IA-Sen, IA-02: Braley, Loebsack run for the hills on health care reform (updated)

All four Iowans in the House of Representatives voted today for the Keep Your Health Plan Act “that allows insurance companies to offer health plans that were cancelled for not meeting new requirements under ObamaCare.” Bruce Braley (IA-01) and Dave Loebsack (IA-02) were among the 39 Democrats who crossed party lines to support the bill, joining Tom Latham (IA-03), Steve King (IA-04), and almost all the Republicans present.

Braley and Loebsack both voted for the Affordable Care Act in 2010 and have opposed most of the Republican bills to repeal the health care reform law. For instance, Iowa’s representatives split on party lines when the House voted in August a bill “to prevent the IRS from enforcing any aspect of ObamaCare,” and when the House voted in July to delay the individual mandate to purchase health insurance.

However, occasionally Braley and/or Loebsack have gone along with GOP efforts to alter the Affordable Care Act. In 2012, Loebsack voted with Republicans to repeal a 2.3 percent tax on medical device manufacturers. In July of this year, Braley joined Republicans to pass a bill delaying the employer mandate to provide health insurance for one year. (President Barack Obama had already announced his decision to delay the employer mandate, despite the financial and political costs of doing so.)

Given the media firestorm over some Americans losing the health insurance plans Obama promised they could keep, I’m not surprised Braley and Loebsack ran for cover today. Both had narrow escapes in 2010 and may face tough election campaigns in 2014.

After the jump I’ve enclosed comments from some of the Iowans in Congress on today’s vote and on the president’s administrative “fix” that may allow some people to keep insurance policies that would have been cancelled for not meeting ACA requirements. (Few Iowans need this fix, because Wellmark and most other health insurance providers were already allowing Iowans to keep their individual policies for another year.) I also enclosed details on why Obama has threatened to veto the bill that passed the House today. Senator Tom Harkin is determined to prevent it from passing the U.S. Senate.

UPDATE: Added a statement from Latham below. Also, the Koch-funded group Americans for Prosperity wasted no time in signaling that they will attack Braley on “Obamacare” regardless of this vote. I doubt he’s gained any political protection for the U.S. Senate race.

SECOND UPDATE: Added new comments from Braley.

The Hill’s Justin Sink explained the key distinction between the House-approved bill and Obama’s administrative action.

Under the administrative fix, insurance companies are permitted to continue offering existing plans to current enrollees, regardless of when they signed up for coverage or if that coverage was recently altered. But unlike the Upton bill, insurance companies can’t offer the bare-bones plans to new enrollees.

Democrats have worried that if insurers were allowed to offer the cheaper, lower-quality plans to new customers, the young, healthy individuals central to the success of the ObamaCare exchanges would choose the less expensive options, dooming the reform effort. Moreover, those individuals’ plans would lack the consumer protections central to driving down health costs under the law.

“I will not accept proposals that are just another brazen attempt to undermine or repeal the overall law and drag us back into a broken system,” Obama said Thursday.

A larger number of Congressional Democrats preferred more limited solutions to the problem of people’s insurance policies being cancelled.

House Democrats offered their own alternative, which takes elements from a proposal being pushed by Sen. Mary Landrieu (D-La.) on the other end of the Capitol. Like the senator’s plan, it requires insurers to keep the insurance policies open for only existing customers.

It also calls on insurers to let their customers know about new coverage options available under Obamacare, as well as consumer protection provisions that are not in existing plans. The plan would also give state insurance commissioners the authority to investigate “unjustified” rate increases.

But while Landrieu’s bill allows consumers to keep their existing plans indefinitely, the House Democratic alternative does it for one year – similar to the administrative fix.

Speaking to Iowa reporters by conference call on November 14 Harkin defended the ACA’s provisions that have led to policy cancellations.

Harkin dismissed criticism that many people are losing their health insurance as a result of the Affordable Care Act. He said an investigation by Senate staffers has found “the vast majority of those are people who had what I call are junk policies.”

Some people have been paying as little as a few hundred dollars a year for health insurance “that didn’t do a darn thing for them” if they become ill, the senator said. That has been OK as long as they remain healthy, but these same people want someone to pay their health care bills if they get sick, he added.

Harkin said he wants to provide an insurance pool with a basic benefits package, and then he’ll let the marketplace work. But he is opposed to a “race to the bottom” for health insurance, and wants people to be covered if they have a preexisting medical condition, if they want to have their adult children covered until age 26, and to make sure that people don’t go bankrupt from their hospital bills.

He complained that when he listens to Republicans, “all they want to do is stay with that old system,” which discriminates against women with breast cancer and hasn’t done enough to provide wellness and prevention programs.

“Everybody has to keep in mind that we are getting rid of an old system that didn’t work,” he said.

Yet in a written statement, Harkin was less critical of the president’s administrative fix.

“If it had been up to me, I am not certain I would have made this decision, but the president felt it was important to do,” Harkin wrote. “My hope, however, is that everyone who has received a cancellation notice will fully and carefully consider their options. In the vast majority of cases, they will find that the coverage that they were paying good money for is not worth the paper it was printed on. It will not cover them if they are hospitalized, if they need expensive prescription drugs to treat an illness or a chronic condition, or if they have a pre-existing condition. If they go to the marketplace, however, they can get quality coverage – in some cases paying a little more, perhaps, but getting many more benefits. In many cases, they may pay less, particularly with the subsidies provided by the Affordable Care Act.”

Harkin cited the case of a woman from Salix who told him her son’s policy had been cancelled. “When they read the fine print, however, they were shocked to learn that he had been paying $200 a month for two years on a policy that covered no preventive care, no prescription drugs and only $600 of a hospital visit. Under the Affordable Care Act, he will now pay $125 a month and has an 80/20 policy.

“In the coming months, we will hear from even more Americans – like the stories I am hearing from Iowans – who are taking advantage of this coverage.”

Steve King press release, November 15 (emphasis in original):

King: Lord Knows He Needs a Lot of Help

Washington, DC – Congressman Steve King released the following statement after the House passed H.R. 3350, the Keep Your Health Plan Act of 2013. This act allows insurance providers to continue to offer all health plans currently available to any individual for the 2014 calendar year.

“This bill is an effort to help the President keep his word,” said King “And Lord knows he needs a lot of help.”

King press release, November 14:

King: He Must Abide by the Constitution

Washington, DC – Congressman Steve King released the following statement in response to President Obama’s announcement on his so called “administrative fix” for the false promise that Americans can keep their health care plan if they like it:

“In the President’s remarks this afternoon he once again stepped outside the bounds of his Constitutional authority, this time regarding the failures of his prized legislative accomplishment-ObamaCare,” said King. “It is unconstitutional for the President to attempt to rule by executive edict. The President has lied numerous times to the American people by promising them if they like their healthcare plan, they can keep it. He continues to pass the blame and execute modifications and delays that change nothing, and this ‘administrative fix’ is once again not the answer. ObamaCare cannot be fixed – it is fundamentally flawed. The American people should not have to take the brunt of the President’s political posturing. He must abide by the Constitution and come to Congress, and this time I suggest he should come on bended knee.”

Press release from Senator Chuck Grassley, November 14:

Floor Speech of Sen. Chuck Grassley on Obamacare Implementation

Delivered Thursday, November 14, 2013

Mr. President, Webster’s Dictionary defines the word “success” as the correct or desired result of an attempt.

I want to discuss the definition of the word ‘success’ as we consider the Affordable Care Act.

On the day the bill was signed into law, President Obama said the following:

QUOTE:  Today we are affirming that essential truth, a truth every generation is called to rediscover for itself, that we are not a nation that scales back its aspirations.  END OF QUOTE

Such grand words for where we are today.

Today, the success of the law that now bears his name, Obamacare, is defined in much more meager terms.

Today, success is that when the folks at HHS got up this morning, Obamacare had not been shutdown, and when the folks at HHS go to sleep tonight their day will have been a success if Obamacare did not have to be shutdown.

Think of all that we have been through to this point.

The fight over the bill and the extreme legislative means used to pass it through Congress.

The 2010 and 2012 elections.

The Supreme Court decision that affectively repealed half of the law’s coverage.

Think of all the changes made to the law through regulation to make sure Obamacare launched.

The postponing of the employer mandate.

The postponing of lifetime limits.

Think of the impact this law has had on our economy.

People losing jobs.

People losing the health insurance they currently have, because if you like what you have you may NOT be able to keep it.

And let’s talk about that for a few minutes.

If you like what you have, you can keep it.

This was the promise the President made to the American people on at least thirty-six separate occasions.

It’s a great soundbite.

It’s easy to say; it rolls off the tongue.

It’s also not true.  It was never true.

It was obviously not true when the law was written.

It was obviously not true when the first proposed regulation came out.

This is what I said on the Senate floor in September of 2010:

QUOTE: Only in the District of Columbia could you get away with telling the people if you like what you have you can keep it, and then pass regulations six months later that do just the opposite and figure that people are going to ignore it. END OF QUOTE

It’s not that I have some magic crystal ball.

We all knew it.

The Administration certainly knew that the day would come when millions of people would receive cancellation notices.

Now, my constituents clearly know it.

I’ve heard from many Iowans who found out the hard way that the President made a bunch of pie-in-the-sky promises that he knew he couldn’t keep.

Constituents like this one from Perry, Iowa, who wrote to me saying:

QUOTE  My husband and I are farmers. For nine years now we have bought our own policy. To keep the cost affordable our plan is a major medical plan with a very high deductible. We recently received our letter that our plan was going away.

Effective Jan 1, 2014, it will be updated to comply with the mandates of Obamacare.

To manage the risk of much higher premiums, our insurance company is asking us to cancel our current policy and sign on at a higher rate effective Dec 1, 2013 or we could go to the government exchange.

We did not get to keep our current policy. We did not get to keep our lower rates. I now have to pay for coverage that I do not want or will never use. We are not low income that might qualify for assistance.

We are the small business owner that is trying to live the American dream. I do not believe in large government that wants to run my life. END OF QUOTE

And from a constituent living in Mason City:

QUOTE: My wife and I are both 60 years old, and have been covered by an excellent Wellmark Blue Cross Blue Shield policy for several years.

It is not through my employer. We selected the plan because it had the features we wanted and needed…our choice. And because we are healthy, we have a preferred premium rate.

Yesterday, we got a call from our agent explaining that since our plan is not grandfathered, it will need to be replaced at the end of 2014.

The current plan has a $5,000 deductible and the premium is $511 per month. The best option going forward for us from Wellmark would cost $955 per month (a modest 87% increase), and have at $10,000 deductible!

And because we have been diligent and responsible in saving for our upcoming retirement, we do not qualify for any taxpayer-funded subsidies. END OF QUOTE.

These are just two of the many letters, emails, and phone calls I’ve received from Iowans.

Thousands have contacted me asking what can be done, now that we clearly see that what the President sold the American people was a bag of Washington’s best gift-wrapped hot air.

I ask the President – I ask my colleagues here in the Senate – to look at all we have been through as a country.

All the grandiose talk about the importance of this statute.

And what we ultimately have is an optional Medicaid expansion with a glorified high risk pool and a government portal that makes the DMV look efficient.

Americans deserve better. They voted for better.

But this Administration will trudge ahead.

Keep the doors open.

Thousands of people enrolled instead of millions.

They just released a number this week for the 36 states using the malfunctioning federal Exchange.

Fewer than 27,000 people.

Including people who haven’t actually committed to purchase the plans … those who have put it in their shopping cart.

Less than 27,000 people.

That’s about 19 people per day per state.

So the Administration will limp along with this pitiful sign up process hoping to get people properly assigned to health plans.

And if the assignment of individuals to plans fails miserably on January 1, the Administration will dig in and sort it out.

If the risk pools are a disaster, the Administration will use extra-regulatory, by any means necessary tools to keep this program afloat.

Because for all the talk of this bill being, in the words of the Vice President, a big expletive deal, success is not defined in the desires of 2010, but in making sure Obamacare exists in some form or fashion on January 20, 2017.

We saw the more of this digging-in and sorting-out today.

Insurance companies sent four million cancellation notices to comply with President Obama’s law.

Let me clear about that.

Insurers read the law; and then they followed they law.

Unfortunately for them, the President did what he’s been doing for three years: He’s taken out his pencil and eraser and rewritten or delayed his law on the fly when it’s not working.

So what does it now mean for insurers who were simply trying to follow the law as written?

Here’s what one insurance consultant had to say:

QUOTE: This means that the insurance companies have 32 days to reprogram their computer systems for policies, rates, and eligibility, send notices to the policyholders via US Mail, send a very complex letter that describes just what the differences are between specific policies and Obamacare compliant plans, ask the consumer for their decision –  and give them a reasonable time to make that decision –  and then enter those decisions back into their systems without creating massive billing, claim payment, and provider eligibility list mistakes.  END OF QUOTE

The only thing the President has accomplished with his announcement today is that he’s delaying his broken promise for a year.  

Again, I have to wonder, what will it take for him to admit that his law isn’t working and at least call for a full delay?    

It is time to admit that Obamacare has not achieved the correct or desired result of an attempt.

It has not been a success by any measure.

Unless of course you lower your standard to the point that the mere act of keeping the doors open is a success.

How sad is that for all we have been through.

Maybe, just maybe, it is time to admit that massive restructuring has failed.

Partisanship has failed.

Perhaps it is time to sit down and consider common sense, bipartisan steps that we could take to lower cost and improve quality.

Perhaps we could enact alternative reforms aimed at solving America’s biggest health-care problems.

Reforms like revising the tax code to help individuals who buy their own health insurance;

Allowing people to purchase health coverage across state lines and form risk pools in the individual market;

Expanding tax-free Health Savings Accounts;

Making health-care price and quality information more transparent;

Cracking down on frivolous medical-malpractice lawsuits;

Using high-risk pools to insure folks with preexisting conditions;

Giving states more freedom to improve Medicaid;

And using provider competition and consumer choice to bring down costs in Medicare, and throughout the health care delivery system.

The American people need to know that this failed program is not the only answer.

Representative Tom Latham’s statement of November 15:

Latham Votes to Restore Health Care Coverage

WASHINGTON, DC –   Iowa Congressman Tom Latham voted today to help restore health care coverage for the millions of Americans who have been forced out of their insurance plans due to the failed promise made by President Obama  related to his new health care law.

The legislation, H.R. 3350, the Keep Your Health Plan Act, protects American’s health care choices by fulfilling the repeated promise by President Obama when promoting his law that “if you like your health care you can keep it.”

“President Obama promised for over four years that “If you like your health care plan, you’ll be able to keep your health care plan, period. No one will take it away, no matter what.” Unfortunately, an ever-growing number of Iowans and Americans are finding health plan termination notices in their mail box that demonstrate the real consequences of the President’s broken promise,” said Latham.

This bipartisan group who supported today’s vote do not believe millions of innocent Americans should be harmed further by this disastrous law that is hurting more  than it is helping.”

SECOND UPDATE: In a conference call with Iowa reporters on November 20,

U.S. Rep. Bruce Braley defended his vote last week on a bill tweaking the Affordable Care Act as part of his responsibility to improve the law “as concerns arise and need to be addressed.” […]

“My job is to provide the oversight and continue to work to try to fix the problems as they come up so that Iowans get access to the coverage they deserve,” Braley said in his weekly conference call with Iowa reporters.

  • Braley

    Braley cast a correct vote. If people want to sit home because they don’t see a true difference between Nruce Braley and Sam Clovis or David Young for example, that is their right.  Deeth is right about elections hinging upon the driving up turnout amongst, but trust me I see significant differences between Braley and most of their field.

    Braley has to compete for swing voters as well.  The only two that I currently see doing that with him are Ernst and Jacobs.  They have to market themselves correctly in order to do this.   It was the right vote for Braley.  If people want a primary, go ahead.  I love the chance to vote in primaries and debate “progressives.”  There isn’t room for endorsements in a primary against Braley, but there is a chance to have a voice heard.

    By the way, I’m still aggravated with Braley for playing a role in the installation of Henry Waxman over John Dingell as Chairman of Energy and Commerce.  If it was up to me I would like to see a primary challenger from the right (what I would consider center to Braley, but I know this won’t happen, LOL! A boy can dream though.  

    • if he didn't want to impose better standards

      for health insurance policies, maybe he shouldn’t have voted for the Affordable Care Act in the first place. From a policy perspective, the vote makes no sense. Allowing insurers to sell policies with substandard benefits and fewer consumer protections to new customers will undermine the health insurance marketplaces, no question.

      This vote only “sort of” makes sense politically. In theory, he gives himself cover, knowing that the Senate probably won’t approve the bill, and if they do, the president probably won’t sign it into law. So he’s protected, while the ACA remains safe. But of course he will be attacked for supporting health care reform anyway. As Americans for Prosperity Iowa is already saying,

      .@BruceBraley trying to jump ship from the disaster he championed for, & votes for Keep Your Healthcare Plan-Sorry,but that ship has sailed!

      So Braley’s not protected politically and has accomplished nothing with this vote.

      • Braley

        I doubt people influenced by Americans for Prosperity ads are going to be up for grabs.  Your point stands however. If people want to buy “bad plans” we have to let them.  If you don’t know what you are signing, try not to sign it.  

        I know that is easier said than done, but if people are going to complain about not getting to keep their bad plan, let them lie in a bed of nails if they want to.

        Braley has been getting letters and yelled at about this.  You obviously have more confidence that legislators actually know what they are voting for.  I have no way to prove that they did or did not understand the ramifications of the Affordable Care Act.  

        • Braley is a smart guy

          He knew that the Affordable Care Act set minimum standards for health insurance plans, and he knew why. The exchanges won’t work without a large number of healthy people joining the pools.  

          • Braley

            Braley is a sharp guy so you are probably right.  If Braley understands the ramifications of it then don’t just do bullet points and expect people to embrace.  Dig in, talk specific provisions and policy.

            The Obama administration and Congressional Democrats always try to pain the rosiest darn picture of every law they pass, the people (average voters, not just Tea Party crazies) then begin to find problems with a law and the Democrats do a terrible job of explaining themselves.  Obama got elected and he seemingly expected people to automatically embrace his agenda, just drop at his feet as if there would be no conservative opposition.

            Braley is a top attorney (arguably in the entire country) you seem him on talk shows and he never mentions the law, he just uses rosy talking points.  His points are pointless.  

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