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  • The House Health Bill: The House Ways and Means Amendments

    Editor’s note: Speaker Nancy Pelosi (D-CA) recently indicated she plans to use the House Ways and Means Committee version of health care reform as the base of the bill moving forward in the House. We’re reposting an analysis of what that bill looked like on the way out of committee and which amendments didn’t make it through.

    Just before the August recess, the House health bill (HR 3200) cleared all three panels. The next step is House floor consideration, presumably in September.

    The House Education and Labor Committee made a series of crucial health policy decisions, and on July 17, the House Ways and Means Committee completed its disposition of the bill. It took a little over 16 hours for the Committee to go through a 1,018-page bill, even though it will significantly change a portion of the economy that makes up almost 17 percent of GDP.

    Ways and Means Committee members engaged in debate over several crucial provisions of the legislation, including those addressed by the two other major House committees responsible for the bill. No attempts to improve HR 3200 succeeded in the House Ways and Means mark-up. Not a single amendment, offered by a Republican or Democrat, passed the Committee.

    The key items that the Committee addressed are as follows:

    Waiting For Doctors’ Care. Many Americans are understandably concerned that, with the government setting benefits and filling in the details of the medical procedures that will or will not be included in health insurance, federal officials may resort to rationing care and controlling access to physicians to save money. Based on the experience of other countries, this process would result in long wait times for patients, particularly those enrolled in the public plan. To prevent such an outcome, Rep. Kevin Brady (R-TX) offered an amendment that would eliminate the public plan if its enrollees experienced longer wait times than the average wait times for enrollees in private health plans. These people would then be able to enroll in private health plans offered on the Health Insurance Exchange. The Brady amendment failed on a straight party-line vote.

    Taxpayer-Funded Benefits for Illegals. The House bill, as currently structured, does not offer clear guidelines to ensure that illegal immigrants cannot access taxpayer-funded health care benefits. Rep. Dean Heller (R-NV) introduced an amendment that would use two citizenship status verification systems, the Income and Eligibility Verification System (IEVS) and Systematic Alien Verification for Entitlements (SAVE) programs, to establish an individual’s eligibility to obtain the bill’s proposed affordability credits or enroll in the public insurance option. Both programs are currently used to determine citizenship status and eligibility for public assistance programs. Safeguards to guarantee that only citizens can access federal health care benefits are necessary, considering that the US Census Bureau currently estimates that 9.6 million of the uninsured are not US citizens. The first Heller amendment failed on a straight party-line vote.

    No Public Plan for Congress. President Obama has repeatedly told Americans that if they liked their current health insurance plan, they could keep it. The problem is that independent analyses of the House bill indicate that millions of Americans would lose their private insurance, particularly coverage offered by employers. Indeed, virtually all independent studies conclude that the public plan would undercut private health plans, and millions of Americans would be dumped into the public plan. Rep. Dean Heller (R-NV) offered an amendment, which would require members of Congress to enroll in the newly-created public health insurance plan. They would thereby have to forfeit their private coverage, currently offered through the successful Federal Employees Health Benefits Program (FEHBP). Even though members of Congress often say that they should follow the same rules that they impose on everybody else, the rhetoric is belied by the House Ways and Means Committee action. The second Heller amendment failed, with 21 Democrats voting no.

    No Freedom to Choose Health Savings AccountsOnce again, the President has said repeatedly that if Americans like the coverage they have today, they would be able to keep it. But under the House bill, the benefits and the terms and conditions of the health benefits that are included in Americans’ health insurance would be determined by federal officials. The House bill would set conditions for what is or is not “acceptable” health insurance coverage.

    Many Americans have personally chosen to enroll in high deductible plans combined with a Health Savings Account (HSA). They have chosen this option because they want to have more direct control over their health care dollars and how their health care dollars are spent. To protect consumers who currently hold these plans, Rep. Eric Cantor (R-VA) proposed an amendment that would include high-deductible plans with HSAs in the House bill’s definition of a “qualified health benefits plan.” The amendment would have prohibited the Secretary of Health and Human Services (HHS) from restricting enrollment in private health plans with HSAs. The Cantor amendment was defeated. In other words, contrary to the President’s promise, under the terms of HR 3200 Americans with HSAs could be forced to switch out of their current plans.

    Likewise, Rep. Dave Reichert (R-WA) introduced an amendment that would repeal the House bill’s statutory prohibition on new enrollees into individual private health insurance plans. As currently drafted, HR 3200 prevents individual plans from enrolling new members after 2013 unless the plan is specifically “grandfathered” under the law or is transformed into a “qualified health benefits plan,” as determined by federal officials, and available through the national Health Insurance Exchange. The Reichert amendment was also defeated. This means that Americans would be prohibited by law from enrolling in a private individual health insurance plan and would be forced by the federal government to buy a different health plan in the national Health Insurance Exchange.

    Government Interference in Medical Decisions. The House bill calls for increased comparative effectiveness research (CER) to determine which treatments are the most cost- andor clinically effective in handling particular medical cases. It creates a new Center for Comparative Effectiveness Research to gather the data. During a news conference from the White House on July 22, President Obama specifically pledged that health care reform would keep the government out of health care decisions. The problem is that government officials may be able to use CER to make payment, treatment, and coverage decisions. This use of reimbursement or regulation would be tantamount to using CER as a mechanism for interfering with health care decisions, something directly counter to the president’s promises. To protect patients covered by government insurance programs from this possibility, Rep. Wally Herger (R-CA) offered an amendment that would prohibit the Centers for Medicare and Medicaid Services (CMS) from using CER to make coverage determinations. The Committee defeated the Herger amendment.

    Increasing the Deficit. President Obama said that he would not support health care legislation that would add to the national deficit, and wanted the health care bills to be “deficit-neutral.” In accordance with this policy objective, Rep. Patrick Tiberi (R-OH) offered an amendment that would require the Secretary of Health and Human Services to submit an annual report to the President and Congress, comparing the expected revenue and spending under the bill’s provisions for the upcoming 10-year period. In the event that projected spending under the bill outpaced revenue, the Secretary would have to reduce spending so that it would not exceed revenue. The Committee defeated Rep. Tiberi’s amendment. Meanwhile, the Congressional Budget Office director Douglas Elmendorf has expressed concerns about the projected cost of the House health care bill.

    Taxpayer Funding of Abortion. The issue of taxpayer-funded abortion, as well as legal requirements on insurance coverage networks to include abortion services, have been raised in all three House committees, as well as in the Senate HELP Committee. Rep. Sam Johnson (R-TX) and Rep. Eric Cantor (R-VA) tried and failed to convince the majority of the House Ways and Means Committee not to impose such a requirement on American taxpayers. Under the proposed House and Senate legislation, there are no provisions that would prevent federal officials from mandating that health insurance plans include abortion services. Johnson’s amendment would have prohibited any federal requirements on insurance plans to cover abortions, and Cantor’s amendment would have prevented taxpayer dollars from being used to fund abortions. Both amendments were defeated. Similar restrictions were also defeated during the House Education and Labor Committee consideration of the bill.

    Three major Committees of the House of Representatives have finished mark-up of HR 3200, a bill the size of a telephone book. Members of the House Ways and Means Committee have clarified their policy positions on crucial items, including the right of employee choice of coverage, the right of Americans to keep private health plans or purchase the private coverage that they like, their right to get medical care without government interference, or whether or not abortion coverage would be a matter of personal choice or government mandate. The House Ways and Means Committee has clearly answered these questions. Moreover, the Committee’s answers, in several instances, directly contradict President Obama’s oft-repeated promises to the American people.

    This post was co-authored by Julius Chen.

    Posted in Obamacare [slideshow_deploy]

    52 Responses to The House Health Bill: The House Ways and Means Amendments

    1. Clarence Feinour, Re says:

      First off thanks for providing this valuable information. Most Americans that take the time to read what you provided, will most likely not want any parts of a Government run Healthcare program. Its clear the Democrats are pushing ahead for a single payer system and the elimination of most Insurance companies. Its pure Socialism in the making. I hope the American people wake up before its too late.

    2. Nancy Renzo, Boca Ra says:

      While millions of hard working, tax-paying Americans will now have a health care system with many undesirable side effects which will significantly reduce both the quality and availability of such care, members of Congress have conveniently excluded themselves from this impending fiasco, that is, they will maintain their current health care system. This is an elitist stand and demonstrates how far removed members of Congress are from the realities of their constitutencies. Further, the inabiity of Congress to act in terms of immigration is now costing every American taxpayer a serious burden financially as well as in terms of quality care, but not members of Congress. It is time to let our representatives know that we will not stand by and let this happen. We can significantly change things by voting these people out of office on the next election as well as move toward a constitutional amendment that would limit their terms of office. Twenty-two years in Congress (e.g., Pelosi, Frank) is just too long as evidenced by their lust for power at all cost. Vote them out, that is, all legislators who do not represent the wishes of the American people. Issues this important should be put to a national vote.

    3. Lynn Beale Valencia says:

      Ladies and gentleman: Please step forward for your free technocrat health plan. Not to worry we have only the best and brightest working on the details.

      Rest easy, we will not allow any funny ideas to creep into the guidelines we are writing to protect you,our most valuable providers and subjects. Every loophole has been covered to assure dynamism ploys for uncontrolled nonconforming innovative fail to penetrate our plan. While there is safety in certainty, danger of uncorrelated research and development by free market radicals outside of technical controls will exist. As you know our creative and elite policy strategist are on the job

      to verify stasis. You need and deserve stability for your personal comfort. To set in place long range cost savings we will not trouble you with details just yet, but be assured our team of carrot chewers and pencil pushers are hard at work.

      Per intergovernment memo # health02504a-cc the first focus will be on minimizing elderly use fees.

    4. Charleen , Louisiana says:

      Thank you for your efforts.

    5. Nelia, AZ says:

      We cannot believe Obama's promises. The devil is in the details and the legalese. Healthcare reform and all the programs concerned with financial matters have little to do with health and finances, and everything to do with government control.

      Government funded abortion and euthanasia ~ what a concept for population control.

    6. Pingback: No Runny Eggs » Blog Archive » Hide and Seek with Obama Care

    7. Lisa, Louisiana says:

      I see a comparison of government run health care to Cash for Clunkers. As millions of people get their "free" doctors visits, doctors are over run, creating long wait times and problems getting these people processed thru an overworked computer system. The gov has to appropriate more funds as the allotted monies are quickly spent. The 3 trillion becomes 9 trillion, with no end to spending in sight. Meanwhile, gov ups the requirements for eligibility. It scares me to death.

    8. Grace, Florida says:

      This should be proof positive that the Republicans have been shut out of the process. The Demoncrats cry all the time that we are the party of "NO" – when they really are the party of "NO". They want the Republicans to support what they want not what we want. It's disgusting. Can't wait to get rid of them all.

    9. Mary Jane McDaniel, says:

      I think that it has become obvious that we cannot afford this plan and it will seriously impact the healthcare system in this country. We need better tax deductions for our health care costs. If we need a public system to provide health care for people who are unemployed and are below a fixed income level, then we could implement that much more economically and still provide coverage for people who really need and cannot afford it on their own.

    10. Hal Pryor, Williamsb says:

      Obama and the Democrats are obsessed with creating a powerful Federal Government that controls all aspects of our lives. Whether or not the health care legislation being rammed through Congress makes any sense is not important. What is important is that the Federal Government will be calling the shots. If the Obama sycophants in Congress can pull it off, we have literally given them the power of life and death. Both Cap & Trade and the currently debated health care plan are bad bills that will hurt America but they will give the Statist Democrats just what they want, an America they can rule in the (benign?) tyrannical fashion to which they aspire.

    11. Tim AZ says:

      I would like to thank the republicans who intriduced all the amendments to the bill while in committee. I know these republicans knew that their ammendments would fail to make it into the bill. They introduced these amendments to keep the bill from leaving the committee in time for a vote before the august recess. So the American people could have access to their representatives in their home districts. There is no other way to get representation when the elitists shut down communications from the people to their representatives while in DC. I am not giving a blanket endorsement to all republicans to be re-elected. Many of them have plenty to answer for and have been in the toxic environment of DC far too long. We the people must institute term limits everytime we vote because not enough politicians will discipline themselves. How's that hope and change going to work out for the liberal elitists?

    12. Bob Robey, Casselber says:

      The thing that amazes me is that when talking to aids you get "I don't know if the senator/congresswoman has read the entire bill." and yet the house has voted on the bill.

      Another thing is that many of these congressmen are not hosting town halls on the issue. I called my representative and demanded that she hold town meetings on the issue and was told her schedule is full. I checked and she is booked for 3 days doing things like touring a new police station. These people have to go and I pray that we throw everyone of them out of office that are up for election this year.

    13. B,F Wmspt, PA says:

      Why wouldn't the current administration want to get rid of the elderly who for the most part vote conservativly and for those of the greatest generation who remember what true facism is. Then they will be free through the state run media to bend the minds of the rest of the don't worry be happy generations that have followed. A storm is coming and I see a future when those that have been tested by advercity will remain while those that continue to look to the increasingly incapable government will perish.

    14. Lynn B. DeSpain says:

      What Congress tells us and what Congress actually does, have always been two diverse directions. That is why a snakes tongue is forked!

      Hozro

    15. Sam Gaylord, Boca Ra says:

      Taxpayer funded health care for illegals??? From our Senators and Representatives this makes a lot of sense. Free Health care results in VOTES in states where only a drivers license is all that is required to prove eligibility (Calif. is one). Then, how will this be paid for??? Simple. Just end coverage of the grannies and grandpas when they close in on the end of their lives. This, after all, is where a very large sum of the present medicare is spent. Wasn't that to be expected?? If our Congress hadn't taken Medicare out of it's "Lock Box" and put it into the General Fund (which is easier to rob) it would probably be very alive and well today.

      Ask around—the question that Democrats loved to ask in most of the last elections—"Do you feel or live better today than you did just 2-4-6 or 8 years ago???

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    17. Loretta , Colorado says:

      We had an article in the paper this weekend comparing Obama to a snake oil salesman at the carnival. A lot of beautiful rhetoric with no ties to truth. Alot of lofty claims and no details.

      Plain and simple, costs too much and cannot deliver the goods! Single-Payer government health insurance for all will be devastating to the quality of care and availability of care. Insisting on including illegal aliens will certainly compound these problems. Canada has these difficulties without illegal aliens!

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    19. Jerry from Chicago says:

      Of course these damn hypocrits won't give up their own health insurance plans. Not a single Congressman/woman, or Senator or any other federal employee has said they will give up their health coverage in favor of the national health care debacle they have in mind for the rest of us.

      They are the American aristocracy. They are inherently better than the rest of us and deserve to be treated better than the rest of us. Just ask any one of them. Their attitude toward the American public is "shut up and do what you are told". They don't believe they owe the public a damn thing. They are not there to represent us; they are there to represent themselves and enrich themselves.

      In recent conversation, one Senator was reportedly overheard complaining to another that he could always tell when tourist season was in Washington due to the smell they (the tax-paying tourists) brought with them. Another complained that these same tourists actually had the gall to use the Senate elevator. This is what these people think of us. To them, we are peasants, or worse, sheep to be shorn. They have become feudal lords and we, their serfs.

    20. Richard, West Texas says:

      The government has done such a wonderful job with Social Security (scheduled to go bankrupt soon), Medicare (also scheduled to go bankrupt soon) Medicaid, and the Post Office (already in government bankruptcy and cutting Post Offices and cutting delievery services). Why would the congress think we would want the government running the healthcare in this country, other than it gives them power under the People Republic of America. WE DO NOT WANT THIS, IT IS PURE GARABAGE!!!!

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    23. Dianna in Columbus says:

      We are members of the 9/12 project started by Glenn Beck and will be in DC the weekend of Sept. 12 for a huge rally against this govt. takeover of every part of our lives. Go to 912dc.org to check out march info and to register to go. Hotels are offering big discounts (some half-price) to protesters. If you want to make your voice heard loud and clear sign up for the march. Congress will be back in session trying to get this monstrosity bill shoved down our throats then. Perfect time to do some marching in the streets, don’t you think? Join thousands from all across this nation who are descending on Washington-its time to rock and roll!

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    26. ruth sonnier, lafaye says:

      We don't have to worry about terroist in our country because OBAMA is creating enough destruction in our country than any terroist could ever do us damange. People please take a stand. MAY GOD BLESS US ALL.

    27. Brett says:

      "Not a single amendment, offered by a Republican or Democrat, passed the Committee."

      What is your basis for this claim? It's really weird. I count the following amendments agreed to in committee:

      Day 5: 21 amendments

      Day 4: 17 amendments

      Day 3: 8 amendments

      Day 2: 3 amendments

      Total: 49 amendments

      Source, here: http://energycommerce.house.gov/index.php?option=

      You should issue a correction so that people who wander on to the "Patients United Now" site aren't mislead by your strange error.

      http://patientsunitednow.com/?q=node/485

      If you want to say something like "none of the amendments we favor passed the committee," then you should probably just say that.

    28. Brett says:

      OOPS – my mistake – my count is from Energy and Commerce and yours is from Ways and Means. Please feel free to disregard or not approve my comment.

    29. Katherine Tate - Jac says:

      GOVERNMENT SHOULD GET OUT OF THE HEALTH CARE BUSINESS- IT'S NONE OF THEIR BUSINESS!!

      Allow individual citizens to establish individual accounts for his/her own health care – and be pooled by private insurers according to risk factors – like every other type of insurance.

      Why should we allow the government to pool EVERYONE TOGETHER??

      Why should those of us who maintain healthy lifestyles, practice sensible diet and exercise habits, etc… pay for those who engage in riskier behavior (poor diet / overeating, substance abuse, or sexually risky behavior, etc.)

      WHAT THEY ARE PROPOSING DOESN'T MAKE SENSE!!

      GOVERNMENT – GET OUT!!

    30. Ramona Cutrer Amite says:

      Thank you for this service and for standing up to the administration for us, the American people. As of yesterday, it has circulated that the Obama administration has caved(in the senate) on the requirement for a government run plan. If, with the emphasis on IF, this is true then why have a plan at all? Isn't this the purpose of this asministration afterall? Or could it just be a ploy to throw the protesters off the scent or a bone if you will, to tone down the passion at the townhall meetings and in doing so get this atrocity forced through just when we think all is well. We must remain on duty and not let our guard down until this plan in its entirety , not in part, is killed and buried once and for all. Now is not the time to celebrate or become smug. That is just what they hope we will so. I don't trust the Obamaites and I thank you for staying on top of this for us and keeping us informed of the false moves and inruns they will attempt on any and all unsuspecting Americans in the coming days.

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    32. rebecca haskell, MI says:

      I have long believed we should be term-limiting all of our representatives. 2 terms for Representatives and 1 term for Senators. I am sick and tired of the arrogance and hubris of these pandering numbskulls who don't even have the decency to join a plan they fully plan on shoving down our throats. Vote them out and make sure they can't ever stay in long enough to build a crooked power base again.

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    52. Freedom of Speech TX says:

      Simple fact. The current proposals are unsustainable. We can never pay for this program. This will result in a taxation explosion unseen before – and it may be permanent.

      The fundamental issue is always cost. They know we cannot pay for this; any estimates are wild guesses.

      Make no mistake, everybody will pay for this, including the middle class, the poor, and the elderly. Mix in cap n' trade and sign the treaty in Copenhagen and it's over.

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