Archive for the ‘Political Diagnosis’ Category

January 25, 2012

State of the Union in LGBT Health

Last night, President Obama delivered his third State of the Union address, describing accomplishments and challenges facing his Presidency and the nation. Earlier this month, and garnering much less attention, the administration released an accounting of its efforts to reduce healthcare inequality for lesbian, gay, bisexual and transgender (LGBT) persons, and challenges still to be tackled.

Among the accomplishments, HHS Secretary Sebelius lists the development of an Institute of Medicine report on LGBT health, a rule requiring hospitals to accept patients’ wishes for who can visit them “regardless of sexual orientation, gender identity, or any other non-clinical factor,” inclusion for the first time of LGBT health concerns in the nation’s Healthy People goals, anti-bullying efforts, and policies and funds to encourage shelters for homeless young people to be properly equipped to provide services to LGBT youth.

Several items for future action were also listed, including promoting “cultural competence” training for healthcare providers to improve care to LGBT patients, guidance to state child welfare agencies on how to better support LGBT young people, and better data collection on sexual orientation and gender identity in health data collection processes in order to better understand and approach health disparities.

There’s a long way to go – a 2010 report indicated that nearly 1/3 of transgender men and women had avoided getting medical care because of discrimination, and about 1 in 5 had been refused care due to their transgender or gender non-conforming status. Lesbian and bisexual women are thought to be at higher risks of heart disease because of higher rates of obesity, smoking, and stress – which may in turn be related to discrimination faced in healthcare systems and society in general. The IOM report mentioned above reminds us that LGBT folks face “a profound and poorly understood set of additional health risks due largely to social stigma.”

Let us hope that in the coming year, as President Obama stated last night about the nation, the state of our LGBT health will be getting stronger.

For an overview of LGBT human rights and discrimination around the globe, see this United Nations report published last November.


September 26, 2011

La Ley para Cosméticos Seguros Atiende un Vacío en las Regulaciones de Seguridad

Escrito por Rachel; traducido del orginial en inglés Sept. 1, 2011.

OBOS has received funding to make blog entries available in Spanish. We hope to expand outreach efforts in the coming year.

Muchas personas que usan cosméticos en los Estados Unidos no se dan cuenta que no se requieren pruebas o aprobación de la FDA para la comercialización de cosméticos.  A su vez, la Agencia Federal no tiene autoridad para requerir que el fabricante retire del mercado productos que no son seguros.  Como los cosméticos no son regulados de la misma manera que los medicamentos, es más difícil para el consumidor hacer una decisión informada, y la FDA tiene menos poder para regular la industria de los cosméticos y para responder a los problemas.

La Ley para Cosméticos Seguros del 2011 (Safe Cosmetics Act of 2011), propuesta por Janic Schakowsky (IL-D) tiene el propósito de ayudar a llenar algunos de estos vacíos en la regulación de los cosméticos.

Esta ley daría poder al gobierno para retirar del mercado los cosméticos no seguros, para requerir mejor información sobre sus ingredientes, establecer estándares de seguridad adicionales y requerir que el fabricante provea información sobre la seguridad del producto.  La ley impone la obligación de informar sobre los efectos adversos para la salud, permite la prohibición de ingredientes que tienen efectos que pueden causar cáncer o problemas con la salud reproductiva, estimula alternativas a las pruebas en animales, aborda la seguridad de los trabajadores, junto a otras medidas.


September 22, 2009

Political Diagnosis: Senate Finance Committee Considers Health Care Reform Bill

The Senate Finance Committee today began its mark up on the health care overhaul bill put forth by Sen. Max Baucus (D-Mont.). C-SPAN is covering it live; you can watch streaming video here.

Baucus, chair of the committee, seemed to anger all Republicans and Democrats when he released a bill last week that was more conservative than what most Democrats in Congress wanted, yet not conservative enough for any Republican to sign on.

Other committee members have since contributed 534 amendments (here they are, in a 348-page document [pdf]), including three different amendments calling for a public health insurance option to compete with private insurers.

*A recent survey of more than 5,000 doctors by the Robert Woods Johnson Foundation found that the overwhelming majority support expanding health care coverage to include both public and private insurance options. Baucus’s bill shuns the public option in favor of co-ops, which are not considered much of a threat to the insurance industry.

Baucus also faces criticism on funding.

Richard J. Kirsch, national campaign manager of Health Care for America Now, told The New York Times: “The tax credits in the original Baucus plan were so low they would make premiums unaffordable for many moderate- and middle-income people, who could also face high out-of-pocket costs. And if they don’t pay the premiums, they might have to pay a fine.”

Baucus (above left, greeting the committee’s ranking Republican, Sen. Charles Grassley of Iowa) has said he will make some modifications to the bill to provide more assistance to moderate-income Americans who need help buying insurance.

The Amendments

Igor Volsky at Wonk Room breaks down some of the most important amendments into categories for coverage, financing and delivery reforms. View the complete list here.

Volsky’s charts also include some of the more outrageous Republican amendments, such as this gem from Sen. John Kyl (R-Ariz.): “Prohibit the federal government’s takeover of health care.”

Ezra Klein, who previously described the Baucus bill as “a very good platform with some very severe failings,” offers five recommendations to improve it, including phasing in Sen. Ron Weyden’s Free Choice amendment and creating real competition for insurance companies. Klein also prepared a good summary of the amendments Sen. Olympia Snowe (R-Maine) has offered, including a public plan trigger.

About Abortion

Sen. Jay Rockefeller (D-W.V.) has proposed a number of useful amendments, including establishing a public insurance option and limiting out-of-pocket costs. But it’s his amendment #C6 (see page 12) that really intrigues me. A hero last week to progressives for his strong stance against a Senate bill that lacks a public option, Rockefeller disappointed many of those same advocates for denying women enrolled in the public plan access to abortion services:

This amendment would add a strong public health insurance option, the Consumer Choice Health Plan (CCHP), to the exchange to compete directly with private plans. Like private health plans, CCHP would be offered to all individuals and businesses purchasing health insurance through the national health insurance exchange. […] At a minimum, the Consumer Choice Health Plan would be required to follow the same insurance regulations as private plans operating in the exchange. CCHP would also be required to offer the same type of plans as private plans participating in the exchange.

Well, not exactly. The CCHP, according to Rockefeller, “shall not include abortion, except in cases of rape, incest, or the life of the mother. It also prohibits the expenditure of Federal funding for abortion and it requires the segregation of funds to ensure that no Federal dollars pay for abortions.”

Did you get the underlined points? His emphasis, not mine.

The Hyde Amendment, enacted in 1976, already prohibits spending federal dollars to pay for abortions for women on Medicaid. Rockefeller’s amendment would expand the restriction to all women who choose the public option.

The Center for Reproductive Rights is urging supporters to call members of the Senate Finance Committee and ask them to vote against anti-choice amendments. You can also contact your senators and ask them to stop anti-choice amendments from being included in the health care bill.

More good reading on health care reform and the abortion debate:
- Frances Kissling, “Exploiting the Healthcare Debate to Restrict Abortion
- Molly M. Ginty, “Obama Fuels Battle Over Funds for Abortion
- Politifact, a project of the St. Petersburg Times, is running a Truth-O-Meter on federal subsidies and abortion
- Rep. Lois Capps, “The Truth About the Capps Amendment
- David Crary (AP), “Abortion-Rights Forces Vexed by Health Care Debate

Baucus Bill is “Bunk for Women”

In a post at Raising Women’s Voices outlining five reasons why the Baucus bill is no good for women, Amy Allina writes that the bill “imposes politics and ideology on what should be a purely medical decision — the question about what services an insurance plan will cover. It singles out abortion for special exclusions, rather than treating it like other medical care, by adopting language that was developed by the House Energy and Commerce Committee as a compromise to prevent anti-choice legislators from using the health reform bill as a vehicle to impose sweeping new restrictions on abortion.”

Another reason: Under the Baucus bill, older Americas could pay up to five times as much as younger customers. The bills to come out of the House allowed only a 2:1 ratio.

“Women, who live longer on average than men, are more likely to bear the costs of this age rating,” notes Allina.

Doing away with any niceties, James Ridgeway, in a post titled “How the Baucus Plan Screws Older People,” writes that “the people who stand to get screwed most by the plan are those who aren’t old enough to qualify for Medicare, but are still old enough to be discriminated against by insurance companies.”

Ridgeway quotes Uwe Reinhardt, an economics professor at Princeton University, who estimates that the age rating will enable insurers to cover roughly 70 percent of the added risk they’ll take on by extending insurance coverage to everyone.

“You’re just using age as a proxy for health status,” said Reinhardt.

Maggie Mahar, author of “Money-Driven Medicine: The Real Reason Health Care Costs So Much,” breaks down even further who benefits when health insurance premiums are allowed to vary based only on tobacco use, age, family composition and where you live (allowing for differences in local cost of care).

She writes at HealthBeatBlog.com:

If you smoke, they can charge you 50 percent more; if you have children they can charge you 50% more than they would charge a childless couple, and if you are a single parent, they can charge you 80% more than they would charge a single adult. (Since children’s health care costs are, by and large, significantly lower than adults’ costs, that seems a pretty steep surcharge for the sin of single parenthood.)

I can imagine that some readers would say that it is only fair to charge smokers more. But consider this: the vast majority of adult smokers in the U.S. are poor. Many will qualify for full subsidies; others will be eligible for partial subsidies. So who will pay 50% more for their health care—you, the taxpayer. If he receives a subsidy, the 50% surcharge isn’t likely to induce a smoker to stop smoking. This is simply another way to funnel more taxpayer money to private sector insurers.

Single parents also tend to cling to the lower rungs of the income ladder. Many will qualify for at least a partial, if not a full subsidy. Who pays the extra 80%? That’s right—you and I.

Finally, if insurers can charge 50-somethings five times as much as they charge 20-somethings (who the Baucus plan refers to as “young invincibles”), a great many of them are going to need subsidies. More tax-dollars winging their way to Aetna.

There is, however, an exemption from the mandate for people over 50 if coverage is deemed unaffordable — which makes no sense, really, since this the time they’re likely to need health care more, not less.

As Mahar concludes, “Somehow, this isn’t what I thought they meant by ‘universal coverage.’”


August 11, 2009

Political Diagnosis: Hijacking Healthcare Reform

The White House Strikes Back: Faced with mixed public support and increasing disruptions at town hall meetings orchestrated by right-wing groups, the Obama administration yesterday launched a new website to help get out the facts on healthcare reform: WhiteHouse.gov/RealityCheck

President Obama also went on the offensive today, telling a friendly town hall audience in Portsmouth, N.H., “For all the scare tactics out there, what is truly scary is if we do nothing.”

The New York Times leads off a story on the new website by noting it was created to “fight questionable but potentially damaging charges that President Obama’s proposed overhaul of the nation’s health care system would inevitably lead to ‘socialized medicine,’ ‘rationed care’ and even forced euthanasia for the elderly.”

The Times’ Jim Rutenberg and Jackie Calmes add that White House officials are also “tacitly acknowledging a difficult reality: they are suddenly at risk of losing control of the public debate over a signature issue for Mr. Obama and are now playing defense in a way they have not since last year’s campaign.”

But Media Matters offers another reason — the White House needs to go around the news media, which has been less than helpful in debunking the smears. Matt Gertz writes:

The White House is doing it because they realize that the media is unwilling or unable to call those smears false, instead – just to pull an example out of thin air – referring to misleading-to-ridiculous claims that Democratic proposals “would inevitably lead to ‘socialized medicine,’ ‘rationed care’ and even forced euthanasia for the elderly” as “questionable but potentially damaging charges.”

What makes this particular case even more absurd is that just yesterday, the Times published “A Primer on the Details of Health Care Reform.” Unfortunately, Rutenberg and Calmes don’t seem to have read it.

If they had, they might have written that claims that health care reform would lead to “socialized medicine” “seem overblown” because “[m]ajor versions of the legislation all rely heavily on a continuation of private health plans” and the CBO has found that under the House bill, 3 million more people would have employer-sponsored insurance in 2016 than would be expected under current law. They also might have called the “euthanasia” claims “unfounded” or noted that the AARP says they’re “flat-out lies.”

Plus: Head over to AlterNet to read “Inside Story on Town Hall Riots: Right-Wing Shock Troops Do Corporate America’s Dirty Work.” Adele Stan chronicles ties between the GOP and the extreme-right Web network Grassfire.org, which is organizing town-hall protesters against healthcare reform. Over at sibling site ResistNet.com, comments have included threats of violence and a video racist screed against President Obama.

Get Your Recess Toolkit: The National Women’s Law Center has put together an advocacy toolkit to help those in favor of comprehensive, affordable and accessible health care make their case to lawmakers home for the August recess. No extreme shouting required.

Campaign Costs: The whole healthcare debate has the feeling of a political race — along with the campaign ad costs. More than $52 million has been spent this year on ads, according to the Campaign Media Analysis Group.

“This has the potential to certainly be the biggest [ever] as far as an advocacy advertising campaign goes,” Evan Tracey, CMAG’s chief operating officer, told the Washington Post.

Reform? Insurance Companies Say Bring it On: Business Week writers Chad Terhune and Keith Epstein have written an in-depth piece detailing how UnitedHealth and and other insurance carriers are operating behind the scenes to shape healthcare reform for their own benefit. Their focus is on the more conservative Blue Dog Democrats, who now wield great power in the healthcare debate:

Some Republicans have threatened to make health reform Obama’s “Waterloo,” as Senator Jim DeMint of South Carolina has put it. The President has fired back at what he considers GOP obstructionism. Meanwhile, big insurance companies have quietly focused on what they see as their central challenge: shaping the views of moderate Democrats.

The industry has already accomplished its main goal of at least curbing, and maybe blocking altogether, any new publicly administered insurance program that could grab market share from the corporations that dominate the business. UnitedHealth has distinguished itself by more deftly and aggressively feeding sophisticated pricing and actuarial data to information-starved congressional staff members. With its rivals, the carrier has also achieved a secondary aim of constraining the new benefits that will become available to tens of millions of people who are currently uninsured. That will make the new customers more lucrative to the industry.

In Other News: The American College of Nurse Midwives has endorsed the House bill, HR 3200, saying the legislation will “improve the health status of women and their newborns.” Read the endorsement letter (pdf) to House Speaker Nancy Pelosi.

Plus: For a progressive analysis of HR 3200, which has been marked up by three House committees, check out this analysis by John Gilman and Ellen Shaffer.


August 3, 2009

Political Diagnosis: The Summer Recess Healthcare Legislation Wrap, Plus the Latest on Efforts to Derail Reform and Dismiss Abortion

Super Fun Health Graphic: Are you an employed single mother? Or maybe you own a small business? Either way, The New York Times explains how bills working their way through Congress might affect you:

nyt_healthcare_comparison

A Hot, Hot Summer: By a 31-28 vote, the House Committee on Energy and Commerce on Friday approved a health reform bill that would cover about 95 percent of Americans. It includes the so-called public option, a government insurance plan that would compete with private insurers. The bill allows the federal government to negotiate with drug companies for lower prices under Medicaid and limits how much insurers can increaes premiums. Subsidies would be provided to lower-income families to help cover the cost of insurance.

Two other committees — Ways & Means, and Education & Labor – approved legislation in mid-July. The full House will take up the bill, HR 3200, when it returns from August recess. Now everyone’s waiting on the Senate Finance Committee, chaired by Sen. Max Baucus (D-Mont.), to move its health reform bill out of committee — a move that isn’t likely to happen until after summer recess. Lawmakers and experts weigh in on what’s slowing everything down.

The Energy and Commerce committee vote was largely along party lines, with five Democrats joining all 23 Republicans opposed to the bill. In a story about how the White House might be ready to move forward without building broader bipartisan support, The New York Times notes that lobbying efforts are going to be “unusually heavy” this month. Indeed, House Republican leader, Rep. John Boehner of Ohio, has promised a “hot summer” for Democrats.

How much hotter than health reform = death can it get? Opposition to health reform already has become increasingly vocal, what with conservative talk radio fueling fear among senior citizens that healthcare reform will lead to end-of-life “rationing” and “euthanasia.” Ceci Connolly of the Washington Post writes:

Not since 2003, when Congress and President George W. Bush became involved in the case of Terri Schiavo, who lay in a vegetative state in a hospice in Florida, have lawmakers waded into the highly charged subject, said Howard Brody, director of an ethics institute at the University of Texas Medical Branch at Galveston.

The attacks on talk radio began when Betsy McCaughey, who helped defeat President Bill Clinton’s health-care overhaul 16 years ago, told former senator Fred D. Thompson (R-Tenn.) that mandatory counseling sessions with Medicare beneficiaries would “tell them how to end their life sooner” and would teach the elderly how to “decline nutrition . . . and cut your life short.”

House Minority Leader John A. Boehner (R-Ohio) and Republican Policy Committee Chairman Thaddeus McCotter (Mich.) said they object to the idea because it “may start us down a treacherous path toward government-encouraged euthanasia.”

Lawmaker, Protect Thyself: House Speaker Nancy Pelosi (D-Calif.), according to the NYT, “distributed cards outlining key points of the House’s health care approach” to all 256 Democrats heading to their home districts for August recess. She might want to send them home with their own personal armor.

Politico reports on growing incivility at town hall meetings led by Democratic representatives: “Screaming constituents, protesters dragged out by the cops, congressmen fearful for their safety — welcome to the new town-hall-style meeting, the once-staid forum that is rapidly turning into a house of horrors for members of Congress.”

Think Progress notes that “much of these protests are coordinated by public relations firms and lobbyists who have a stake in opposing President Obama’s reforms.”

The lobbyist-run groups Americans for Prosperity and FreedomWorks, which orchestrated the anti-Obama tea parties earlier this year, are now pursuing an aggressive strategy to create an image of mass public opposition to health care and clean energy reform. A leaked memo from Bob MacGuffie, a volunteer with the FreedomWorks website Tea Party Patriots, details how members should be infiltrating town halls and harassing Democratic members of Congress.

Visit Think Progress for the memo, which Lee Fang says “resembles the talking points being distributed by FreedomWorks for pushing an anti-health reform assault all summer.”

All this makes the 1994 version of Harry & Louise look like the nicest, most honest couple you’d ever meet (funny how life repeats itself, with a twist).

Center of Debate: Back to the legislation approved by the Energy & Commerce committee … By a vote of 30 to 28, the committee approved an amendment (pdf) that states abortion would not be included in the “essential benefits package” to be defined by the government.

Dan Gilgoff at U.S. News & World Report explains the details:

The amendment, proposed by Democratic Rep. Lois Capps, prohibits the federal government from compelling private providers participating in the federal healthcare exchange to cover abortion. But it also bars the government from prohibiting those plans from offering such coverage. And it requires that at least one of the private plans participating in the exchange cover abortion—and at least one of the plans to not. [...]

Democratic defenders of the Capps amendment say it applies the Hyde Amendment, which for more than three decades has prohibited Medicaid from funding abortions except in very limited circumstances, to the new government-controlled healthcare. Private healthcare providers are free to cover abortion, but not with federal funds. The public plan would cover abortion, but not with federal funds; a Capitol Hill aide tells me money for abortions would come from what participants pay into the public plan.

Abortion has been the political football since the debate over healthcare commenced this year.

“One of the very real dangers in the debate on how to fix American healthcare is that women’s health will become a bargaining chip, with the GOP and anti-abortion forces trying to frame healthcare reform as an endrun to government ‘interference’ in our lives by ‘mandating’ abortion and gasp, contraception,” writes Lucinda Marshall.

And over at RH Reality Check, Amanda Marcotte looks at how the media has been reinforcing unexamined arguments against public funding for abortion, and she explains the true story:

Here’s the unvarnished truth: There is no way that any kind of public health care plan will have elective abortion coverage. Nor is there any real chance of abortion becoming mandated coverage. It’s more likely that breast implants will be paid for by tax money. It’s more likely that a public insurance option will provide everyone wth an iPod Touch. Believe me; even most pro-choicers gave up a long time ago on hoping that we could overturn the Hyde Amendment that bans women who are on federally funded insurance programs from getting elective abortions covered, and there’s no way that this will change if the number of women on federally funded health insurance grows. And even though it would only be fair and cost-effective to mandate coverage for elective abortion, in this country that’s sadly a pipe dream.

Plus: For more on fact vs. fiction, read this AP story on distortions in the health care debate. Meanwhile, Princeton economics professor Uwe E. Reinhardt offers a glimpse of what a health reform bill would look like if it conformed with the American public’s idea of “common sense” in health care. And Bill Moyers on Friday re-aired a must-see interview with former insurance industry executive Wendell Potter. Watch it or read the transcript. You may come away mad, but you won’t be disappointed.

Want to Cut Costs? Over Here, Mr. President: Also at RH Reality Check, Jennifer Block, author of “Pushed: The Painful Truth About Childbirth and Modern Maternity Care,” writes about where healthcare cost savings can be found:

A new economic analysis forecasts savings of $9.1 billion per year if 10 percent of women planned to deliver out of hospital with midwives. (Right now, just one percent do). If America is serious about reform, midwifery advocates are saying, “Hey, how about us?”

Childbirth, in fact, costs the United States more in hospital charges than any other health condition — $86 billion in 2006, almost half paid for by taxpayers. This high price tag — twice as high as what most European countries spend — buys us one of the most medicalized maternity care systems in the industrialized world. Yet we have among the worst outcomes: high rates of preterm birth, infant mortality, and maternal mortality, with huge disparities by race.

Tell Me: What’s Wrong With Single-Payer Again?: David Brooks and Gail Collins try to figure it out. Collins starts with this set-up:

Since something like a third of the cost of health care is in administration, and the problem with reorganizing health care has to do with all the multitudinous plans and policies, a single-payer system would be far and away the most cost effective answer. We don’t talk much about it because it isn’t politically possible. But it isn’t politically possible because we don’t talk about it. The opponents of a public plan are afraid that people would all gradually migrate toward it, causing the insurance industry as we know it to wither away. Wouldn’t that be a good thing?

In Other News, Senate Committee Grasps Reality: It seems that funding for abstinence-only sex education is losing its luster. The Senate Appropriations Committee on Thursday approved its fiscal year 2010 spending bill (HR 3293) for health, education and labor programs, minus funding for the controversial program. The $730 billion bill, approved by a vote of 29-1, includes $104.5 million for a comprehensive “Teen Pregnancy Prevention” program and no funding for abstinence-only sex ed. Abstinence-only advocate Sen. Sam Brownback (R-Kan.) cast the only “no” vote.

“After more than a decade, Congress has finally begun to put teenagers’ health above politics and ideology,” Michael Macleod-Ball, acting Director of the ACLU Washington Legislative Office, said in a statement. “The Committee’s actions represent a looming victory for young people, parents and advocates of science-based approaches.”

The same statement notes that the measure must still go to the full Senate for a vote, “where misguided efforts to reinsert funding for abstinence-only programs are possible.”

Take Action
From the Big Push for Midwives, sign the “I pushed for out-of-hospital maternity care” petition in support of  including out-of-hospital maternity care and Certified Professional Midwives, who are specially trained to provide it, in federal healthcare reform legislation.


July 22, 2009

Political Diagnosis: More on Abortion and Health Care Reform and “Third Way” Pregnancy Prevention Legislation

With President Obama less than an hour away from addressing the nation to allay the concerns of skeptics and build public support for health care reform, we’ve been reading some troubling accounts of whether coverage for abortion services will be included in the proposed public insurance option, which is prefered by Obama and many who say it’s necessary for reform.

In a wide-ranging health care discussion Tuesday night with Katie Couric, Obama discussed abortion coverage:

Katie Couric: Do you favor a government option that would cover abortions?

President Obama: What I think is important, at this stage, is not trying to micromanage what benefits are covered. Because I think we’re still trying to get a framework. And my main focus is making sure that people have the options of high quality care at the lowest possible price.

As you know, I’m pro choice. But I think we also have a tradition of, in this town, historically, of not financing abortions as part of government funded health care. Rather than wade into that issue at this point, I think that it’s appropriate for us to figure out how to just deliver on the cost savings, and not get distracted by the abortion debate at this station.

Over at The American Prospect, Dana Goldstein writes in response that Obama is referencing the Hyde Amendment, which Obama said he opposed when he was a presidential candidate.

“[W]hile none of the health reform bills in Congress threaten Hyde, reproductive health advocates have been trying for decades to repeal the ban,” writes Goldstein. “By deferring to this ‘tradition,’ Obama seems to be signaling that he could support a public plan that excludes abortion coverage.”

Under the current Hyde provisions, federal funding under Medicaid is allowed under some circumstances: rape, incest and to save the life of the mother. (The National Abortion Federation has a good fact sheet on the history of Medicaid and the Hyde Amendment, and how states have responded with their own funding.)

The Washington Post, meanwhile, reports that centrist House Democrats have proposed a “compromise” over federal funding for abortions.

Saying they are “increasingly concerned about potential roadblocks around the issue of abortion” in Congress’ health-care debate, abortion opponent Rep. Tim Ryan (D-Ohio) and four other Democrats propose “a common-ground solution” that would neither require nor ban private insurers from covering the procedure as long as federal funds are not used, according to a letter obtained by The Washington Post.

The letter to House Speaker Nancy Pelosi (D-Calif.) was also signed by Reps. Dale Kildee (Mich.), James Langevin (R.I.), Artur Davis (Ala.) and Kendrick Meek (Fla.).

The lawmakers say that their proposal “maintains the current status quo in the private market” and would not “preempt constitutionally permissible state laws” governing notification requirements and other restrictions on obtaining an abortion.

“Now it is imperative that we reach some consensus on the issue of abortion in health care reform, so that we can move this critical legislation forward,” the lawmakers wrote.

And in a separate story published this afternoon, WaPo’s Dan Eggens and Rob Stein explain more about the conflict and how it may affect bipartisan legislation that’s expected to be introduced this week aimed at  encouraging pregnancy prevention along with improved government support for young mothers.

The measure from Ryan, who opposes abortion, and Rep. Rosa DeLauro (D-Conn.), who supports abortion rights, has attracted an unusual array of supporters ranging from Planned Parenthood to evangelical leaders such as the Rev. Joel Hunter of Orlando. [...]

The prevention bill being proposed by Ryan and DeLauro would establish a series of new and expanded initiatives focused on contraceptives and other prevention measures, including expansion of Medicaid coverage for family planning services. The bill, which was drafted by the centrist advocacy group Third Way, also includes a series of grants and policies aimed at helping young mothers, including expanded maternity care options and more financial assistance for adoptions.

Backers say the Ryan-DeLauro bill has been carefully scrubbed for months to remove policies that might alienate either side, such as financial support for the morning-after pill. Hunter, senior pastor of Orlando’s Northland megachurch, said the proposal “isn’t going to end the disagreement or the alarm that comes up on both sides. But I think it is the first of its kind to take such an incendiary culture-war issue and really make progress. It’s a start.”

“The Ryan approach represents the politics of the future on abortion,” said Rachel Laser, Third Way’s culture program director.

Update: Here’s a this-just-in action alert from National Women’s Health Network:

There are reports that compromise discussions are taking place right now in the House Energy and Commerce Committee that would single out abortion services for onerous restrictions. This could result not only in extending existing abortion restrictions, but also in taking abortion coverage away from women who currently have it. Now is a critical time to speak out and let Congress know that reproductive health care is basic health care for women and must be treated like any other type of health care.

We must tell House members that women want health care reform that includes the comprehensive care that we need throughout our lives. Tell them also that politicians shouldn’t be making the decisions about what’s included in a health benefits package. If your Representative is a member of the Energy and Commerce Committee, it’s especially important that you take action immediately! (Click here to see a list of Energy and Commerce Committee members, and here to find the name and contact information for your Representative.) Please cc nwhn@nwhn.org so that we know how many of you have taken action for quality, affordable health care that meets women’s health needs.

Plus: And for the latest in health care statistics … a new Gallup poll says 1 in 6 adults are now without health insurance: “The current percentage of uninsured Americans (16.0%) represents a small, but measurable increase over last year. Hispanic Americans, at a rate approaching triple the national average, are the most likely subset of the population to be uninsured. Those making less than $36,000 per year are the second-most-likely group to be uninsured, with 18- to 29-year-olds following closely behind.”


July 20, 2009

Political Diagnosis, Part II: Road to the Supreme Court is Paved with Public Humiliation; Surgeon General Nominee and Abortion; Asylum for Battered Women

Road to the Supreme Court: It may not have been great theater, but the confirmation hearing of Judge Sonia Sotomayor did offer fire(fighters) without brimstone; a lesson on the dangers of nunchucks; the theory of neutral man’s burden; and many, many words.

Through it all, Sotomayor displayed nothing but “intelligence, grace and patience.” Melissa Harris-Lacewell describes the public humiliation Sotomayor endured as an Elizabeth Eckford moment.

It appears that  Sotomayor will be confirmed — with at least some Republican support — as the third woman and the first Latina on the Supreme Court. But as Frank Rich notes, Republicans still have some ‘splainin’ to do:

Southern senators who relate every question to race, ethnicity and gender just assumed that their unreconstructed obsessions are America’s and that the country would find them riveting. Instead the country yawned. The Sotomayor questioners also assumed a Hispanic woman, simply for being a Hispanic woman, could be portrayed as The Other and patronized like a greenhorn unfamiliar with How We Do Things Around Here.  [...]

It’s the American way that we judge people as individuals, not as groups. And by that standard we can say unequivocally that this particular wise Latina, with the richness of her experiences, would far more often than not reach a better conclusion than the individual white males she faced in that Senate hearing room. Even those viewers who watched the Sotomayor show for only a few minutes could see that her America is our future and theirs is the rapidly receding past.

Plus: How many words, you ask? Politico crunched the numbers and determined that between the start of the confirmation hearing on Monday and the end of the senators’ primary questioning and comments on Thursday, senators out-talked Sotomayor by about a third.

“And Republicans – clearly more leery of the Democratic-nominated Sotomayor than those on the other side of the aisle — spent the most time with Sotomayor. The average Republican had 5,908 words to the Democrats 4,217,” writes Patrick Gavin.

Millions More Like Her: Regina Benjamin, the new surgeon general nominee, attended a Catholic elementary school and attends mass regulary. Her numerous honors include an award from Pope Benedict XVI and another inspired by Mother Teresa. But — and here’s the shocking part — Benjamin, a family physician who has spent her life providing health care to the rural poor, supports abortion rights.

Not so shocked? Neither is this Catholic school grad. But this Washington Post story plays it up, noting that Benjamin’s position on reproductive health services “potentially could put her at odds with the Catholic Church.”

The story goes on to note:

Those who know Benjamin said her beliefs will not interfere with her role as surgeon general, which would include acting as the country’s chief health educator. If confirmed, she would lead the 6,000-member uniformed Public Health Service Commissioned Corps, issue public health messages and advise the president and health and human services secretary.

“We all have our religions, but when you speak as the surgeon general to the American people, it’s not about your religion,” said David Satcher, a former surgeon general under President Bill Clinton. Satcher taught community health to Benjamin at the Morehouse School of Medicine in Atlanta. “I don’t see why the surgeon general has to get involved in a discussion about abortion.”

Asylum for Battered Women: The pathway is a narrow corridor with strict conditions, but the Obama administration, reversing a Bush administration stance, has “opened the way for foreign women who are victims of severe domestic beatings and sexual abuse to receive asylum in the United States,” reports The New York Times. Julia Preston writes:

In addition to meeting other strict conditions for asylum, abused women will need to show that they are treated by their abuser as subordinates and little better than property, according to an immigration court filing by the administration, and that domestic abuse is widely tolerated in their country. They must show that they could not find protection from institutions at home or by moving to another place within their own country.

The administration laid out its position in an immigration appeals court filing in the case of a woman from Mexico who requested asylum, saying she feared she would be murdered by her common-law husband there.

According to court documents filed in San Francisco, the man repeatedly raped her at gunpoint, held her captive, stole from her and at one point tried to burn her alive when he learned she was pregnant.


July 20, 2009

Political Diagnosis: Obama Goes on Offensive for Health Reform; Abortion Debate Heats Up; Desperate for “Friends with Benefits” …

No super fun healthcare graphic this week. Instead, we present a tongue-in-cheek video that gives new meaning to “friends with benefits.”

Full Court Press: “With skepticism about the president’s health-care reform effort mounting on Capitol Hill — even within his own party — the White House has launched a new phase of its strategy designed to dramatically increase public pressure on Congress: all Obama, all the time,” reports the Washington Post.

That includes a primetime news conference on Wednesday, internet video and direct appeals to supporters.

Moving Along, Alone: The Senate’s Health, Education, Labor and Pensions (HELP) Committee speeded up health reform last week with the passage of the Affordable Health Choices Act (pdf), which aims to make health insurance available to all Americans.

Though approved without any Republican votes, Democrats were quick to point out that the bill includes more than 160 Republican amendments; it’s therefore legit to call it “bipartisan.”

Ellen Shaffer, co-director of the Center for Policy Analysis, blogs about the Senate developments in “The Good, the Bad and the Murky.” On discussion of a single-payer amendment to the Senate bill:

Bernie Sanders’ state single payer amendment elicits shining and shameful moments: Strong statements of support from Senators Tom Harkin (“We have a dysfunctional system”), Jeff Merkley, and Sherrod Brown. Listen To Your Staff Demerit for Barbara Mikulski (“Can’t states enact single payer anyway?” [She is reminded that states need waivers for ERISA, and transfers of federal funds.] “Oh.” She still voted No.

On Friday, two House committees — Ways & Means, and Education & Labor – approved the reform legislation (HR 3200). The Education & Labor panel rejected two amendments offered by Rep. Mark Souder (R-Ind.) “that would have precluded plans participating in the health insurance exchange — including the proposed public insurance plan — from covering abortion services,” according to Daily Women’s Health Policy Report.

By a 25-19 vote, the Education & Labor committee did approve an amendment allowing states to create single-payer health care systems if they so choose. Calling it a victory for single-payer advocates, John Nichols of The Nation writes about the importance of regional initiatives.

Meanwhile, the House Energy and Commerce Committee continues its deliberation. All eyes are on “tenacious dealmaker” Rep. Henry A. Waxman (D-Calif.).

On the Senate side, everyone’s waiting for the Finance Committee to release details of its proposal. Considering the importance of Finance Chair Sen. Sen. Max Baucus (D-Mont.), the Sunlight Foundation thoughtfully decided to take a look at the circle of lobbyists surrounding both Baucus and other committee members.

Abortion Debate Heats Up: Appearing on Fox News on Sunday, Peter R. Orszag, the White House budget director, was asked whether he was prepared to say that “no taxpayer money will go to pay for abortions.” His response: “I am not prepared to say explicitly that right now. It’s obviously a controversial issue, and it’s one of the questions that is playing out in this debate.”

Here’s the full transcript. Dana Goldstein has more.

In a New York Times story on the role of abortion in the healthcare debate, Robert Pear and Adam Liptak write:

Abortion has been simmering behind the scenes as an issue in legislation to guarantee access to health insurance for all Americans. The debate affects not only the public health insurance plan that Democrats want to create, but also private insurers, who would receive tens of billions of dollars of federal subsidies to cover people with low and moderate incomes.

Under the House bill, for example, most insurers would have to provide an “essential benefits package” specified by the health and human services secretary, who would receive recommendations from a federal advisory committee. Opponents of abortion want Congress to prohibit inclusion of abortion in that benefits package, while advocates of abortion rights say the package should be left to medical professionals to determine.

Budget Bummer: The Congressional Budget Office concluded that the bills under consideration do not accomplish Obama’s goal of slowing long term the rate of growth in health care. Is it accurate/relevant? Experts weigh in. Other experts weigh in.

Orszag on Sunday called the House bill “deficit neutral.” One undisputed outcome: the CBO assessment won’t make negotiations easy this week.

Missing Kennedy: “As a divided Senate tangles over health care legislation, there is bipartisan consensus on one point: Ted Kennedy could make a big difference, if only he were here,” writes Mark Leibovich.

Kennedy is battling brain cancer, and his presence on Capitol Hill has been missed. In an essay published in Newsweek last week, Kennedy wrote that universal, affordable health care is the “cause of my life.”


July 13, 2009

Political Diagnosis: Global Gag Rule; Update on Conscience Clause; New Violence Against Women Advisor; The Last Word on Sarah Palin? …

Supreme Court Decisions and You: The National Women’s Law Center has released an analysis of 2008-2009 Supreme Court decisions that have a direct effect on women’s lives. Here’s the report (pdf); more discussion at the NWLC blog, Womenstake:

In Fitzgerald v. Barnstable School Committee, the Supreme Court safeguarded women’s and girls’ rights by allowing them to pursue remedies for gender discrimination in schools under both Title IX and the Constitution. In Crawford v. Metropolitan Government of Nashville and Davidson County, Tennessee, the Court ruled that employees are protected from being subject to retaliation for cooperating with an employer’s internal investigation of discrimination. “The Court’s decisions in these two cases kept hard-won protections in place,” [NWLC Co-President Marcia] Greenberger said.

But not all outcomes were positive:

“In AT&T Corp. v. Hulteen, the Supreme Court ignored the realities of the workplace and the intent of Congress and ruled against female workers,” Greenberger said. As Justice Ginsburg noted in a strong dissent in the case, the Court’s decision permitted AT&T to pay women lower pension benefits for the rest of their lives.

Gag on Global Gag Rule: Ever since President Ronald Reagan instituted the “global gag rule” in 1984, its existence has been dependent on which party is in the White House. If it’s a Democrat, it’s revoked; if it’s Republican, it’s reinstated. On Thursday, the Senate Appropriations Committee voted 17-10 to approve an amendment to a Department of State and foreign affairs appropriations bill that would make permanent President Obama’s reversal of the global gag rule. Emily Douglas has more.

The global gag rule, also known as the Mexico City policy (the site of the United Nations International Conference on Population where it was first announced), prohibits international family planning groups that receive U.S. aid from offering abortion services or providing information about safe abortion, even if they use other funding. It would be great to see it gone, for good.

New NIH Director: President Obama has nominated Francis Collins, best known for leading the public effort to sequence the human genome, to be director of the National Institutes of Health. Chris Wilson at Slate looks at how Collins, an evangelical Christian, has combined his faith in God with his faith in science.

New Violence Against Women Advisor: “Vice President Joe Biden’s June 26 announcement of a White House Advisor on Violence Against Women stirred some public grumbling about President Barack Obama’s recent ‘czar frenzy,’” writes Kayla Hutzler at Women’s eNews.

“But at a time of rising pressure on domestic violence shelters, representatives of two of the largest advocacy groups for ending domestic violence were far more enthusiastic about the creation of the post. They were also excited at the naming of Lynn Rosenthal, a former executive director at the New Mexico Coalition against Domestic Violence in Albuquerque, with a substantial resume of safety advocacy and working ties to Biden.”

Here’s the White House announcement, and a New York Times editorial in favor of the appointment.

The Last Word on Sarah Palin (Fingers Crossed): Go read “Palin’s Long March to a Short-Notice Resignation,” then head over to Slate for Dahlia Lithwick’s parting shot: “[Wh]en the dust settles, the lesson may be that she was simply a woman who made no sense.”

Looking Ahead to 2012: Jill Miller Zimon wonders, “Could we see a female-female GOP ticket for president and vice president in 2012?”

Update on Conscience Clause: Kay Steiger has written a good round-up of efforts at the state level to pass legislation that allows medical professionals to refuse to provide services that violate their religious or moral beliefs.

Speaking of conscience clauses, anyone remember the federal rule instituted in the final days of the Bush administration? It cut off federal funding for state and local governments, hospitals, health plans and clinics that did not fully accommodate doctors, nurses, pharmacists or other employees who refuse to provide care they feel violates their beliefs. Aimed at abortion and family planning services, it went beyond laws that already provide for healthcare workers and threatened access to many health services, including infertility treatment, end-of-life care, blood transfusions and mental health counseling.

President Obama moved to rescind the rule, as expected, but the process has been very slow. The 3o-day public comment period on rule changes ended in April; Health and Human Services Department is still reviewing the hundreds of thousands of comments received.

Administration officials acknowledged early on that they were looking for a compromise, but we haven’t heard much more on the subject until President Obama told a group of religion reporters earlier this month that the new policy would “certainly not be weaker” than what existed before President Bush’s expansion:

We will be coming out with I think more specific guidelines.  But I can assure all of your readers that when this review is complete there will be a robust conscience clause in place.  It may not meet the criteria of every possible critic of our approach, but it certainly will not be weaker than what existed before the changes were made.

David Brody has the full transcript of Obama’s remarks.


July 13, 2009

Political Diagnosis, Part II: Reduce Healthcare Costs, Support Midwives; Healthcare Reform Should Leave Out Moral Values; Funding Long-Term Care …

A continuation of the latest in health reform politics and discussions

Speaking of reducing bureaucratic interference, Lois Uttley of Merger Watch wrote the definitive get-your-act-together letter to Congress warning against drafting healthcare legislation that shortchanges women.

Referring to numerous Senate amendments, such as no funding for abortion, that “would deny health care to women, gays and lesbians, people with HIV and anybody else conservatives don’t like,” Uttley offers the following advice:

Apparently, you conservative Republicans have forgotten the advice GOP consultant Frank Luntz gave you just two months ago about how to talk about health reform: “What Americans are looking for in health reform is more access to treatments and more doctors … with less interference from insurance companies and Washington politicians and special interests.” That means we don’t want any more interference in our health care from you, or any of the right-wing groups urging you to use health reform to restore the rejected Bush “moral values” agenda.

There’s enough blame to go around. Indeed, Uttley lashes out with a masterful bipartisan critique:

Now, let’s turn to you Democrats who are supposedly running Congress. You are spending far too much time trying to win over colleagues who are never going to vote for health reform, no matter if you offer them abortion exclusions or new provider “conscience” laws or other provisions that would hobble health reform. You need to get over your worries that if you support inclusion of a strong public plan in health reform, somebody is going to call you a socialist.

Don’t forget that women are among the strongest supporters of moving quickly on health reform this year. Why? Women are grassroots experts on what is broken in the current health system.

Insurance plans try to squirm out of covering us when we are having babies by declaring our pregnancies to be “pre-existing conditions.” In a lot of states, insurance companies charge us more than men for health coverage, largely because of the costs of having children. They call this “gender rating.” We call it discrimination.

Read on for more about what makes us (frustrated) experts.

The Near Future of Long-Term Care: Here’s an aspect of health reform that hasn’t received much news. From NPR:

As the Senate Health, Education, Labor and Pensions (HELP) Committee marked up the long-term care part of a health care change bill Tuesday, Health and Humans Services Secretary Kathleen Sebelius sent a letter to committee Chairman Ted Kennedy with an endorsement. She signaled the Obama administration’s support for something called the Community Living Assistance Services and Supports Act (CLASS Act).

That legislation, which is part of the committee’s health bill, would let workers choose to have government deduct money from their paychecks — maybe $65 to $100 a month — and put it in a savings account. When they get old or disabled and need care, they could then use that money.

There’s opposition from Republicans, but they’re not the only ones voicing concerns:

Bob Kafka, of the disability civil rights group ADAPT, said not enough is done for poor people who can’t afford to have the money deducted from their weekly paychecks — or who, because of their illness or disability, may not be able to work at all. “Secretary Sebelius’ letter adds insult to injury,” said Kafka. “This administration has totally said to low income people with disabilities, ‘You do not count.’ ”

Kafka’s group endorsed the CLASS Act but wants it paired with passage of another bill called the Community Choice Act. That would allow people who get long-term care services through Medicaid to use that money for help to stay at home. Now, the only thing they are guaranteed is that Medicaid will pay for them to live in a nursing home — and home services are limited, require being on yearlong waiting lists, or are unavailable.

Want to Reduce Healthcare Costs? Support Midwives: Writing at The American Prospect, Miriam Perez reports on advocacy efforts to get all states to recognize and license certified professional midwives. Unlike certified nurse midwives, who are allowed to practice in all 50 states and generally work in hospital settings alongside obstetricians, CPMs practice outside of hospitals, mostly in homes or birth centers. How is this related to health care reform? Perez explains:

Childbirth is among the top five causes for hospitalization, and the No. 1 cause for women. According to Childbirth Connection, Cesarean section is the most common operating-room procedure, and in 2009 the C-section rate hit an all-time high according to the Centers for Disease Control and Prevention, at 31.8 percent of all births. These rates account, in part, for the increasing cost of maternity care in the U.S. Maternal and newborn charges totaled $86 billion in 2006, 45 percent of which was paid for by Medicaid. The federal government is already footing a huge portion of the U.S.’ maternity-care bill, and these midwives think they can help reduce costs significantly, and not just for low-income women. [...]

David Anderson, economics professor at Centre College in Kentucky, has run the numbers and says that midwifery care could save us billions of dollars annually, without affecting quality of care (maybe even improving it). Anderson posits that if we increase the percentage of women giving birth out of hospital by 10 percent (currently at only 1 percent nationally) we could save close to $9 billion per year. He points to the difference in baseline costs for out-of-hospital birth — a difference of more than $6,000 when comparing the average cost of a home birth to an in-hospital one. Another main cost reducer, according to Anderson, is the significantly lower rate of C-sections for out-of-hospital births.

It’s not just the costs that are lower, according to these advocates. The outcomes are better too, which in turn, further lowers cost by reducing additional care needed by sick babies and mothers. Anderson adds that if CPMs are allowed to practice in all 50 states, competition will drive down prices for maternity care, since more women will have access to a low-cost alternative to hospital births.

Visit The Big Push for Midwives for more information.

How To Fund Health Care Reform: House Democrats are expected to add details today to a proposed healthcare bill. The bill will include a tax increase on wealthy couples.  House Ways and Means Committee Chairman Charles Rangel (D-N.Y.) predicted the plan could generate as much as $540 billion over 10 years. From the Chicago Tribune:

Married taxpayers earning more than $350,000 a year in adjusted gross income and single filers making more than $280,000 a year would pay a surtax of at least 1%. Rates would rise on higher incomes, with families earning more than $1 million paying about 3%.

The tax plan faces an uncertain fate in the House and the Senate, where Democrats and Republicans are working on their own proposals to offset the costs of helping tens of millions of people get health insurance. Senate leaders have shown much less interest in a new income tax. President Obama, meanwhile, has proposed raising more than $300 billion over 10 years by limiting the deductions that wealthy Americans take on their income taxes.

News Analysis: Another site to add to your healthcare reform reading list — The New England Journal of Medicine has a useful section featuring the latest news and articles on costs and coverage.


July 13, 2009

Political Diagnosis: Legislation by August Looks Like a Longshot; The Democrat/Republican (and Democrat/Democrat) Divide; Public Insurance Plan is Not Single Payer, Repeat …

This Week’s Super Fun Health Reform Graphic: This Washington Post graphic looks at the potential upsides and downsides of the various proposals under consideration and attempts to answer bottom-line questions, such as:  Will you get the care you need? Can you avoid financial ruin?

washington_post_healthcare

Got Time?: It’s unlikely Congress will agree on healthcare legislation before the August recess, Democrats and Republicans said on Sunday morning talk shows — especially as attention turns this week to the confirmation hearing for Judge Sonia Sotomayor (more on that later).

CNN’s “Situation Room” Sunday morning was an exercise in political politeness. Health and Human Services Secretary Kathleen Sebelius spoke optimistically about a bipartisan approach and coming to some agreement on how reform will be funded: “I think everything is on the table and discussions are underway.”

But when it came time to hear from senators Debbie Stabenow (D-Mich.); Judd Gregg (R-N.H.); Lamar Alexander (R-Tenn.); and Kent Conrad, D-N.D.), it was clear that Democrats and Republicans are dining at different tables, and some Democrats are sitting at opposite ends. (Scroll down for debate).

Stabenow said taxing employee’s health benefits is “off the table”; Alexander says it’s on. Stabenow wants a public option; Conrad is backing his own “compromise” plan of membership-controlled co-ops that theoretically would provide competition for insurance companies.

Conrad cited three examples of successful co-ops: The Associated Press, Ace Hardware and Land O’Lakes. Hmmm.

*Side note: For a smart assessment of why co-ops won’t work — but what they do add to the debate — read “The Trouble with Conrad’s Compromise” by Jacob Hacker, the co-director of the Center for Health, Economic and Family Security at U.C. Berkeley and a fellow at the New America Foundation.

Back to the question of the public insurance option, which Republicans are generally against — Gregg called it a “slippery slope” to a single-payer system (despite less-than-zero encouragement from the administration for single-payer) and warned of  ”putting a bureaucrat between you and your doctor.”

Stabenow did advocates of the public option proud with her response:

Well, my first choice and very strong choice is a public option. And I have to say, Wolf, that what my friends are saying, Senator Gregg and Senator Alexander really are scare tactics that have been put forward by folks that don’t want to change the system because they make a lot of money off the current system right now.

The reality for families today is if there’s an insurance company bureaucrat between you and your doctor telling your doctor what they’re allowed to do because of what they’ll pay for, telling you what they’ll pay for, putting you through all kinds of bureaucracy to try to figure out if you can get care, assuming you’re not dropped if you get sick or can’t get insurance if you have a pre-existing condition.

So what we’re talking about is putting somebody on your side, being able to make sure that the insurance company, the for profit insurance company won’t provide you with a low cost insurance policy for your family that you have another choice.

For more on the Democratic split, The Washington Post reports on the rebellion by the fiscally conservative Blue Dog Democrats and the meeting on Friday between the coalition and House leaders. The Blue Dogs said the public insurance plan would ”seriously weaken the financial stability of our local hospitals and doctors.”

And for more on the public insurance option, check out this paper published at the Urban Institute. John Holahan and Linda J. Blumberg describe how the public plan might be structured, how many people might be expected to enroll, and how much money the public plan might save.

Jonathan Cohn at The New Republic writes that “preliminary estimates from the Congressional Budget Office suggest that a strong public option — the kind that the House of Representatives is putting in its reform bill — should net somewhere in the neighborhood of $150 billion in savings over ten years.”

“The sources cautioned that these were only the preliminary estimates, based on previous discussions — that CBO had not yet issued final scoring on language in the actual bill,” adds Cohn. “But the sources felt the final estimate would likely be close.”

Ezra Klein adds an important caveat — “the final score will go up or down depending on the interactions between the public option and other elements of the final bill.”

He concludes:

Conservatives saying that a policy that will save $15 billion a year will end American health care — or, as Rep. Paul Broun would have it, “kill people” — have jumped off the deep end. Liberals who have invested all their hopes in the public plan might also be a bit disappointed. The CBO score seems to imply the likeliest of all possible outcomes: The addition of a public insurance option is a good, but modest, change to the health-care system.

Questions for Howard Dean: In a Q&A in The New York Times Magazine, former Vermont governor and presidential candidate Howard Dean sums up his role on healthcare: “My role is to try to get the Democratic Party to do the right thing. I believe that if we don’t pass the health care plan with the public option, it won’t be health care reform, and we’ll lose a tremendous number of seats in 2010.”

AlterNet did a more substantive interview with Dean about the politics involved in achieving real reform, per Dean’s new book, “Howard Dean’s Prescription for Real Health Care Reform,” and the folly of passing a bipartisan bill that doesn’t change a thing.

Here’s Dean response to the question: “What do you think about the argument that if we in the progressive movement had started basically pushing [Michigan Rep. John] Conyers’ HR 676 [single-payer bill], we might not have a better chance of meeting in the middle with a hybrid plan such as the one that you’ve laid out.”

HD: Well, I think that was a mistake made by the administration. I do not think we should have “taken single-payer off the table.” I don’t believe that the votes are there for single-payer, and I don’t believe that the politics are right for single-payer, but single-payer has some good things to recommend it, and we should be discussing what those good things are. And the most important part of single-payer is its cost effectiveness. It is just incredibly cost effective relative to any other system.

And so, you know, I don’t know about the positioning, because in some ways you’re right — because we started with the public option. The public option — and people don’t understand this in Congress — the public option is the compromise. [...]

If you give up the public option, then this is not worth doing. You can do some insurance reform, but you shouldn’t put any money into it. Just force the insurance companies to behave differently by the law, but don’t put a trillion dollars into the system we already have. It’s already too expensive.


July 1, 2009

Political Diagnosis: Roadblocks and Lines (Not) Drawn in the Sand – the Week in Health Reform

This Week’s Super Fun Health Reform Graphic: The Kaiser Family Foundation’s side-by-side comparison of healthcare reform proposals now includes details about the House Tri-Committee proposal (discussed here last week). Check it –

kaiser_side_by_side_proposal

We also direct your attention to the Center for Policy Analysis, a resource for information on progressive health reform. The real treasure is its EQUAL Health listserv (Equitable, Quality, Universal, Affordable Health). Sign up and take part in conversations about women’s health, national health reform and how to advocate for policies that would benefit us all.

The Center also provides guidance on reaching out to members of Congress: This chart shows which caucus committee members belong to — which is a good indication of which plan they’re supporting. Use it to contact your representative, because times are tough …

Perilous Roadblocks: “Four divisive issues could dash President Barack Obama’s hopes of overhauling health care: cost, creating a government-run plan, taxing workers’ benefits and penalizing employers that don’t offer coverage,” writes the AP’s Ricardo Alonso-Zaldivar. “Even if lawmakers come back from their July Fourth recess charged up to tackle health care, these issues are going to keep simmering for months. A big blowup over any single one could threaten the entire legislation.”

We Got Nothing: Republicans are doing their part to wage fear over a government-supported health insurance program (the public option), while also acknowledging that none of the existing Democratic plans will gather bipartisan support.

“Asked how many Senate Republicans could sign on to developing Democratic plans, Senator Richard M. Burr of North Carolina, author of a Republican alternative, said: ‘I think right now, none. Zero,’” reports The New York Times, which later on notes, “Republicans, however, have yet to put forward their own concrete plans that would broadly expand health coverage while also holding down costs.”

Over at Talking Points Memo, Zachary Roth points out that arguments against the public option on the grounds that it will destroy free-market competition miss the mark:

Sen. Richard Shelby (R-AL), speaking earlier this month on Fox News, called President Obama’s plan the “first step in destroying the best health care system the world has ever known.” A public option, Shelby added, would “destroy the marketplace for health care.”

But the notion that most American consumers enjoy anything like a competitive marketplace for health care is flatly false. And a study issued last month by a pro-reform group makes that strikingly clear.

The report, released by Health Care for America Now (HCAN), uses data compiled by the American Medical Association to show that 94 percent of the country’s insurance markets are defined as “highly concentrated,” according to Justice Department guidelines. Predictably, that’s led to skyrocketing costs for patients, and monster profits for the big health insurers.

The full HCAN report and executive summary are available here.

Marking Progress (or Lack Thereof): Obama adviser David Axelrod isn’t ruling out the possibility of a tax on health insurance benefits:

Speaking on ABC’s “This Week,” David Axelrod declined to repeat Obama’s “firm pledge” during the campaign that families making under $250,000 would not see “any form of tax increase, not your income tax, not your payroll tax, not your capital gains taxes, not any of your taxes.”

Instead, Axelrod said the president has no interest in “drawing lines in the sand” on the issue of how to pay for the costly health reform plan making its way through Congress.

Nor is he holding all that tight to the public option. Again with the sand, this time on NBC’s “Meet the Press”:

Axelrod said he is “confident that we’re going to get a health care reform bill”: “I think a public choice will be part of it. I think the public wants to have that option, and wants to see that kind of competition, and I think we will have that.”

Moderator David Gregory followed up: “When it comes to a public plan, though, no ultimatums from the president?”

“Well, the president believes strongly in a public choice, and he has made that very, very clear,” Axelrod replied. “He has made that clear privately. He has made that clear publicly, and we’re going to continue to do so. … Look, we have gotten a long way down the road by not drawing bright lines in the sand — other than on the major points, which is that we can’t add to the deficit with this health care reform, so it has to be paid for, it has to reduce costs, and we want to make sure that all Americans have quality, affordable health care.

Single-Payer Advocates Not Only Ones Feeling Left Out: Emily Pierce at Roll Call writes:

Sens. Ron Wyden (D-Ore.) and Bob Bennett (R-Utah) have 11 other co-sponsors already — six Democrats, one Independent and four Republicans — on their bill, which is aimed at creating more competition in the insurance market and lowering costs by eliminating employer-provided health care coverage. Instead, consumers would get pay raises equal to their current health benefits and buy insurance on the open market.

Bennett said he believes the bill has lacked traction with Senate leaders because neither he nor Wyden is in a position to place it at the center of the debate.

“Hell has no fury like a committee chairman whose jurisdiction has been challenged. And neither Sen. Wyden nor I is a committee chairman,” Bennett said. “I think that’s part of it.”

Insured but Unprotected: Just a reminder of how poorly our current system protects those with insurance: The New York Times reports that “an estimated three-quarters of people who are pushed into personal bankruptcy by medical problems actually had insurance when they got sick or were injured,” and patient advocates are calling for federal rules “to correct the current state-by-state regulatory patchwork that allows some insurance companies to sell relatively worthless policies.”

“Underinsurance is the great hidden risk of the American health care system,” said Elizabeth Warren, a Harvard law professor who has analyzed medical bankruptcies. “People do not realize they are one diagnosis away from financial collapse.”

Plus: Elizabeth Warren earlier this year appeared on PBS’s NOW with Maria Hinojosa. Read or listen to the interview.

Health Reform That Benefits Women: From Women’s eNews: As Congress debates at least 10 health care proposals, prominent women’s advocates say work and wage issues make the single-payer model the best deal for women — but it’s not picking up much legislative support . Molly M. Ginty talked to a number of women’s health advocates, including our own Judy Norsigian. OBOS has formally endorsed the single-payer model. Amnesty International also urged action on single-payer this week.

Though single-payer legislation is not being considered in the Senate, the House is weighing it in the form of the U.S. National Health Care Act (HR 676), which was introduced January 26 by Michigan Rep. John Conyers, Jr.

Prominent advocates for women’s health say the lagging single-payer model would serve women best. The National Women’s Health Network, for instance, has endorsed this model since 1978.

“Most of the leading health care proposals on the table would tie insurance coverage to employment in a way that is problematic for women,” said Judy Norsigian, executive director of the Boston-based Our Bodies, Ourselves.

The story notes that California Rep. Barbara Lee plans to reintroduce another single-payer plan — the U.S. Universal Health Service Act (HR 3000). It was in fact reintroduced last week.

Single-Payer Testimony: Single-payer advocates Quentin Young and Steffie Woolhandler, both with Physicians for a National Health Program, last week testified before the House Ways and Means and the Energy and Commerce committees, respectively.

Dr. Young’s testimony reads in part:

I wish to make two points to the Members of this Committee. The first is that the best health policy science, literature, and experience indicate that the Tri-Committee proposal will fail miserably in its purported goal of providing comprehensive, sustainable health coverage to all Americans. And it will fail whether or not it includes a so-called “public option” health plan.

The second point I wish to make is that single-payer national health insurance is not just the only path to universal coverage, it is the most politically feasible path to health care for all, because it pays for itself, requiring no new sources of revenue.

Wendell Potter, a former health insurance executive who had a change of heart, also testified. Potter is now senior fellow on health care for the Center for Media and Democracy in Madison.

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National Women’s Law Center
: Join NWLC on July 6 for a national health care reform call-in day, and tell your members of Congress that health care reform can’t wait. More info.

Are you on Twitter? NWLC is running a Twitter stream on healthcare reform. Finish the sentence, “Women need health care reform this year because … ” and add the hashtag #healthcare09 to your tweet.

Stay tuned for Political Diagnosis II, the rest of the week in Washington …


June 22, 2009

Political Diagnosis: The Latest on Health Reform Legislation in the House and Senate; Awaiting News From the White House Council on Women & Girls; The FDA’s Full Plate …

This Week’s Super Fun Health Reform Graphic: The award goes to The New York Times for the multi-tab Key Challenges in the Healthcare Debate. Below is the view from the section on “Getting Through Congress.”

 

nyt_healthcare_challenges


Cuts to Medicare Drug Costs
: The AARP has endorsed an offer by drug manufacturers to discount the price of some Medicare prescriptions by $80 billion over the next decade. The announcement was made today at the White House; a transcript of President Obama’s remarks is available here.

“The unusual offer by the Pharmaceutical Research and Manufacturers of America (PhRMA) is part of its effort to convince skeptical lawmakers that it backs major health-care legislation,” writes Ceci Connolly of the Washington Post. “Though the agreement represents a fraction of the total cost of health-care reform, it has been managed for maximum public relations exposure.”

Connolly explains how the deal would work:

When the Medicare prescription drug benefit approved by Congress went into effect in 2006, it left a coverage gap that charges seniors the full cost of medications once a patient has received $2,700 worth of drugs, until the total reaches about $6,100. At that point, “catastrophic” coverage kicks in and covers nearly all drug expenses.

“The existence of this gap in coverage has been a continuing injustice that has placed a great burden on many seniors,” Obama said over the weekend.

Under the proposal, seniors who fall into the coverage gap known as the “doughnut hole,” would pay half price for all brand-name medicines. The discounts could save 3.5 million retirees up to $1,700 a year, according to AARP. In addition, the full price of the drug would count toward a person’s out-of-pocket total, thus maximizing the insurance benefit.

Connolly also wrote a good Sunday Outlook piece on Obama’s strategic approach to health reform, and this morning she participated in an online discussion about the article.

Study Time: It’s a busy week for Congress, as three House committees — Ways and Means, Energy and Commerce and Education and Labor — take up health-reform legislation. Here’s the draft bill released Friday by House Democrats.

Kaiser Health News’ Mary Agnes Carey discusses the highlights of the bill, which includes an individual mandate for coverage, with some exclusions, and an employer mandate – called “pay or play.” As for how it will be paid for:

They stressed that everything is on the table. They have some ideas. They want major Medicare and Medicaid system reform such as ‘accountable care’ organizations that really try to coordinate medical care to make sure it’s the best possible care for the patient and reducing hospital re-admissions.

But of course, they’re always talking about taxes as well. And these are some of the ideas that will be discussed in the coming weeks: a tax on the benefits that an employer provides, a payroll tax, a tax on sugary drinks, taxes on alcohol, value added taxes (also called VAT) on some goods and services.

Igor Volsky at The Wonk Room notes that the Tri-Committee proposal “seems to contain a fairly robust public insurance option.” The Times published a poll Sunday showing overwhelming support for a government-funded public option that would compete with private insurance plans.

“On the whole,” adds Volsky, “the bill’s affordability measures are impressive.” His post includes a comparison of the HELP bill, the Senate Finance Committee draft and the Tri-Committee bill.

Raising Women’s Voices notes that the new House bill includes a statement on meeting women’s health care needs. Two points in particular stand out:

  • Include coverage of maternity services as a benefit category in the new basic benefit package. All plans in the Exchange would be required to maternity services and over time plans outside the Exchange would be required to do so as well.
  • Prohibit plans in the Exchange from charging women more than men by banning gender rating. This protection will extend to all health plans outside the Exchange over time as well.

Pus: The Senate debate kicked off Wednesday, and it was a rocky start. Jeffrey Young at The Hill has more.

Here are six senators to watch for their involvement in crafting a bipartisan health-care bill, via The Fix. Three former Senate majority leaders — Democrat Tom Daschle, and Republicans Bob Dole and Howard Baker — have reemerged with their own plan. They must be missing the excitement.

Dan Balz writes that Obama is soon going to have to “make clear what he’ll accept and what he won’t” when it comes to “cost and coverage, revenue and savings, a public option or not, and the cost vs. the desirability of bipartisan agreement.”

Cost and coverage suddenly became a more central issue after the Congressional Budget Office issued new estimates last week. The goal of reform advocates long has been a plan that moves the country to universal coverage. Earlier assumptions put the price tag in the neighborhood of $1 trillion over 10 years. The CBO shattered those assumptions, though their numbers were based on incomplete plans.

A preliminary estimate of the Senate Finance Committee’s draft bill put the price tag of universal coverage at $1.6 trillion over 10 years. That was considerably more than anyone anticipated and forced the committee to delay work on the bill. The cost of the incomplete plan drafted by the Senate Health, Education, Labor and Pensions Committee was pegged at about $1 trillion over 10 years, but the CBO said that would still leave 30 million (rather than the current 46 million) people without coverage.

Talking Points: Media Matters notes that during a Sunday morning interview with members of the Obama administration’s health care team, Good Morning America’s Diane Sawyer didn’t include any questions that reflected the concerns or positions of progressives.

Meanwhile, single-payer advocates continue to make news. The Boston Globe has a Q&A with Dr. Steffie Woolhandler, a Cambridge Health Alliance internist and Harvard Medical School professor who co-founded Physicians for a National Health Program. And MinnPost.com interviews PNHP’s president, Dr. Oliver Fein, who notes how popular single payer has become, despite its unpopularity:

What I think is really interesting is that although Sen. [Max] Baucus says that single payer is off the table, at the minimum, we’re the elephant under the table. Everybody is referring to us.

So, you have someone like [Health and Human Services Secretary Kathleen] Sebelius now saying we’ll create a public option that will not go to single payer. You have Republicans saying that the thing they fear is single payer; you have a whole variety of discussion that’s going on that keeps referring to this thing called single payer. Probably one of the real problems is there’s not enough of a definition for the public to make an assessment about what that really is.

Plus: Here’s Sebelius’s no-single-payer interview with NPR.

In other political news …

So About That All-Important Sounding Council …: Linda Lowen, About.com Guide to Women’s Issues, is waiting to hear what the White House Council on Women and Girls is doing. And she doesn’t like waiting. Via Feminist Peace Network (she doesn’t like waiting, either).

Did You Hear the One About the Republican Senator Who Wouldn’t Condemn Clinic Violence?: Sadly, it’s true. Jodi Jacobson reports at RH Reality Check that an anonymous Republican senator used his (it’s presumed, with good reason, that the Republican in question is male) power “to put a ‘hold’ on a Senate Resolution originally introduced by U.S. Senators Jeanne Shaheen (D-NH), Barbara Boxer (D-CA), and Amy Klobuchar (D-MN) condemning violence against women’s health providers, thereby blocking any vote on the resolution.”

Bush Bioethics Panel No More: The New York Times reports: “Members of the President’s Council on Bioethics were told by the White House last week that their services were no longer needed and were asked to cancel a planned meeting, a council staff member said Wednesday.”

Reid Cherlin, a White House press officer, told the NYT the panel was designed to a “a philosophically leaning advisory group” that was more about discussion than consensus-building.  that favored discussion over developing a shared consensus. Obama will appoint a new panel charged with offering “practical policy options,” said Cherlin.

The FDA’s Full Plate: FDA Commissioner Margaret Hamburg told USA TOday there’s no truth to the rumors that the FDA will split in two, with one half overseeing food safety and tobacco and the other responsible for oversight of medical products.

Drug safety, tobacco regulation and direct-to-consumer advertising top Hamburg’s agenda. On the subject of advertising, Hamburg said, “There certainly have been concerns about the quality and authenticity of some of the messages … We have a dedicated staff working on the issue.”


June 15, 2009

Political Diagnosis: Single Payer Advocates Get Hearing; Obama to Speak Before AMA; Congressional TriCaucus Takes on Health Disparities; Healthy Families Act …

Confused About Health Care Reform? Start Here: Check out the Kaiser Family Foundation resources explaining the basics of health care reform. It’s worth pointing to each week, especially since it’s continually updated.

Arguments for Single Payer Make the Record: Single-payer advocates finally got a hearing last week before the House Education and Labor Committee’s subcommittee on health, employment, labor and pensions. C-SPAN has the video.  Dana Milbank brings the snark.

american_medical_associationObama Meets the AMA: President Obama today will address delegates at the American Medical Association meeting in Chicago. It’s the first time since 1983 that a president addressed an AMA delegates meeting, and it’s bound to get interesting.

The AMA came out against a government-sponsored insurace plan designed to compete against private insurance companies (also known as the “public option”); the group later softened its opposition. AMA President Dr. Nancy Nielsen on Saturday said that AMA’s priorities are increased payments from Medicare and medical liability reform.

Obama suports the public insurance plan. And this weekend he outlined “$313 billion in proposed cuts over the next decade to the Medicare insurance program for the elderly and Medicaid for the poor to help cover the cost of expanding insurance coverage.”

But he is open to reining in medical suits.

AMA is the largest physician lobby, representing 180 medical societies, but it has lost clout over the years. Medical school students account for its largest member groups, and less than 20 percent of all practicing physicians are members of the AMA. Over at ThinkProgress, Lee Fang explains a bit about the AMA’s ties to the health industry:

Started in the mid 19th century as an accrediting organization, the AMA has morphed into a behemoth lobbying and member services entity that is deeply entwined with the for-profit health industry.

In the past century, the growth of AMA has been not only funded by health industry lobbies such as drug makers, but this relationship has tailored AMA’s anti-reform policy agenda. In reading the Huffington Post and the New America Foundation articles revealing AMA’s opposition to health reform during the New Deal, its efforts to block the passage of Medicare, and the AMA’s critical role in defeating health reform in 1993, questions arise over why the AMA has historically opposed any initiative to take health care out of the hands of the for-profit health industry.

Read on.

Senate Members Look for More Options: “As President Obama traveled to the heartland to sell a government-run insurance plan as essential to health-care reform, Senate negotiators began to explore a possible bipartisan compromise modeled after rural cooperatives,” reports the Washington Post.

That model was presented by Senate Budget Committee Chair Kent Conrad, a Democrat from North Dakota who has introduced, as a “potential compromise” on the public plan, a system of federally-chartered co-ops that could offer a non-profit alternative to for-profit insurance companies. Ezra Klein has a Q&A with Conrad.

rep_barbara_leeMinority Groups Joins Forces on Health Care: Members of the Congressional TriCaucus — comprised of the Congressional Black Caucus, the Congressional Hispanic Caucus and the Congressional Asian Pacific American Caucus — last week introduced The Health Equity and Accountability Act of 2009. The groups are working together to ensure that the health needs of minorities are taken into account in any health reform plan and that the elimination of racial and ethnic disparities becomes a priority.

“Today over 47 million people lack health insurance in America and although racial and ethnic minorities account for about one third of U.S. population, they account for more than half of the uninsured,” Congressional Black Caucus Chair Barbara Lee (CA-09) said in a statement.

These are the reform elements the TriCaucus has identified as priorities:
·    A public health insurance option that is universal and includes mental and dental health services.
·    Elevating the National Center on Minority Health and Health Disparities at the National Institutes of Health and strengthening the Office of Minority Health within the Department of Health and Human Services.
·    Addressing cultural and linguistic concerns such as credentialing for medical translators and ensuring adequate reimbursement for language and translation services.
·    Healthcare provisions regarding clinical trials must also — whenever possible — include racial and ethnic diversity to find out effects on a broad range of groups.

“Access to culturally competent quality health care should be one of the most basic of all entitlements,” said Rep. Danny K. Davis (IL-07), who serves as co-chair of the CBC Health and Wellness Taskforce. “Expansion of community, migrant, family and rural health centers will help make this concept a reality.”

Plus: “Public health officials have long recognized — and tried to eliminate — the sharp disparities in health among racial and ethnic minorities. But there is another group as well that ranks well below average on many measures of health: people with disabilities,” reads this Boston Globe editorial in favor of state legislation that addresses health disparities faced by people with disabilities, as well as other minorities.

Solutions for Healthcare Reform: The Chicago Tribune recently published a package of stories featuring reform suggestions from industry leaders, including pharmacists, insurers and doctors in smaller practices.

Plus: It appears a solution for the cost of reform is even trickier.

Healthy Families Act Gets Hearing: Five years after it was first introduced, the House last week held its first-ever hearing on the Healthy Families Act. The bill would enable workers at companies with more than 15 employees to take up to seven paid sick days per year to care for themselves or a sick family member.

The AFL-CIO blog reports on the hearing and points to a new study (pdf) from the Center for Economic and Policy Research that found mandatory paid sick days do not lead to higher unemployment.

Plus: Did you know the United States is the only country among 22 countries ranked high for economic and human development that does not guarantee paid sick days or sick leave for workers? CEPR breaks it down in a separate study, “Contagion Nation.”

Take Action
National Partnership for Women & Families: Support paid sick days. Find out if your elected officials have cosponsored the Healthy Families Act, and please urge them to do so today.


June 9, 2009

Political Diagnosis: Single-Payer Advocates Get Hearing; Sen. Kennedy’s Bill Makes the Rounds; Obama and the Common Ground Fail; Time to Repeal Hyde Amendment …

President Obama is taking the health care debate to the people (starting with Saturday’s weekly radio address, which irked Republican Sen. Charles E. Grassley. And it looks like there could be a major shift over taxing employer-sponsored health insurance (more on what that means). In other news …

The single-payer model will finally get some attention on Wednesday when the Health, Employment, Labor and Pensions Subcommittee of the House Education & Labor Committee holds a hearing titled “Examining the Single Payer Health Care Option.” The hearing starts at 10:30 a.m. in 2175 Rayburn House Office Building. It’s open to the public, but you’ll have to get there early to get a seat. The webcast may be shown here.

A story in the Washington Post this past weekend portrayed single-payer advocates as a thorn in Obama’s side. Dan Eggen writes:

The White House and Democratic leaders have made clear there is no chance that Congress will adopt a single-payer approach — named for the idea that a single government-backed insurance plan would pay for all Americans’ medical costs — because it is too radical a change.

That has not dissuaded single-payer activists, who have spent months hounding Democratic lawmakers and organizing demonstrations, including one that resulted in 13 arrests at a Senate hearing last month. The offensive continues this weekend with plans to swamp a series of “house parties” on health care hosted by Organizing for America, an Obama-backed project at the Democratic National Committee.

The movement poses both an opportunity and a challenge for Obama, who is able to position himself as a centrist by opposing a single-payer plan but who risks angering a vocal part of the Democratic base.

“Obama is really the one who is puzzling to us,” said Rose Ann DeMoro, executive director of the California Nurses Association, a union that has been leading many of the single-payer protests. “We were all supporters of him. . . . It’s hard to understand how he can expect to rally support around a plan that will leave the big insurance companies in charge and keep hurting patients.”

Plus: The Nation talks with Vermont Sen. Bernie Sanders about single payer and the various public insurance options now under consideration.

A draft of the health care bill authored by the Health, Education, Labor and Pensions Committee, led by Sen. Edward Kennedy, is now under review. The bill includes provisions that would guarantee health coverage for all Americans, including government-subsidized premiums for people with incomes up to 500 percent of the poverty level ($110,000 for a family of four). The bill would penalize employers who do not help to provide insurance.

“Though the bill is far from finished, lacks key details and only touches on one of [the] categories of reform, it offers a glimpse into the direction the Democrats hope to take the American healthcare system,” writes Jeffrey Young at The Hill. The bill, Young adds, “is limited to the areas of health insurance coverage and does not touch upon contentious issues such as the creation of a government-run health plan or how to pay for the expected $1 trillion-plus cost of the total package.”

Kennedy is in Massachusetts, undergoing treatment for brain cancer, and his gravitas on the Hill is missed. Sen. Christopher J. Dodd, the No. 2 Democrat on the health committee, has taken on the main role, reports The New York Times.

The White House sponsored a women’s health round-table on Friday. Cindy Pearson, executive director of the National Women’s Health Network, took part, representing both NWHN and Raising Women’s Voices, as did Marcia Greenberger, co-president of the National Women’s Law Center, and Sabrina Corlette, director of health policy programs at the National Partnership of Women and Families. The White House Briefing Room blog has some (very) lite coverage.

Plus: HealthReform.gov published a summary of why the current healthcare system doesn’t work for women.

In a move that caught pro-choice activists off-guard, Obama named Alexia Kelley, executive director of Catholics in Alliance for the Common Good (CACG), to head the Center for Faith-Based and Neighborhood Partnerships at the Department of Health and Human Services.

“Kelley is a leading proponent of ‘common ground’ abortion reduction — only CACG’s common ground is at odds with that of Obama,” writes Sarah Posner at TAPPED. “While the administration favors reducing the need for abortion by reducing unintended pregnancies, Kelley has made clear that she seeks instead to reduce access to abortion. That is an extremely disturbing development, especially coming this week in the wake of George Tiller’s assassination.”

Frances Kissling, past president of Catholics for a Free Choice, urges greater oversight on future appointments.

Meanwhile, Loretta Ross, national coordinator of SisterSong Women of Color Reproductive Health Collective, is also disappointed with Obama positioning himself in the middle of the road. “I believe President Obama should show strong leadership in repealing the Hyde Amendment that prohibits public funding for abortions for poor women,” Ross writes at On the Issues magazine. “This would send a strong signal of support to his allies in the reproductive justice movement and we need his leadership on this issue.”

Ross continues:

In fact, if President Obama helps repeal Hyde, he is merely following in the footsteps of Republican Presidents Richard Nixon and George H.W. Bush, both of whom showed strong support for family planning at one point.

In May 2009 in hyping a controversy over President Obama’s speech at Notre Dame University in Indiana, anti-abortionists incorrectly vilified President Obama for being the most “pro-abortion” president in history.  They conveniently forget Richard Nixon’s and George H.W. Bush’s support for family planning in the 1960s and 1970s. According to research by the National Family Planning & Reproductive Health Association, President Nixon pledged his commitment for all family planning methods in a July 18, 1969 message to Congress.

A great piece — go read the rest.

Take Action
National Advocates for Pregnant Women
: Urge your senator to vote now to confirm President Obama’s nomination of Dawn Johnsen (pdf) to head the Justice Department’s Office of Legal Counsel, the division responsible for providing legal advice to the president and key agencies, particularly on matters related to the “War on Terror” and to homeland security.

“Given the recent murder of Dr. George Tiller, something many see as an act of domestic terrorism, it is more important than ever to have someone in that office who understands law enforcement, the appropriate uses of government power to counter terrorism and the centrality of reproductive justice to the lives, health and safety of women and their health care providers,” NAPW said in an email.

Democracy for America: Live chat on healthcare reform with Howard Dean — Tuesday, June 9, at 9 p.m., EST. Sign up here.