home

Saturday Night Open Thread

Are you snowed in on the East Coast or just relaxing inside tonight?

If you missed the health care news (BTD has followed the developments, just scroll down) the Dems have their 60 votes, here's the CBO summary of the Manager's Amendment (full letter here. ) And no one likes the abortion compromise.

Six detainees from Guantanamo have arrived home in Yemen. 91 Yemenis remain, among the 200+ detainees still being held.

Here's an open thread, all topics welcome.

< Stupak | Attempts At Cost Containment, Except The Best One >
  • The Online Magazine with Liberal coverage of crime-related political and injustice news

  • Contribute To TalkLeft


  • Display: Sort:
    Statement from House Pro Choice Dems (5.00 / 2) (#1)
    by Jeralyn on Sat Dec 19, 2009 at 07:23:47 PM EST
    "As the Co-Chairs of the Congressional Pro-Choice Caucus, we have serious reservations about the abortion provision included in the U.S. Senate's health care bill. This provision is not only offensive to people who believe in choice, but it is also possibly unconstitutional. As we have maintained throughout this process, health care reform should not be misused to take away access to health care. The more than 190-member Caucus will review this language carefully as we move forward on health care reform."

    U.S. Reps. Diana DeGette (D-CO) and Louise M. Slaughter (D-NY), Co-Chairs of the Congressional Pro-Choice Caucus

    With due respect to them, what changed (5.00 / 1) (#2)
    by andgarden on Sat Dec 19, 2009 at 07:26:06 PM EST
    between when they voted for the Stupak language and today?

    Parent
    Maybe the Outrage (none / 0) (#13)
    by Militarytracy on Sat Dec 19, 2009 at 08:46:28 PM EST
    Probably the expectation that Dems gave a sh!t (none / 0) (#19)
    by Ellie on Sat Dec 19, 2009 at 09:14:07 PM EST
    ... about women at all. It's been forty years of lip service about marching forward (while moon-walking backwards.)

    Now that we've seen the D's magical trifecta of majorities and the WH swipe-card this worst betrayal yet without pause or apology, I hope this POS dies an awful death and takes a mess of Dems down with it.

    Parent

    These kinds of statements (5.00 / 2) (#24)
    by Anne on Sat Dec 19, 2009 at 09:55:55 PM EST
    are starting to sound a lot like the sternly-worded letters that are issued from the various committees: lots of finger-wagging and tsk-tsking, but not a whole lot more.

    It's not enough, and I refuse to give them credit for saying these things if they are not willing to actually DO anything.

    "Just words" just doesn't cut it anymore.

    Parent

    And even Bernie Sanders can be bought (5.00 / 2) (#34)
    by Cream City on Sat Dec 19, 2009 at 10:55:36 PM EST
    in the Senate, with lots of moolah for his pathetically underpopulated state in the bill, so now he will vote for it, I read.

    Boxer, Sanders, and so many more all willing to dump on women.  Take names, get ready for when all of them run again.  Let this be their last term.

    Parent

    I used to listen to (5.00 / 1) (#36)
    by shoephone on Sat Dec 19, 2009 at 11:02:50 PM EST
    "Fridays with Bernie" on the Thom Hartmann Show every week. But then I realized that Bernie is full of sound and fury, signifying nothing.

    Parent
    Yah, and we're bitter and (5.00 / 1) (#56)
    by gyrfalcon on Sun Dec 20, 2009 at 09:22:13 AM EST
    cling to our guns here, in VT, too.  Not much for church, but then I guess we and Bernie can't fit all your stereotypes at once.  Sorry about that.

    The money, as I'm sure you actually know, is to make up the difference between our already quite high state Medicaid funding and the mandate in the new bill.

    "Dumping on women" is of course ridiculous.  The Nelson language, if it survives conference, essentially backs things up to current law, which is Hyde, and fends off the much, much more onerous and actually new Stupak restrictions.  You have to twist yourself into one heck of a pretzel to characterize that as "dumping on women."

    "Let this be their last term!"-- actually funny.  That's every single Democrat in the Senate.  Good luck with that.

    Parent

    In my state, one of the most hardest-hit (none / 0) (#62)
    by Cream City on Sun Dec 20, 2009 at 11:16:36 AM EST
    by this economy, with a fourth of our children going hungry in my city and other awful impacts we see daily all around us, Medicaid is being cut, too, because of our budgetary straits.  But because my Dem (not faux Dem like yours but Dem) Senators are being principled, they didn't hold their votes hostage for bribes for us.  Our bad?

    But you badly misread the impact of the Nelson amendment.  Its impact will be even worse than the Hyde Amendment.  That has been detailed here -- by Steve M, for one -- and elsewhere, but you opt to ignore it all and take our money, our taxes going to your state, and run.  Fine, but don't run off your mouth about what you opt to ignore.

    Parent

    "pathetically underpopulated state" (none / 0) (#44)
    by jtaylorr on Sun Dec 20, 2009 at 12:12:06 AM EST
    I didn't know a state's population had any bearing on how pathetic is was. Good thing I live in California.

    Parent
    Not so fast! (1.00 / 1) (#65)
    by Politalkix on Sun Dec 20, 2009 at 05:45:42 PM EST
    If you live in the Bay area of California you are already under CC's bus. You will now have to make some room for the entire Senate and people from the state of Vermont there.

    Parent
    Huh? I love the Bay area (none / 0) (#66)
    by Cream City on Mon Dec 21, 2009 at 12:21:35 AM EST
    and many folk in California, including family.

    You really are so weird here on this blog.  Who is all this nonsense you do here for, anyway?

    Parent

    Good to know that you love the Bay area (1.00 / 1) (#67)
    by Politalkix on Mon Dec 21, 2009 at 02:08:11 AM EST
    so I suppose your slams while ginning up "bittergate" and discussing cost of housing in the bay area were just politics!
    Anyways..


    Parent
    Once again, you make up s*it (none / 0) (#68)
    by Cream City on Tue Dec 22, 2009 at 08:59:46 AM EST
    that I never said.  Or you confuse me with another commenter, which would be my charitable guess but for your constant nonsense here.  Stop your efforts to stop the discourse on this blog.

    Parent
    Well, the good news is (none / 0) (#46)
    by Cream City on Sun Dec 20, 2009 at 12:14:44 AM EST
    that all that money going to his state will mean a lot more per capita.  

    Parent
    Is it Medicaid money? (none / 0) (#60)
    by Militarytracy on Sun Dec 20, 2009 at 09:54:06 AM EST
    I might be tempted to sell my soul for some medicaid money.

    Parent
    I'll (5.00 / 1) (#51)
    by Ga6thDem on Sun Dec 20, 2009 at 05:48:07 AM EST
    be impressed if they vote against it.

    Parent
    Hard to believe they actually (5.00 / 1) (#8)
    by SOS on Sat Dec 19, 2009 at 08:30:37 PM EST
    intend to drop this load of crap on America on Christmas Day.

    Talk about the ultimate insult.

    More than a lump of coal in our stockings (none / 0) (#9)
    by shoephone on Sat Dec 19, 2009 at 08:33:15 PM EST
    It's like their dumping the entire coal mine on our houses.

    Parent
    Maybe these guys can include (none / 0) (#12)
    by SOS on Sat Dec 19, 2009 at 08:45:33 PM EST
    a consumer booklet on how to bend, evade, shelter, and use loopholes to avoid the IRS and fines since they are leading experts on that.

    Parent
    After Met HD of "Tales of Hoffman" (5.00 / 3) (#11)
    by oculus on Sat Dec 19, 2009 at 08:41:28 PM EST
    (marvelous) and two glasses of Retsina with my Spanikopita lunch, I am ready to listen to my Christmas CDs.  First up:  Berlioz "Infancy of Christ," my fave. No snow here.

    How did you rate the day that rightfully ... (none / 0) (#16)
    by Ellie on Sat Dec 19, 2009 at 08:50:23 PM EST
    ... should have been mine???

    Parent
    Fabulous. I'm pretty late on the Christmas (5.00 / 1) (#22)
    by oculus on Sat Dec 19, 2009 at 09:31:18 PM EST
    spirit thing but in the mood now.  Just about to listen to King's College Cambridge Nine Lessons and Carols, followed by Britten's Ceremony of Carols.  

    Parent
    Nine Lessons and Carols w/ B. Britten (5.00 / 1) (#64)
    by Peter G on Sun Dec 20, 2009 at 11:42:23 AM EST
    I have that same recording.  Lovely.  A seasonal regular.

    Parent
    Winter Wonderland (none / 0) (#18)
    by Peter G on Sat Dec 19, 2009 at 09:08:00 PM EST
    A good foot of snow so far here, just west of Philadelphia.  Just wish my middle daughter wasn't stuck in Roanoke 2/3 of the way home on her drive (with 3 friends, thank goodness) from Americorps post in Mississippi.  She said Western Virginia was just impossible for traffic and driving in the storm, even on the Interstate. Hopefully they'll be able to get on the road again tonight and make it safely home tomorrow sometime.

    Parent
    Saw that too this morning (none / 0) (#41)
    by Radiowalla on Sat Dec 19, 2009 at 11:46:24 PM EST
    and liked it, but not as much as the live version with Placido Domingo.  Plus I hated the barcarolle scene with the women upside down and spread-eagled.  Yuck!

    Retisina?  Not so much.  Spanakopita, bravo!  

    I had two manhattans and watched the DVD of "Gosford Park."  This was escapism at is finest.

    Parent

    Absolutely no one is better than (none / 0) (#43)
    by oculus on Sat Dec 19, 2009 at 11:59:39 PM EST
    Placido Domingo in that role or in Otello, imo.  I was not wild about the "ladies" doing the splits upside down.  Did make me curious as to what nudity was not shown to HD viewers that was visible at the opera house.  

    Parent
    Ahh Christmas Music (none / 0) (#47)
    by CoralGables on Sun Dec 20, 2009 at 12:54:48 AM EST
    my favorite Christmas CD needs to be played too.

    That would be Christmas Island by Jimmy Buffett. I'm guessing Hector and Jimmy don't have a whole lot in common.

    Parent

    Snowed in...or close to it, anyway. (5.00 / 2) (#20)
    by Anne on Sat Dec 19, 2009 at 09:23:50 PM EST
    We've got at least 2 feet of snow, and it's still coming down; been a long time since we've had this kind of storm - in Maryland - with snow in December - most of our big snows come in February.

    At least it's very dry, powdery, light snow - not that heavy, heart-attack indusing snow.

    And we still have power - watching National Lampoon's Christmas Vacation - truly a classic!

    "Inducing" - Argh (none / 0) (#21)
    by Anne on Sat Dec 19, 2009 at 09:29:08 PM EST
    Hate when I do that!

    Probably the extra glass of Rex Goliath Chardonnay (known as "The Big Chicken" in my house).

    Parent

    Keep f^cking that Big Chicken (none / 0) (#27)
    by Spamlet on Sat Dec 19, 2009 at 10:21:37 PM EST
    Sympathies (none / 0) (#33)
    by gyrfalcon on Sat Dec 19, 2009 at 10:52:00 PM EST
    It's very peculiar to be sitting here in Vermont with clear skies and watching semi-hysteria on CNN about "massive nor'easter"-- south of us.

    What we've had instead is the better part of a week of single-digit temps, below zero overnight, and it ain't even winter yet!

    Parent

    Manhattan is a white blanket (none / 0) (#37)
    by andgarden on Sat Dec 19, 2009 at 11:03:12 PM EST
    But the advantage of living in the city is that everything will be back to normal by dinnertime tomorrow.

    Parent
    Heh (none / 0) (#58)
    by gyrfalcon on Sun Dec 20, 2009 at 09:32:09 AM EST
    That's one of the misconceptions city folk have about the country.  Country roads get completely cleared down to the pavement (or gravel) continuously as soon as a storm starts.  Cities get far, far, far more tied up and screwed up by major snowfalls (even minor ones) than the country does.  We're back to normal as soon as the falling snow lightens up enough to see clearly.

    With long distances and no public transportation, we take the condition of our roads very, very seriously.  Also, there are far fewer of them, thus far fewer miles to plow, plus plenty of room to just push the snow off into the edges of the fields.

    No need for snow tires, even-- unless you live in or around one of our pathetic little "cities" of 10,000 or 20,000.

    I need a Zamboni to get up and down my steep drive, but once I'm on the public road, no problem.

    Parent

    h/t e e cummings (5.00 / 5) (#28)
    by Spamlet on Sat Dec 19, 2009 at 10:40:43 PM EST
    it's defunct
    the health care reform of
    Buffalo Barack
           who used to
           ride a watersmooth-silver
                                pony
    and win onetwothreefourfive red-state caucuses justlikethat
                               Jesus
    he was Teh One
                         and what I want to know is
    how do you like your media darling
    BTD


    Judge John Tinder (none / 0) (#3)
    by IU Liberal Law School Alum on Sat Dec 19, 2009 at 07:34:22 PM EST


    Could you put up the Amazon Love Link for TL? (none / 0) (#4)
    by Ellie on Sat Dec 19, 2009 at 07:38:55 PM EST
    I'm up to my tookus (is that Tribally correct spelling?) in my year-end, and for conscientious reaons prefer donating that way than Pay-Palling some much-deserved love TL's way.

    It's work, personal, yadda yadda; no complaints with the Pal or anything.

    I'm at home, buggy, while fam & friends are enjoying what apparently constitutes a shot across the Bough in the War on Bill O'Reilly's Particular Celebration.

    To that end, here's a selection from one of my favorite holiday mixes (Have an Egregiously Offensive Holiday, You Knuckleheads) from Sarah Silverman. I'm not a usual fan of her stuff, but I spit-take this song and vid every December.

    Tuchus (5.00 / 1) (#10)
    by gyrfalcon on Sat Dec 19, 2009 at 08:39:04 PM EST
    Also "shot across the bow"-- referring to a ship, not a tree...

    Parent
    Trying to cough out an Xmas pun there (none / 0) (#14)
    by Ellie on Sat Dec 19, 2009 at 08:46:44 PM EST
    WTF, I can barely make my cats laugh tonight, even wearing my "sick" bath robe (as opposed to the eye-popping lounge-wear I normally wear.)

    Parent
    My cats laugh at me (5.00 / 1) (#30)
    by gyrfalcon on Sat Dec 19, 2009 at 10:46:19 PM EST
    pretty much continuously, bathrobe or no bathrobe.

    Parent
    Amazon canceled that program (5.00 / 1) (#23)
    by Jeralyn on Sat Dec 19, 2009 at 09:53:58 PM EST
    so there's only paypal, and snail mail.

    Parent
    Tuchus (5.00 / 1) (#42)
    by Radiowalla on Sat Dec 19, 2009 at 11:48:12 PM EST
    as in they tuchus to the cleaners.

    Parent
    Jubge John Tinder... (none / 0) (#5)
    by IU Liberal Law School Alum on Sat Dec 19, 2009 at 07:46:45 PM EST
    I graduated from the Indiana School of Law with Justice John Tinder of the 7th Circuit Court of Appeals. I would describe myself as one of the most left leaaning members of my class and a staunch Democrat. I would describe John as a conservative, a brilliant individual and the first person I would choose to be a Federal D istrict court judge, a Court of Appeals Judge or a Supreme Court Justice. I am proud to know hm and to be his friend. Neil Weikart. Minneapolis

    Patty Murray, what a dunce (none / 0) (#6)
    by shoephone on Sat Dec 19, 2009 at 08:02:31 PM EST
    I can't wait to withhold my vote from her next year -- just as I withheld my vote from Maria Cantwell in 2006.

    Boxer and Murray are too sickening even to shrug (5.00 / 2) (#25)
    by Ellie on Sat Dec 19, 2009 at 09:59:19 PM EST
    "We said we would not accept language that prohibited a woman from using her own private funds for her legal reproductive health care -- this compromise meets that test," [Barbara Boxer and Patty Murray] said.

    Glad no one got mussed up while magnanimously granting women the pseudo-right to spend money privately to probably not get what they're definitely not gonna get under what they already paid for.

    That's change I can barely believe is happening!

    Parent

    Lots of things that should be (5.00 / 1) (#26)
    by andgarden on Sat Dec 19, 2009 at 10:19:41 PM EST
    covered in the bill that were never going to me. And as Anthony Weiner said last week, "[s]ome of us have compromised our compromised compromise."

    If you're waiting to repeal Hyde before you can support a healthcare bill, well, hunker down. I don't even think we were able to get the kids of the undocumented included.

    Parent

    Whether 'be' or 'me' is a tpyo you're doubly right (5.00 / 1) (#29)
    by Ellie on Sat Dec 19, 2009 at 10:43:17 PM EST
    ... covered in the bill that were never going to me

    Snark aside, thanks for keeping on top of the nuts and bolts of this with the other HC mavens. For me this is biz AND personal AND political. I like to know ahead of time what I might have to buy, and wouldn't were it not for a handful of sites staying on top of this from the early stages.

    I don't want to (literally) bank my house on known bad actors suddenly doing the right thing.

    Parent

    Really (none / 0) (#31)
    by gyrfalcon on Sat Dec 19, 2009 at 10:48:27 PM EST
    Hyde is unfortunately the law of the land, just as Roe v. Wade is.

    It's rather a large victory if they can keep this bill from being worse than Hyde, which is what Stupak would do.

    Parent

    I almost wonder if Stupak (5.00 / 1) (#32)
    by andgarden on Sat Dec 19, 2009 at 10:51:37 PM EST
    would better-fail the undue burden test, and be more likely to be spiked in Court. Sure wouldn't want to stake my hopes on that, though.

    Parent
    Not with this court, I wouldn't (5.00 / 1) (#35)
    by shoephone on Sat Dec 19, 2009 at 10:56:52 PM EST
    That's what I think (none / 0) (#38)
    by andgarden on Sat Dec 19, 2009 at 11:05:30 PM EST
    It's up to Kennedy, remaining keeper of Casey.

    BTD indicated earlier that he thinks otherwise.

    Parent

    It's not change (none / 0) (#57)
    by gyrfalcon on Sun Dec 20, 2009 at 09:24:11 AM EST
    It's law, unfortunately.  See "Hyde amendment."

    Parent
    Understatement (none / 0) (#7)
    by lentinel on Sat Dec 19, 2009 at 08:27:52 PM EST
    Passengers on the EuroStar train going from France to England got stuck in the tunnel. Some of the passenger cars had no light and no heat. Some had no light, no heat and no water. The passengers were trapped up to 14 hours.

    Today, EuroStar apologized for the "inconvenience".

    My claustrophobia is so bad (5.00 / 2) (#17)
    by Militarytracy on Sat Dec 19, 2009 at 08:53:47 PM EST
    I would have been completely losing it.  Some of the tunnels around New York....I start clutching at my chest a bit, while I'm driving.

    Parent
    Me (none / 0) (#53)
    by lentinel on Sun Dec 20, 2009 at 06:54:32 AM EST
    too.

    Parent
    Irish Times says five hours. (none / 0) (#15)
    by oculus on Sat Dec 19, 2009 at 08:48:08 PM EST
    Spin (none / 0) (#55)
    by lentinel on Sun Dec 20, 2009 at 07:06:21 AM EST
    The British press is interesting.
    Once again, they appear to be protecting the government and Eurostar.

    Early reports from individuals caught in this nightmare said that they were trapped for fourteen hours.

    Later reports from the press, not quoting anyone, said 10 hours.

    Later reports said four hours. Then three hours.

    Finally, the London Times just said, "hours".

    They wound up giving the impression that it wasn't worse than a delay at an airport caused by a snowstorm.

    In fact, imo, it was a massive failure of a major company in which the governments of England and France are involved.
    What it feels like is a massive failure of government to provide for the safety of consumers.

    The coverage, as I mentioned, appeared to me to be a cover-up of the details of neglect - even contempt - of the passengers.
    No backup electrical systems. No heat. And not even light. And, for some no water. And, from what I read, not even a means of communicating with the trapped passengers.

    The bottom line imo: If something happens that is the responsibility of government, or an industry protected by the government, we are totally on our own. That's the way it was in NYC on 9/11.

    Parent

    The Irish Times is definitely not (none / 0) (#63)
    by oculus on Sun Dec 20, 2009 at 11:41:33 AM EST
    in the habit of protecting the British government.  But you are probably correct.

    Parent
    Uhm..the last bit of the CBO (none / 0) (#39)
    by Andy08 on Sat Dec 19, 2009 at 11:12:03 PM EST
    document posted doesn't sound reassuring at all....
    These longer-term calculations assume that the provisions are enacted and remain unchanged throughout the next two decades. However, the legislation would maintain and put into effect a number of procedures that might be difficult to sustain over a long period of time. Under current law and under the proposal, payment rates for physicians' services in Medicare would be reduced by about 21 percent in 2010 and then decline further in subsequent years. At the same time, the legislation includes a number of provisions that would constrain payment rates for other providers of Medicare services. In particular, increases in payment rates for many providers would be held below the rate of inflation. The projected longer-term savings for the legislation also assume that the Independent Payment Advisory Board is fairly effective in reducing costs beyond the reductions that would be achieved by other aspects of the legislation. Based on the longer-term extrapolation, CBO expects that inflation-adjusted Medicare spending per beneficiary would increase at an average annual rate of less than 2 percent during the next two decades under the legislation--about half of the roughly 4 percent annual growth rate of the past two decades. It is unclear whether such a reduction in the growth rate could be achieved, and if so, whether it would be accomplished through greater efficiencies in the delivery of health care or would reduce access to care or diminish the quality of care.


    "Savings" to be achieved (5.00 / 1) (#61)
    by KeysDan on Sun Dec 20, 2009 at 10:12:22 AM EST
    has been as slippery as nailing jello to a tree.  The $500 billion in "efficiencies" are likely to be a cut in benefits and movement of eligibility to  age to 70.   Medicare is supposedly now on the ropes and going down for the count in 2017, and yet, it is to finance half of the extended coverage over ten years (a short ten-years at that, starting to count in 2014). Cost containment, as with the "Cadillac"plans, is to reduce benefits and increase the out-of-pocket expenses.

    Parent
    The savings are the least believable (none / 0) (#40)
    by andgarden on Sat Dec 19, 2009 at 11:14:24 PM EST
    aspect of this package.

    Parent
    It is indeed but what the CBO (none / 0) (#48)
    by Andy08 on Sun Dec 20, 2009 at 01:25:55 AM EST
    says here --and that noone else admits but we all know-- is that there the possibility that they "would reduce access to care or diminish the quality of care." For me this is patently clear as a consequence of the 40% excise tax; good plans will disappear, no longer offered. The excise tax will have a discriminatory impact on plans that cover older workers and retirees, or workers in high cost regions or high risk occupations, and plans serving women. The net result of the 40 percent excise tax will be to force many plans to cut back important health care benefits. "New" plans will cut back coverage; eliminate care, limit access and increase substantially co-pays and deductibles. I get it now; the Senate (and Obama?) idea of health care is expand coverage in exchange of giving up mine. So much for "if you like your current plan you keep it " that's BS when the excise tax will make insurance co.&employers stop offering it altogether. I am disgusted.

    Parent
    Who drives in this weather? (none / 0) (#45)
    by nycstray on Sun Dec 20, 2009 at 12:14:25 AM EST
    12:30 a.m.: The Northern State Parkway on Long Island, the Lincoln Tunnel connecting Manhattan and New Jersey, and the Verrazano Narrows Bridge are all closed due to accidents.

    from my weather bug. And I thought the few cars going down my street were nuts a few hours ago . . .

    In other news, I don't know why in the heck I didn't start making candy earlier in life. The centers to my peppermint patties are YUMMY! And organic, lol!~ SUPER easy to make. Tomorrow if I have enough varieties of centers done, I'll be chocolate dippin' durin' football.

    someone finally reminded me (none / 0) (#49)
    by The Last Whimzy on Sun Dec 20, 2009 at 02:38:50 AM EST
    that people are disappointed in obama cause he turned out to be a moderate, like Clinton.

    that's an insult to Clinton.


    Garrison Keillor, limosine liberal and face of NPR (none / 0) (#52)
    by Wile ECoyote on Sun Dec 20, 2009 at 05:53:49 AM EST
    The WH loves the bill (none / 0) (#54)
    by jbindc on Sun Dec 20, 2009 at 06:58:14 AM EST
    White House blog - "Making a Good Bill Even Better:

    Congress has been working hard for months to shape health insurance reform legislation that will bring down costs, expand coverage, increase accountability for insurers, and attack our mounting deficit. We got good news today on all those fronts, as fresh statements of support from the Small Business Majority, the American Cancer Society, and the American Diabetes Association amongst others make clear.

    We learned today from the Congressional Budget Office that this bill will reduce the deficit by $132 billion over the first decade, and more than $1 trillion in the decade after that. That makes it the biggest deficit-reduction effort in over a decade. All while expanding coverage to 30 million more Americans.

    But bringing down the deficit and expanding coverage are only part of what insurance reform will do. And today the Senate introduced a package of changes to their bill that will make critical progress in ensuring competition, providing affordable choices, and holding the insurance companies accountable. These improvements were bundled together in what's called a manager's amendment - and here are some of the highlights:

        * Penalizing insurers for unfair rate hikes. If insurers who arbitrarily jack up rates before the exchanges come online, they won't be allowed to participate in them - they'll miss the opportunity to compete for millions of new customers. That creates a strong incentive to keep premiums low before the exchanges are up and running in 2014.
        * Making sure your money goes toward care, not administrative costs. Insurers will be required to spend a greater portion of your premium on the care you receive, rather than administrative costs or salaries. And if they don't, they'll have to pay you a rebate.
        * Ending discrimination based on pre-existing conditions. Once the exchanges are open in 2014, insurance companies will no longer be able to deny you coverage because you have a pre-existing condition. In the meantime, the legislation immediately creates a high-risk pool where adults with pre-existing conditions can purchase affordable coverage. And for families with kids, the news is even better: insurers will immediately be prohibited from denying coverage to kids with pre-existing conditions. Period.
        * Protecting your access to care. Lifetime limits on benefits will be banned right away.
        * Annual limits will also be banned once the exchanges are up and running. The manager's amendment ensures that in the meantime, the use of annual limits will be tightly restricted until we can do away with this unfair practice entirely.
        * More help for small business. The bill now includes additional help for small businesses. The health insurance tax credit for small businesses will now start in 2010, eligibility for the credit will be expanded, and small businesses will see improved purchasing power to make sure employees are getting good coverage at a good value.
        * Choice and competition. Insurers will now offer multi-state plans under the supervision of the Office of Personnel Management. That means more choice and more competition in your state.
        * Focusing on quality, not quantity. Health care providers will be reimbursed by Medicare for the quality of care, not just the quantity of tests and treatments. Shifting the way we reimburse for care is one of the most important things we can do to rein in spiraling health care costs - and it means a renewed focus on what's best for the patient.

    All told, it's been a landmark day in the health insurance reform effort. There's a lot more hard work to be done, and we're confident that the Senate and House will continue to work hard to get this bill across the finish line and to the President's desk. For the millions of Americans who don't have coverage, for those who are struggling with costs or being mistreated by their insurance company, every day counts. It's time for us to deliver.