Senate passes reconciliation bill 56-43

Senate Republicans failed to derail passage of the budget reconciliation bill containing changes to the health insurance reform bill and to the student loan program. The vote was 56-43, with all but three Democrats (Blanche Lincoln and Mark Pryor of Arkansas, Ben Nelson of Nebraska) voting yes and all Republicans present voting no. The Democratic strategy was to defeat all proposed amendments, so no Democrat offered an amendment to put a public health insurance option in the bill. However, some changes to the part of the bill dealing with Pell grants were made, which means the amended version of the reconciliation bill will have to go back to the House for another vote.

I assume the House will have the votes to pass the amended reconciliation bill. In theory, House Democrats could try to add a public health insurance option, but that would require another vote in the Senate. I think leadership wants to declare victory on this issue and move on.

Speaking of health insurance reform, it turns out the bill Obama just signed had a loophole that will allow insurers to keep denying coverage to children with pre-existing conditions until 2014. Health and Human Services Secretary Kathleen Sebelius claims this can be fixed through rule-making, but we'll see. I suspect insurance companies will be able to work around most of the supposedly tough regulations in the new law.

Another health insurance reform news thread

President Barack Obama gave House Democrats a pep-talk today, and his speech (which wasn't pre-written) got rave reviews from many Democrats. If only the Senate bill were as good as Obama made it sound.

As Nathan mentioned earlier today, House Democratic leaders have decided to ditch the "deem and pass" method for passing health insurance reform with a single vote, even though the legislative procedure isn't as rare or controversial as Republicans would have you believe. Instead, the House will hold an hour of flood debate tomorrow on "the rule to allow reconcilation to get to the floor," then House members will vote on the rule, then they will debate the Senate health insurance reform bill and vote on it. I assume this means that House Speaker Nancy Pelosi is confident she has the 216 votes she needs.

Bart Stupak is now claiming only about half a dozen Democrats are willing to vote against the bill unless it contains major new restrictions on private insurance coverage of abortion. Stupak was supposed to hold a press conference this morning, but he cancelled it, so maybe that means he didn't get the deal he was hoping for from Pelosi. David Dayen speculates on who is still in the Stupak bloc. David Waldman warns about the prospect that Stupak will use a "motion to recommit" to try to get his anti-abortion language into the reconciliation fix package.

Senator Tom Harkin and the three Iowa Democrats in the House "announced a major breakthrough today on the issue of Medicare payment reform in the final health care reform bill," according to a joint press release. Excerpt:

[Representatives Dave] Loebsack, [Senator Tom] Harkin, [Leonard] Boswell and [Bruce] Braley have been outspoken advocates for changing the way Medicare pays health care providers for services, from its current fee-for-service system into a quality and value-based system.

Loebsack, Harkin, Boswell and Braley helped negotiate a compromise adding language to the health care reform bill that provides an immediate $800 million to address geographic disparities for both doctors and hospitals, as well as written guarantees from Health and Human Services Secretary Kathleen Sebelius for further action to reform Medicare reimbursement rates that do not qualify for reconciliation under the Byrd Rule. The Senate bill previously only provided a Medicare reimbursement fix for doctors.

The House reconciliation package maintained automatic implementation of a value index as part of the reimbursement structures for doctors, beginning in 2015. This language was secured in the Senate bill with the help of Harkin and is based on Braley’s Medicare Payment Improvement Act, introduced in June 2009. Under the fixes secured in the Senate bill and the House reconciliation package, Iowa doctors will see five percent increases in current Medicare reimbursement rates in both 2010 and 2011.

I posted the whole press release, containing more details, at Bleeding Heartland. This deal appears to have secured the vote of Peter DeFazio (OR-04) as well. Yesterday he threatened to vote no because of language on the Medicare payments disparity.

Outside the Capitol, tea party protesters shouted racist insults and held signs threatening gun violence if health care reform passes. Congressional Republicans should disavow this reprehensible behavior, but of course they won't.

Share any relevant thoughts in this thread.

Stupak may yet bring down health insurance reform (updated)

Several undecided House Democrats came out in support of the health insurance bill today, but it's still not clear whether leaders have the 216 votes they need. Between six and twelve Democrats are in Bart Stupak's bloc, which will vote for the bill only if it severely restricts private insurance coverage for abortions. Chris Bowers thinks some "bullshit" compromise may peel away the few votes House Speaker Nancy Pelosi needs from the Stupak bloc, but a more disturbing possibility is taking shape.

Stupak is demanding that his amendment be voted on later as an "enrollment corrections" bill. The parliamentary procedure here is complicated, so I ask you to read David Waldman or David Dayen for an explanation.

Pro-Choice Caucus co-leader Diana DeGette claims that 40 to 555 House Democrats may not vote for the final deal if it includes a promise to enact the Stupak language separately. I assume most of those would cave, but if even five or ten stood their ground, they would cancel out the Stupak bloc members.

Given how much Democrats rely on women voters to win elections, it's amazing that they would sell out abortion rights to appease a few anti-choicers. Although the Catholic Bishops have opposed the health insurance reform bill, a major Catholic newspaper as well as groups representing Catholic hospitals and nuns are supporting it. Then again, after abandoning other core Democratic positions on health care reform (like letting Medicare negotiate for lower drug prices), what's another kick in the teeth for the base?

Meanwhile, Senate Majority Leader Harry Reid offers what sounds to me like false hope of a separate vote on a public health insurance option. Such a vote would have to be attached to a budget reconciliation bill in order to have any hope of passing the Senate.

As far as I know, the dispute over Medicare reimbursement rates has not been resolved yet. Peter DeFazio has threatened to vote no if geographical disparities in Medicare payments are not corrected, and today Representative Bruce Braley's spokeswoman told me that he is undecided on the bill, in part because of that issue. Other House Democrats have also expressed concern, according to the Huffington Post. I doubt Braley will end up voting against health insurance reform, but I wouldn't be surprised to see Pelosi negotiate language on Medicare reimbursement rates that's closer to the House bill.

UPDATE: Stupak was supposed to hold a press conference Saturday morning at 11, but that was cancelled. I assume that means he and Pelosi don't have a deal yet, but who knows?

Health insurance reform whip count thread

Sunday's House vote on health insurance reform still looks like a nail-biter, though some would argue that the question isn't whether Speaker Nancy Pelosi will find 216 votes, but which Democrats in tough districts will be allowed to vote no.

Various whip counts are floating around the internet. Take your pick from David Dayen's version at FireDogLake, the Chris Bowers tally at Open Left, or the latest from The Hill staff.

Here's some recent news: Peter DeFazio (OR-04) is now threatening to vote no because yesterday leaders stripped out language on correcting geographical disparities in Medicare spending. Stupak bloc member Marcy Kaptur (OH-09) is now leaning toward "yes." John Boccieri (OH-16), who voted against health care reform in November, is switching to "yes." Dina Titus (NV-03) also confirmed today that she will vote yes.

This thread is for any comments related to Sunday's vote. I will update later if more Democrats on the fence announce their positions.

IA-Gov: Culver won't have a primary challenger after all

Jonathan Narcisse told the Des Moines Register's Kathie Obradovich yesterday that he won't run against Governor Chet Culver in the Democratic primary. He plans to register for the ballot as an independent candidate. Narcisse served a term on the Des Moines School board is the publisher of several African-American and Latino-oriented publications. He also appears regularly on some talk radio programs in Iowa. His political views are an unusual blend, as you can see from reading his manifesto, An Iowa Worth Fighting For. Narcisse advocates some ideas commonly associated with Republican candidates (big reductions in corporate and property taxes and the size of government), as well as others usually heard on the political left (e.g. supporting living wage legislation and reform of drug laws and sentencing).

Obradovich reported yesterday,

Narcisse says he collected enough signatures to get on the ballot (the deadline is Friday), but he said his changed his mind about filing based on what he heard from Iowans as he’s traveled around the state. “They really want an independent voice,” he says, someone not tied to either party.

I asked Narcisse if he would be willing to release the signatures, because otherwise people will be skeptical that he was able to collect them. He didn’t outright refuse but he also didn’t say he would release them. He said he’s used to dealing with skepticism from the media but he’s focused on making his case to voters around the state. But if he’s going to say he’s collected them, he should prove it.

Obradovich posted a press release from Narcisse, which explained his decision and thanked the volunteers who "helped me obtain the signatures that I needed to be on the June 8th primary ballot."

Ever since Narcisse announced plans late last month to run for governor as a Democrat, many political observers have privately predicted that he would not be able to meet the signature requirements. Narcisse can speak knowledgeably about public policy for hours, but his campaign manager is a management consultant and former teacher with no previous political experience. Democrats seeking statewide office in Iowa had to submit more than 4,000 total signatures (0.5 percent of the party's statewide vote in the 2008 presidential election), including at least 1 percent of the party's vote total in that election in at least 10 counties. (Statewide Republican candidates needed to meet the same percentage targets, but that worked out to fewer total signatures because Barack Obama did so much better than John McCain in Iowa.)

A strong statewide organization could collect more than 4,000 signatures on short order; Republican candidate Rob Gettemy's campaign collected 3,000 in the second Congressional district in just two weeks. I agree with Obradovich that observers will remain skeptical about Narcisse's campaign if he doesn't release his nominating petitions. Republican blogger Craig Robinson writes today that Narcisse's story has shifted dramatically in the last three days. He concludes, "The inability for Narcisse to get on the Democratic primary ballot is a deadly blow to any credibility he may have had as a candidate."

Ed Fallon had been recruiting some Democrat other than Narcisse to challenge Culver, but nothing materialized. In my opinion, Culver didn't deserve a primary challenger despite the many complaints you hear about him from Iowa Democrats.

Senate sends small jobs bill to Obama

The U.S. Senate gave final approval to a small jobs bill today by a vote of 68-29. Eleven Republicans and the Senate's two independents joined 55 Democrats to pass the bill. The only Democrat to vote no was Ben Nelson of Nebraska (roll call here). The motion to invoke cloture on this jobs bill passed the Senate on Monday by a 60-31 vote, with six Republicans voting with all Democrats but Ben Nelson (roll call here).

From the Washington Post:

The centerpiece of the bill is a new program giving companies a break from paying Social Security taxes for the remainder of 2010 on any new workers they hire who had been unemployed for at least 60 days. Employers would also get a $1,000 tax credit for each of those workers who stays on the payroll for at least one year.

Aside from that program, the measure includes a one-year extension of the law governing federal transportation funding, and would transfer $20 billion into the highway trust fund. The bill also extends a tax break allowing companies to write off equipment purchases, and expands the Build America Bonds program, which helps state and local governments secure financing for infrastructure projects.

Last month the Senate approved a similar bill, but after the House made minor changes, the bill had to clear the Senate again before going to the president's desk.

Most House Democrats support a larger job-creation bill with more money for infrastructure projects, but there may not be 60 votes in the Senate for such a measure.

What will it take to close the gun show loophole?

How many more tragedies need to happen before elected officials have the guts to close the gun show loophole? The latest high-profile beneficiary of this loophole was the mentally ill attacker in the recent shootings near the Pentagon.

Law enforcement officials say [John Patrick] Bedell, a man with a history of severe psychiatric problems, had been sent a letter by California authorities Jan. 10 telling him he was prohibited from buying a gun because of his mental history.

Nineteen days later, the officials say, Bedell bought the Ruger at a gun show in Las Vegas. Such a sale by a private individual does not require the kind of background check that would have stopped Bedell's purchase.

Republican politicians fall all over themselves trying to prove how loyal they are to the National Rifle Association. Some are against any kind of background checks for people who want to carry firearms in public. Too many Democrats are afraid to stand up to this NRA-approved extremism. Meanwhile, a Republican pollster's recent survey of gun owners shows that they understand the need for reasonable limits:

Mr. Luntz queried 832 gun owners, including 401 card-carrying N.R.A. members, in a survey commissioned by Mayors Against Illegal Guns, the alliance of hundreds of executives seeking stronger gun laws. In flat rebuttal of N.R.A. propaganda, the findings showed that 69 percent of N.R.A. members supported closing the notorious gun-show loophole that invites laissez-faire arms dealing outside registration requirements.

Even more members, 82 percent, favored banning gun purchases to suspects on terrorist watch lists who are now free to arm. And 69 percent disagreed with Congressionally imposed rules against sharing federal gun-trace information with state and local police agencies.

I know it's not realistic to hope that a historically large Democratic majority in Congress would have the guts to take on the gun show loophole. (They can barely find enough votes to pass what's essentially a 1993 Republican health care reform proposal.) Too bad "pro-gun" Democrats would rather preserve their NRA scorecard ratings than enact limits that even rank and file NRA members find reasonable.

Caution: Now entering a fact- and logic-free zone

I've heard some strange arguments against marriage equality, but the latest from Iowa Family Policy Center President Chuck Hurley is a doozy. Reacting to a new report on HIV and syphilis rates among gay and bisexual men, Hurley asserted,


“The Iowa Legislature outlawed smoking [in some public places] in an effort to improve health and reduce the medical costs that are often passed on to the state,” Hurley said. “The secondhand impacts of certain homosexual acts are arguably more destructive, and potentially more costly to society than smoking.” [...]


“Iowa lawmakers need to pay attention to hard facts and not be persuaded by emotion laden half-truths,” he said. “Because of their unwillingness to correct the error of last April’s Iowa Supreme Court opinion, the Iowa Legislature is responsible for sanctioning activities that will lead to dramatically higher rates of HIV and syphilis in Iowa.”


Where to begin? Smoking increases the risk of heart disease, cancer, stroke, and various respiratory ailments, causing an estimated 438,000 preventable deaths every year nationwide. In Iowa, smoking directly causes an estimated 4,400 deaths each year, and secondhand smoke claims another 440 lives. Smoking causes about $1 billion in health care costs every year in Iowa, of which about $301 million is covered by Medicaid.

AIDS is a serious health threat in the U.S., but not on the same scale as smoking. AIDS has caused fewer than 20,000 deaths nationwide per year in the past decade. The total number of AIDS deaths in this country since the epidemic began is estimated at just under 600,000. I was unable to find statistics showing how many Iowans have died of AIDS, but according to this report for the Iowa Department of Public Health, 114 Iowans were diagnosed with HIV in 2005, and 79 Iowans were diagnosed with AIDS the same year. The numbers may have increased somewhat since then, but AIDS is nowhere near as "destructive" and "costly" to Iowans as smoking. Iowa's syphilis rate is far below the national average, and none of the states with the highest syphilis rates permit same-sex marriages. If Iowa legislators want to influence the syphilis rate, they should focus on providing adequate funding levels for STD testing and ensuring that young people have access to medically accurate sex education.

Hurley's argument is not only fact-free, but also illogical on several levels. He seems to think that allowing same-gender couples to get married is going to encourage many more Iowans to experiment with gay sex. Do you know anyone who decided to become gay because they knew they'd be able to get married? Has homosexual activity diminished in New York and New Jersey since those states' legislatures declined to legalize same-sex marriage? Did California's Proposition 8 reduce the number of gays and lesbians having sex there?

If Hurley is worried about promiscuity and sexually-transmitted diseases, he should be happy to see gay couples settle down and get married. His opposition to gay marriage is more coherent than, say, Terry Branstad's, but it's also more detached from reality. Maybe Hurley's latest comments aren't the worst argument ever against gay marriage, but they are certainly a contender.

Contrary to the strange fantasies of the Iowa Family Policy Center crowd, the Iowa Supreme Court didn't make the sky fall last April. Fortunately, most Iowans understand that our state legislators have more important things to do than overturn same-sex marriage rights. They also sense that giving legal recognition to the relationships of committed same-sex couples does no harm to other people. More than 90 percent of respondents in a statewide poll conducted last September said gay marriage had caused "no real change" in their lives.

Republicans failed to bring a constitutional amendment on marriage to a floor vote in the Iowa House or Senate this year. However, they kept trying to inject the marriage issue into unrelated legislation, most recently a bill that would take gun rights away from people who are subject to a restraining order or have been convicted of domestic abuse crimes.

GOP should return money raised from deceptive census mailings

On Wednesday the House of Representatives unanimously approved HR 4261, the Prevent Deceptive Census Look-Alike Mailings Act. The short bill would ban fundraising letters like those the Republican National Committee and National Republican Congressional Committee sent last month, which gave the appearance of being official census documents. Those mailings were legal because they did not "use the full name of the U.S. Census Bureau or the seal of any government agency." However, even Republicans have admitted that the tactic crosses a line, and no one in the House GOP caucus wanted to go on record opposing the bill on Wednesday.

On the other hand, it costs Congressional Republicans nothing to vote for this bill. Their committees are already cashing checks from this year's deception, and the next census won't roll around for ten years. If Republicans truly believe it's wrong to raise money with a fake census letter, they should return all contributions from suckers they've duped this year.

Senate votes to extend unemployment and other benefits, tax credits

Yesterday the Senate approved HR 4213, the Tax Extenders Act of 2009, by a 62-35 vote. As you can see from the roll call, every Democrat present except Ben Nelson of Nebraska voted for the bill. All but six Republicans (Kit Bond of Missouri, Susan Collins and Olympia Snowe of Maine, Lisa Murkowski of Alaska, David Vitter of Louisiana and George Voinovich of Ohio) voted against it. Republican Scott Brown of Massachusetts voted for the cloture motion to let the bill proceed but against the bill.

Senator Tom Harkin's office summarized some of the $140 billion bill's key provisions:

o Extend the current federal unemployment benefits program through Dec 31, 2010.

o Extend the federal funding of the state share of Extended Benefits through Dec 31, 2010.

o Extend eligibility for the temporary increase of $25 per week in individual weekly unemployment compensation through Dec 31, 2010.

o Extend the 65 percent subsidy for COBRA coverage through Dec 31, 2010. o Extend the Medicare payment fix for doctors.

o Extend FMAP, the federal share of Medicaid payments, to give state budgets some relief.

Last week, Congress passed a 30-day extension of the federal unemployment benefits program (through April 5th) and the extension prior to that continued unemployment benefits for 2 months (from Dec 2009 to Feb 2010).

The Hill reported that about $80 billion of the bill's cost "goes toward prolonging increased levels of federal unemployment aid and COBRA healthcare benefits for the jobless through the end of December." According to the Washington Post, the main Republican objection was that the bill will add to the deficit. It's notable that Republicans never let concerns about the deficit stop them from voting for unaffordable wars or tax cuts for the wealthy. But unemployment benefits that help struggling families while stimulating the economy and creating jobs are too expensive for Republicans.

House Democrats may want a conference committee to reconcile the bill the Senate passed yesterday with a $154 billion jobs bill the House approved in December. That bill included "significant new spending for infrastructure projects, as well as aid to states to prevent layoffs of key personnel such as teachers, police and firefighters." Senate Majority Leader Harry Reid has reportedly promised to "bring up a bill that included the infrastructure and state fiscal aid measures from the House jobs bill" before the Senate's Easter break.


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