Democrats Push Back on Unsavory Estimate
By John Amick
The Obama administration sent two of its top surrogates in the health-care reform debate to beat back recent projections by the Congressional Budget Office that current reform plans are not deficit neutral, and could possibly further expand the price tag of health care in America.
Repeating the line that President Obama will not sign legislation that isn't deficit neutral going forward, Director of the Office of Management and Budget Peter Orszag and Health and Human Services Secretary Kathleen Sebelius both said today that legislation is currently incomplete, and cost-saving measures are being debated in congress and the White House.
"We're looking at what's happening with regard to new policy. And with regard to new policy, this is deficit neutral over the first decade," Orszag said on "Fox News Sunday," as Congress and the White House face prospects that health-care legislation in the House and Senate will not be settled by the August recess of Congress.
Orszag said the only reason the CBO projected the increase in the deficit (around $240 billion over 10 years) was because legislation maintained current payment rates for physicians under Medicare.
"It is keeping current Medicare reimbursement rates for doctors, which was always baked into the cake," Orszag said on CNN's "State of the Union." "Everyone anticipates that even absent health care reform, that would be taken care of. If you take that off the table, in terms of new policy, the House bill is deficit-neutral."
Orszag asserted, on both Fox and CNN, that the president's wish for the inclusion of a "standing commission (Medicare Payment Advisory Commission, or MedPAC) of doctors and medical experts to oversee cost-saving measures," as Obama said in his weekly multimedia address, to modernize Medicare is vital in continuing to improve upon cost-saving measures that the administration projects to be around $500 billion in existing Medicare and Medicaid costs.
"I think the single most important thing that's missing from the legislation at this point is our proposal for an independent commission of doctors to help the policy-making process be more flexible, lead to higher quality and lower costs over time," Orszag said on "State of the Union."
In response to Orszag, Republican Sen. Judd Gregg (R-N.H.) said the CBO's predictions were another hit to what he doesn't consider reform at all.
"Those were pretty damning words, to be very honest with you, and they should make us step back, pause and take a look at the -- what's going forward in the Congress and say, 'How can we do this better?'" Gregg said on "Fox News Sunday." "And there are ways to do this better."
"There are certain things that the Congressional Budget Office didn't score, savings that we have, with people not getting sick, preventive care, people not having to be readmitted to the hospital, and a variety of things that is just a question of which assumptions are you using," Rangel said on CBS's "Face the Nation."
The House plan proposes a surtax on the wealthiest earners in America, a point of high contention for legislators, mainly Republicans, who insist this burden will fall on small business owners.
"Well, if you tax the rich, that means that you're going to push small business into a 45.7 percent top tax rate, which is like -- like 10 percent more than corporations pay," Republican Sen. Orrin Hatch of Utah said on "Face the Nation." "And it's going to kill a lot of jobs, a lot of opportunities."
Rangel answered Hatch, saying the accusations of small business bearing the brunt of the tax burden is a miscalculation.
"It's just wrong to say that this is a tax on small businesses," Rangel said. "We exempt small business from a lot of the penalties. We give tax credits so that they're able to hire and get people health care in small businesses. This is a tax on less than 1 percent of the wealthiest people in the United States of America."
Sec. Sebelius wouldn't commit the administration to any proposals to tax the richest Americans, yet she said all "ideas are in play," and that the Obama administration is dedicated to keeping their word in paying for reform.
"In the last bill, the Medicare bill in 2003, billions of dollars of new drug benefits were provided for America's seniors. That's good news, they needed the drug benefit. Not a dime was paid for, not an effort to put any money on the table," Sebelius said on "Meet the Press," referring to a Republican-controlled congress and White House that ignored CBO standards in 2003 during debate over the Medicare Part D bill.
When pressed about President Obama's tight deadline of August 1 for the Senate and House to have their versions of health-care reform prepared for the return of Congress on September 8, both Sebelius and Orszag were hopeful yet non-committal on whether this goal would come to fruition.
"We think we can make that," Orszag said on CNN. "We're working toward that. And we have to remember, there are some who are advocating the delay simply because they don't have anything to put on the table."
Hatch wants to slow the march for final approval of the Senate bill, saying it's about rushing through the debate for Obama, not crafting the kind of bill Republicans would support, if any.
"I think there's a really good reason why the president wants to do it," Hatch said on "Face the Nation." "He knows he can't sell if it lasts -- if the debate lasts very long because it is so expensive and costly."
Accusations of obstructionism by Republicans in overhauling health care were renewed in recent days when Sen. Jim DeMint (R-S.C.) compared a failed reform attempt to a political nightmare for President Obama.
"If we're able to stop Obama on this, it will be his Waterloo," Sen. DeMint said Friday. "It will break him."
Senate Minority Leader Mitch McConnell of Kentucky pushed back on the quote by DeMint.
"... My goal is not to stop the president, my goal is to get the right kind of health care for America," McConnell said. "And the direction in which the president and the majority in the House and Senate want to take this is the wrong direction."
Sen. McConnell did his part to repeat GOP concerns that any notion of a public health insurance plan would stifle competition and encourage rationing of care that exceeds that of the current system of private health insurance companies.
"When Secretary Sebelius says that there will be more competition if you have a government-run insurance company, there will be no competition," McConnell said on "Meet the Press." "The government will, with the backstop of the taxpayers, undercut the 1300 or so health insurance companies we have. We won't have any competition at all. Pretty soon the doctors and the hospitals will all be working for the government."
When asked if providing health care to the 47 million Americans without insurance is a moral issue, McConnell said that anyone can get emergency room care, though that is not exactly an acceptable system.
"We all agree it is not the most efficient way to provide health care to find somebody only in the emergency room and then pass those costs on to those who are paying for insurance," McConnell said. "So it is important, I think, to reduce the number of uninsured."
Sen. Gregg was the only Republican to detail a Republican alternative to the Democratic proposals being considered.
"The way we would cover those folks (the uninsured) is we would require them to buy health care policies for catastrophic events," Gregg said on Fox. "They would have to self-insure under that. But they would not be a burden to the system if they, unfortunately, contracted a serious disease or were seriously injured in an accident.... So we do pay for it, and we do cover everyone, and we put in place a replacement of the reimbursement system so we reimburse doctors on the basis of quality and outcomes rather than on the basis of the number of procedures."
Republican Support for Sotomayor
In recent days, McConnell became the first Republican to publicly say he will not vote for Supreme Court nominee Sonia Sotomayor. He said today that while he hails her personal story and admires her career, he is not convinced that she will be an impartial "umpire, call(ing) the balls and strikes."
"What I worry about with regard to Judge Sotomayor is that her personal views, which she's expressed quite frequently, lead me to believe that she's--lacks the objectivity that you would prefer to have in a member of the Supreme Court," McConnell said.
Sen. Jeff Sessions (R-Ala.) the ranking Republican on the Senate Judiciary Committee, which wrapped its series of confirmation hearings with Sotomayor last week, said he won't commit to a "no" vote yet, but does hold lingering concerns.
"I was troubled by a number of the things that the nominee has said, a number of the rulings that she has made, and I think it is a very serious and awesome responsibility to launch someone on a lifetime appointment with the power, in effect, to actually amend the Constitution, if they are not faithful to it when they render a ruling that alters its classical meaning," Sessions said on "State of the Union."
Chairman of the committee, Sen. Patrick Leahy (D-Vt.) bristled at any mention of existing ambiguity of Sotomayor's qualifications after the week's hearings.
"It's certainly easy enough for somebody to make up their mind how they'll vote or not based on these 17 hours of hearings, longer than most nominees ever have, 3,600 cases," Leahy said on "State of the Union." "Certainly she's had more experience on the trial bench and the court of appeals bench than any nominee to the U.S. Supreme Court in decades.... I find it pretty easy to make up my mind."
In response to the question of whether Sotomayor will receive Republican support in the Senate for confirmation (at least three GOP senators will vote for her), Leahy lamented the treatment of Sotomayor among Republican leaders.
"I understand Mitch McConnell and I've worked with Senator McConnell on different things, but like the other leaders of the Republican Party, he came out very, very early against her, and he doesn't want to change his mind," Leahy said, going on to bring up Newt Gingrich's assertion that she was a bigot. "... the leadership of the Republican Party came out against her long before we ever had the hearing, long before they had a chance to look at her record. I think that's unfair."
Sessions responded by saying any questioning of the nominee during the hearings was fair.
"We gave our absolute best to make sure this was a fair hearing, but it had to be vigorous," Sessions said. "We had to ask about things that people cared about, her speeches, her prior pleadings that she did and some of her decisions, which are troubling."
Best of the Rest:
- Sen. Gregg on 40 million+ uninsured:
"Well, first, it's not a monolithic group. About 20 million of those folks earn more than $75,000. They're basically young people who opt to spend their money on something other than health care insurance."
- Sen. McConnell on a possible second stimulus:
"We've got an old saying down home that there's no education in the second kick of a mule. We've seen what happened with the first stimulus. The president said "Rush and spend it, pass it, we'll, we'll hold unemployment to 8 percent," which now pretty clear we're going to 10. In my state it's almost 11. By any measurable index, the stimulus package has been a failure."
- Sen. Leahy on racially-tinged questioning of Sotomayor's qualifications:
"That (racial politics) is what it comes across. It comes across that if you belong to a group that tries to help Hispanics, help them in school, help them in other things, somehow you're suspicious. The same arguments were used against Thurgood Marshall and others. I think it's wrong."
- Rep. Rangel on Sen. Hatch's view that Republicans have been shut out of the health reform process:
"And to say that Republicans in the Senate are not involved, my friend Chuck Grassley, the senator on the Finance Committee, he spends more time in the White House than I do. So the opportunity is there for anyone to jump in. And I welcome anything that Republicans want to do to improve this bill."
Posted at 2:45 PM ET on Jul 19, 2009
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