Senate Health bill

[jdp]

Thankyou. Why was last nights (well, this mornings) vote so pivotal then? Shouldn't the Christmas eve be the pivotal one?

When is it likely to get the signature then?

Because the Manager's Amendment changed the language of the bill to make it acceptable to the two hold outs, Senator Nelson of Nebraska and Senator Lieberman of Connecticut. An amendment during debate requires 60 votes to succeed, if it didn't succeed then the bill itself wouldn't have a chance at passing. So this was kind of a 'test' vote. That is why it was pivotal.

At this point there is another vote on Tuesday I believe on weather to accept the language of the amendment as it is then on Wednesday the cloture motion on debate of the bill itself. Again both require 60 votes. Then on Thursday it's a straight up or down vote (majority) to pass the bill.

From there it goes to a committee with the House where they will try and merge the two versions into one that is acceptable and the same for both the house and the Senate. Then there needs to be another round of debate, cloture, and up or down voting. So it still has a ways to go.

 

[JoeTheJuggler]

From what I read, the vote that happened after midnight last night was the cloture vote, and succeeded by a 60-40 vote as expected.

From CNN:

Democrats won a major victory in their push for health care reform early Monday morning as the Senate voted to end debate on a package of controversial revisions to a sweeping $871 billion bill.

A final vote to pass the Senate bill is just a matter of form since it only requires a majority to pass.

Then comes the merging of the House and Senate bills. . . .

 

[JoeTheJuggler]

I find your analogies strained and your reasoning rococo.

The government has been not paying for abortions since ... uh, 1776 ...

That's not quite true. See my earlier post on the Hyde Amendment. It was passed in 1976, but Roe v. Wade legalized abortion in 1973. I don't know if it ever happened, but the legal possibility of government paid abortion was there for a brief window.

At any rate, I think the point is the same people who invented this "government interfering with the doctor/patient relationship" are the ones in favor of the government making the decision wrt abortion (and indeed who supported the Hyde Amendment).

Criticizing the hypocrisy of that position doesn't mean accepting the idea that government regulation of health insurance is anything like the "government takeover of healthcare" or "socialism" or whatever.

 

[jdp]

The issue is with the government deciding what is and isn't necessary for a mother's health -- making decisions that should be in the doctor's realm. Given that all pregnancy is inherently dangerous to the mother, it could easily be argued that this sort of decision is entirely in the patient's realm. Rococo or not, my argument works and yours is fallacious.

So again I ask, does the language presented in the Senate bill differ in any substantial way to the situation as it exists today? I don't see how it does. To my knowledge, publicly funded abortion coverage was never available to those getting plans from government assistance programs. Would the language in this bill, with regard to abortion and 'government interference', differ from the status quo?

 

[JoeTheJuggler]

So again I ask, does the language presented in the Senate bill differ in any substantial way to the situation as it exists today? I don't see how it does. To my knowledge, publicly funded abortion coverage was never available to those getting plans from government assistance programs. Would the language in this bill, with regard to abortion and 'government interference', differ from the status quo?

I think you're correct.

If this abortion language hadn't been added to the bill, to the best of my understanding, it would have to be assumed to abide by the Hyde Amendment.

 

[Cynic]

So again I ask, does the language presented in the Senate bill differ in any substantial way to the situation as it exists today? I don't see how it does. To my knowledge, publicly funded abortion coverage was never available to those getting plans from government assistance programs. Would the language in this bill, with regard to abortion and 'government interference', differ from the status quo?

But this is a distraction from my argument. I never said it would be any different; I said it would be wrong.

 

[ZirconBlue]

According to the commentary on NPR, this was the first of 3 such votes that would need to be made, and that the votes had to be at least 30 hours apart. They didn't really explain what each vote was for.

The early morning vote was the first of three times Democrats will need to muster all 60 members of their caucus to get the bill passed over unanimous Republican objections. Under Senate rules, each of those votes must be separated by 30 hours. In order to get lawmakers and their staffs out by Christmas Eve, the first of the three was set for just after 1 a.m.

Link.

 

[JoeTheJuggler]

According to the commentary on NPR, this was the first of 3 such votes that would need to be made, and that the votes had to be at least 30 hours apart. They didn't really explain what each vote was for.

The NY Times article said something similar:

The vote was 60 to 40 — a tally that is expected to be repeated four times as further procedural hurdles are cleared in the days ahead, and then once more in a dramatic, if predictable, finale tentatively scheduled for 7 p.m. on Christmas Eve.

Linky.

I'm not sure that's right, though. I think at least a couple of these votes are on the bill itself and only require a simple majority.

Also, I'm not sure if they're talking about votes just to pass this bill in the Senate or if that includes votes after the bill is merged with the House bill.

 

[jdp]

But this is a distraction from my argument. I never said it would be any different; I said it would be wrong.

So your objection is with how abortion is handled currently and into the future. Not any perceived change that could be in the pipe. Whatever healthcare proposal is in the pipe I don't think you'll see any federal funding of abortion in the near future, when it doesn't relate to any specific situations at least.

 

[JoeTheJuggler]

I shouldn't answer for Cynic, but maybe he sees it as a missed opportunity to challenge the Hyde Amendment. Also there is the real effect that the abortion language added to the healthcare bill would have on the policies private insurance companies will offer (though again, I don't think it's much of a change).

Originally, I thought Cynic was making the same point I was: that it's hypocritical for the same people who insist that this insurance reform bill would set up government death panels, threaten to euthanize Grandma, socialize medicine or comprise a government takeover of healthcare would also have no problem with the government deciding that at least some women can't choose to have abortions.

It seems to me that the people who want government out of healthcare have no problem with government, private corporations and even Catholic bishops being involved in making decisions about healthcare. As I said, the biggest "wrong" about this is the hypocrisy.

 

[MattusMaximus]

Nice to see the American Medical Association is on board with the Senate bill

 

[Cynic]

I shouldn't answer for Cynic, but maybe he sees it as a missed opportunity to challenge the Hyde Amendment.

Yes, that's one of my points.

Originally, I thought Cynic was making the same point I was: that it's hypocritical for the same people who insist that this insurance reform bill would set up government death panels, threaten to euthanize Grandma, socialize medicine or comprise a government takeover of healthcare would also have no problem with the government deciding that at least some women can't choose to have abortions.

And that was certainly another, and was the thrust of my "so much for" bit. As is usual in politics, a thing is bad right up until it benefits you.

 

[WildCat]

Nice to see the American Medical Association is on board with the Senate bill

"The AMA still wants separate action by the Senate to repeal the existing Medicare payment formula for doctors to prevent periodic reimbursement cuts."

And you can bet your sweet patootie that will happen, and when it does the CBO estimate goes bye-bye.

 

[Dr Adequate]

First, I never said "suddenly" -- that's you misrepresenting my argument.

I never said you did. But a bill becoming law does do so suddenly. One minute it isn't law, the next minute it has the President's signature on it. If the bill means that not paying for abortions will, from then on, constitute government interference, then this change will necessarily be a sudden one.

A situation in which a person is 100% dependent on the government to pay for medical care in which the government refuses to pay for a procedure recommended by her doctor would be interference regardless of the timeframe involved, and I never said otherwise.

But they would be free, as before the passage of the bill, to pay for it themselves.

If they go from the goverment supplying 0% of their healthcare needs, and leaving the remaining 100% up to them --- to the government supplying 99% of their healthcare needs and leaving the remaining 1% up to them --- then I don't see why the 1% the government still isn't paying for becomes interference by virtue of the 99%.

Second, military (i.e. government) insurance pays for abortions when the mother is put at risk if the pregnancy goes to term. So you're wrong there too.

But not, fortunately, in any relevant way.

Comparing a doctor-recommended procedure to using food stamps to acquire caviar is beneath you, Dr. Adequate. Or at least I think it is -- perhaps I have you confused with someone else. You are conflating two distinct types of dependence here and ignoring the distinction between endangering health and a preference for a certain type of food.

But the relative importance of the right to pay for caviar and the right to pay for a medically necessary abortion are not relevant to the goodness of the analogy.

I lately saw a Christian apologist, accused of the No True Scotsman fallacy, express feigned indignation that apparently atheists couldn't tell the difference between genocide and putting salt on one's porridge. But the fact that one is morally neutral and the other is not does not affect the analogy in so far as it was being applied.

The issue is with the government deciding what is and isn't necessary for a mother's health -- making decisions that should be in the doctor's realm. Given that all pregnancy is inherently dangerous to the mother, it could easily be argued that this sort of decision is entirely in the patient's realm. Rococo or not, my argument works and yours is fallacious.

But the government is not more "making decisions" in this realm than it was previously. The fact that they will now take someone's tonsils out doesn't affect the abortion issue.

 

[jdp]

Yes, that's one of my points.

I don't think it was a missed opportunity; honestly, I don't think that opportunity was ever there. And it won't be there for the foreseeable future. It's like those who think we missed an opportunity to create a single payer system.

And that was certainly another, and was the thrust of my "so much for" bit. As is usual in politics, a thing is bad right up until it benefits you.

I think saying "so much for" overlooks some good changes that have gotten this far. It sounds to me like what you're saying is that if we don't get abortion coverage then the whole thing is just junk. I think that sets an impossible standard to meet given our circumstances.

 

[SezMe]

My problem with the abortion dimension of the bill is not that it extends Hyde but that it greatly expands its reach. As I understand it, insurance companies that participate in the exchange (which, for all practical purposes, is mandatory) cannot offer abortion coverage. Note that it is NOT government funding of abortion which is proscribed, it is ALL abortion insurance. So, for example, if a woman wanted a policy that included abortion coverage and was willing to pay 100% of the premium for that coverage, she still cannot get it.

In effect, abortion is outlawed except for those sufficiently well off to pay for it themselves. It's a sad state of affairs.

 

[JoeTheJuggler]

My problem with the abortion dimension of the bill is not that it extends Hyde but that it greatly expands its reach. As I understand it, insurance companies that participate in the exchange (which, for all practical purposes, is mandatory) cannot offer abortion coverage. Note that it is NOT government funding of abortion which is proscribed, it is ALL abortion insurance. So, for example, if a woman wanted a policy that included abortion coverage and was willing to pay 100% of the premium for that coverage, she still cannot get it.

In effect, abortion is outlawed except for those sufficiently well off to pay for it themselves. It's a sad state of affairs.

That was the wording in one version, but it's not what's in the Senate bill at this point.

Now it says that the subsidy money can't cover the part of the premium that covers abortion. So presumably, insurance bills will be itemized, at least to some extent, and someone receiving a subsidy to help pay for her health insurance will be free to pay for abortion coverage with her own money.

Who knows, it might even create a niche market for abortion insurance providers.

At any rate, it seems that neither side of the abortion debate is happy with the language, but both sides (by and large) find it barely palatable.

 

[jdp]

That was the wording in one version, but it's not what's in the Senate bill at this point.

I think it was the Stupak Amendment in the House bill that was like this.

Now it says that the subsidy money can't cover the part of the premium that covers abortion. So presumably, insurance bills will be itemized, at least to some extent, and someone receiving a subsidy to help pay for her health insurance will be free to pay for abortion coverage with her own money.

Who knows, it might even create a niche market for abortion insurance providers.

At any rate, it seems that neither side of the abortion debate is happy with the language, but both sides (by and large) find it barely palatable.

I think the Senate version, with the Manager's Amendment, sets up separate accounting as you describe. And you're right, nobody likes the language on either side. Both see this reform as a way to advance their opinion.

 

[Meadmaker]

But they would be free, as before the passage of the bill, to pay for it themselves.

I heard on the radio today that actually, under the proposed bill, if someone sought medical insurance that covered abortion, they would be disqualified from medical coverage under the government plan.

Take that for what it's worth. It's a poorly remembered repeating of something I heard from a caller to a radio talk show. In other words, don't believe it unless it's confirmed. I even reached my destination, and stopped listening, before the host could respond. I would hope it isn't true, but I post it here on the off chance that someone will know the truth behind the caller's allegation.

 

[Meadmaker]

My problem with the abortion dimension of the bill is not that it extends Hyde but that it greatly expands its reach. As I understand it, insurance companies that participate in the exchange (which, for all practical purposes, is mandatory) cannot offer abortion coverage. Note that it is NOT government funding of abortion which is proscribed, it is ALL abortion insurance. So, for example, if a woman wanted a policy that included abortion coverage and was willing to pay 100% of the premium for that coverage, she still cannot get it.

In effect, abortion is outlawed except for those sufficiently well off to pay for it themselves. It's a sad state of affairs.

This must have been what that caller I heard was referring to.