Senate Passes Health Care Bill

Shortly after 7 a.m. this morning, with Vice President Joe Biden presiding, the Senate passed the health care bill by a 60 to 39 margin.

The vote was largely a formality, because Democrats already gained the 60 votes to invoke cloture and only needed a simply majority this morning. While there was some talk of a few Democrats defecting on the final vote when they were no longer needed, ultimately, the caucus stuck together — as did Republicans. Sen. Jim Bunning was the only absent Senator.

“This is for my friend Ted Kennedy, aye” the 92-year old Sen. Robert Byrd said when he voted, according to Mike Madden.

Sen. Arlen Specter, who became the 60th vote for Democrats when he effectively switched parties earlier this year, tweeted a similar sentiment: “With the passion of Ted Kennedy on our hearts. Aye.”

Shortly after voting on the health care bill, the Senate voted by a 60 to 39 margin to raise the federal debt limit by $290 billion to $12.4 trillion. How apropos.

With the health care bill having passed the Senate, it will have to be reconciled with the version that passed the House, and a number of obstacles still remain. Among other differences, the House bill has a public option and stronger abortion language. Given that Speaker Nancy Pelosi only had 3 votes to spare when the House passed the bill the first time around by a 220 to 215 margin, she’ll have some work to do. Rep. Bart Stupak and a handful of others who voted for the bill the first time have said they couldn’t without his abortion language, while a few more liberal members have lamented the lack of a public option. And whatever is negotiated to win approval in the House cannot upset the delicate balance that enabled Reid to achieve 60 votes in the Senate. At this point, however, the smart money would have to be on Democrats doing whatever they need to do to get this across the finish line.

Senate Health Care Bill Clears Last Procedural Hurdle: Final Vote Tomorrow

The Senate just voted 60 to 39 to cut off debate on the Senate health care bill, setting up a final vote for tomorrow morning at 7 a.m.

Leading up to the vote, Democrats defeated a number of Republican points of order challenging the constitutionality of elements of the health care bill such as the individual mandate as well as the “unfunded mandate” to the states in the form of expanding Medicaid by 15 million people. Sen. Jim DeMint also attempted to add an amendment that would have changed Senate rules to bar the practice of trading votes for earmarks, but it was tabled by a 53 to 46 vote.

Once the bill clears the Senate tomorrow, it will have to be reconciled with the House bill and then pass both chambers once again.

Obama and Reid Both Double-Counted Medicare Cuts

Earlier today, the Congressional Budget Office explained that the savings generated by Democrats’ proposed Medicare cuts could either be used to finance the health care bill or to extend the solvency of Medicare, but could not do both at the same time.

Put another way, Democrats cannot claim that their bill would both strengthen Medicare and decrease the defict. But that’s exactly what Democrats have been claiming over the the past week.

For instance, here was President Obama, during his Saturday remarks after Democrats secured the 60 votes needed to pass the health care bill:

This bill with strengthen Medicare and extend the life of the program.   Because it’s paid for and gets rid of waste and inefficiency in our health care system this will be the largest deficit reduction plan in over a decade.  In fact, we just learned from the Congressional Budget Office that this bill will reduce our deficit by $132 billion over the first decade of the program, and more than one trillion dollars in the decade after that.

And here was Sen. Harry Reid, speaking on the Senate floor in advance of the key cloture motion at 1 a.m. on Monday morning:

“And it protects America’s oldest citizens by strengthening Medicare and extending its life by nearly a decade….

“This bill also strengthens our future by cutting our towering national deficit by as much as $1.3 trillion dollars over the next 20 years — that’s trillion, with a ‘T.’  It cuts the deficit more sharply than anything Congress has done in a long time.

Similar comments have been echoed by Democrats during the several weeks that the Senate has been debating health care — it would have been nice to have the CBO memo back when it could have actually made a difference.

Top House Dem: Scrap Senate Bill and Start Over

Rep. Louise Slaughter, chairwoman of the House Rules Committee, has declared that the Senate bill does not represent real reform and cannot be reconciled with the version that passed the House of Representatives. Instead, she recommended killing the Senate bill and starting all over.

“The Senate health care bill is not worthy of the historic vote that the House took a month ago,” Slaughter wrote in an opinion piece appearing on CNN’s website today.

She complained that without the presence of a public option, the bill won’t lower costs and would represent a subsidy to private insurance.

“Although the art of legislating involves compromise, I believe the Senate went off the rails when it agreed with the Obama Administration to water down the reform bill and no longer include the public option,” she wrote.

She also complained that the bill would allow insurers to charge higher premiums to older people and does not repeal the antitrust exemption enjoyed by insurers.

She concludes:

Supporters of the weak Senate bill say “just pass it — any bill is better than no bill.”

I strongly disagree — a conference report is unlikely to sufficiently bridge the gap between these two very different bills.

It’s time that we draw the line on this weak bill and ask the Senate to go back to the drawing board. The American people deserve at least that.

The statement is a headache for Democratic leadership at a time when they are on the verge of passing a bill in the Senate. In the first go around, the House bill passed by a narrow 220 to 215 vote, so Speaker Nancy Pelosi only has three votes to spare. The absence of the Stupak abortion language is already going to cost her some votes among pro-life Democrats (as well as the lone Republican to vote for it, Joseph Cao), so any votes she loses on the left would have to be made up elsewhere. Any compromise to attract liberal members of the House could upset the delicate balance that achieved 60 votes in the Senate. On the other hand Rep. Jason Altmir, a Democrat who voted against the bill the first time, said “a lot” of Blue Dog Democrats could support something along the lines of the Senate bill this time around. 

Via the Hill.

Now They Tell Us: CBO Double Counted Medicare Savings

After allowing Democrats for weeks to argue that their Medicare cuts would both help finance the new health care legislation and extend the solvency of Medicare, the Congressional Budget Office explained today that the bill could do one or the other, but not both at the same time.

The new memo, released after Democrats have already secured 60 votes, reads:

The key point is that the savings to the HI (Medicare Hospital Insurance) trust fund under the PPACA (Patient Protection and Affordable Care Act) would be received by the government only once, so they cannot be set aside to pay for future Medicare spending and, at the same time, pay for current spending on other parts of the legislation or on other programs. Trust fund accounting shows the magnitude of the savings within the trust fund, and those savings indeed improve the solvency of that fund; however, that accounting ignores the burden that would be faced by the rest of the government later in redeeming the bonds held by the trust fund. Unified budget accounting shows that the majority of the HI trust fund savings would be used to pay for other spending under the PPACA and would not enhance the ability of the government to redeem the bonds credited to the trust fund to pay for future Medicare benefits. To describe the full amount of HI trust fund savings as both improving the government’s ability to pay future Medicare benefits and financing new spending outside of Medicare would essentially double-count a large share of those savings and thus overstate the improvement in the government’s fiscal position.

Via Say Anything.

Sen. Jeff Sessions, after conversing with CBO director Doug Elmendorf, said that without the revenue from the Medicare cuts, the bill would actually increase deficts by nearly $300 billion, FoxNews reports.

“Either you’ve weakened the Medicare substantially or you’re going to have no money to spend on the new program that’s being created,” Sessions said. “You cannot spend this money twice.”

UPDATE: Here are some more thoughts from David Hogberg and Megan McArdle.

Landrieu Lies About Cost-Cutting in Senate HC Bill

Under fire from C-SPAN callers who accused her of selling her health care vote for $100 million in aid to Louisiana, Sen. Mary Landrieu on Tuesday made false claims about cost-cutting achieved by the Senate health care bill.

Asked by a C-SPAN host, “Can you specifically tell our viewers how this will lower health care costs?” Landrieu responded:

Well first of all, it’s going to lower the cost to our government over time. Again we’re spending 16 percent of our gross national product on health care. Japan, which is a competitor, and they’re a much smaller country, but they are a robust economic country in the world, they’re spending 8 percent of their GDP. Now, ours is projected to go up to 18 percent. So if we could taper this off, and stay at 16 percent, or go down to 15 percent, over time, 14 percent. That may be aggressive, but when we start bending that cost curve, the government will save money, therefore every taxpayer will save money.

She’s absolutely right that if we reduced the amount of money we spend on health care, it would save the government money. The problem is, the legislation she supports would do the exact opposite.

The government agency that is tasked with keeping tabs on total national health care expenditures — that is, the source of the 16 percent of GDP number — is the Centers for Medicare and Medicaid Services. Earlier this month, CMS analyzed the Senate bill, and they found that if enacted, health care spending would swell to 20.9 percent of GDP — higher than if we simply did nothing.

Democrat Congressman Switches Parties Over Health Care

The Politico reports:

POLITICO has learned that Rep. Parker Griffith, a freshman Democrat from Alabama, will announce today that he’s switching parties to become a Republican.

According to two senior GOP aides familiar with the decision, the announcement will take place this afternoon in Griffith’s district in northern Alabama.

Griffith’s party switch comes on the eve of a pivotal congressional health care vote and will send a jolt through a Democratic House Caucus that has already been unnerved by the recent retirements of a handful of members who, like Griffith, hail from districts that offer prime pickup opportunities for the GOP in 2010.

I await the barrage of stories in the media about how Democrats are losing moderates because the party has been hijacked by the radical leftist fringe.

Largest Deficit Reduction in History?

For months, Democrats have been arguing that their health care bill would be deficit neutral, but the American people haven’t been buying it. A Quinnipiac poll released earlier today found that by a 73 percent to 18 percent margin, Americans don’t believe President Obama will be keep his promise that the health care bill would reduce the deficit — and just 32 percent of Democrats believe him. Evidently, Democrats have decided that the best way to confront this perception is to make even bolder claims. While initially the idea was that it wouldn’t add to the deficit, on Saturday Obama declared that the Senate bill was “the largest deficit reduction plan in over a decade.” Not to be outdone, Sen. Dick Durbin later boasted on the Senate floor that it was “the greatest deficit reduction bill in the history of the United States.”

The claim is based on a report by the Congressional Budget Office estimating that the Senate bill would reduce the deficits by $132 billion from 2010 to 2019. The CBO’s finding, however, was the result of a number of assumptions and accounting gimmicks that disguise the true cost of the legislation. More than half of that deficit reduction comes from the revenues generated by the Class Act — a new government-run long-term care insurance program that begins collecting premiums before it starts paying out benefits. That means that in the first decade, it reduces the deficit by $72 billion, but the CBO also tells us that it begins operating at a loss after 2029. The CBO also assumed that Democrats would allow a substantial cut in doctors payments under Medicare to actually happen, even though they already used the defense spending bill to delay the cuts until late February, at which time they are expected to reintroduce $250 billion legislation to avert those cuts over the next decade. This item alone would wipe out all of the projected deficit reduction, and then some. The Senate bill also delays 98 percent of the spending until after 2014 so that the bill will appear cheaper over the CBO’s 10-year budget window. And the CBO assumed that future lawmakers would actually enact the proposed Medicare cuts, which it noted “is often not the case for major legislation.”

But putting all of that aside, let’s just say for the sake of argument that the $132 billion deficit reduction figure is valid. It’s still worth putting in the proper context. According to the White House Office of Management and Budget, cumulative deficits will be $9.1 trillion from 2010-19, while the CBO, using different assumptions, projected the deficits at $7.1 trillion. As the chart below demonstrates, the projected deficit reduction from the health care bill in its first 10 years pales in comparison to overall deficits accumulated during the same period.

Thus, by making wild statements about this being the largest deficit reduction package in history, Democrats are going to pay a political price down the road. Even if the health care legislation reduces the deficit (which I don’t think will happen), Americans won’t isolate the effect of that one bill. All they’ll care about is that a massive health care bill passed that Democrats claimed would reduce deficits, and yet there are still massive deficits.

Sebelius: Everybody Will Pay for Abortion Coverage

Via Ed Morrissey, I see this illuminating interview in which Health and Human Services Secretary Kathleen Sebelius says that under the Senate health care bill, everybody purchasing a health care policy on the new government-run exchange would have to pay into a fund to finance abortion coverage for others. The interview was conducted by that BlogHer‘s Morra Aarons-Mele. Transcript, and video, below.

SEBELIUS: And I would say that the Senate language, which was negotiated by Senators Barbara Boxer and Patty Murray, who are very strong defenders of women’s health services and choices for women, take a big step forward from where the House left it with the Stupak amendment, and I think do a good job making sure there are choices for women, making sure there are going to be some plan options, and making sure that while public funds aren’t used, we are not isolating, discriminating against, or invading the privacy rights of women. That would be an accounting procedure, but everybody in the exchange would do the same thing, whether you’re male or female, whether you’re 75 or 25, you would all set aside a portion of your premium that would go into a fund, and it would not be earmarked for anything, it would be a separate account that everyone in the exchange would pay.

BLOGHER: It’s a bit confusing, but â€_

SEBELIUS: Okay. It is a bit confusing, but it’s really an accounting that would apply across the board and not just to women, and certainly not just to women who want to choose abortion coverage.

BLOGHER: Oh, that’s good, that’s good.

By 2-to-1 Margin, Independents Oppose Obamacare

A new Quinnipiac poll finds that independents oppose Democrats’ health care legislation by a 58 percent to 30 percent margin — or nearly 2-to-1. Among the broader population, it’s opposed 53 percent to 36 percent.

In another finding, by a 73 percent to 18 percent margin, Americans do not believe that President Obama will keep his promise to cut the deficit. What’s especially shocking, is that less than a third of Democrats — just 32 percent — believe he will keep his promise.

It’s worth keeping in mind that for Democrats to win in conservative states or districts, they must be able to win independents, and at least have a respectable showing among Republicans. This health care bill won’t make it much better.