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Monday, July 19, 2010

Real Clear Politics and Health Care Reform

Today's health care section of Real Clear Politics is a microcosm of the problems that the administration faces on health care reform. Today, it links to three different stories and each is a problem for the Democrats. The first story is about how health insurers are pushing for plans that will limit the choices patients will have in choosing their doctors from the New York Times.

As the Obama administration begins to enact the new national health care law, the country’s biggest insurers are promoting affordable plans with reduced premiums that require participants to use a narrower selection of doctors or hospitals.

The plans, being tested in places like San Diego, New York and Chicago, are likely to appeal especially to small businesses that already provide insurance to their employees, but are concerned about the ever-spiraling cost of coverage

But large employers, as well, are starting to show some interest, and insurers and consultants expect that, over time, businesses of all sizes will gravitate toward these plans in an effort to cut costs.

The tradeoff, they say, is that more Americans will be asked to pay higher prices for the privilege of choosing or keeping their own doctors if they are outside the new networks. That could come as a surprise to many who remember the repeated assurances from President Obama and other officials that consumers would retain a variety of health-care choices.

Of course, President Obama billed health care reform as a way to cut costs and expand choice. The reality is of course very different.

The second story, also from the New York Times, is about how the Obama administration has taken to calling the mandates a tax.

When Congress required most Americans to obtain health insurance or pay a penalty, Democrats denied that they were creating a new tax. But in court, the Obama administration and its allies now defend the requirement as an exercise of the government’s “power to lay and collect taxes.”

And that power, they say, is even more sweeping than the federal power to regulate interstate commerce.

Administration officials say the tax argument is a linchpin of their legal case in defense of the health care overhaul and its individual mandate, now being challenged in court by more than 20 states and several private organizations.

It's true that the power to tax is a constitutional mandate of the federal government. The problem is that if this mandate is a tax, then that's a tax on everyone. Yet, President Obama so famously promised that 95% of the country wouldn't be taxed under his administration.

If this mandate is a tax, then it also means that everyone's taxes are going up.

Finally, there's this story from Politico in which both the left and right are pushing back against his abortion policy in health care reform.

The key lines are these: "The Obama administration has decided that no woman in the new high-risk insurance pools will be allowed to obtain abortion coverage beyond limited cases (rape, incest, endangering the life of the woman). Not even if she pays for that coverage with her own money...

"...The president committed his administration to preventing any federal funds from being spent on abortion care. But the fact is, this announcement from HHS goes well beyond that. Nothing in the new health care reform law requires a ban on abortion coverage in the high-risk pools. No law passed by Congress forced this decision. The Obama administration has chosen to place a new burden on ill and medically vulnerable women seeking abortion coverage."


Talk dominated conservative news outlets over the last few days that New Mexico and Pennsylvania were going to allow elective abortions as part of their applications for access to the new federal insurance pools. Among the sparks for that round of stories was an AP report in which New Mexico officials initially said elective abortion would be covered under its policies, then started walking that back.

But the National Right to Life Committee sparked an uproar by claiming a similar issue was arising in Pennsylvania. Pennsylvania officials strenuously denied that and Democrats accused the NRLC of creating an issue out of whole cloth aimed at testing an executive order President Obama signed last March.

It still remains unclear if the new health care reform will use federal tax dollars to fund abortions. The president said no and even signed an executive order to stop it. We don't live in a dictatorship and so an executive order is largely useless.

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