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Obama health plan includes provisions from Minnesota lawmakers

WASHINGTON, D.C. — President Obama’s health care plan is getting a somewhat predictable reception: Minnesota Democrats find much to like, while Republicans like Rep. John Kline charge it’s more of the same (and not in a good way).

“It’s a reasonable conversation starter,” said Rep. Keith Ellison. “I think he combines some elements that people can agree to.”

Linda Douglass, director of communications for the White House Office of Health Reform, said in a media conference call Monday morning that the Senate’s health care plan was the basis of the administration’s plan.

There is no public option in the plan, though it does establish a health insurance exchange. It would also require insurers to justify steep rate hikes to a federal agency, a process that already exists at the state level in Minnesota and 24 other states.

Rep. Keith Ellison
REUTERS/Larry Downing
Rep. Keith Ellison

Ellison — who said his criticism of the president sometimes is that he “aims too low” — is a strong advocate for a public option, something that wasn’t included in the White House plan. However, advocates said the president’s proposal doesn’t preclude a public option that could conceivably compete in the health exchange proposed in the president’s plan.

More than 20 senators, including Al Franken, have now signed on to a letter asking Senate Majority Leader Harry Reid to use the budget reconciliation process to hold a vote on a public option. Sen. Amy Klobuchar has indicated that she could vote for such a plan if it came forward.

Reid, a fan of the public option himself, has said he’s open to doing just that — especially if Republicans attempt to filibuster this latest compromise plan.

Biggest Minnesota amendments included
Though there were some initial jitters about several amendments Minnesota lawmakers had sponsored not being included in the text of Obama’s proposal, White House officials later said anything from the Senate’s plan not specifically addressed in the 11-page summary the Obama administration put out should be assumed to be included.

Rep. Tim Walz
MinnPost/Corey Anderson
Rep. Tim Walz

One of those omissions in text (but that remains included in Obama’s plan) was a provision that includes quality-of-care value index as part of the Medicare reimbursement. It was the top legislative priority on health care reform for several Minnesota Democrats, including Klobuchar, and Reps. Betty McCollum and Tim Walz.

“For me, this has always been the most crucial part of health care reform and I look forward to continuing to work to ensure that we achieve pay for value reform so that patients have access to quality care,” Walz said.

Klobuchar agreed, saying: “In the end, I want to make sure that health reform bill reduces cost, includes my value index provision, and works for Minnesota.”

Franken said: “I appreciate that the president’s proposal acknowledges the investment that states like Minnesota have made in covering low income residents at state expense.

“The proposal mentions an 8 percent increased match on ‘certain health services’ and I look forward to discussing how this would benefit Minnesota. I also have concerns that Minnesota not be penalized in Medicare reimbursement rates for offering efficient, quality care, so I’ll want to make sure the value index Sen. Klobuchar and I fought so hard for is included in any final package.”

Sen. Al Franken
REUTERS/Rich Clement
Sen. Al Franken

Franken’s medical loss ratio amendment, which would require 85 percent of health care insurance premiums on large group plans to be spent on actual medical costs, is also included in the administration’s proposal.

Also included was a Klobuchar plan to speed up the availability of generic prescription drugs.

However, Minnesota would be uniquely affected by the ending of a tax credit for “black liquor,” a wood byproduct produced by paper mills. Black liquor can be used as a biofuel, and thus could be claimed under a tax incentive designed to increase the production of cellulosic biofuels, White House officials said.

Doing away with that credit would save the federal government an estimated $24 billion over the next 10 years, much of that money presumably coming from Minnesota, given the relative abundance of paper mills in the state.

Republicans remain opposed
Kline, the leading Republican on the House Education and Labor Committee and the only Minnesota lawmaker invited to Thursday’s White House summit, hit out at the proposal.

Kline was among the many Republicans who called for the administration to scrap the existing legislation — and with a proposal largely based on the Senate’s passed bill, he said it’s clear that didn’t happen.

Rep. John Kline
Rep. John Kline

“Rather than hitting the reset button and coming to the negotiating table with a blank sheet of paper, the Obama Administration has cobbled together a complex and costly plan that would reshape one-sixth of our economy and upend the way Americans get health care — a prospect the American people have already rejected,” Kline said in a statement.

Kline’s take reflected what seemed to be a consensus from Republican leaders.

“This new Democrats-only backroom deal doubles down on the same failed approach that will drive up premiums, destroy jobs, raise taxes, and slash Medicare benefits,” House Minority Leader John Boehner said in a statement. House Minority Whip Eric Cantor told “Good Morning America” that the plan was “dead on arrival.”

Another point of contention — eagerly forwarded along by several Republicans on the Hill — was that the Congressional Budget Office said Monday it can’t yet score the plan to find out how much it will cost because it’s not detailed enough.

“Although the proposal reflects many elements that were included in the health care bills passed by the House and the Senate last year, it modifies many of those elements and also includes new ones,” CBO Director Douglas Elmendorf wrote in his blog.

“Moreover, 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.”

Ellison said starting from scratch was an unreasonable demand.

“The Republicans wish we were dumb enough to do that,” Ellison said. “They want to just delay and delay and delay, but the moment of delay is over and they’re not going to hold universal health care hostage anymore.”

White House Communications Director Dan Pfeiffer said it’s now time for Republicans to agree on a plan, post it online and come to the negotiating table.

“It is our hope that the Republicans will come together around their plan and post it online before the meeting,” Pfeiffer said. “The president is coming to this meeting with an open mind, and his hope is that the Republicans do too.”

Derek Wallbank is MinnPost’s Washington, D.C., correspondent and can be reached at wallbank[at]minnpost[dot]com.

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Comments (8)

  1. Submitted by Annemarie Cairns on 02/23/2010 - 11:09 am.

    The same 132 Republican lawmakers who voted “NO” to Obama taxpayer-centric FUNDED & DEFICT-REDUCING health reform, voted “YES” to the Bush/GOP DEFICIT-FUNDED 2003 Medicare Rx Drug Modernization Act which, among others:

    1. Was partially written by pharmaceutical industry lobbyists.

    2. Denied Medicare its right to negotiate lower Rx prices and gave pharmaceutical companies the power to charge whatever they want.

    3.Outlawed importing of cheaper Rx drugs, including from Canada to protect high Rx prices & profits of pharmaceutical companies

    3. Created Medicare Part D & the controversial “doughnut hole”, which has left many seniors unable to pay for their medicines (Obama reform will eliminate this)

    4. Created over $140 billion in windfall profits for PHARMA and government-endorsed higher Rx drug prices for US taxpayers

    5. Ignored & included no provisions to address issue of uninsured Americans; an issue which costs taxpayers $65 – $130 billion annually (numbers of uninsured grew from 39 to 45 million under Republican rule – Obama plan will bring 30 million into the system)

    6. Cost estimated at around $1 trillion since 2003, with NO PROVISION FOR FUNDING

    7. Rammed a $1 trillion fiscal trainwreck through Congress in a year when Bush/GOP already swelled US National Debt with trillions from unfunded Iraq war, 2 tax cuts & $830 billion fed & export deficits.

    SHAME ON YOU, REPUBLICANS!

    24 Republican SENATORS who voted “YES” in 2003:
    Lamar Alexander (R-TN), Bob Bennett (R-Utah), Kit Bond (R-Kan), Sam Brownback (R-Ky), Jim Bunning (R-KY), Saxby Chambliss (R-GA), Thad Cochran (R-MISS), Susan Collins (R-Maine) John Cornyn (R-TX), Mike Crapo (R-ID), Mike Enzi (R-WY), Chuck Grassley (R-Iowa), Orrin Hatch (R-Iowa), Kay Bailey Hutchison (R-TX), Jim Inhofe (R-Okla), Jon Kyl (R-AZ), Richard Lugar (R-IN), Mitch McConnell (R-KY), Lisa Murkowski (R-AK), Pat Roberts (R-Kan), Jeff Sessions (R-AL), Richard Shelb, Olympia Snowe (R-Maine), George Voinovich (R-Oh)

    Among 108 Republican representatives who voted “YES” in 2003:
    Marsha Blackburn (R-TN)
    John Boehner (R-Ohio)
    Eric Cantor (R-VA)
    Joe “You Lie” Wilson (R-SC)
    Pete Hoekstra (R-MI)
    Randy Neugebauer (R-TX)
    Roy Blunt (R-MO)

  2. Submitted by Eric Schubert on 02/23/2010 - 11:19 am.

    One of the really good items in President Obama’s plan is The CLASS Act, which would start to create an insurance plan for people to pay for long-term care needs, such as stroke, Alzheimer’s care, physical assistance. Every Minnesota policymaker should be able to support that.

    Eric Schubert
    Ecumen
    http://www.changinagingblog.org

  3. Submitted by Bernice Vetsch on 02/23/2010 - 01:28 pm.

    Yes, Annemarie (#1). In 2003, Republicans even often excluded Democrats from conference committees or, if invited, made changes AFTER the conference and before the vote (such Doctor Frist’s addition of $20 billion to protect vaccine developers from liability when their products killed people – after promising Ted Kennedy it would not be included).

    Medicare Part D costs so much because it is privatized. If Congress had merely added drugs to Medicare as a regular benefit and negotiated prices, as the VA does, we would save $80 billion per year when adding taxpayer dollars to seniors’ excess premium costs, co-pays, deductibles and doughnut hole purchases (Dean Baker, 2006).

    I fell into the doughnut hole in September this year. After paying full price for several expensive drugs for four months, I found at the end of the year that my insurer had paid out a little over $1,800 and I had paid $1,700-plus in out-of-pocket drug costs and premiums.

  4. Submitted by myles spicer on 02/23/2010 - 03:02 pm.

    Just had to add…I loved Cairns’ fact filled, well thought out response!

    If the Dems rely at all on a GOP contribution to health care reform, it will never get done, and it could be decades more before this travesty on America’s health and well being has an opportunity to be righted.

  5. Submitted by Rebecca Hoover on 02/23/2010 - 08:04 pm.

    It bothers me tremendously that the national heath care reform discussion does not address the travesties occurring in our nursing homes. It is shocking to view the Medicare nursing home ratings sheets and to see the heartbreaking and disturbingly poor performance of nursing homes run by organizations such as Ecumen, Presbyterian Homes, and the Masons.

    For example, if you want to spend a sleepless night, look at the percent of patients with pressure sores (these are sores that can be prevented with adequate care and turning of patients and can be hideous sores that eat even to the bone). Or look at the percent of depressed patients at some sites.

    These numbers are an indictment of our society and of the organizations that run these cruel “homes”.

  6. Submitted by Dan Gerber on 02/24/2010 - 12:16 am.

    Was it back in 2003 (or after) when Medicare recipients had to choose a medical and drug plan? I helped a family member
    and the choices were mind-numbing. I recall that there were
    plans from out of state as well as plans based here in MN.
    If that’s what’s being touted as an “exchange” I’m not
    favorably impressed. Too many choices, too confusing.

  7. Submitted by Richard Schulze on 02/24/2010 - 06:44 am.

    Yet 30-some odd countries cover all of their citizens at a lower cost with better public health outcomes, so there are at least 30-some odd ways to reform health care at lower cost.

    Perhaps the problem is that the entities that would feel pain at such a transition have more resources, discipline, and messaging capability than the hapless Democrats?

  8. Submitted by Bernice Vetsch on 02/24/2010 - 08:39 am.

    Dan (#6) Bush’s head of Medicare at that time tried to help his mom select a drug plan and failed. It was too complicated for him, yet millions of seniors were supposed to spend hours on-line (or sitting across from a helper) listing all the drugs they used; checking all insurers’ formularies to be sure they were included; comparing rates of all the insurers whose plans, at the moment, covered their drugs. Seniors, of course, could only change plans once a year, while insurers could drop drugs from their formularies as often as every seven days.

    A law written in large part for and by the drug and insurance companies. And its biggest mover in the House, Billy Tauzin, left the Congress to become Big Pharma’s $2 million per year chief lobbyist. Life is good, says Billy.

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