Ben Nelson, Pushover?

By Big Tent Democrat, Section Other Politics
Posted on Sat Dec 19, 2009 at 07:49:08 AM EST
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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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Ben Nelson, Pushover? | 70 comments (70 topical)

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If you want to parse it out, (none / 0) (#1)
by andgarden on Sat Dec 19, 2009 at 07:53:12 AM EST

I believe this is the substitute amendment. (PDF)

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.


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. . .


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

this (PDF)


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.


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

I have a headache

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?

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.

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.


: 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.


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.


TPM has that section separated (none / 0) (#20)
by MO Blue on Sat Dec 19, 2009 at 08:23:30 AM EST

TPM


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.


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.


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.


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.


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?)


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.


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


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?


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.

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.


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.


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.


: 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.

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.


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).


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

sorry

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.


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.


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

Silly.


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.


Who cares? (none / 0) (#49)
by Big Tent Democrat on Sat Dec 19, 2009 at 08:56:38 AM EST

Not me.


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.


It's fluff (none / 0) (#51)
by Big Tent Democrat on Sat Dec 19, 2009 at 09:02:39 AM EST

Not substance.


: 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.


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.


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!

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.


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.


: 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.

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?


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.


: 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.

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.


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?