The Conspiracy to Reverse Health Care Reform Begins and Ends in the States
By Robert Kraig
It is becoming clear that the opposition to health care reform from the unholy alliance of right wing politicians and big health insurance is so pathologically intense that they will not give up the fight. Usually after a major legislative battle in Washington, the losing side expresses disappointment but admits the result, just as candidates for office concede defeat after a hard fought election. But the fanatical opposition to historic health care reform is of a different order.
First there were the 16 state attorneys general who used scarce public dollars to file a frivolous law suit based on a pre-Civil War reading of the Constitution. 6 more AGs are now poised to join the original 16 in this windmill tilting exercise. Then came reports of a "two term" strategy to repeal reform, championed by the darling of the right Wisconsin Congressman Paul Ryan and others--it would take two elections to possibly pick up enough seats in Congress. Another stated strategy is to starve reform from Congressional appropriations to block implementation.
Despite all the noise about these tactics, the greatest threat to health care reform is not frivolous law suits or the usual shift in Congressional seats to the minority party during midterm elections but the potential sabotage of implementation in the states. To a degree that is not yet fully recognized, the states are responsible for implementing the critical pieces of health care reform. The insurance regulations that outlaw the worst industry practices are largely to be implemented and enforced in the states. The health insurance exchanges, the centerpiece of the whole reform package, are to be planned and run by the states.
The greatest threat is that the unholy alliance between big health insurance and conservative politicians will undermine and compromise state-level implementation so much that the reforms are discredited. Think a health care Katrina-effect, where the willful undermining of federal emergency management capacity which made a natural disaster much worse was then used by the very same politicians responsible for the fiasco to discredit government. An early example is Georgia's decision to refuse to implement the high risk pool mandated by the reform law. In this case, the federal government will simply perform the task for Georgia of offering coverage to people with preexisting conditions who can't find coverage anywhere else, but what other essential tasks such as enforcing the prohibitions against preexisting condition discrimination and creating an effective health insurance exchange with high quality and affordable health insurance options will be deliberately sabotaged?
The only way to counter such looming health care treason against the economic well being and health of the people is strong state-based health care coalitions that monitor implementation very closely and hold state officials accountable for doing their part to guarantee affordable health care for everyone in America.
Wednesday Governor Jim Doyle announced the creation of a new Office of National Health Care Reform to spearhead implementation of the historic health care reforms that were recently approved in Washington. The office will be co-chaired by Department of Health Services Secretary Karen Timberlake and Insurance Commissioner Sean Dilweg.
Governor Doyle set a goal of Wisconsin leading the nation in implementing the new national health care reform laws, and implementing some of its key provisions early. This includes Wisconsin beginning new health insurance exchange ahead of the 2014 timeline required by the new federal law. The exchange will offer a market place where people can buy subsidized insurance and where the worst health insurance industry abuses are outlawed. This is a crucial step for Wisconsin residents to realize the concrete improvements in health care cost, accessibility, and quality that are promised by national reform.
The success of national health care reform is critically dependent on implementation in the states. Governor Doyle has given the effort a real boost by setting the challenging goal of leading the nation in implementing the historic reforms. It is also crucial that the Governor has placed the new office spearheading implementation under the strong leadership of Secretary Timberlake and Commissioner Dilweg. This is a real opportunity to create a framework for national health care reform implementation in Wisconsin before the Governor leaves office.
The sweeping health care reforms that President Obama signed into law last month leave many crucial decisions to the states. With its history of state-level health care reform, Wisconsin has the opportunity to lead other states in how to expand affordable access to health coverage as quickly and effectively as possible. The Governor's stated goal of establishing Wisconsin's health insurance exchange early is a crucial step.
This is not an April fools day joke. Really it's not. In a speech in Oklahoma of all places last week, Wisconsin Congressman Paul Ryan claimed that the great leaders of progressive reform, Theodore Roosevelt, Woodrow Wilson, and Wisconsin's own "Fighting Bob LaFollette" (sic) "would have scorned the self-proclaimed progressives of our day." This is because, Ryan tells us, the progressives supported empowering the people and expanding democracy. The claim in the speech, which you can read on Ryan's Facebook account, is that health care reform has pushed America to the brink of a tipping point where so many will be benefited by the action of the government that the individual freedom created by the Founding Fathers will be destroyed and replaced by European socialism.
As someone who has written an academic book and peer reviewed articles on progressivism, I can't resist refuting Ryan's absurd distortion of progressivism. If you think Ryan's history contradicts everything you learned in school about early 20th Century progressives, you are right. There were several strands of progressive thought, but they all shared the belief that in a modern industrial era American governmental institutions needed to be adapted to new economic and social conditions in order to maintain traditional American values of freedom and economic opportunity. Heeding a traditional view of limited government, as the conservatives of the day demanded, would lead to a profoundly unequal and undemocratic society in which large corporations would destroy individual freedom and participatory democracy.
In this light, the new health care law is very much within the proud lineage of progressive reform. It is a use of our democratic institutions, and yes the instrument of government, to help improve a major social and economic problem that will not get better on their own. It is also a use of democratic power to check unfettered corporate power, especially that exercised by big health insurance.
We do not have to guess how the early 20th Century progressives would have reacted. The Progressive Party, which nominated Theodore Roosevelt for President in 1912, was the first major party to have a health care reform plank. In addition, progressive era reformers were the first in America to advocate for compulsory health insurance.
This brings us back to Congressman Ryan. At one level, Ryan's Oklahoma speech articulates a bizarre right-wing revision of American history that has been developed over the last couple of decades in right wing think tanks. The new right history dumbs down the Founding Fathers (progressives of their era in point of fact) claiming they created eternal religiously based governing doctrines which can never by adapted to new conditions and happen to parallel modern ultra-conservative ideology (Perhaps the best known purveyor of this right wing history of America is the Fox News talk jock Glenn Beck).
We should give Ryan credit--despite his horrendous misreading of American history and his defamation of "Fighting Bob" La Follette--for recognizing that something big is at stake in the health care reform debate. In fact, Ryan seems to recognize that more than many mainline Democratic politicians. What is at stake, as I discuss in the blog post below this one, is the faith that American democracy can solve our most pressing problems, and continue the social and economic progress of the past two centuries.
Historic Health Care Vote Reflects Renewal of Confidence in America
By Robert Kraig
The health care bill that just passed the U.S. House of Representatives and was signed by the President two days later is the most sweeping social justice legislation to move through Congress in over forty years.
This is one of those rare instances when calling a vote "historic" is not an exaggeration. Guaranteeing affordable health care for everyone in America has been a goal of reformers for nearly 100 years, going all the way back to Republican President Theodore Roosevelt.
The historic vote reflects a renewal of national self-confidence that America is up to the task of solving our most pressing problems. We used to be a nation brimming with confidence that our democracy had the capacity to achieve great things. But over the last thirty years, naysayers have promoted the self-defeating idea that economic and social problems were beyond our capacity to remedy.
The idea that a nation that built the first large scale democracy, created the largest middle class in history, defeated fascism, sent the first person to the moon, and established basic civil rights for every American, is not capable of guaranteeing affordable health care is profoundly pessimistic. In a triumph of the American can-do spirit, the health care vote is a signal of renewed confidence in the potential of American democracy. We will need this kind of boldness and self-assurance to deal with other pressing problems, especially the Wall Street-generated economic crisis that has created record unemployment.
The health insurance industry's abusive practices and greedy double-digit rate increases have outraged the public. Yet insurance CEOs and their political friends are convinced they can reverse the historic health care vote. However, there are signs that the tide is already turning against them, despite their determination to fight progress to the bitter end. Polls taken after the vote show a spike in public support, and this support will only grow as the public focuses more on what reform will do for average people and less on the process in Congress.
It is not hard to see why health care reform is growing in popularity when you look at the benefits of the new law. In Wisconsin the bold and sweeping new reforms will:
Provide health care premium subsidies to up to 1.3 million Wisconsin families and 123,900 small businesses. The average family of four in Wisconsin will get a $5,800 tax credit to pay for health coverage and the average small business will get a 50% tax credit.
Prevent 10,300 medical cost related bankruptcies per year in Wisconsin, by outlawing insurance policy annual and life time limits on coverage, and capping out-of-pocket costs.
Guarantee that 63,200 Wisconsinites with preexisting conditions such as cancer, heart disease, and diabetes, can buy coverage and not have their policy rescinded by their insurance companies.
Improve Medicare for 877,000 Wisconsinites by closing the prescription drug donut hole, providing free primary and preventative care, and improving the solvency of the program.
Improve health coverage for 3.8 million Wisconsinites who are covered by private insurance by allowing them to keep their coverage, and outlawing the worst insurance industry abuses.
Limit insurance industry profits and overhead, ensuring that at least 85% premium dollars go to medical care.
Give 455,000 young adults in Wisconsin the opportunity to obtain health coverage through their parent's policies.
Like Social Security and Medicare, which were highly controversial before they were enacted, Wisconsinites will not even think of giving up these benefits once they are established. It is imperative that we use the renewed sense of national purpose the historic health care vote provides to fight back against the efforts of "bitter end' opponents to block implementation, or repeal the law before it can take full effect. As a nation, we also need similar boldness and faith in American democracy to make progress on other critical agenda items, especially the jobs crisis that threatens to undermine the American dream for so many.
Late last night the U.S. House of Representatives passed the most sweeping social justice legislation to move through Congress in over forty years. Wisconsin Members of Congress Tammy Baldwin, Steve Kagen, Ron Kind, Gwen Moore, and David Obey all made courageous and history-making votes in favor of the bill. This is one of those rare instances when calling a vote “historic” is not an exaggeration. Guaranteeing affordable health care for everyone in America has been a goal of reformers for nearly 100 years, going all the way back to President Theodore Roosevelt. Last night’s vote is a major milestone in the long journey to extend the promise of American life to everyone in our great nation.
As important as Sunday’s vote was, it does not end the debate over health care reform. Make no mistake: special interests and opponents of reform will be organizing from day one to repeal this bill and take away our access to affordable health care. Our job is to stand our ground and not let that happen. As many critical decisions are left to the states in this bill, successful implementation here in Wisconsin will depend on the State Legislature and the next Governor acting with the same courage Congress showed last night. Wisconsin must continue to lead the way on health care reform.
Wisconsin consumers will realize some of the benefits of health care reform almost immediately, such as stopping insurance companies from canceling coverage retroactively when a person gets sick, and putting lifetime limits on the dollar value of benefits. Other short- and long-term benefits of health care reform include reducing drug costs for seniors, saving money for small business owners, preventing insurance companies from denying care based on pre-existing conditions, lowering the growth trajectory of health insurance costs and expanding coverage for uninsured people.
According to the House Energy and Commerce Committee, the bill that the House passed yesterday will have the following benefits for Wisconsin residents (Note: numbers by Congressional district are available upon request):
Premium subsidies and tax credits for up to 1.369 million families and 123,900 small businesses in Wisconsin to help them afford coverage. The average family of four making $50,000 per year will be eligible for a tax credit of $5,800 per year, and small businesses will receive a 50% tax credit to provide health insurance. Everyone will have access to group health insurance, and there will be new limits on insurance industry profits and overhead.
Prevent 10,300 medical cost related bankruptcies per year in Wisconsin. The bill eliminates annual and life time limits on coverage, and caps annual out-of-pocket costs at $6,200 for individuals and $12,400 for families who purchase insurance on the new health insurance exchanges, or through a small business.
Guarantee that 63,200 Wisconsinites with preexisting conditions such as cancer, heart disease, and diabetes, can buy coverage and not have their policy rescinded.
Improve Medicare for 877,000 Wisconsinites by closing the prescription drug donut hole, providing free primary and preventative care, and improving the solvency of the program.
Improve health coverage for 3.798 million Wisconsinites who are covered by private insurance (67% of Wisconsin residents). People with private insurance will be able to keep their current coverage, and will be protected by insurance reforms such as the elimination of annual and lifetime limits, the elimination of recessions for people who become ill when insured, and a ban on coverage denials for preexisting conditions. The bill also limits insurance industry profits and overhead, which will assure that more premium dollars go to medical care.
Give 455,000 young adults in Wisconsin the opportunity to obtain health coverage through their parent’s policies.
Provides millions in new funding to 90 community health centers in Wisconsin.
This past Tuesday, March 9th, five thousand plus health care reform supporters took a stand against Big Insurance CEO's at the insurance lobby's annual meeting at the Ritz-Carlton hotel in Washington D.C. The health insurance industry executives are trying to protect their pockets by blocking necessary health care reform but the protesters had a mission: To make a citizens' arrest and stop the crimes of Big Insurance. The message was loud and clear: We need congress to listen to us and not the insurance companies. We need health care reform NOW!
Congress got the message, and the House is voting on the Senate bill this Saturday. We are at the finish line for passing comprehensive legislation. Health care reform should not be a political issue but rather a moral responsibility to our citizens. House Speaker Nancy Pelosi declared that when she brings health care reform to the house floor, "we will have the votes." In the last days of the debate, the home stretch, we need to push congress to finish the job and provide quality, affordable health care for all.
On Tuesday a bus load of people from Wisconsin joined thousands from throughout the country to take a stand against the health insurance industry CEO's who are spending millions to protect their profits and block meaningful health care reform. Meanwhile, House Speaker Nancy Pelosi predicted on Friday a final vote on health care as early as the end of this week.
The protest and the Ritz-Carleton hotel, where health insurance industry executives were having their annual lobby meeting, drew national media coverage. Listen to Citizen Action of Wisconsin's Organizing Director, Brian Rothgery, discuss what happened at the protest with WCLO Radio's Stan Milam.
The "No Sacred Cows" blog will have more updates this week on the protest, and the approaching historic vote on national health care reform.
On Sunday people from all over Wisconsin started a long bus ride to Washington to take a stand against the health insurance industry CEO's who are spending millions to protect their profits and block meaningful health care reform. They will be joining thousands of people from around the country who will be protesting Tuesday at the Ritz-Carlton Hotel, where the big health insurance companies will be having their annual meeting. Once there, protesters will share their own health care experiences and express their outrage towards CEOs who make millions by denying our care, hiking premiums, and devastating America's families and businesses. The protest will take place Tuesday morning, and should be widely covered by the national media.
This convening of health insurance industry executives could not come at a more momentous moment. It shows the arrogance of big health insurance that its CEOs would gather at a ritzy Washington hotel at the same time Congress is deciding whether to enact meaningful national health care reform. These CEOs need to understand that their millions in political contributions and lobbying expenditures will no longer drown out the voices of average citizens from across Wisconsin and the rest of the country demanding action on the health care crisis. The hardy Wisconsinites sojourning to Washington to tell their personal health care stories and stand up to the big insurance companies are sending a clear message to Congress that it is time to finish the job on health care reform.
The bus stated in the Twin Cities, and made pick ups in Eau Claire, Tomah, Madison, and Milwaukee. We had press events at several locations, and got excellent television coverage across the state (see press section on front page of this website). See for example the coverage on Ch. 19 in La Crosse, Ch. 4 in Milwaukee, and Ch. 12 in Milwaukee.
The protest on Tuesday could be a major turning point, as Congress makes its final decision on health care reform, because it reminds everyone why the movement for guaranteed affordable health care started in the first place. The Wisconsin bus riders I talked to Sunday where very aware that they were engaged in what may be an historic event: a freedom ride to liberate American's from the worst excesses of the big health insurance companies.
After last Thursday’s health care summit it seems that Democrats are ready to push the health care bill through with or without Republicans support, through reconciliation if necessary. The summit proved that there are core elements of the comprehensive package that both parties can agree on but Republicans continue to insist on starting over.
President Obama has seized control of the debate and is adamant that Congress get the job done on health care reform before more Americans have to suffer. Throughout the summit, Obama kept pressing for areas of agreement to keep things moving forward and it is clear that he will not stop pressing for action until Congress takes final up or down vote on health care reform.
Obama promises that he will do what it takes to get Congress to pass comprehensive legislation within a couple weeks, telling legislators to schedule a vote by March 18. In the FINAL push for reform, Obama is going all out to extend insurance coverage to 31 million Americans who don't have it and provide real health security for all. The long road to a healthier America has been bumpy but a smooth ride could be around the next curve.
Although Obama released his health care proposal just days before the event, he is prepared to push a final bill through with or without Republicans support. At the summit, Democrats anticipate stopping the rumors that the legislation is partisan and secretive. Calling a bipartisan meeting demonstrates that Obama is willing to negotiate with the Republicans, but are they willing to finding the middle ground with Democrats? Either way, it would be in the best interest of both parties to work together and come up with solutions that will be a win-win for them and benefit all Americans. The reality remains, no matter how much partisan disagreement there is in Washington, Americans are physically and socially suffering because of the inability of Congress to unify for the greater good.
With the majority of Americans frustrated by delays, Congress needs a push to get the job done. The summit is President Obama's last ditch effort to welcome suggestions, counter-opinions and additional proposals that some Republicans and Democrats feel are necessary to get them board with comprehensive health-care reform. This is an opportunity for the two parties to collaborate and avoid further polarizing the country. America can't wait any longer for real health care reform.
