on their parents’ plans regardless of their academic status, Brown was able to return to her mother’s insurance. That provision of the health law was enacted at a crucial time — not long afterward, Brown needed to undergo emergency surgery to remove two feet of her intestine that had swollen shut. She wouldn’t have been able to afford the procedure otherwise.

But Brown is now 26 years old, and no longer qualifies for coverage under that Obamacare provision. Although she’s currently employed full-time at a nonprofit, the small organization can’t offer her any health benefits. She’s tried to apply for insurance plans on her own, but she’s been denied because of her pre-existing condition. She cannot currently afford the lifesaving treatment to manage her illness, a form of chemotherapy that costs $15,000 for each infusion. She is desperate to enroll in the health law’s new marketplaces so she can have the coverage she needs.

“I tell you this because I am tired of being reduced to a number, a statistic or, even worse, being described as a freeloader that wants to live off of the government health care teat,” Brown explains in her open letter. “I tell you this because if you defund Obamacare, or delay it even for one year, as you are debating today, then this will be my last letter to you. I will be dead before my 27th birthday.”

In an interview with ThinkProgress, Brown explained that she had been following the political drama in the lead-up to the current shutdown, and she decided to write her letter “out of incredible hurt and anger.”

“I don’t think that our elected officials are willfully terrible people — I think they are just so caught up in the game, so dead set on doing whatever it takes to get those votes next re-election season, that they forget that they’re talking about actual people,” the Oklahoma resident explained. “That’s what I wanted them to remember from reading my letter.”

Brown believes that Obamacare has already saved her life, because it allowed her to receive surgery while she was covered under her mother’s plan as a young adult. “Without that surgery I would have died a very painful death,” she noted. And with the law’s state-level insurance marketplaces opening to the public, Brown says her life will be saved all over again. She’ll be able to afford her medications and her regular chemotherapy treatments. She’ll hopefully be able to avoid another surgery.

But she’s still disappointed in her lawmakers. Congress ultimately failed to delay Obamacare’s marketplaces from opening for enrollment, but the federal government has still ground to a halt. And in Brown’s home state of Oklahoma, politicians are still resistant to health reform. Some Republicans continue to fight against the health law’s optional Medicaid expansion, which would help extend coverage to the state’s considerable uninsured population. Seventeen percent of Oklahoma adults don’t have health coverage.

“I am a very proud Oklahoman, and I plan to make my career and raise a family here, but I do not feel that our state elected officials are serving our best interests,” Brown told ThinkProgress, saying she’s “baffled and saddened” that her elected officials have dug in their heels against health reform.

“That, to me, is not in the spirit of being an Oklahoman,” she continued. “I grew up in a small western Oklahoma town, where you took sick neighbors casseroles and you offered to watch each other’s children. In short — you helped out your fellow man. And that’s what Obamacare is about, for me.”


This material [the article above] was created by the Center for American Progress Action Fund. It was created for the Progress Report, the daily e-mail publication of the Center for American Progress Action Fund. Click here to subscribe.

Why Are American Health Care Costs So High?

By the incomparable John Green, who says the following about his sources: “For a much more thorough examination of health care expenses in America, I recommend this series at The Incidental Economist and The Commonwealth Fund’s Study of Health Care Prices in the U.S. Some of the stats in this video also come from this New York Times story.”