Barack Obama on Health Care Democratic incumbent President; IL Senator (2004-2008)

Sub-sections under Health Care:
• AIDS
• ObamaCare
• Obamacare Criticism
• Universal Coverage
• Voting Record
• Other issues under Health Care

Prioritize finding a cure for cancer

All kids should get vaccinated, but not by law

President Barack Obama said parents should get their kids vaccinated. "The science is pretty indisputable," Obama said. "We've looked at this again and again. There is every reason to get vaccinated, but there aren't reasons to not."

The White House has stopped short of saying that there should be a law requiring parents to get their children vaccinated. "The president believes it shouldn't require a law for people to exercise common sense and do the right thing," a White House press secretary said. "And again, this is the right thing for them to do both by their own children, but by also other children in the community. They have a responsibility to do this. "

ObamaCare didn't crush jobs nor explode deficits

So the verdict is clear. Middle-class economics works. Expanding opportunity works. And these policies will continue to work, as long as politics don't get in the way. We can't slow down businesses or put our economy at risk with government shutdowns or fiscal showdowns. We can't put the security of families at risk by taking away their health insurance, or unraveling the new rules on Wall Street, or refighting past battles on immigration when we've got a system to fix. And if a bill comes to my desk that tries to do any of these things, it will earn my veto.

Ebola teaches us how to prevent future pandemics

FactCheck: Yes, 10 million newly insured last year

FactCheck: We don't know for sure how many uninsured Americans have gotten coverage through the Affordable Care Act, but Obama's math is in line with estimates published last year in the New England Journal of Medicine. That analysis--which was conducted in part by Health and Human Services--estimated that 10.3 million Americans gained insurance due to ObamaCare, based on the decline in the uninsured rate and 2014 census estimates.

That estimate is more generous to ObamaCare than the most recent Gallup Poll, but Gallup still found the percentage of Americans without health insurance is lower than it's ever been. The polling firm said earlier this month that roughly 13 percent of Americans lack health insurance--a steep drop of more than 4 percent since ObamaCare enrollment began.

An AIDS-free generation is within our reach

We reduced senior Rx prices & pushed preventive care

ROMNEY: That's $1 for every $15 you've cut. They're smart enough to know that's not a good trade. I want to take that $716 billion you've cut and put it back into Medicare. By the way, we can include a prescription program if we need to improve it. But the idea of cutting $716 billion from Medicare to be able to balance the additional cost of ObamaCare is, in my opinion, a mistake.

I don't think Medicare vouchers are the way to go

OBAMA: I think it's important for Governor Romney to present this plan that he says will only affect folks in the future. And the essence of the plan is that you would turn Medicare into a voucher program. It's called premium support, but it's understood to be a voucher program.

Q: And you don't support that?

OBAMA: I don't. And let me explain why.

ROMNEY: Again, that's for future people, not for current retirees.

OBAMA: The idea, which was originally presented by Congressman Ryan, your running mate, is that we would give a voucher to seniors and they could go out in the private marketplace and buy their own health insurance. The problem is that because the voucher wouldn't necessarily keep up with health care inflation, it was estimated that this would cost the average senior about $6,000 a year.

Voucher system puts seniors at mercy of insurance companies

OBAMA: Medicare has lower administrative costs than private insurance does, which is why seniors are generally pretty happy with it. And private insurers have to make a profit. Nothing wrong with that. That's what they do. And so you've got higher administrative costs, plus profit on top of that. And if you are going to save any money through what Governor Romney's proposing, what has to happen is, is that the money has to come from somewhere. And when you move to a voucher system, you are putting seniors at the mercy of those insurance companies. And over time, if traditional Medicare has decayed or fallen apart, then they're stuck.

Too many Americans skip preventive care due to cost

A: Today, there are too many Americans who do not get the preventive health care services they need to stay healthy. Many people put off preventive care because the deductibles and copays are too expensive. That's why I fought for the Affordable Care Act, which will make sure all Americans have access to quality preventive health care services. Under the Affordable Care Act, Americans can now get vital preventive services--including the full suite of routine vaccines recommend by the Advisory Committee on Immunization Practices--with no co-pay or deductible. The health care law also created the Prevention and Public Health Fund, an investment in promoting wellness, preventing disease, and investing in public health infrastructure across the country. Ultimately, I believe the health care law is a significant step forward in ensuring that every American has access to the preventive care and immunizations that they need to stay healthy.

FactCheck: ObamaCare covers only 1/2 of 30 million uninsured

THE FACTS: That's only half true. About half of the more than 30 million uninsured Americans expected to gain coverage through the health care law will be enrolled in a government program. Medicaid, the federal-state program for low-income people, will be expanded starting in 2014 to cover childless adults living near the poverty line.

The other half will be enrolled in private health plans through new state-based insurance markets. But many of them will be receiving federal subsidies to make their premiums more affordable. And that's a government program, too.

Starting in 2014 most Americans will be required to carry health coverage, either through an employer, by buying their own plan, or through a government program.

OpEd: Incremental plan builds on patchwork system

The main problem with Obama's current approach is that his plan builds on, and further complicates a patchwork profit-driven system that is inherently inefficient. By expanding coverage without addressing the fundamental drivers of escalating cost, Obama (or his successor) risks a draconian cut in services later on.

2003 Rx Drug Bill combined worst of public & private sectors

Reading that sentence, you get the feeling that Obama assigns roughly symmetrical blame for that outcome. But it wasn't "ideology & political gamesmanship" in general that produced such a wretched excuse for a program; it was George W. Bush's alliance with the insurance and drug industries that added red tape, inflated costs, and cut net benefits. On the other hand, the bill would not have passed unless conservative Democrats had chosen to be Bush's enablers. So Obama's criticism of both parties had some substance--it was not just calculated positioning as an anti-Washington outsider.

Give more help to those denied a life of dignity & respect

Address minority health needs by more coverage & targeting

A: One of the biggest reasons that there are disparities is that African-Americans & Latino Americans are much more likely not to have health insurance. And so if we set up a system in which everybody’s got health insurance, some of those disparities are immediately going to be reduced. Folks who are working but don’t have health care benefits- those groups are disproportionately minority. [Covering them via their employer] would be the first step. There are some particular issues within the minority community that I think we can address in a targeted way. Lead paint may seem like an ancillary issue except for the fact that incidence of lead poisoning among African-American & Latino youths is sky high. It has huge ramifications in terms of their long-term health. Obesity and diabetes in minority communities is more severe.

Allow prescription drug re-importation

Lead eradication of malaria and HIV, like we did with Ebola

That's how we stopped the spread of Ebola in West Africa. Our military, our doctors, our development workers--they were heroic. They set up the platform that then allowed other countries to join in behind us and stamp out that epidemic. Hundreds of thousands--maybe a couple million lives were saved.

When we help African countries care for the sick, It's the right thing to do, and it prevents the next pandemic from reaching our shores. Now right now, we are on track to end the scourge of HIV/AIDS, that's within our grasp, and we have the chance to accomplish the same thing with malaria, something I'll be pushing this Congress to fund this year. That's American strength. That's American leadership. And that kind of leadership depends on the power of our example.

Advocated condom use to avoid AIDS at Saddleback Church

CDC estimate: a half million would follow Obama's AIDS test

Use whatever works with AIDS, including teaching abstinence

A: When Michelle and I were traveling in Kenya, we took an AIDS test. I compliment George Bush on the PEPFAR program [President’s Emergency Plan for AIDS Relief]. My view is that we should use whatever the best approaches are, the scientifically sound approaches are, to reduce this devastating disease. Part of that should be a strong education component and I think abstinence education is important. I also think that contraception is important; I also think that treatment is important; I also think that we have to do more to make antiviral drugs available to people who are in extreme poverty. So I don’t want to pluck out one facet of it. Now, that doesn’t mean that non-for-profit groups can’t focus on one thing while the government focuses on other things. I think we want to have a comprehensive approach.

We need condom distribution to deal with the scourge of AIDS

Homophobia prevents talking about HIV/AIDS

Got tested for AIDS, with wife, in public, in Kenya

BIDEN: You’re asking, how do we prevent these 17-year-olds from getting HIV? All the things that were said here [by other candidates] are good ideas; but they don’t prevent that. I spent last summer going through the black sections of my town, trying to get black men to understand it is not unmanly to wear a condom, getting women to understand they can say no, getting people in the position where testing matters. I got tested for AIDS. I know Barack got tested for AIDS. There’s no shame in being tested for AIDS.

OBAMA: I just got to make clear--I got tested with Michelle, when we were in Kenya in Africa. I don’t want any confusion here about what’s going on.

BIDEN: And I got tested to save my life, because I had 13 pints of blood transfusion.

OBAMA: I was tested with my wife. In public.

Curing AIDS must be all-hands-on-deck effort

Lead global fight against AIDS

18 millions people have gained health insurance

FactCheck: 7M new Medicaid includes woodwork & normal churn

Is it true? The Facts: ObamaCare expands Medicaid to individuals with incomes of up to 138% of the poverty level. So far, 25 states have expanded Medicaid. Because of the ACA, the number of Americans on Medicaid will increase by 8 million in 2014.

That figure includes some people who were previously eligible for Medicaid but had never signed up before all the publicity about new health-care options (known as people coming out of the "woodwork"), and also includes people previously enrolled in Medicaid who are deemed eligible for another year (in other words, "normal churn").

[Those two categories add up to as much as 4.8 million people, although states don't report those figures well, so much is left to guesswork. Obama's estimate would mean those two categories are only 1 million people]. No matter how you slice it, it does not add up to 7 million.

12 million covered; zero denied for pre-existing conditions

That's what health insurance reform is all about--the peace of mind that if misfortune strikes, you don't have to lose everything. Already, because of the Affordable Care Act, more than 3 million Americans under age 26 have gained coverage under their parents' plans. More than 9 million Americans have signed up for private health insurance or Medicaid coverage.

And here's another number: zero. Because of this law, no American can ever again be dropped or denied coverage for a preexisting condition.

Boards of experts identify best practices & keep costs down

OBAMA: When Governor Romney talks about this "unelected" board that we've created, is a group of health care experts, doctors etc., to figure out, how can we reduce the cost of care in the system overall? So what this board does is basically identifies best practices and says, let's use the purchasing power of Medicare and Medicaid to help to institutionalize all these good things that we do.

ROMNEY: In order to bring the cost of health care down, we don't need to have a board of 15 people telling us what kinds of treatments we should have. We instead need an incentive: performance pay, for doing an excellent job, for keeping costs down,

OBAMA: This board that we're talking about can't make decisions about what treatments are given. That's explicitly prohibited in the law.

ObamaCare says insurance companies can't jerk you around

ROMNEY: I sure do. It's expensive. It has killed jobs.

OBAMA: Well, four years ago, it wasn't just that small businesses were seeing costs skyrocket, but it was families who were worried about going bankrupt if they got sick. If they had a pre-existing condition, they might not be able to get coverage at all. If they did have coverage, insurance companies might impose an arbitrary limit. And let me tell you exactly what ObamaCare did. Number one, if you've got health insurance, it doesn't mean a government takeover. You keep your own insurance. You keep your own doctor. But it does say insurance companies can't jerk you around. They can't impose arbitrary lifetime limits. They have to let you keep your kid on your insurance plan until you're 26 years old. And it also says that you're going to have to get rebates if insurance companies are spending more on administrative costs and profits than they are on actual care.

Ignored advice to postpone reform, because it was needed

He did it because he believes that here in America, our grandparents should be able to afford their medicine; our kids should be able to see a doctor when they're sick; and no one in this country should ever go broke because of an accident or illness.

And he believes that women are more than capable of making our own choices about our bodies and our health care--that's what my husband stands for.

They called ObamaCare "Armageddon", but no asteroids fell

Repealing healthcare reform would cost $250B

This means further reducing health care costs, including programs like Medicare and Medicaid, which are the single biggest contributor to our long-term deficit. The health insurance law we passed last year will slow these rising costs, which is part of the reason that nonpartisan economists have said that repealing the health care law would add a quarter of a trillion dollars to our deficit. Still, I'm willing to look at other ideas to bring down costs, including one that Republicans suggested last year--medical malpractice reform to rein in frivolous lawsuits.

Medicare is major driver of our long-term liabilities

Rep. RYAN: No.

Pres. OBAMA: No?

Rep. RYAN: People 55 and above are grandfathered in.

Pres. OBAMA: But just for future beneficiaries, the basic idea would be that at some point we hold Medicare cost per recipient constant as a way of making sure that that doesn't go way out of whack, right?

Rep. RYAN: We drew it as a blend of inflation and health inflation. Medicare is a $38 trillion unfunded liability-- it has to be reformed for younger generations because it's going bankrupt. And the premise of our idea is, why not give people the same kind of health care plan we here have in Congress?

Zero fines & no mandate for small business

OBAMA: Here’s your fine--zero.

McCAIN: Zero?

OBAMA: Zero, because as I said in our last debate and I’ll repeat, I exempt small businesses from the requirement for large businesses that can afford to provide health care to their employees, but are not doing it. I exempt small businesses from having to pay into a kitty. But large businesses that can afford it, we’ve got a choice. Either they provide health insurance to their employees or somebody has to. Right now, what happens is those employees get dumped into either the Medicaid system, which taxpayers pick up, or they’re going to the emergency room for uncompensated care, which everybody picks up in their premiums.

No exclusions for pre-existing conditions

A: Here’s what I would do. If you’ve got health care already, and probably the majority of you do, then you can keep your plan if you are satisfied with it. You can keep your choice of doctor. We’re going to work with your employer to lower the cost of your premiums by up to $2,500 a year. And we’re going to do it by investing in prevention. We’re going to do it by making sure that we use information technology so that medical records are actually on computers instead of you filling forms out in triplicate when you go to the hospital. That will reduce medical errors and reduce costs. If you don’t have health insurance, you’re going to be able to buy the same kind of insurance that Sen. McCain and I enjoy as federal employees. Because there’s a huge pool, we can drop the costs. And nobody will be excluded for pre-existing conditions, which is a huge problem.

Health care is a right: something’s fundamentally wrong now

McCAIN: I think it’s a responsibility, in this respect, in that we should have available and affordable health care to every American citizen, to every family member. And with the plan that I have, that will do that. But government mandates I’m always a little nervous about. But it is certainly my responsibility. It is certainly small-business people and others, and they understand that responsibility. American citizens understand that.

OBAMA: Well, I think it should be a right for every American. In a country as wealthy as ours, for us to have people who are going bankrupt because they can’t pay their medical bills--for my mother to die of cancer at the age of 53 and have to spend the last months of her life in the hospital room arguing with insurance companies because they’re saying that this may be a pre-existing condition and they don’t have to pay her treatment, there’s something fundamentally wrong about that.

Ban insurance companies from discriminating against the sick

Include everyone who wants insurance in national pool

I’ve got a health plan and a plan to get it implemented

Voluntary universal participation, like in Medicare Part B

CLINTON: [Obama’s plan] would be as though Franklin Roosevelt said let’s make Social Security voluntary --let’s let everybody get in it if they can afford it--or if Pres. Johnson said let’s make Medicare voluntary. Now, if you want to say that we shouldn’t try to get everyone into health insurance, that’s a big difference.

OBAMA: I believe that if we make it affordable, people will purchase it. In fact, Medicare Part B is not mandated, it is voluntary. And yet people over 65 choose to purchase it, Hillary, and the reason they choose to purchase it is because it’s a good deal. And if people end up seeing a plan that is affordable for them, I promise you they are snatching it up because they are desperate to get health care. And that’s what I intend to provide as president of the United States.

Buy private insurance via National Health Insurance Exchange

Against enforcement mechanism for mandating insurance

OBAMA: About 95% of our plans are similar. We both set up a government plan that would [cover] pre-existing conditions. We both want to emphasize prevention. But I emphasize reducing costs. If we provide subsidies to those who can’t afford it, they will buy it. Sen. Clinton has a different approach. She believes that we have to force people who don’t have health insurance to buy it, or there will be a lot of people who don’t get it. But if you are going to mandate the purchase of insurance & it’s not affordable, then there’s going to have to be some enforcement mechanism that the government uses. And they may charge fines to people who already don’t have health care, or take it out of their paychecks. And that, I don’t think, is helping those without health insurance. That is a genuine difference.

Subsidies to people who can’t afford care--not single payer

Problem isn’t mandating coverage, but affording it

Cautious incremental plan offers choice & subsidy

You can see these tendencies in Obama’s healthcare plan, which bars insurers from refusing coverage to anyone, lets people choose between private plans and a public one, and offers subsidies to those who cannot afford the rates. This approach borrows heavily from John Edward’s much-praised scheme, but it falls short of his call for universal coverage. At any rate, The New Republic estimates that Obama’s plan would leave about fifteen million American uninsured.

It can be argued that an incremental attitude is the best way to pass liberal legislation these days. Obama has said as much. “For a political leader to get things done, he or she ideally should be ahead of the curve, but not too far ahead.”

Tackle insurance companies on reimbursement system

Government healthcare like members of Congress have

A: That’s correct. Part of the reason that you’re confused about the candidates’ differences is because the differences probably matter less than the commonalties. All of the major Democratic candidates are advocating some form of universal health care. The question is, how do we get there? My proposal says:

• We will set up a government program similar to the one that I utilize as a member of Congress, that anybody who wants to can buy into, that we will subsidize those who can’t afford it.
• That we will pay for those subsidies by imposing a set of cost-saving measures that will actually improve quality at the same time that they lower costs.
• Using health IT, information technologies, not just for billing but for maintaining medical records, for communicating between doctors and nurses and pharmacists.
• To reduce errors and reduce bureaucracy.
• Managing the chronically ill.

Morally wrong that terminally ill must consider money

A: It shouldn’t be. And it’s wrong. You know, my mother died of ovarian cancer when she was 53 years old. And I remember in the last month of her life, she wasn’t thinking about how to get well, she wasn’t thinking about coming to terms with her own mortality, she was thinking about whether or not insurance was going to cover the medical bills and whether our family would be bankrupt as a consequence. That is morally wrong. It’s objectionable. That’s why I put forward a comprehensive legislation for universal health care so that all people could get coverage. My attitude is, that since you are paying my salary as taxpayers, you should have health care that is at least as good as mine. And the key to that is not only a good plan, but we’ve also got to overcome the drug & insurance company lobbies, that spent $1 billion over the last 10 years to block reform. As president, I am going to take them on.

Increase competition in the insurance and drug markets

Obama’s plan will reduce costs and save a typical American family up to $2,500 each year:
• Driving adoption of state-of-the-art health information technology systems.
• Improving access to preventive care & chronic disease management programs.
• Requiring hospitals to collect & report cost & quality data.
• Reforming our market structure to increase competition in the insurance & drug markets
• Lowering drug costs by allowing importation of safe medicines & increasing use of generics.

National Health Insurance Exchange for private coverage

Obama’s plan will provide affordable, comprehensive and portable health coverage for all Americans by:
• Making available a new public health plan that will allow individuals and small businesses similar to that available to members of Congress. No one will be turned away or charged more due to illness, and everyone who needs it will receive a subsidy.
• Making available a National Health Insurance Exchange to help individuals purchase private coverage and to reform the private insurance market Any American could enroll in participating private plans, which would have to provide comprehensive benefits, issue every applicant a policy, and charge fair and stable premiums.
• Immediately ensuring all 9 million currently uninsured children.
• Expanding Medicaid and the State Children’s Health Insurance Program [as a] critical safety net function.
• Requiring employers to make a meaningful contribution to the health coverage of their employees.

Give people the choice to buy affordable health care

Employers are going to have to pay or play

The market alone can’t solve our health-care woes

Given the money we spend on health care, we should be able to provide basic coverage to everyone. But we have to contain costs, including Medicare and Medicaid.

The market alone cannot solve the problem--in part because the market has proven incapable of creating large enough insurance pools to keep costs to individuals affordable. Overall, 20% of all patients account for 80% of the care, and if we can prevent disease or manage their effects, we can dramatically improve outcomes and save money.

With the money saved through increased preventive care and lower administrative and malpractice costs, we would provide a subsidy to low-income families and immediately mandate coverage for all uninsured children.

There is no easy fix, but the point is that if we commit to making sure everyone has decent care, there are ways to do it.

Health care tied to balancing costs and taxes nation wide

2008: must be national system; not state-level pilots

Will expand health coverage & allow meds to be re-imported

OpEd: Passing ObamaCare with no GOP caused long-term rancor

During the bill's passage, I spoke to one of the president's senior staffers and said that this unilateral act would create an unprecedented level of dissension and rancor that could preclude cordial working relationships for an extended time. The response I got was, "So what? That's nothing new."

This "my way or the highway" approach has resulted in disaster. Influenced by special interest groups, like some of the insurance companies that stood to benefit from the exchanges, and the Trial Lawyers Association, which supports anything that doesn't include tort reform, Democrats tried to create a bandwagon effect.

The Democrats now have an albatross around their necks with ObamaCare and will forever be blamed for destroying a reasonable healthcare system that was working for 85% of the populace.

FactCheck: Some Medicare premiums went up under ObamaCare

THE FACTS: Some Medicare premiums have gone up, not stayed flat.

As Obama said, insurers can no longer turn people down because of medical problems, and they can't charge higher premiums to women because of their sex. The law also lowered costs for seniors with high prescription drug bills. But Medicare's monthly premium for outpatient care has gone up in recent years.

Although the basic premium remained the same this year at $104.90, it increased by $5 a month in 2013, up from $99.90 in 2012. Obama's health care law also raised Medicare premiums for upper-income beneficiaries, and both the president and Republicans have proposed to expand that.

FactCheck: Yes, 9M signed up, but only 3M are newly insured

THE FACTS: That's not to say 9 million more Americans have gained insurance under the law. The administration says about 6 million people have been determined to be eligible for Medicaid since Oct. 1 and an additional 3 million roughly have signed up for private health insurance through the new markets created by the health care law. That's where Obama's number of 9 million comes from. But it's unclear how many in the Medicaid group were already eligible for the program or renewing existing coverage.

Likewise, it's not known how many of those who signed up for private coverage were previously insured. One large survey suggests the uninsured rate for US adults dropped by 1.2 percentage points in January, to 16.1%. That would translate to roughly 2 million to 3 million newly insured people since the law's coverage expansion started Jan. 1.

Lie of the Year: 'If you like your plan, you can keep it'

So this fall, as cancellation letters were going out to approximately 4 million Americans, the public realized Obama's breezy assurances were wrong. Out of a total insured population of about 262 million, that was less than 2%, but there was no shortage of powerful anecdotes about canceled coverage. Obama and his team made matters worse by suggesting they had been misunderstood all along. The stunning political uproar led to this: a rare presidential apology.

For all of these reasons, PolitiFact has named "If you like your health care plan, you can keep it," the Lie of the Year for 2013. Readers in a separate online poll overwhelmingly agreed with the choice.

ObamaCare and RomneyCare both expand private insurance

ROMNEY: The right answer is not to have the federal government take over health care and start mandating to the providers across America, telling a patient and a doctor what kind of treatment they can have. That's the wrong way to go.

OBAMA: There's a reason why Governor Romney set up the plan that he did in Massachusetts. It wasn't a government takeover of health care. It was the largest expansion of private insurance. But what it does say is that "insurers, you've got to take everybody."

ROMNEY: The federal government taking over health care for the entire nation and whisking aside the 10th Amendment, which gives states the rights for these kinds of things, is not the course for America to have a stronger, more vibrant economy.

OpEd: ObamaCare passed by constitutionally suspect tactics

People in South Carolina were outraged by what they were seeing in Washington. As far as I was concerned, the health-care law was a part of the same DC mentality that had given us the bailouts: Don't fix the problem, just throw it back on the taxpayers and have them pay for it.

2009: Accused of "Obamunism" and "Chains We Can Believe In"

On one sidewalk, liberals wore Obama t-shirts while chanting "Yes we did!". On the other sidewalk, middle-aged conservatives and retirees from rural Iowa waved homemade signs.

"This bill is Communism!" one protester shouted. "Obamunism!" yelled another.

Millions of Americans believed their government had ignored their wishes by forging ahead with health-care reform despite a mounting wave of opposition. Polls showed that Obama's signature bill remained stunningly unpopular. 2/3 of Americans thought it would cost too much; 44% expected the quality of their health care to decline, while only 8% expected it to improve.

A homemade sign read "Chains We Can Believe In."

OpEd: True cost of ObamaCare was end of bipartisanship

By the time the true cost of his health-care reform bill had already become clear, it had triggered the official, ugly end to his campaign vision of accord and bipartisanship. The same president who insisted during his speech on election night that the country "resist the temptation to fall back on the same partisanship and pettiness and immaturity that has poisoned our politics for so long," now found himself at the center of a political climate that he described with the same word. "It's poisonous," he said.

All his talk of bipartisanship had yielded few results, with not one Republican voting for his budget or his stimulus package, and only one Republican voting for his health-care bill.

OpEd: No authority to micromanage citizens' healthcare

FactCheck: healthcare reform saves $2B to $10B, not $250B

The truth is that this largely remains to be seen. Many of the cost-saving measures the president has touted are untested, such as changes in the way care is delivered, new payment models and pilot projects that some experts applaud, and others question.

The nonpartisan Congressional Budget Office expects that for most Americans, who get their insurance through work, health insurance premium costs won't change significantly from what they would have been without the law. CBO estimated that the major parts will cost $10 billion over the 2010-2019 period, while Medicare's Office of the Actuary determined savings of only $2 billion.

Overall, Medicare's chief actuary expects total spending on health care to rise over 10 years--but that's because about 34 million persons will gain health care coverage.

OpEd: Obama's public responsibility for health is socialism

Obamacare mandates that the American people must go out and buy government-approved health insurance in the private market. I defy anyone to show me the clause in the Constitution that gives Washington the authority to do this.

OpEd: Slices $500B from Medicare; repeals Medicare Advantage

What's wrong with Obamacare?
• It slices $500 billion from Medicare, sharply cutting funding for elderly care.
• It repeals the Medicare Advantage program, which subsidized premiums that gave the elderly coverage beyond what Medicare provides. Now they would have to buy more limited Medigroup coverage at higher cost with no subsidies available.
• It sets up a Medical Review Board to rule on what kind of care is allowed and what is not permitted under Medicare--specifying who can get procedures like hip replacement, bypass surgery, and high-cost cancer chemotherapy. The board's decisions would be based on age, condition, and other personal factors; doctors who refuse to follow their rules would be fined or face cuts in their reimbursement.

OpEd: Obamacare decides when life is worth preserving

Human beings have no standing to ask this question. Only God does. But Obamacare preempts divine authority, and arrogates to men and women the responsibility for deciding when life is worth preserving and when it is not.

To a certain extent, all doctors and all families have always faced this excruciating decision. Now, Obama is demanding that it be decided by a calculation of Quality Adjusted Life Years (QALYs), in which physicians, with bureaucrats peering over their shoulders and cost accounting peering over theirs, must equate life with money and come up with an answer.

OpEd: authority to require private insurance purchases?

Nowhere in the Constitution is Congress given the power to mandate that an individual enter into a contract with a private party or purchase a good or service. The authors of the Obama Bill say that requiring people to buy health insurance is covered by the Constitution's interstate commerce clause, which allows Congress to regulate a "class of activity."

But where is the interstate commerce? Congress has refused specifically and repeatedly t allow health insurance companies to compete across state lines. Republicans have been seeking this authority for years as a way to use private competition to hold down costs, but the Democrats have always refused.

OpEd: ObamaCare was achieved by Cuba 50 years ago

I cannot stop thinking about a world in which more than 1/3 of the population lacks the medical attention and medicines essential to ensuring its health.

OpEd: cut $622B in Medicare despite claiming no cuts

Obama said ObamaCare would not add to the deficit, would bend the cost curve down, and would reduce premiums, while the evidence shows just the opposite. Obama said that under his plan people could keep the insurance they had. Independent groups have shown this claim is simply false. At one point, President Obama was even so brash as to claim his plan would not cut Medicare benefits--even though the White House's own fact sheet said at the time that two-thirds of health-care reform would be paid for by $622 billion in Medicare and Medicaid cuts. The deceptions have badly injured his credibility.

High-risk pool for uninsured, now in plan, was GOP idea

Creating a high-risk pool for uninsured folks with preexisting conditions, that wasn't my idea, it was Senator McCain's. And I supported it, and it got incorporated into our approach. Allowing insurance companies to sell coverage across state lines to add choice and competition--that's a [GOP] idea that was incorporated into our package. And I support it, provided that we do it hand in hand with broader reforms. So when you say I ought to be willing to accept Republican ideas on health care, let's be clear: I have.

Cross-state-line insurance leads to cherry-picking

Pres. OBAMA: Actually, I've gotten many of your ideas. Some of the ideas we have embraced in our package Some of them are embraced with caveats. So let me give you an example. One of the proposals that has been focused on by the Republicans as a way to reduce costs is allowing insurance companies to sell across state lines. We actually include that as part of our approach. But the caveat is, we've got to do so with some minimum standards, because otherwise what happens is that you could have insurance companies circumvent a whole bunch of state regulations--mammograms as part of preventive care, for example. Part of what could happen is insurance companies could go into states and cherry-pick and just get those who are healthiest and leave behind those who are least healthy, which would raise everybody's premiums who weren't healthy.

Tort reform only saves $5B per year; not enough to matter

Pres. OBAMA: I am willing to work with you tort reform, but the CBO says, at best, this could reduce health care costs relative to where they're growing by a couple of percent, or save $5 billion a year, and it will not bend the cost curve long term or reduce premiums significantly. If we're going to do multi-state insurance so that people can go across state lines, I've got to be able to go to an independent health care expert, who can tell me that this won't result in cherry-picking and the least healthy being worse off. I've read your legislation, and the good ideas we take.

Didn't tackle healthcare for political benefit, it's needed

After nearly a century of trying--Democratic administrations, Republican administrations--we are closer than ever to bringing more security to the lives of so many Americans. The approach we've taken would protect every American from the worst practices of the insurance industry. It would give small businesses and uninsured Americans a chance to choose an affordable health care plan in a competitive market. It would require every insurance plan to cover preventive care.

FactCheck: Obama's estimate of $1T saved is closer to $132B

It's true that the CBO's admittedly rough estimate said the bill could reduce the deficit below its projected level by "as much as" about $1 trillion over 20 years--but it also said the reduction could be half of that amount. And it noted the estimate is subject to a great deal of uncertainty.

CBO normally gives estimates for 10-year periods, and the nonpartisan entity doesn't like to go beyond that. It said the Senate bill could produce a net deficit reduction of $132 billion over 2010-2019. For the next decade, CBO said the reduction would be "in a broad range between 1/4% and 1/2% of GDP." Senate Democrats estimated that would mean a reduction of $650 billion to $1.3 trillion. But CBO emphasized how squishy that large range is [while Obama did not].

FactCheck: Exempts small business, but no $2,500/yr savings

McCain misstated Obama’s health care plan, claiming it would levy fines on “small businesses” that fail to provide health insurance. Actually, Obama’s plan exempts “small businesses.”

$15B subsidies to private insurers was a lobbyist giveaway

End-of-life self-medication ok; euthanasia by others not ok

A: I believe in everybody having a living will so that their views on these issues can be factored in by family members. I don’t think that it’s appropriate to empower doctors themselves to make that decision. But I think that it is important for us to be able to allow people who are terminally ill, in excruciating pain, to get the medicine they need to relieve that pain.

Q: By “relieve that pain” you mean hasten the end of life if they choose to?

A: I think that there has to be very strict guidelines to ensure that somebody who is making a decision to relieve their pain [is acting appropriately]. That is distinguished from euthanasia in which someone else is making the decision for them.

AdWatch: punishing uninsured families doesn’t make sense

Hillary’s health care plan forces everyone to buy insurance, even if you can’t afford it... and you pay a penalty if you don’t.

Punishing families who can’t afford health care to begin with just doesn’t make sense. Bill Clinton’s own Secretary of Labor, Robert Reich, wrote, “I’ve compared the two plans in detail... But in my view Obama’s would insure more people, not fewer, than HRC’s.“

The Obama Health Care Plan:
• Offers health care coverage for all Americans similar to that of members of Congress, and subsidies to help those who cannot afford it.
• Reduces insurance costs more than Hillary’s plan, including capping insurance company profits in places where they have taken advantage of people.
• Saves the typical family up to $2,500 per year.

FactCheck: Yes, Obama favored single-payer, despite denial

But Obama’s denial doesn’t hold up. In a speech in June 2003, Obama said: “I happen to be a proponent of a single-payer health care program. I see no reason why the US cannot provide basic health insurance to everybody. A single-payer health care plan, a universal health care plan. And that’s what I’d like to see.“

After his election, Obama tempered his position, saying in May 2007, ”If you’re starting from scratch, then a single-payer system would probably make sense. But managing the transition would be difficult. So we may need a system that’s not so disruptive.

FactCheck: OPPORTUNITY to insure all, but no GUARANTEE

• It attributes to The Washington Post a line saying Obama’s plan would save families about $2,500. But the Post was citing the estimate of the Obama campaign and didn’t analyze the purported savings independently.
• It claims that “experts” say Obama’s plan is “the best.” “Experts” turn out to be editorial writers at the Iowa City Press-Citizen-- who, for all their talents, aren’t actual experts in the field.
• It quotes yet another newspaper saying Obama’s plan “guarantees coverage for all Americans,” neglecting to mention that, as the article makes clear, it’s only Clinton’s and Edwards’ plans that would require coverage for everyone. Obama’s plan wouldn’t guarantee that every individual HAD health insurance, just that everyone would have the OPPORUNITY to obtain it.

FactCheck: Reducing obesity would save $18B, not $1T

Obama got this claim from a “candidate briefin book” put out by the Center for American Progress, a liberal think tank run by former Clinton chief of staff John Podesta. CAP cites the CDC & the Commonwealth Fund as sources for the estimate, but representatives from both organizations told us that the claim was unfamiliar to them.

We worked up our own back-of-the-envelope estimate: The CDC officially estimates that obesity cost $75 billion in 2003; & that approximately half of the cost burden for both overweight and obese people is borne by Medicaid and Medicare; & obesity rates doubled between 1980 and 2000. So if obesity rates returned to “rates that existed in 1980” they would be cut in half, and Medicare & Medicaid would save about a quarter of $75 billion, or roughly $18.75 billion per year.

FactCheck: Correct that insurance lobbying cost $1B

According to the Center for Responsive Politics, the pharmaceutical and insurance industries spent $1.2 billion and $949 million, respectively, on all lobbying efforts since 1998. Moreover, the two industries combined shelled out about $193 million in political donations and expenditures backing Republicans, about twice as much as they spent supporting Democrats. So it is reasonable to conclude that the pharmaceutical and insurance industries have indeed spent at least $1 billion combating legislation that Obama favors.

Reform failed in ‘90s because of drug company lobbying

Shifting Medicaid to states means some people don't get help

ROMNEY: I would like to take the Medicaid dollars that go to states: you're going to get what you got last year, plus inflation, plus 1%, and then you're going to manage your care for your poor in the way you think best. Don't have the federal government tell everybody what kind of training programs they have to have and what kind of Medicaid they have to have. Let states do this.

OBAMA: Governors are creative. But they're not creative enough to make up for 30% of revenue on something like Medicaid. What ends up happening is some people end up not getting help.

ROMNEY: If a state gets in trouble, well, we can step in and see if we can find a way to help them.

Add 2,000 new primary-care residency spots

The president's program would add 2,000 new residency spots for primary-care doctors and general surgeons. The proposal originally called for 15,000, but it was trimmed to hold down costs. 2,000 extra doctors is a pitiful response to the problems of providing care for 30 million new patients!

The legislation increases funding for the National Health Service Corps, which helps repay up to $50,000 in student loans for doctors, nurse practitioners, and dentist who work in under-served parts of the country. These incentives to encourage people to go into medicine fly in the face of the fact that Obama is financing his program by slashing reimbursement rates for doctors. The results will be lower-quality care.

2009: Expanded SCHIP by loosening eligibility standards

In August 2007, Congress passed a bill to extend the program by loosening eligibility standards, providing incentives for states to enroll more customers, and making it easier for states to enroll higher-income families. Funded by raising cigarette taxes, the measure was vetoed by President Bush, who argued the expansion violated the program's original purpose. Democrats passed it a second time, and Bush vetoed it again. Eventually Democrats settled on passing a temporary reauthorization of the program until March 2009, when there would be a new president. And sure enough, Congress passed a bill expanding SCHIP in January 2009, and President Obama signed it as soon as he took office.

Reduce premiums and uninsured get same coverage as Congress

McCAIN: I want to give every family a $5,000 refundable tax credit. Take it and get anywhere in America the health care that you wish. [For employers], if you want to do the right thing with your employees and provide them health insurance, we’ll give you a 50% credit so that you will actually be able to afford it.

When your child gets sick, you don't shop for best bargain

If we started from scratch, one-payer system would be best

• Cover uninsured Americans: Obama will require that all children have healthcare coverage.
• Reducing costs of catastrophic illnesses for employers and their employees: The Obama plan would reimburse health plans for a portion of the catastrophic costs they incur.
• Helping patients: Support disease management programs. Coordinate and integrate care. Require full transparency about quality and costs.

Universal health care means anyone who wants it can get it

OBAMA: Well, look, I believe in universal health care, as does Sen. Clinton. And the point of the debate, is that Sen. Clinton repeatedly claims that I don’t stand for universal health care. And, you know, for Sen. Clinton to say that, I think, is simply not accurate. Every expert has said that anybody who wants health care under my plan will be able to obtain it. President Clinton’s own secretary of Labor has said that my plan does more to reduce costs and as a consequence makes sure that the people who need health care right now, all across America, will be able to obtain it. And we do more to reduce costs than any other plan that’s been out there.

CLINTON: [Leaving out a mandate is the same as saying] that we shouldn’t try to get everyone into health insurance.

Mandating kids’ insurance ok; mandating adults has problems

OBAMA: I have no objection to Sen. Clinton thinking that her approach is superior. But we still don’t know how Sen. Clinton intends to enforce a mandate.

CLINTON: Sen. Obama would enforce the mandate by requiring parents to buy insurance for their children.

OBAMA: This is true.

CLINTON: If you have a mandate, it has to be enforceable. So there’s no difference here.

OBAMA: No, there is a difference. I do provide a mandate for children, because we have created programs in which we can have greater assurance that those children will be covered at an affordable price. But we don’t want to put adults in a situation in which, on the front end, we are mandating them, we are forcing them to purchase insurance, and if the subsidies are inadequate, the burden is on them, and they will be penalized. And that is what Sen. Clinton’s plan does.

Young adults up to age 25 can be covered under parents’ plan

OBAMA: Which is why I cover them.

CLINTON: Except when the illness or the accident strikes. And what Sen. Obama has said, that then, once you get to the hospital, you’ll be forced to buy insurance, I don’t think that’s a good idea. We ought to plan for it, and we ought to make sure we cover everyone. That is the only way to get to universal health care coverage. But if we don’t even have a plan to get there, and we start out by leaving people, you’ll never ever control costs, improve quality, and cover everyone.

OBAMA: With respect to the young people, my plan specifically says that up until the age of 25 you will be able to be covered under your parents’ insurance plan, so that cohort that Sen. Clinton is talking about will, in fact, have coverage.

Adults will get health care as they can afford it

No one turned away due to illness or pre-existing condition

The Obama Plan will have the following features:
• Guaranteed Eligibility: No American will be turned away FROM ANY INSURANCE PLAN because of illness or pre-existing conditions.
• Comprehensive Benefits: The benefit package will be similar to that offered through Federal Employees Health Benefits Program (FEHBP), the plan members of Congress have.
• Affordable Premiums, Co-Pays and Deductibles.
• Subsidies: Those in need who do not qualify for Medicaid or SCHIP will receive an income-related federal subsidy to buy into the new public plan or purchase a private health care plan.
• Simplified Paperwork and Reined in Health Costs.
• Easy Enrollment:
• Portability and Choice Participants will be able to move from job to job without jeopardizing their health care coverage.
• Quality and Efficiency: Insurance companies will be required to report data on quality.

AdWatch: Pressure insurance & drug companies to change

Being poor in this country is hazardous to your health

A: The president can do everything to address this and can afford it if we are able to bring people together to get it done. And this is something that I am committed to doing as president. But it is indisputable that if you are poor in this country that is hazardous to your health, if you are black or brown, too, and poor, it can be downright deadly. Right now, even when blacks or Latinos have the same health insurance as whites, they are not receiving the same quality of care. And that means that we’ve got to have more black and brown doctors and nurses; we’ve got to have studies in terms of making sure that we are eliminating these disparities; we’ve got to make sure that we are doing outreach in these communities ahead of time to prevent disease.

Added 20,000 children to Illinois healthcare

National insurance pool & catastrophic insurance

Healthcare system is broken without lifetime employment

Focus on the affordability of a broad healthcare plan

Crises happen in our lives and healthcare is necessary

No need to mandate coverage; just let people afford it

OBAMA: Absolutely it does. John and I have a disagreement. John thinks that the only way we get universal coverage is to mandate coverage. I think that the problem is not that people are trying to avoid getting health care coverage. It is folks like that who are desperately in desire of it, but they can can’t afford it.

Q: [to Edwards]: Does Sen. Obama provide universal coverage

EDWARDS: No, because the only way to provide universal coverage is to mandate that everyone be covered. Sen. Obama’s made a very serious proposal, and I’m not casting aspersions on his plan. It just doesn’t cover everybody. The only way to cover everybody is to mandate it. We have talked about it too long. We have got to stand up to the insurance companies and the drug companies. It is the only way we’re ever going to bring about real change. We should be outraged by these stories.

Voted NO on means-testing to determine Medicare Part D premium.

SUPPORTER'S ARGUMENT FOR VOTING YES: Sen. ENSIGN: This amendment is to means test Medicare Part D the same way we means test Medicare Part B. An individual senior making over $82,000 a year, or a senior couple making over $164,000, would be expected to pay a little over $10 a month extra. That is all we are doing. This amendment saves a couple billion dollars over the next 5 years. It is very reasonable. There is nothing else in this budget that does anything on entitlement reform, and we all know entitlements are heading for a train wreck in this country. We ought to at least do this little bit for our children for deficit reduction.

OPPONENT'S ARGUMENT FOR VOTING NO: Sen. BAUCUS: The problem with this amendment is exactly what the sponsor said: It is exactly like Part B. Medicare Part B is a premium that is paid with respect to doctors' examinations and Medicare reimbursement. Part D is the drug benefit. Part D premiums vary significantly nationwide according to geography and according to the plans offered. It is nothing like Part B.

Second, any change in Part D is required to be in any Medicare bill if it comes up. We may want to make other Medicare changes. We don't want to be restricted to means testing.

Third, this should be considered broad health care reform, at least Medicare reform, and not be isolated in this case. LEGISLATIVE OUTCOME:Amendment rejected, 42-56

Voted YES on requiring negotiated Rx prices for Medicare part D.

Proponents support voting YES because:

This legislation is an overdue step to improve part D drug benefits. The bipartisan bill is simple and straightforward. It removes the prohibition from negotiating discounts with pharmaceutical manufacturers, and requires the Secretary of Health & Human Services to negotiate. This legislation will deliver lower premiums to the seniors, lower prices at the pharmacy and savings for all taxpayers.

It is equally important to understand that this legislation does not do certain things. HR4 does not preclude private plans from getting additional discounts on medicines they offer seniors and people with disabilities. HR4 does not establish a national formulary. HR4 does not require price controls. HR4 does not hamstring research and development by pharmaceutical houses. HR4 does not require using the Department of Veterans Affairs' price schedule.

Opponents support voting NO because:

Does ideological purity trump sound public policy? It shouldn't, but, unfortunately, it appears that ideology would profoundly change the Medicare part D prescription drug program, a program that is working well, a program that has arrived on time and under budget. The changes are not being proposed because of any weakness or defect in the program, but because of ideological opposition to market-based prices. Since the inception of the part D program, America's seniors have had access to greater coverage at a lower cost than at any time under Medicare.

Under the guise of negotiation, this bill proposes to enact draconian price controls on pharmaceutical products. Competition has brought significant cost savings to the program. The current system trusts the marketplace, with some guidance, to be the most efficient arbiter of distribution.
Status: Cloture rejected Cloture vote rejected, 55-42 (3/5ths required)

Voted YES on expanding enrollment period for Medicare Part D.

Voted YES on increasing Medicaid rebate for producing generics.

Voted YES on negotiating bulk purchases for Medicare prescription drug.

Increase funding for AIDS treatment & prevention.

HIV/AIDS Initiatives
The CBC’s Minority HIV/AIDS Initiative will focus on those areas hardest hit by the epidemic, many of which are in districts that we represent. The initiative will focus on prevention and treatment and we will also seek to re-direct and/or increase funding levels based on a detailed review of the implementation of the initiative. In addition, the CBC recognizes the devastating impact of HIV/AIDS on the global workforce, specifically in Africa, and on the allocation of resources of developing countries. Therefore, the CBC will continue its efforts to support a comprehensive global policy aimed at ending the scourge of HIV/AIDS around the globe.

More funding for Rx benefits, community health, CHIPs.

The Congressional Black Caucus is committed to improving America’s health care system by focusing on, among other items, the following issue areas:
• Eliminating Health Care Disparities.The CBC will emphasize the importance of eliminating health care disparities as it relates to access, treatment and availability in communities of color and other disadvantaged communities. The CBC will also ensure that America keeps its promise to our veterans, and will support funding for the best health care programs at our veterans’ hospitals.
• Patients’ Bill of Rights. The CBC will support a strong and enforceable Patients’ Bill of Rights that puts medical decisions back in the hands of doctors, and gives patients the right to seek damages when they are harmed by decisions influenced by non-medical professionals.
• Medicare Prescription Drug Benefit. The CBC supports a prescription benefit program for the Medicare program. The price of prescription drugs is too high for most seniors, and many seniors go without the necessary medication they need, or have to choose between conflicting priorities.
• Support for Health Providers in Underserved Communities. The CBC will support the development of networks of providers, community hospitals and health centers in underserved communities to increase the quality of care provided to patients. We will also seek funding and technical assistance to assist Community Health Centers in developing a system of comprehensive health services in both urban and rural communities.
• Healthy Children. The CBC will work to expand the Children’s Health Insurance Program. We will also focus on increasing immunization rates, better dietary and physical fitness programs, prevention of teenage pregnancies and anti-drug and smoking initiatives. In addition, we will support efforts to ensure that mental health is covered under basic health plans.

Improve services for people with autism & their families.

Amends the Public Health Service Act to require the Secretary of Health and Human Services to:

1. convene, on behalf of the Interagency Autism Coordinating Committee, a Treatments, Interventions, and Services Evaluation Task Force to evaluate evidence-based biomedical and behavioral treatments and services for individuals with autism;
2. establish a multi-year demonstration grant program for states to provide evidence-based autism treatments, interventions, and services.
3. establish planning and demonstration grant programs for adults with autism;
4. award grants to states for access to autism services following diagnosis;
5. award grants to University Centers of Excellence for Developmental Disabilities to provide services and address the unmet needs of individuals with autism and their families;
6. make grants to protection and advocacy systems to address the needs of individuals with autism and other emerging populations of individuals with disabilities; and
7. award a grant to a national nonprofit organization for the establishment and maintenance of a national technical assistance center for autism services and information dissemination.
8. Directs the Comptroller General to issue a report on the financing of autism services and treatments.

Establish a national childhood cancer database.

Conquer Childhood Cancer Act of 2007 - A bill to advance medical research and treatments into pediatric cancers, ensure patients and families have access to the current treatments and information regarding pediatric cancers, establish a population-based national childhood cancer database, and promote public awareness of pediatric cancers.

Authorizes the Secretary to award grants to childhood cancer professional and direct service organizations for the expansion and widespread implementation of:
1. activities that provide information on treatment protocols to ensure early access to the best available therapies and clinical trials for pediatric cancers;
2. activities that provide available information on the late effects of pediatric cancer treatment to ensure access to necessary long-term medical and psychological care; and
3. direct resource services such as educational outreach for parents, information on school reentry and postsecondary education, and resource directories or referral services for financial assistance, psychological counseling, and other support services.

Preserve access to Medicaid & SCHIP during economic downturn.

A bill to preserve access to Medicaid and the State Children's Health Insurance Program during an economic downturn.

• Economic Recovery in Health Care Act of 2008 - Prohibits finalizing, implementing, enforcing, or otherwise taking any action, prior to April 1, 2009, on any changes to Medicaid programs or State Children's Health Insurance Program (SCHIP).
• Amends the U.S. Troop Readiness, Veterans' Care, Katrina Recovery, and Iraq Accountability Appropriations Act of 2007 to extend through April 1, 2009, the moratorium relating to the cost limit for providers.
• Amends the Medicare, Medicaid, and SCHIP Extension Act of 2007 to extend through April 1, 2009, the moratorium relating to rehabilitation services, school-based administration, and school-based transportation.
• Provides for state fiscal relief through a temporary increase of Medicaid federal medical assistance percentage (FMAP).