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Objecting to 'Gag Order' on Insurers, Republicans Threaten to Delay HHS Confirmations

By David S. Hilzenrath
Senate Republicans said they will delay confirmation of Obama administration nominees to the Department of Health and Human Services unless HHS lifts what Republicans are calling a "gag order" on insurers.

Insurers serving people on Medicare "should not be threatened with punishment if they speak out on a matter of public concern simply because the administration disagrees with their position," Senate Republican leader Mitch McConnell of Kentucky and other top Senate Republicans said in a letter Thursday to HHS Secretary Kathleen Sebelius.

The dispute began when the big insurer Humana, which manages health plans for Medicare beneficiaries, sent a letter to health plan members saying that reform proposals under consideration by Congress could cause "millions of seniors and disabled individuals" to lose "important benefits and services." Humana urged its plan members to contact their elected representatives.

HHS accused Humana and other insurers of misleading Medicare beneficiaries. It ordered them to stop and said they could face enforcement action for violating restrictions on communications between Medicare health plans and their members.

The contretemps is the latest in a series of side-issues to engulf the debate over health care policy.

An HHS spokesman reiterated the department's position Thursday night.

"Our Department is committed to protecting Medicare beneficiaries and ensuring that their personal information is not used inappropriately. Seniors on Medicare should not be subjected to misleading information about their Medicare benefits," spokesman Nicholas Papas said in a statement. "We have serious concerns that certain communications from a major insurance company violated CMS regulations and our investigation will continue."

Several top department positions remain unfilled and could be affected by the Republicans' threat to use parliamentary procedures to delay confirmation votes. Those positions include the assistant secretary for public affairs, the surgeon general, and the administrator of the Centers for Medicare and Medicaid Services.

The communications in dispute involve so-called Medicare Advantage plans paid by the government to provide care for Medicare beneficiaries who choose to enroll in them as an alternative to traditional fee-for-service Medicare. The private plans can impose tighter restrictions on members' care while offering extra benefits.

Democratic health care legislation would reduce funding for Medicare Advantage plans, which the administration and others say are overpaid. Insurers say the funding cuts would lead to reduced benefits.

Republicans said HHS's actions were at odds with guidance it issued in 1997 on communications between Medicare HMOs and their members. "While it may be difficult for a reviewer to ascertain whether or not the information about legislation ... is accurate and without slant or unrevealed self-interest, we believe that prohibiting such information would violate basic freedom of speech and other constitutional rights of the Medicare beneficiary as a citizen," Bruce Merlin Fried, director of HHS's Center for Health Plans and Providers, wrote in 1997.

The 12-year-old memo predates changes in the regulation of Medicare health plans, "and we are in the process of evaluating those changes in this context," HHS spokesman Papas said.

The department is not aware of any insurers other than Humana spreading misleading information to their Medicare beneficiaries, Papas said.

By Web Politics Editor  |  September 24, 2009; 8:05 PM ET
Categories:  B_Blog , Health Care  
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The Repuglicans would rather this country FAIL than see Obama succeed!

Posted by: asclepious2 | September 29, 2009 6:57 PM | Report abuse

Humana gets Federal Dollars - JUST LIKE ACORN!

Where is R-IA King ?

Where is CNN?

Aug 27-2009- on C-Span-

Tom Scully- Bush's CMS Administrator stated Medicare Advantage, Part C- is overpaid!

This is what OBAMA wants to CUT!

Back door elimination to Medicare Med Advantage is now unfolding as to why this was infiltrated into Medicare.

Mr. Scully admits that Med Advantage turned out to be tactfully wrong- he would not admit the other failure- the philosophical failure.

Yet they continue to scare the seniors with their 'death panels' rhetoric.

Scully admits politically- no one wants to tell those 10 million seniors on Med Advantage that the benefits that were subsidized by tax dollars to Insurance companies will no longer be given thus they will not get the benefits they thought they were going to get.

GOP will not - will never admit what they set up has failed miserably.

Just like GOP will never admit MED D failed miserably.

Back door elimination to all democratic institutions- that is the C-Street Philosophy.


NONE of you!

Med Advantage is not MEDICARE

Posted by: sasha2008 | September 28, 2009 9:25 AM | Report abuse

The president has sworn to protect and uphold the Constitution of the United States of America. FREE SPEECH The communication of thoughts on a subject matter, which is exactly what Humana did. COMMUNISIM = DICTATORSHIP = NO FREE SPEECH.

Posted by: prossers7 | September 28, 2009 6:31 AM | Report abuse

Please take this health care survey for my AP Government class. Here is the link.

Thank You

Posted by: brn4music | September 26, 2009 9:29 PM | Report abuse

Please take this health care survey for my AP Government class. Here is the link.

Thank You

Posted by: brn4music | September 26, 2009 9:23 PM | Report abuse

Humana should not be sending these people veiled threats in this manner. I agree with TurnTurn who suggested they present their opinion via the media, and not exploit their access to Medicare recipient information.

That said, I oppose the current plan for reform. We desperately need some kind of reform, but not done so quickly and to satisfy some political aspirations. Without question there are people in need of health care access. In reality, we all have access, the issue is cost. Do you want to lose everything to get the care you need? Of course not. How do we help everyone without making everyone poor? Take is slow and do it right. Adding millions to an insurance program overnight will cripple the system. Think not? Visit your local ER some afternoon. Imagine the line extending into the parking lot.

roxanne371 – You should be worried about your benefits. Already many physicians are turning away Medicaid patients because of poor reimbursement. Medicare is also not reimbursing well and only getting worse. Maybe that is the plan…if you can’t get to a doctor then you can’t cost the system money.

rooster54 – You wrote: “There's a special place in hell for those who oppress the poor while sucking up to the rich. It will be packed with republicans and peppered with a sprinkling of blue dog sell-outs.”

Since you brought religion into this...Certainly heaven will be a lonely place. We are to lift our brother up in the spirit of Jesus Christ, not as a mandate of the government. Many democrat policies seem to provide for this, but often include things clearly not Biblical. Republican policies seem to leave everyone fending for themselves. That leaves our churches to provide for the poor and downtrodden, who will inherit the earth. As a democrat, do you need the government to ensure you spend your money properly?

cdmomega – Your post has an awfully bitter and angry tone. Why is that? And your comments about Republicans being uneducated and backwoods is unfounded. Where do you think most of the blue collar people come from anyway? Why would an educated elitist be a plumber, electrician, carpenter, roofer, construction worker, etc.? How is a corporate executive who went through night school, raised a family, and now represents his company abroad being a moron? I know many of these folks who have various levels of education and few of them are anxious to see the government take more from their paychecks. Some have been saved from unspeakable horrors by public programs, but still recognize that you can’t get everything from the government. Consider talking to someone about your anger and resentment. And feel free to share your wealth with your fellow man in whatever manner you see fit. I will do the same -- preferable, without the government’s interference.

Posted by: kadetray | September 26, 2009 6:21 PM | Report abuse

This is just another instance of democrat frustration when their mob is unable to supress the truth!

Posted by: Davole | September 26, 2009 9:05 AM | Report abuse

Buyers remorse for so many on that Obama guy

Posted by: Obama_TRAITOR_in_Chief | September 26, 2009 2:28 AM | Report abuse

The Congressional Budget Office reported to the US Senate the same misleading information Humana mailed to its customers. Only difference is the CBO stated these lies as a facts and not as a possiblity as Humana suggests.

Unfortunately, liberal brothers allies of the axis of evil, we can't say the CBO directer is a Republican because he was appointed by Pelosi and worked under the Clinton Administration.

Posted by: NorthMan | September 26, 2009 1:12 AM | Report abuse

")that would help cut the costs but no you want to attack the rich and make them responsible for it. we need to regulate the insurance industry and make them accountable for their actions in the name of bloated profits at our expense.the democraps need to stop misleading the public about the costs that they will hand down to us when the rich cannot afford it any more. and we need to have a balance of power in this country to combat this administrations abuse of the constitution"

Posted by: tswank1 | September 25, 2009 3:00 PM

Huh? Sounds like tswank1 has his lines crossed (sort of a "Nuke the Whales" moment on the right. Or does he really think that the Republicans are against "bloated profits" for insurance companies and the Democrats are for them.

Reminds me of a guy I saw in a video of the 9/12 rally praising Glen Beck for smoking out Van Jones and wearing a t-shirt that said "9-11 was an inside Job."

Posted by: msh41 | September 25, 2009 11:08 PM | Report abuse

So the liberals in congress wants "open discourse" on health care reform only if the discourse supports their agenda. Very telling. This tactic should scare the pants off people. Silence any opposition! Do not let the truth get in the way of "our" legislation!

Posted by: Chamaco | September 25, 2009 10:13 PM | Report abuse

annetta3: Did you read the whole article before you drank the KoolAid?

VisionBKR, MwHoke: Free Speech doesn't protect a corporation that asks to participate in a government program and agrees to abide by the rules and regulations of that program and then turns around and violates those rule and regulations (and possibly the law).


If the companies are overpaid by scales set by their GOP drones (like alleged doctor Bill Frist, former GOP Senate Majority Leader whose presidential aspirations crashed with the stock of HCA, his family's comapany, AFTER BillyBoy did a quick stockdump in a little insider trading through his not-so-blind trust: gotta love these Repuglican paragons of virtue) then there will still be profit to be made and the leeches will remain firmly attached to the federal money vein.

tswank1: The nations that have single payer health services outrank the US in almost every category; the health care crisis is happening now with insurance companies already regulated by the states; by your reckoning, somewhere between 70% and 80% of the people in America (the number that favor health care reform, including the American Medical Association) contribute nothing to the wealth of America (I'm sure you yourself are a real wealth-generating machine); the best study available ( [the president referred to in the link is George W. Bush]) show malpractice suits add between zero and three tenths of a per cent to health costs, not even a blip on the scale of cost increases. This is a canard often put forward by the right in the belief that most people will be too lazy or just too plain stupid to look it up. Congratulations. Your achievement of being wrong on everything you wrote is truly impressive.

Posted by: cdmomega | September 25, 2009 7:56 PM | Report abuse

The President has assured us that if we like our insurance coverage, that we can keep it. I have Medicare Advantage, that I chose and I pay for every month, and I want to keep it.

He has also said if we like our doctors that we can keep them. I probably will be able to because I have a long association with mine, but as the cuts to Medicare providers are made more doctors will decide not to take Medicare patients because of the reimbursement rate. Some seniors already have a hard time finding doctors and it will only get worse.

I don't think that I got the Humana letter, or if I did it went into my recycle pile without reading it because I don't have a relationship with them. My understanding of the contents of that letter is that it warned of just those kinds of cuts.

I guess the truth hurts and this administration doesn't tolerate truths that do not reflect well on them.

Posted by: annetta3 | September 25, 2009 5:13 PM | Report abuse

The difference between the AARP and Humana letters is that AARP didn't LIE.

The GOP is a wholly owned subsidiary of Corporate America. Of course it would move to protect Humana's efforts to lie to and mislead the elderly Medicare recioients. After all, lying to and misleading the public is the basis of the GOP's political and governmental phiosophy. Remember when George W. Bush's administration threatened to fire an official if he revealed the TRUE cost of their gift to Big Pharma, the Medicare prescription drug benefit? Or how the Iraq war would cost the US a maximum of $17 BILLION? That we would be greeted with flowers, as liberators?

And what of the chorus harping on deficit spending to try and repair the financial damage they engineered? Didn't Dick Cheney say Ronald Reagan proved deficits didn't matter? I guess he meant only GOP deficits caused by cutting taxes for the richest people in the country. (GW BUSH: ". . . the Haves and the Have Mores... my base.")

The American middle class has suffered stagnating and declining real income for almost three decades of GOP government. (There was a brief respite under Clinton: little gain but a brief stall in the decline.) Health care reform -- real reform, with a strong Public Option -- would be a small but welcome relief. It is no wonder that it is so vehemently opposed by those who wish the US to be divided into a plutocratic oligarchy ruling over a domestic third-world-class population. Then they could save the costs of shipping jobs overseas because American workers could be paid wages as low or lower than workers in developing nations.

When someone decries Class Warfare, remember: Class Warfare has been waged in the US from its beginning, from the TOP DOWN. When you hear loud objections to Socialism, remember: The opposite of Capitalism isn't Socialism or Communism. It is Laborism. Working people are the great majority in this country and form the real base of our democracy. In the words of Woody Guthrie, this is our country. The Capitalist is, by nature, opposed to democratic rule. The Capitalist feels the government exists to take care of him, not the people. And the GOP is completely captive to the Capitlist. The Democrats may kowtow to him, also, but they do occasionally remember who elected them.

The Repuglican Party is a stain on this country (like the tea on Chuck Norris' flag). It has done more to damage our nation than any external enemy could even dream.

We may need a two-party system in this country, but the GOP doesn't have a divine right to be one of the two. We need a true left wing: the Democrats are conservative to the point of being, on many issues, indistinguishable from the GOP. We need a Liberal or Labor party, or call it something else, but a party that actually offers a difference from the status quo. Give the conservative, uneducated, backwoods, tea-partying morons something to really cry about.

Posted by: cdmomega | September 25, 2009 4:25 PM | Report abuse

Thank God we have so many brave Republicans willing to protect the rights of the health insurance industry (protecting the rights of the few in the face of the tyranny of the mob!)

Posted by: lithium452 | September 25, 2009 4:17 PM | Report abuse

this healthcare issue is getting real old the democraps aren't interested in fixing the problem they want to turn it into socialized medicine so we can be like the rest of the failures in the world.stop complaining about the republicans and look in the mirror the only ones that want it are the ones that do not contribute to the wealth of this country only take from it.if we have tort reform on the trial lawyers(who donate to democraps)that would help cut the costs but no you want to attack the rich and make them responsible for it. we need to regulate the insurance industry and make them accountable for their actions in the name of bloated profits at our expense.the democraps need to stop misleading the public about the costs that they will hand down to us when the rich cannot afford it any more. and we need to have a balance of power in this country to combat this administrations abuse of the constitution

Posted by: tswank1 | September 25, 2009 3:00 PM | Report abuse

ruraledcomm, you forgot the part when he told her she should beg for charity for help. What an A hole. How can people not see what the republicants are doing. They are in for the money...bought and paid for by the insurance industry. There are many gullible people out there and some can easily be frightened by the republicants rhetoric and the insurance companies fearmongering.

Posted by: bigfrog1 | September 25, 2009 2:31 PM | Report abuse

AARP also sent a letter, but their letter said there would not be reduction in benefits. AARP owns an insurance company. Why were they not threatened if they didn't stop trying to influence their membership?

I think as Americans we may disagree about many things, but I think we usually know when something isn't fair. Targeting Humana seems to be unfair to me.

Posted by: annetta3 | September 25, 2009 12:54 PM | Report abuse

HHS Secretary Kathleen Sebelius. is just another Obama socialists. They both need to move to China where they would fit in nicely.

Posted by: HellMan1 | September 25, 2009 12:58 AM
They sure do. That way we'd have a little inside help when we go to borrow more money from them to fund the that W. started when he was busy cuttin' brush and dismantling our country.


Posted by: dennissuper | September 25, 2009 12:21 PM | Report abuse


Posted by: boblesch | September 25, 2009 11:54 AM | Report abuse

An awful large number of Republicans must own stock in these insurance companies. They seem to defend them over the interest of the people that these companies purport to insure.
I'm astonished that these insurers could deny costs involved in treatment for my son who was a cancer patient, and of course the republicans have made sure we can’t sue them outside of Federal Court. Isn't it amazing that in America, an insurance company can put profit over the very life of a patient, despite what his doctor prescribed, and more amazing is how many people put political party over fixing the abuses that are inflicted on us on a daily basis by these greedy companies?

Posted by: jimmcq | September 25, 2009 11:20 AM | Report abuse

HHS is right, the Republicans wrong. No agency using government funds should be allowed to ask its members or customers to lobby their Congressional representatives. The Republicans, deeply committed to defeating the Obama health reform initiative, of course want medical insurance groups to advocate lobbying against it. Republican "concern" for free speech is obviously disingenuous.

Posted by: ejmurphy414 | September 25, 2009 11:17 AM | Report abuse

The issue really should be - Can Humana or any insurer use their relationship with a Medicare enrollee to advance their political position? After all they are sending private letters to patients using the address obtained as part of enrollment into Medicare - no one is directly enrolled into Humana. In other words Humana is acting as an agent of CMS & Medicare and they should be subject to CMS rules. Humana is free to advertise their positions in the media, if they choose. But no direct communications using CMS' privileged data is CMS' condition for doing business as an agent. That seems fair and as it should be.

Posted by: TumTum | September 25, 2009 10:48 AM | Report abuse

We need to add another verse to that song those NJ schoolkids sang about how our benevolent leader and protector, Barack Hussein Obama, wants to save us from those big bad insurance companies.

Posted by: giantsfan | September 25, 2009 10:31 AM | Report abuse

yay! Censorship!!!

Posted by: visionbrkr | September 25, 2009 9:35 AM | Report abuse

so if they do this can't they also shut HCAN up too? Oh wait, they're FOR the president's reforms so they can lie all they want.

Posted by: visionbrkr | September 25, 2009 9:30 AM | Report abuse

It has been my belief that the 1st Amendment of the United States Constitution allowed freedom of speech.
FDR proclaimed it to be one of the "4 Freedoms".
It appears that the current administration is following in the footsteps of Hugo Chavez and Kim Jong Il in limiting this right.

p.s. I hope that the current administration and the media denounce what happened in New Jersey. I could hear, the justifible outrage, if this class had to sing a song praising George Bush.

Posted by: mwhoke | September 25, 2009 7:12 AM | Report abuse

There's a special place in hell for those who oppress the poor while sucking up to the rich. It will be packed with republicans and peppered with a sprinkling of blue dog sell-outs.

Posted by: rooster54 | September 25, 2009 6:13 AM | Report abuse

HHS Secretary Kathleen Sebelius. is just another Obama socialists. They both need to move to China where they would fit in nicely.

Posted by: HellMan1 | September 25, 2009 12:58 AM | Report abuse

It's pretty clear that a reduction in payments to Medicare Advantage plans would reduce the benefits to people enrolled in those plans. How is stating that fact misleading? This seems like a pretty clear cut example of the Government using intimidation to stifle legitimate criticism of their poorly thought out policy proposals.

Posted by: fallsmeadjc | September 24, 2009 10:58 PM | Report abuse

You see, the party of NO true colors in terms of the health care reform debate..they don't give a damn about the American people, they just want to protect their financial of NO, no ideas, no plans, nothing..did you see Rep.Cantor response to that lady at his recent town hall meeting.."sell all your assets, then when you are broke, we can help you"..that is the party of NO solution to health care reform..priceless, no wonder they are so out of touch with mainstream of NO, soon to be extinct like the dinosaurs and the dodo..

Posted by: ruraledcomm | September 24, 2009 10:28 PM | Report abuse

If payments are reduced to physicians and other healthcare providers you will eventually see a loss of benefits in the fact that providers will no longer take medicare patients or will no longer provide certain treatments - so the end result is a smaller network of care providers and an ever growing pool of patients - tell me where this is NOT a loss of benefits - we'll be like the other countries where the government is involved above & beyond where they need to be - you can die before seeing a healthcare provider or you will no longer be given specific treatments because medicare does not want to pay for them. It will create a spiral effect that just gets worse. Do the politicians really think that the babyboomers who control the money, etc., are going to lie down for that? We put you guys into office we can certainly finally get angry enough to start taking you out and replacing you with others. Party politics are not as important any longer - it is what you do or do not do while in office.

Posted by: roxanne371 | September 24, 2009 10:15 PM | Report abuse

For God's sake, leave the insurance companies alone. They are looking out for our best interests just like they have done for generations. Seriously, if those sneaky @@#@!#$ raise my premiums one more time, I will move to Canada. For real.

Posted by: seemstome | September 24, 2009 8:34 PM | Report abuse

Is Pat Roberts delaying Health Care Legislation Bill for the American people or for Lobbyists?

Posted by: usadblake | September 24, 2009 8:31 PM | Report abuse

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