Wednesday, January 19, 2011

Wonkbook: Health-care debate, round two

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Health-care reform isn't getting repealed this week. It's getting re-debated. The GOP's control of the House -- and thus of at least some of the agenda -- gives them a second opportunity to make their case against the bill. It also, however, puts the Republicans in a position Democrats will recognize immediately: They're behind a specific piece of health-care legislation with sweeping implications, some of which are popular, and many of which are not. In the coming days, Americans will hear a lot about the Congressional Budget Office's estimate that repealing health-care reform will cost more than $200 billion, and they will hear a lot about the government's estimate that as many as 129 million Americans under age 65 have a pre-existing condition, and they will hear a lot of individual stories emphasizing the dysfunction of the status quo that Republicans would return us to. Just as Democrats found themselves stuck with the downsides of reform, Republicans are going to be lashed to the dysfunctions of the status quo.

In the end, repeal will pass the House -- likely tomorrow -- and quickly die in the Senate. Then comes the more interesting phase of the fight over health-care reform: The GOP's effort at revision. Republicans, who already know that repeal will fail, are preparing to begin the longer and more complex campaign to replace, rewrite, or simply undermine various parts of the bill. The relevant committees in the House will try to develop alternatives, while the GOP will look for Democrats willing to sign onto targeted attacks on the legislation. That will allow them to focus their energies on the parts of the legislation that are tough for Democrats to defend, rather than letting the Democrats force them to focus on the parts of the legislation that are easy for Democrats to defend. But this strategy has its own dangers: As the least popular bits of the bill are either successfully preserved or somehow changed, more and more of the bill's opponents will lose their reason for fighting the legislation. There'll still be a smaller group looking for full repeal, but they'll have to contend with not only the bill's supporters, but also those who just want to move forward and see how the legislation works and what then needs to be done to fix it.

Previewing the Repeal Debate

The GOP's strategy for repealing health care reform extends beyond this week, reports Janet Adamy: "Republicans in Congress have been picking up Democratic allies interested in swapping out parts of the law, including taxes levied on insurers, the creation of a long-term care insurance program and penalties for Americans who don't carry insurance...The new Republican majority in the House is expected to pass its repeal measure Wednesday. It may pick up a small number of Democratic votes but will likely go no further. The Senate isn't expected to take up the legislation. President Barack Obama's veto pen would await any unexpected twist. On Thursday, a day after the repeal vote, the House will pass a measure directing committees to craft new legislation."

Democrats, however, are finding the fight over repeal more congenial than the fight over passage, reports Jennifer Haberkorn: "'We welcome, in a certain sense, their attempt to repeal it because it gives us a second chance to make a first impression,' Sen. Chuck Schumer (D-N.Y.) said Sunday on NBC?s Meet the Press...During floor debate, House Democrats plan to share stories of people who have benefited from the legislation ? and issue a warning that those people would be hurt if the law is repealed. Internal polling by pro-reform groups such as Families USA has found that personal stories are more effective than a list of consumer-friendly provisions.

As many as half of all Americans have a pre-existing condition, reports Amy Goldstein: "As many as 129 million Americans under age 65 have medical problems that are red flags for health insurers, according to an analysis that marks the government's first attempt to quantify the number of people at risk of being rejected by insurance companies or paying more for coverage. The secretary of health and human services is scheduled to release the study on Tuesday, hours before the House plans to begin considering a Republican bill that would repeal the new law to overhaul the health-care system. The report is part of the Obama administration's salesmanship to convince the public of the advantages of the law, which contains insurance protections for people with preexisting medical conditions."

Five provisions employers would like to see repealed: http://bit.ly/hAUyV0

The Center on Budget and Policy Priorities runs a Myth/Fact on the legislation's CBO score: http://bit.ly/hGpUJ0

More Top Stories

President Obama has begun an effort to simplify the government's regulations, writes, well, President Obama: "This order requires that federal agencies ensure that regulations protect our safety, health and environment while promoting economic growth. And it orders a government-wide review of the rules already on the books to remove outdated regulations that stifle job creation and make our economy less competitive. It's a review that will help bring order to regulations that have become a patchwork of overlapping rules, the result of tinkering by administrations and legislators of both parties and the influence of special interests in Washington over decades...We are also making it our mission to root out regulations that conflict, that are not worth the cost, or that are just plain dumb."

More Republican leaders are calling for Congress to block an increase in the debt limit, reports Elizabeth Wilkinson: "Three potential Republican candidates for president came out against boosting the federal debt limit without substantial spending cuts, raising the temperature in a debate that is quickly becoming a test of Washington's newfound appetite for financial discipline. Rep. Mike Pence of Indiana and former Republican House Speaker Newt Gingrich on Monday joined former Minnesota Gov. Tim Pawlenty in calling for spending cuts and opposing any increase in the $14.3 trillion debt ceiling without them...Congressional GOP leaders say a vote to raise the limit is inevitable if the nation is to avoid defaulting on its loans. They hope to formulate a compromise that combines increasing the debt limit with a package of spending cuts."

Norwegian pop interlude: Annie plays "Heartbeat" live.

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Still to come: Regulators are behind in implementing FinReg; up to half of all under-65 Americans have a preexisting condition; a GOP Senator is proposing gun control legislation in the wake of the Tucson shooting; the recession could permanently reduce greenhouse gas emissions; and a robot that can mimic human movements in real time.

Economy

The SEC and CFTC are behind on implementing FinReg, report Jean Eaglesham and Victoria McGrane: "Regulators have missed or postponed several deadlines to write rules needed to implement the financial overhaul triggered by the Dodd- Frank law. The Securities and Exchange Commission and Commodity Futures Trading Commission are straining to keep up with the workload of turning the language in last summer's law into regulations in time to begin enforcing some of the new rules this summer. SEC officials postponed at least seven of the agency's self-imposed deadlines related to the law, including revising the definition of an 'accredited investor' to whom higher-risk investments can be sold...Two of the Dodd-Frank proceedings delayed by the SEC have since been completed."

The FDIC is working on implementing FinReg's "resolution authority" provision, reports Brady Dennis: "An important part of that new tool allows government officials, should a large failure occur, to create a 'bridge' institution that would keep critical parts of a firm operational while it is dissolved and liquidated over time...At the same time, the new powers represent a daunting challenge for the FDIC, which has plenty of experience shutting down troubled firms but has dealt primarily with small banks. Focusing on some of the nation's financial behemoths, observers say, will require a different set of skills...The Office of Complex Financial Institutions will have a staff of about 150, composed of FDIC employees and outside hires."

The administration wants to ease up pressure on China on its currency: http://politi.co/hrJJGu

But Sen. Chuck Schumer is introducing legislation targeting China in time for Premier Hu Jintao's US visit, reports Ian Swanson: "Sen. Charles Schumer (D-N.Y.) is using a Sino-American summit to strike at Chinese economic policies. Schumer and two other Democrats announced Monday they will introduce legislation hitting China for currency manipulation just as Chinese President Hu Jintao is set to arrive in the United States for a critical summit with President Obama...Hu downplayed criticism of China?s currency, and sought to turn the table on the U.S. by criticizing the Federal Reserve?s bond-purchasing program, which is meant to stimulate the U.S. economy and lower the unemployment rate."

Revaluing China's currency won't bring the US jobs, writes Mark Wu: "I recently did an analysis of the top American exports to our 20 leading foreign markets, and found little evidence that an undervalued Chinese currency hurts American exports to third countries. This is mostly because there is little head-to-head competition between America and China. In less than 15 percent of top export products -- for example, network routers and solar panels -- are American and Chinese corporations competing directly against one another. By and large, we are going after entirely different product markets; we market things like airplanes and pharmaceuticals while China sells electronics and textiles."

We need a new bankruptcy law for state governments to prevent bailouts, writes David Skeel: http://on.wsj.com/fosPib

Rise of Skynet interlude: A robot that mirrors human body movements in real time.

Health Care

My column imagining what the health-care system will look like in 2030: "As we know now, the law was the first word in health-care reform, not the last. The next big policy change came five years later, when the failure of a modest deficit-reduction bill caused the bond market to send interest rates on Treasury debt soaring. Congress got serious about deficit reduction, and fast. Three months later, the Balanced Budgets and Sustainable Growth Act of 2015 was signed into law. Among other things, it ended the deduction for employer-based health insurance and replaced it with a refundable tax credit for everyone, no matter where their coverage came from."

Former Senate Majority Leaders Bill Frist and Tom Daschle are proposing new state-based health care reforms: http://politi.co/gB2OhQ

Republican health care reform cost estimates are dishonest, writes Paul Krugman: "First of all, says the analysis, the true cost of reform includes the cost of the 'doc fix.' What?s that? Well, in 1997 Congress enacted a formula to determine Medicare payments to physicians. The formula was, however, flawed; it would lead to payments so low that doctors would stop accepting Medicare patients. Instead of changing the formula, however, Congress has consistently enacted one-year fixes. And Republicans claim that the estimated cost of future fixes, $208 billion over the next 10 years, should be considered a cost of health care reform. But the same spending would still be necessary if we were to undo reform. So the G.O.P. argument here is exactly like claiming that my mortgage payments, which I?ll have to make no matter what we do tonight, are a cost of going out for dinner."

The Center on Budget and Policy Priorities runs a Myth/Fact on the legislation's CBO score: http://bit.ly/hGpUJ0

The GOP can have a civil health care discussion if it wants one, writes EJ Dionne: http://wapo.st/huU8Zk

Domestic Policy

GOP Sen. Richard Lugar wants to renew the assault weapons ban, reports Shira Toeplitz: "Sen. Richard Lugar (R-Ind.) this weekend called on Congress to reinstate the assault weapons ban that expired in 2004. Lugar is the first GOP senator to call for increased gun control following the Tucson tragedy that killed six people and wounded 13 others, including Arizona Rep. Gabrielle Giffords. But Lugar, who supported the initial 10-year-long assault weapons ban when it passed in 1994, said he's not optimistic about the chances for passing gun control legislation this Congress...Lugar is going out on a limb by expressing his support for bringing back the now-defunct assault weapons ban - especially because local Tea Party activists have promised to field a primary challenger for the six-term senator."

The National Labor Relations Board is suing to block state constitutional amendments banning "card-check" organizing: http://nyti.ms/eYSopP

Bruce Reed is Joe Biden's new chief of staff, reports Anne Kornblut: "Vice President Biden named former Clinton administration domestic policy adviser Bruce Reed as his new chief of staff on Friday, the latest move in a reshuffle that has brought several Clinton-era veterans into key roles in the Obama White House...Reed's hiring suggests a potential rightward ideological shift as well, especially on economics. Along with Daley and former Clinton economics adviser Gene Sperling, Reed encouraged free trade and deficit reduction during the economic boom years of the 1990s. While their return has triggered dismay among liberals, it has delighted moderates who believe the administration needed more experienced hands to manage the economy for the next two years."

Sen. Mike Lee thinks child labor laws are unconstitutional, writes Ian Millhiser: http://bit.ly/eNmsGp

Pro-gun logic doesn't hold up, writes Bob Herbert: "The contention of those who would like college kids and just about everybody else to be armed to the teeth is that the good guys can shoot back whenever the bad guys show up to do harm. An important study published in 2009 by researchers at the University of Pennsylvania School of Medicine estimated that people in possession of a gun at the time of an assault were 4.5 times more likely to be shot during the assault than someone in a comparable situation without a gun...We need fewer homicides, fewer accidental deaths and fewer suicides. That means fewer guns. That means stricter licensing and registration, more vigorous background checks and a ban on assault weapons. Start with that. Don?t tell me it?s too hard to achieve. Just get started."

Video game music interlude: The Office theme song, played in Minecraft.

Energy

The recession could permanently cut emissions, reports Matthew Wald: "The previous Congress failed to pass climate change legislation, and the new House is openly hostile to the idea. But what the government has not mandated, the economy is doing on its own: emissions of global warming gases in the United States are down. According to the Energy Department, carbon dioxide emissions peaked in this country in 2005 and will not reach that level again until the early 2020s...The Energy Department?s projection of emissions in 2020 was lower in 2008 than in 2007, and has kept falling...Of course, the recession will end one day, but the economy will look different when it does, experts say. By then, the United States will be further along in its multidecade trend away from energy-intensive industries and toward a service-based economy."

Americans' concern about gas prices is growing: http://bit.ly/huezbR

Secretary of State Hillary Clinton has named climate change one of our top priorities with China, reports Ben Geman: "Secretary of State Hillary Clinton used a wide-ranging speech on U.S.-China relations Friday to call for expanded cooperation on curbing greenhouse gas emissions. China and the U.S. are the world?s largest emitters, and her comments come ahead of Chinese President Hu Jintao?s state visit to the White House next week. 'Our cooperation at the U.N. climate conference in Mexico was critical to the conclusion of the Canc�n agreement. Now, we must build on that progress by implementing the agreements on transparency, funding and clean energy technology,' Clinton said in remarks at the State Department."

A major solar company is moving to China, reports Keith Bradsher: "Aided by at least $43 million in assistance from the government of Massachusetts and an innovative solar energy technology, Evergreen Solar emerged in the last three years as the third-largest maker of solar panels in the United States. But now the company is closing its main American factory, laying off the 800 workers by the end of March and shifting production to a joint venture with a Chinese company in central China. Evergreen cited the much higher government support available in China. The factory closing in Devens, Mass., which Evergreen announced earlier this week, has set off political recriminations and finger-pointing in Massachusetts."

Policymakers in Europe are moving away from energy efficiency: http://nyti.ms/h2V6Cy

Closing credits: Wonkbook is compiled and produced with help from Dylan Matthews, Mike Shepard, and Michelle Williams. Photo credit: Brendan Hoffman Photo



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