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Ben Nelson, Pushover?

I assume Reid has paid the ransom (I see very little that Nelson got here that could not have been handled in 10 minutes. Maybe I am missing something.) If this is it - I have only one more demand and I would support this bill - sunset the mandates. If I were a House Progressive, that would be my one demand that I would think I could get and I would make it non-negotiable.

If this is the Manager's Amendment (PDF), we may have gotten off cheap on the Medicaid portion - here is a special exemption for Nebraska on Medicaid looks like:

‘‘(3) Notwithstanding subsection (b) and paragraphs 5 (1) and (2) of this subsection, the Federal medical assistance percentage otherwise determined under subsection 7(b) with respect to all or any portion of a fiscal year that begins on or after January 1, 2017, for the State of Nebraska, with respect to amounts expended for newly eligible individuals described in subclause (VIII) of section 11 1902(a)(10)(A)(i), shall be determined as provided for under subsection (y)(1)(A) (notwithstanding the period provided for in such paragraph).

(Emphasis supplied.)

On abortion, it looks like a state opt out:

'‘(a) STATE OPT-OUT OF ABORTION COVERAGE.— ‘‘(1) IN GENERAL.—A State may elect to prohibit abortion coverage in qualified health plans offered through an Exchange in such State if such State enacts a law to provide for such prohibition.

To be honest, if Hyde was changed to this, it would be a win. Of course, this is on top of Hyde, so it is well, ridiculous.

It seems the insurance companies gave Nelson his marching orders - maybe they thought the entire bill was at risk. Nelson appears to have wasted everyone's time. In any event, I think Stupak will not accept this.

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  • Display: Sort:
    If you want to parse it out, (none / 0) (#1)
    by andgarden on Sat Dec 19, 2009 at 07:53:12 AM EST
    Don't rhink so (none / 0) (#3)
    by Big Tent Democrat on Sat Dec 19, 2009 at 07:56:46 AM EST
    That still has the opt out public option.

    Parent
    Well, the Senate clerk is reading it aloud now (none / 0) (#4)
    by andgarden on Sat Dec 19, 2009 at 07:58:23 AM EST
    Other than that, dunno. . .

    Parent
    How about (none / 0) (#5)
    by andgarden on Sat Dec 19, 2009 at 07:59:17 AM EST
    this (PDF)

    Parent
    That looks like it (none / 0) (#6)
    by Big Tent Democrat on Sat Dec 19, 2009 at 08:01:31 AM EST
    You'd think they'd have a way (none / 0) (#8)
    by andgarden on Sat Dec 19, 2009 at 08:03:17 AM EST
    to show the changes. Congress seems to manage its document revision as if it were the 1980s.

    Parent
    No kidding (none / 0) (#19)
    by Militarytracy on Sat Dec 19, 2009 at 08:22:38 AM EST
    I have a headache

    Parent
    get a file error when I try to access (none / 0) (#7)
    by MO Blue on Sat Dec 19, 2009 at 08:01:50 AM EST
    Server may be overloaded (5.00 / 1) (#9)
    by andgarden on Sat Dec 19, 2009 at 08:03:52 AM EST
    Try to right-click and download?

    Parent
    Well (none / 0) (#2)
    by Ga6thDem on Sat Dec 19, 2009 at 07:56:13 AM EST
    if he goes along then you can guarantee that the Obama administration has sold women down the river. But hey, we're all just a bunch of dried up old hags to them anyway so they really don't care.

    They forgot about us (none / 0) (#10)
    by jbindc on Sat Dec 19, 2009 at 08:05:10 AM EST
    being under the bus, and all.

    Parent
    As to Medicaid, (none / 0) (#11)
    by andgarden on Sat Dec 19, 2009 at 08:12:04 AM EST
    If the objection is that states can't afford it--and that's fair these days--why not offer a complete Federal takeover? Bueller?

    Also, (none / 0) (#12)
    by andgarden on Sat Dec 19, 2009 at 08:13:50 AM EST
    "state opt out of abortion coverage"

    Have not found that (none / 0) (#13)
    by Big Tent Democrat on Sat Dec 19, 2009 at 08:15:26 AM EST
    p. 38: SEC. 1303. SPECIAL RULES. (none / 0) (#14)
    by andgarden on Sat Dec 19, 2009 at 08:16:08 AM EST
    That's it? (none / 0) (#18)
    by Big Tent Democrat on Sat Dec 19, 2009 at 08:21:27 AM EST
    Stupak won't accept that.

    Parent
    That ought to be interesting (none / 0) (#21)
    by andgarden on Sat Dec 19, 2009 at 08:23:39 AM EST
    In fact (none / 0) (#15)
    by Big Tent Democrat on Sat Dec 19, 2009 at 08:19:40 AM EST
    Have not found much of anything.

    I did not see the Stupak part of this.

    I think I found the Nebraska bribe for Medicaid. Other than that, nothing really.

    Parent

    Page 38 forward (none / 0) (#17)
    by andgarden on Sat Dec 19, 2009 at 08:20:35 AM EST
    I'm not sure how this compares.

    Parent
    TPM has that section separated (none / 0) (#20)
    by MO Blue on Sat Dec 19, 2009 at 08:23:30 AM EST
    Yup, seems I have a good ear (none / 0) (#22)
    by andgarden on Sat Dec 19, 2009 at 08:24:33 AM EST
    I can't tell you how this compares to what came before.

    Parent
    It's an opt out (none / 0) (#23)
    by Big Tent Democrat on Sat Dec 19, 2009 at 08:26:04 AM EST
    Hyde is more restrictive than this.

    This is pointless. States could always opt out.

    Parent

    That's what I thought (none / 0) (#26)
    by andgarden on Sat Dec 19, 2009 at 08:32:11 AM EST
    My default presumption is that Nelson doesn't actually care about any of this. He just has to appear to have gotten concessions.

    Parent
    Not much of an appearance (none / 0) (#28)
    by Big Tent Democrat on Sat Dec 19, 2009 at 08:34:42 AM EST
    quite frankly.

    I expect the bishops to denounce him and Stupak to say no.

    I think Nelson screwed up here. His real constituency was the insurance companies and they told him to vote Yes. But he has little real cover.

    Interesting misplay by Nelson.

    Oh BTW, how much did the progressive pushback have to do with this meekness do you think?

    I tell you what - I have one demand left myself and then I will become a supporter - Sunset the mandates and I am in.

    Parent

    I'm thinking that the subsidy just acts (none / 0) (#32)
    by andgarden on Sat Dec 19, 2009 at 08:42:37 AM EST
    as a tax credit. The "penalty" is really just a tax increase. What sucks is that it's a really regressive tax.

    I want to look at the whole thing more closely. In particular, I want to see how it deals with the fact that you don't insure for certainty. (i.e., how are ins. companies in the exchange expected to square the circle of chronic conditions?)

    Parent

    Since this is of great importance to me (none / 0) (#36)
    by Militarytracy on Sat Dec 19, 2009 at 08:45:35 AM EST
    I'd just like to say thanks for applying your skills there.  Please let us know what you think.

    Parent
    Not following you (none / 0) (#41)
    by Big Tent Democrat on Sat Dec 19, 2009 at 08:51:17 AM EST
    The mandate is just a tax increase (none / 0) (#43)
    by andgarden on Sat Dec 19, 2009 at 08:52:02 AM EST
    Of course (none / 0) (#46)
    by Big Tent Democrat on Sat Dec 19, 2009 at 08:53:56 AM EST
    Seems that way (none / 0) (#33)
    by Militarytracy on Sat Dec 19, 2009 at 08:42:55 AM EST
    He must have something that gets him noticed in all of this, because he isn't going save anyone from a threatening illness or impending early death....that's for damned sure.  If you refuse to seek positive attention, that only leaves the other.  What a putz

    Parent
    I had been terrified (none / 0) (#16)
    by Molly Pitcher on Sat Dec 19, 2009 at 08:20:03 AM EST
    that the state would send a public health nurse to check my house for the illegal guns.

    for what it's worth (none / 0) (#24)
    by desmoinesdem on Sat Dec 19, 2009 at 08:30:04 AM EST
    Bruce Braley (D, IA-01) said on Thursday that the Senate bill is unlikely to pass the House, based on conversations he's been having.


    That's a different question (5.00 / 1) (#25)
    by Big Tent Democrat on Sat Dec 19, 2009 at 08:32:09 AM EST
    I just do not see what Nelson got that justifies holding it up.

    I doubt there was ever struggle to give Nebraska the extra 43 million it was going to pay in Medicare.

    An opt out on abortion coverage in the exchanges? Hell, Hyde already is restrictive. Who would even bother to opt out?

    Parent

    Medicaid I mean (none / 0) (#29)
    by Big Tent Democrat on Sat Dec 19, 2009 at 08:39:59 AM EST
    Bernie! (none / 0) (#62)
    by gyrfalcon on Sat Dec 19, 2009 at 10:53:19 AM EST
    According to McConnell's whiny press conference right now, it's not just Nebraska that gets a break on Medicaid, Vermont does, too.

    Parent
    He got his 15 minute of fame (none / 0) (#34)
    by Cream City on Sat Dec 19, 2009 at 08:43:59 AM EST
    and may we hope that little show is over.

    But I bet there's a sequel.

    Parent

    If they changed the funding mechanism (none / 0) (#30)
    by MO Blue on Sat Dec 19, 2009 at 08:41:12 AM EST
    by removing the provision that taxes insurance plans, it would have a better chance of passing and not be so likely to become a bill that people hate. Dislike, maybe.

    Parent
    I think the entire bill was at risk (none / 0) (#27)
    by Militarytracy on Sat Dec 19, 2009 at 08:33:30 AM EST
    to get this in this fashion this morning.  Perhaps it needed to be to get here too.  The insurance industry has to have new customers or it is going to die.  Of course with the economy I can't promise them that the fresh blood isn't going to be bled already and will be on medicaid.

    If Stupak will not accept (none / 0) (#31)
    by Buckeye on Sat Dec 19, 2009 at 08:42:15 AM EST
    does this have to go to conference committee?  I do not see Pelosi being able to call an immediate vote and getting it to Obama.

    Stupak is in the House (none / 0) (#58)
    by gyrfalcon on Sat Dec 19, 2009 at 10:01:58 AM EST
    this is the Senate bill.  Stupak doesn't get another vote until the conference report comes to the House.

    Parent
    I know that. (none / 0) (#70)
    by Buckeye on Sun Dec 20, 2009 at 08:41:45 AM EST
    My point is that for this to become law, it will have to pass the house.  The abortion language will not pass his threshold.  Right now, the PO is out and less strict language on abortion.  This may not pass the house.  Any changes threatens the Senate where 60 votes are needed.

    Parent
    BTD: you support the excise tax? (none / 0) (#35)
    by Andy08 on Sat Dec 19, 2009 at 08:44:40 AM EST


    No (none / 0) (#38)
    by Big Tent Democrat on Sat Dec 19, 2009 at 08:47:09 AM EST
    I am writing a new post where I add that demand.

    Parent
    Thanks, whoever thought (5.00 / 1) (#54)
    by Andy08 on Sat Dec 19, 2009 at 09:10:10 AM EST
    of paying for "health insurance reform" ( i don't like health "care" reform) by burdening the middle-class/union/blue collar works
    should be ....hung (imho).  

    Parent
    works--->workers (none / 0) (#55)
    by Andy08 on Sat Dec 19, 2009 at 09:10:35 AM EST
    sorry

    Parent
    Here's something really funny on p 67 forward (none / 0) (#37)
    by andgarden on Sat Dec 19, 2009 at 08:46:48 AM EST
    IN justifying the Commerce clause grant, the bill also seems to justify the mandate (I think they're calling it a "requirement" now).

    It is a tax (none / 0) (#39)
    by Big Tent Democrat on Sat Dec 19, 2009 at 08:50:54 AM EST
    They do not need commerce clause power in my opinion.

    Parent
    But they're making a Lopez excuse anyway (none / 0) (#42)
    by andgarden on Sat Dec 19, 2009 at 08:51:32 AM EST
    The amendment there is new IMO, so maybe this is their response to Markos.

    Parent
    Markos made an constitutional argument? (none / 0) (#45)
    by Big Tent Democrat on Sat Dec 19, 2009 at 08:53:32 AM EST
    Silly.

    Parent
    NO (none / 0) (#48)
    by andgarden on Sat Dec 19, 2009 at 08:55:40 AM EST
    They're responding to the general objections to the mandate in this (superfluous) section. They reference the Massachusetts example.

    Parent
    Who cares? (none / 0) (#49)
    by Big Tent Democrat on Sat Dec 19, 2009 at 08:56:38 AM EST
    Not me.

    Parent
    Just an observation (none / 0) (#50)
    by andgarden on Sat Dec 19, 2009 at 08:57:59 AM EST
    that the package responds to more than just Nelson.

    Parent
    It's fluff (none / 0) (#51)
    by Big Tent Democrat on Sat Dec 19, 2009 at 09:02:39 AM EST
    Not substance.

    Parent
    Indeed, but my historical sense is piqued (5.00 / 2) (#52)
    by andgarden on Sat Dec 19, 2009 at 09:04:32 AM EST
    See page 71 if you want to parse out (none / 0) (#40)
    by andgarden on Sat Dec 19, 2009 at 08:50:55 AM EST
    what the mandate penalty will be.

    I assume it is the same as before (none / 0) (#44)
    by Big Tent Democrat on Sat Dec 19, 2009 at 08:53:07 AM EST
    Cross-references make it hard to read (none / 0) (#47)
    by andgarden on Sat Dec 19, 2009 at 08:54:38 AM EST
    I defer to people who have experience construing this stuff.

    Parent
    Wish they would publish these (none / 0) (#53)
    by MO Blue on Sat Dec 19, 2009 at 09:09:50 AM EST
    things in plain English. It is all gobbledygook to me. Probably that is the intent.

    Parent
    Lawyer speak :) (none / 0) (#56)
    by Militarytracy on Sat Dec 19, 2009 at 09:19:16 AM EST
    When they refer back to other parts of (5.00 / 1) (#57)
    by Militarytracy on Sat Dec 19, 2009 at 09:19:59 AM EST
    the bill or other legislation though......they should have to provide a damned link!

    Parent
    My understanding on the abortion language (none / 0) (#59)
    by Makarov on Sat Dec 19, 2009 at 10:35:54 AM EST
    is that someone purchasing coverage through the exchange would have to write a separate check, or make a separate credit card payment in order to get abortion coverage.

    This would be more problematic under small employer health care subsidies for obvious reasons (privacy) than the individual market.

    As others noted, states are free to determine whether their exchanges will offer abortion coverage at all. Of course, this becomes problematic with the provision for "nationwide plans" that allows insurers in one state to offer coverage to those in other states. Potentially, someone in state A that forbids abortion coverage could purchase a nationwide plan from state B that includes it. Unless, of course, abortion coverage is wholly eliminated from nationwide plans.

    Not how I read it (none / 0) (#60)
    by Big Tent Democrat on Sat Dec 19, 2009 at 10:37:56 AM EST
    One check credited for payment into two different accounts.

    Parent
    A CNN reporter (none / 0) (#66)
    by Makarov on Sat Dec 19, 2009 at 02:33:29 PM EST
    cited the specific example I made - that the consumer would have to write two checks. I got it from her, and not from a read of the bill.

    Parent
    That's what Nelson thinks it says (none / 0) (#67)
    by andgarden on Sat Dec 19, 2009 at 02:42:43 PM EST
    I haven't read the language closely enough to be sure.

    Parent
    Hypo: HHS Secretary requires (none / 0) (#61)
    by andgarden on Sat Dec 19, 2009 at 10:47:50 AM EST
    that the national nonprofit plan includes an abortion coverage option. Do states get a say about whether it's available locally?

    Parent
    Another hypo -- let me ask you (5.00 / 1) (#63)
    by Cream City on Sat Dec 19, 2009 at 11:07:32 AM EST
    whether you think that a court challenge would have legs?  I doubt it, based on precedents.  I'm getting so d*mn tired of all of this chipping away at court ruling that was grounded (not the way I would have wished, but it was) in Constitutional rights.

    Can states opt out of Brown v Board of Ed?  Then why Roe v Wade?  Lawyers, edify me.

    Parent

    My reading of the cases is that it likely wouldn't (5.00 / 1) (#65)
    by andgarden on Sat Dec 19, 2009 at 11:27:27 AM EST
    But I think BTD disagrees. I hope he's right.

    Parent
    Good question (none / 0) (#64)
    by Steve M on Sat Dec 19, 2009 at 11:12:04 AM EST
    I was just looking at the provisions regarding nationwide plans in general, and states have to opt-out of the whole nationwide plan concept if they want to - they can't just opt out of one specific plan.  But I'm not sure how the nationwide nonprofit plan fits in.

    Parent
    What a joke <n/t> (none / 0) (#68)
    by FreakyBeaky on Sat Dec 19, 2009 at 04:48:58 PM EST


    Once the constituents and state gov't. (none / 0) (#69)
    by oculus on Sat Dec 19, 2009 at 09:35:47 PM EST
    of states other than NE and VT find out about the Bill's provision of Medicaid help for just those two states, won't the other states' residents be mightily ticked off?