House votes to repeal health reform, Branstad completes flip-flop

The House of Representatives passed a bill today on “Repealing the Job-Killing Health Care Law Act” by a vote of 245 to 189. Iowa’s delegation split along the usual party lines: Democrats Bruce Braley (IA-01), Dave Loebsack (IA-02), and Leonard Boswell (IA-03), who voted for the Affordable Care and Patient Protection Act last year, voted against repeal. Republicans Tom Latham (IA-04) and Steve King (IA-05) voted against health insurance reform last year and for repealing it. King was delighted: “100% of my language to repeal 100% of ObamaCare just passed the House with 100% Republican support = 100% great day 4 the USA!” Press releases from Braley, Loebsack, Boswell, Latham and King are after the jump. Latham’s statement mentions the main points of the “replacement health care legislation” House Republicans are drafting.

Various groups and politicians have issued statements warning that many Americans will be hurt by repealing the health insurance reform. I’ve posted a few of those after the jump too, but I wouldn’t lose any sleep worrying about that just now. Repeal is a dead letter at least through 2012 and could advance in 2013 only if Republicans capture the U.S. Senate and defeat President Barack Obama.

I found it interesting that only three House Democrats voted for today’s repeal bill, even though 13 current members of the Democratic caucus voted against health insurance reform in the last Congress. Good whipping by Nancy Pelosi and Steny Hoyer, or recognition that popular support for repeal may be declining?

Here in Iowa, Governor Terry Branstad announced on January 18 that he joined the state of Florida’s lawsuit challenging the constitutionality of health insurance reform:

“I am signing on to this suit as the governor on behalf of the people of Iowa, because I believe Iowa taxpayers deserve to be heard on this critical matter,” Branstad said in a statement. “As we begin constructing our five-year budget, there is no doubt that the current federal health care law will shackle Iowa taxpayers for billions in unfunded mandates.”

The suit challenges the individual mandate of the health care reform law, as well as the expansion of Medicaid, the state-federal health insurance program for low-income people, said Branstad spokesman Tim Albrecht.

Branstad’s action is purely symbolic. The case will be litigated no matter how many states sign on as plaintiffs, and if the law is ruled unconstitutional, all states will be affected, not just those that joined the suit. Though I’m not an attorney, it seems that a whole lot of federal laws would have been struck down over the years if unfunded mandates really were unconstitutional.

Legal experts disagree over whether the Commerce clause gives Congress the power to require individuals to purchase health insurance reform.

Politically, Branstad’s opposition to health insurance mandates will boost his standing with the Republican base. They don’t really mind “activist judges,” and they won’t remember that Branstad advocated for a mandate to purchase health insurance as recently as 2007. (He explained why here.) The governor’s legal counsel, Brenna Findley, made the case against the individual mandate a central argument in her campaign against Attorney General Tom Miller last year. Miller supports the federal health insurance reform and has said the law is “heavily on the side of constitutionality.”

Bruce Braley’s statement:

Washington, DC – Today, Congressman Bruce Braley (IA-01) voted against the Republican bill to repeal the health care reform law.

“The new majority campaigned on balancing the budget and getting our deficit under control, but their very first legislative initiative would blow a $230 billion hole in our deficit,” said Congressman Braley. “There’s no way I could support this irresponsible legislation.”

If enacted into law, the Republicans’ repeal would also roll back the most popular provisions that protect consumers from insurance company abuses. Insurance companies would once again be able to deny coverage to children and adults with pre-existing conditions, prevent young adults from staying on their parents’ plans until age 26 and drop coverage for pregnant women and cancer survivors.

“The health care law, and the Republicans’ effort to repeal it, has a human face,” said Braley. “My nephew was finally able to take a new job, knowing his four-year-old son Tucker won’t be dropped from his new health plan because of a liver cancer diagnosis. That’s just one family. There are millions like them in Iowa and across the country.”

“My Republican colleagues also don’t seem to understand the very serious ramifications of their political games – or they haven’t read their own bill. The text of their bill clearly states that they intend to repeal the health care law and restore its provisions as if it had never been enacted. One consequence of that language is that if this bill becomes law, millions of seniors across the country would be forced to pay the government $250 that they received and already spent under the health care reform law. I know Iowa’s seniors can’t afford that – and I certainly won’t let my constituents pay the price for this political stunt.”

Dave Loebsack’s statement:

WASHINTGON, DC-Today, Congressman Loebsack voted in opposition to legislation that passed the House of Representatives to repeal the Patient Protection and Affordable Care Act. Repealing health care reform would eliminate key new patients’ rights, increase out-of-pocket health costs, and unfortunately, in some cases, take away Iowans’ health coverage. Last week, the independent Congressional Budget Office estimated that repealing the Patient Protection and Affordable Care Act would increase the deficit by $230 billion.

“The historic health care bill signed into law last year, put patients ahead of insurance company profits by ending the worst industry practices, reigning in exploding health care costs, ensuring more Iowans have access to care, and giving taxpayers more for their money,” said Loebsack. “Unfortunately, if the bill is repealed, Iowans will lose these benefits and the peace of mind that comes with having stable, quality health care.”

In the Second District alone repealing health care reform now would allow insurance companies to deny coverage to up to 268,000 individuals, including up to 33,000 children, with pre-existing conditions. It would also eliminate new health care coverage options for almost 1,800 young adults. In addition, repeal would increase prescription drug costs for up to 11,400 seniors who hit the Medicare Part D “donut hole” and deny new preventive care benefits to approximately 95,000 seniors.

Loebsack cosponsored amendments to preserve provisions of the Patient Protection and Affordable Care Act that prohibit insurance companies from denying coverage to individuals with pre-existing conditions, allow young adults to stay on their parents’ health insurance until age 26, extend the solvency of Medicare by an additional twelve years, close the prescription drug “donut hole” for seniors, and maintain tax cuts to small businesses to provide health care to their employees. None of these amendments were allowed to come to the Floor for a vote.

“These provisions are critical to helping Americans live longer, more productive lives. If the bill is repealed, millions of Americans could be denied access to care, our future health care costs will rise, and the deficit we leave to our children and our grandchildren will increase by $230 billion,” added Loebsack.

Leonard Boswell’s statement:

Washington, D.C. – Today, Congressman Leonard Boswell voted against H.R. 2, the Patients’ Right to Repeal Act, which repeals current health care law that protects Iowa’s families, seniors, and workers from insurance company abuses.

Boswell released the following statement on his vote.

“Instead of focusing on what Iowans really care about, which is jobs and the economy, the new Republican majority is wasting taxpayers’ dollars on repealing laws that helps more Iowans afford health insurance and prevents insurance companies from taking advantage of consumers when they are at their most vulnerable. H.R. 2 is playing politics at its worst – on the public dime.”

“Under repeal, Iowa’s families, seniors, and workers would lose rights that protect them from insurance company abuses and give them more freedom and control over their health care choices. Repeal may also have severe repercussions on our economy, which has seen an average of 20,000 private sector jobs added each month in the health care industry since the passage of health care reform. Iowans cannot afford the cost of repeal.”

Tom Latham’s statement:

Iowa Congressman Tom Latham voted on Wednesday to repeal President Obama’s job-destroying health care law off the books as he prepares replacement health care legislation that addresses the actual concerns of Iowans.

The House voted 245 – 189 to repeal the health care legislation, which was supported by President Obama and authored by congressional Democrats last year.  In the months since its passage, the credibility of supporters’ claims that the bill would decrease health spending and lower the deficit has steadily eroded.

“The health care law is full of new government mandates and taxes that will raise premiums, destroy jobs and further weaken our country’s fiscal standing,” Congressman Latham said following the vote.  “Striking this massive policy failure from the books is a necessary step so we can enact real reform that makes premiums more affordable and encourages job growth.  Those are the reforms the American people have been demanding all along.”

Congressman Latham is crafting his own health care legislation that will expand coverage and lower costs for millions of Americans without adding to the national debt.

His legislation, which he will formally introduce in the coming days, includes the following provisions:

– It guarantees affordable health care to those with pre-existing conditions, without making coverage unaffordable for others.

– It greatly reduces the cost of individual health policies by allowing a full deduction for health insurance premiums – whether or not a taxpayer itemizes deductions.

– It allows health insurance plans to be purchased across state lines.

– It establishes small business health plans, so small employers can pool together to negotiate for lower premiums for workers.

– It contains real medical liability reform, capping damages and awards in liability cases.

– It enhances health savings accounts by allowing taxpayers to use HSA funds to pay the premiums for the health insurance plan that is paired with the account.

– It cracks down on Medicare and Medicaid fraud.

Congressman Latham’s legislation also would retain the common-sense features recently enacted into law that received broad support among citizens and lawmakers.  Retained provisions include requiring coverage for pre-existing conditions in children, allowing dependents to stay on their parents’ policies until age 26, prohibiting annual and lifetime benefit limits and preventing insurers from unjustly canceling policies.

“The legislation that I intend to introduce is a common-sense approach to addressing the weaknesses in our health care system without destroying what works well,” Congressman Latham said. “It utilizes the provisions of the new health care law that received bipartisan backing while taking real steps to lower health care costs for middle-class Iowans.  Congress will continue to debate health care in the months ahead, and I plan to do what I can to make sure the principles and features of my health care bill play prominently in that ongoing debate.”

Steve King’s statement:

   “When ObamaCare passed, I made a pledge to work to uproot the law from the U.S. Code. To fulfill this promise, I drafted and introduced language to repeal ObamaCare ‘as if such Act had not been enacted.’ Today, the House of Representatives passed this language, and we are one step closer to fully repealing the law,” said King.

   “Today’s historic vote was made possible because Americans have consistently demonstrated both resolve and fervor for repeal. In fact, Americans even elected 87 new Republicans to the House of Representatives to provide repeal supporters with the reinforcements we needed to answer their calls for repeal.”

   “Today’s repeal vote represents not only a promise kept, but also the beginning of the end of ObamaCare itself. I will continue to work for ObamaCare’s repeal until this unconstitutional law is no longer on the books.”

Excerpt from an Iowa Democratic Party statement:

Non-partisan research has shown how devastating a repeal of the Affordable Care Act would be for Iowa and the nation:

   * 400,000 jobs annually would be lost nationally as a result of repeal according to Harvard economist David Cutler.

   * $230 billion would be added to our national deficit over the next decade according to the Congressional Budget office, of which Senator Grassley has said, “for health care budgeting purposes, CBO’s word is the only one that counts.”

   * 57,216 small businesses in Iowa would see a tax increase if health care reform is undone. [Internal Revenue Service, 4/19/10]

   * 713,155 Iowa children would once again be excluded from coverage based on a pre-existing condition. [U.S. Census Bureau, 1/7/10]

   * 43,100 senior citizens in the state would see an increase in prescription drug costs as the Medicare “donut hole” is opened back up. [House Commerce Committee, 3/20/10]

   * 247,000 young adults in Iowa would no longer be able to remain on their parent’s health care coverage. [House Commerce Committee, 3/20/10]

   * 788,000 Iowa families would see their taxes soar without tax credits and other assistance in the Affordable Care Act. [House Commerce Committee, 3/20/10]

Statement from Iowa PIRG:

Health Care Repeal Would Have Costly Consequences for Iowa Consumers and Small Businesses

Des Moines, IA – Consumers and small businesses in Iowa will face significantly higher insurance premiums and could see costly coverage denials and price discrimination if efforts to repeal the federal health care law prevail in Congress or in the courts, according to The Cost of Repeal: Examining the Impact on Iowa of Repealing the New Federal Health Care Law , a new report released today by Iowa PIRG.

According to the report, in the short term, repeal would strip tax credits from over 51,100 small businesses in Iowa. And over the longer term, the cost of offering employer-based health insurance could jump by more than $3000 a year under current law.

“In today’s economy, the higher costs that would result from repeal are the last thing that Iowa consumers and businesses need,” said Sonia Ashe, Iowa PIRG Advocate.

The new Iowa PIRG report draws on data from independent sources, including the nonpartisan Congressional Budget Office, other government agencies, business groups and health analysts, and finds the following:

•    Repealing the new state health insurance exchange would drive premiums on the individual market 20% or higher for the same coverage by 2016.

•    Without the new law’s insurance reforms, the 23.7% of Iowan residents who have pre-existing conditions, ranging from asthma to cancer, will continue to face coverage denials and price discrimination when purchasing their own insurance.

•    If the insurance reforms are repealed, Iowan women will continue to pay higher prices than men for health coverage.

•    Rolling back last year’s law would drive up employer health costs, leading to 3,796 fewer jobs created per year in Iowa by the end of the decade.

•    Outright repeal would pull $2.8 billion in federal Medicaid dollars out of the state’s economy and terminate establishment or expansion of 83 community health centers across Iowa.

The U.S. House of Representatives is scheduled to vote on a bill to repeal the new law outright on Wednesday.  And Washington’s intensely partisan debate over health care threatens to spill over to Iowa’s Capitol Building as the Governor and state legislators consider key implementation decisions.

The Cost of Repeal recommends a set of pro-active policy changes on which supporters and opponents of last year’s health care law should be able to find common ground.  These include:

1.    Using the substantial authority the state has under current law to design a health insurance exchange that is adapted to meet the needs of our state’s markets, consumers, and businesses.

2.    Taking additional steps to contain health care costs, like using information technology to ensure that doctors receive the latest research about which treatments are most effective – at the patient’s bedside.  

3.    Crack down on balance-billing, a practice whereby hospitals or providers accept payment from a patient’s insurance plan, then charge additional amounts-above and beyond the usual co-pays and cost sharing.

“Before our elected officials join this headlong rush to repeal in Washington, they should consider the consequences for our state, and look for solutions that hold down costs, not increase them,” said Ashe.

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