Confederation Council Foundation for Africa Inc.,
Biden pens Obamacare op-ed for Iowa paper
Biden praised Obama for taking up the health care issue "in the middle of the greatest economic crisis since the Great Depression."
"I still remember the turmoil and uncertainty of those early days — and the president’s determination to act swiftly to stop the hemorrhaging," Biden wrote. "I remember something else especially clearly: President Obama’s insistence that we fix America’s broken health care system."
He reminded the skeptics that trouble for the middle class had started long before the economic crisis, and would continue long after economic recovery unless we did something about our health care system. He reminded them of the stories he’d heard when he ran for president — of folks seeing their premiums rising while their wages stagnated, of insurance companies refusing to cover children born with chronic diseases, of cancer patients hitting their lifetime limits in the first weeks of chemotherapy.
In 2010, because of his perseverance, we passed the Affordable Care Act.
The 70-year-old hasn't ruled out a third run for president in 2016.
Earlier this month, Biden traveled to Iowa to speak at Sen. Tom Harkin’s annual steak fry, a political tradition where, as ABC News noted, a young Sen. Barack Obama made his Iowa debut in 2006.
And last week, Biden held a private fundraiser for Iowa congressional candidate Jim Mowrer in Washington.
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- President Barack Obama
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Shut down a $15M daily hit on Md. economy, state estimate finds
Because of the high concentration of federal workers in Maryland, state officials project a two-week furlough period would amount to $51 million in lost income and sales tax revenue. Those estimates generally assume federal workers would not be paid retroactively as they have been after past shutdowns.
"The state income tax impact would be mitigated if federal workers receive retroactive pay after the shutdown ends; however, it is unlikely that most of the sales tax receipts would be recaptured," the memo states.
Lawmakers in Congress must pass a stop-gap spending bill by Monday night to avoid shutting down the when it begins the new fiscal year on Tuesday -- but the effort to do so has been complicated by a debate over the 2010 Affordable Care Act.
Republican leaders have floated the idea of a temporary spending bill that would avoid the immediate deadline and instead kick the health care debate into mid-October, when Congress must negotiate to raise the nation's $16.7 trillion debt ceiling.
Meanwhile, the Senate is expected to vote this weekend on a bill that would keep the running without stripping money for Obamacare.
Maryland is home to 300,000 federal workers.
Maryland shows Obamacare can be affordable
Our view: With some of the lowest projected insurance rates in the nation, Maryland leads the way in creating a vibrant health insurance exchange
There are several reasons why the 25 percent increase figure is misleading. The first is a bit technical but important. That average refers not to the average increase for any individual who buys a policy now versus post-Obamacare. It refers to the average cost of all the policies sold by a particular carrier. Because the Affordable Care Act eliminates exclusions for pre-existing conditions and lifetime caps on benefits, it is expected, at least in the early stages, to attract a disproportionate share of older and sicker patients into the insurance exchange. Thus, at least in the short term, a larger share of the policies purchased on the exchange may be more costly than is now the case. The better a state does at encouraging younger, healthier people to buy into the insurance pool — as required by law — the more those figures will eventually even out. But in the meantime, it's important to understand that if you buy a policy from Aetna now, it won't necessarily be 25 percent more expensive in the fall.
In fact, the amount you pay out of pocket for your care costs may well be lower under Obamacare, even if your premiums go up. That's because the insurance policies allowed in the health care exchange all must meet certain minimum qualifications in terms of their benefits and covered services. Most preventive care under the Affordable Care Act will be included in the price of insurance premiums, without deductibles or co-pays. People who previously bought low-rate, high deductible, low-benefit plans may find that they will now not only get a more comprehensive set of services but also pay less in the end, even if their premiums go up.
And that's not counting the fact that most — state officials estimate three-fourths — of the people buying coverage on the exchange will be eligible for federal subsidies. Those credits are available on a sliding scale for people earning up to four times the federal poverty level, or about $94,000 for a family of four.
Finally, it's important to consider that if a consumer thinks the rate he or she is paying is too high, the exchange makes it easy to shop around. Maryland and other states are busy creating web portals that allow consumers to and services for health insurance the way they now shop for airline tickets on sites like Expedia. And there is a significant variation in the projected costs from one company to another. According to the Maryland Insurance Administration rates for a basic, "bronze" level plan for a 25-year-old non-smoker range from $124 a month (BlueChoice) to $237 (All Savers). The premium for a higher-quality "silver" plan for a 50-year-old non-smoker would range from $267 a month (Coventry) to $470 (All Savers).
The rates announced on Friday represent significant reductions from the initial proposals made by the nine companies seeking to do on the exchange. Regulators found fault with a number of assumptions the insurers made with regard to the workings of Obamacare, with projected administrative expenses and with the expected customer population for the exchange. They reduced the proposed rates by at least 20 percent for four of the nine insurers. One analyst for the conservative-leaning Heritage Foundation fretted that Maryland's approved rates may actually be too low to foster a healthy competition among insurers. Maryland's rates are either the lowest or close to it among the states that have published their projected premiums so far.
As tempting as it is to look for a single, bottom-line number to say whether health insurance will be more or less expensive under Obamacare, the truth is that such a comparison is ultimately imperfect, if not meaningless, because of the changes in the way the health insurance marketplace will be structured. Some people will doubtless wind up paying more and others less, but for a different set of services than before. The real questions about Obamacare are whether more people will have coverage, whether people will be healthier, and whether the nation's out-of-control rise in can be checked. It will take years to get definitive answers, but the signs from Maryland and other states that have embraced the reforms are encouraging.
How Obamacare will help the uninsured and unemployed
Woman struggles under $1,000 monthly medical bills
So she asked the pharmacist and staff for a favor.
"I asked them to break up the prescription to give me one-third," says the woman, who would not allow her name to be published because she didn't want to disclose her medical conditions. "This was just for three of the five life-saving medications I take."
There's a reason why Ann could only afford a third of some of the drugs her doctor prescribes, and it can be summed up in five words: "I have no ."
Ann is unemployed, having lost her job as an art teacher a year ago. She says her unemployment is "too large to qualify me for state health benefits," which is hard to believe, but we'll come back to that.
"I pay $1,000 in per month," she says. "I do not use the emergency room. I do not see doctors except for a non-discounted $75 per month fee for prescription refills every two months. I pay full price for eyeglasses and dental care."
She lays all this out — a set of facts undoubtedly familiar to a few million uninsured, single American adults — and, in light of last week's Supreme Court decision, Ann asks, with incredulity, this question:
"I now have to pay a tax on top of my out-of-pocket health care costs?"
She alludes to the Supreme Court ruling that the individual mandate in the nation's new health care law is constitutional on tax law grounds. Barring Mitt Romney's election and a Republican-led repeal of the law, the Internal Revenue Service will soon be able to impose a tax penalty of either $695 a year or 2.5 percent of income, whichever is greater, on anyone who doesn't secure health insurance.
Ann got alarmed when she heard this.
She's already out-of-pocket $12,000 a year for medical expenses, and the IRS is going to hit her with a tax penalty, too?
I told Ann to sit tight while I got her some answers.
She's probably not the only uninsured American who thinks they're going to be penalized for not being able to afford health insurance.
But the worthy goal of the Affordable Care Act is to get more people insured — up to 30 million more — by either expanding the Medicaid program for the poor or by making private insurance more affordable to the middle class. Part of that $12,000 Ann pays now toward medical expenses will go toward securing insurance — and she'll save a lot of during the course of a year. Once insured, she won't have to pay the tax penalty, either.
I called Kathy Westcoat, president of HealthCare Access Maryland, the Baltimore-based nonprofit that helps people like Ann navigate the health delivery system. There are a lot of Marylanders who either don't know what benefits are available to them or, unemployed for the first time in their working lives, have too much pride to ask for help (or to allow their full names to be published in a newspaper.)
First question for Westcoat: Could an unemployed woman with $12,000 a year in annual medical expenses really be ineligible for public health care benefits, even after the expansion of Medicaid in Maryland a few years ago?
"It sounds crazy," says Westcoat, "but it's often true. The state has a program, Primary Adult Care, for single adults between 19 and 64. PAC has some good benefits — free primary care doctor visits, free or low-cost prescription drugs — but it's very limited. You can't see a specialist, for instance; it's not good for people with chronic diseases."
And it's not available for any able-bodied person who has more than $1,050 a month in income. So, single Maryland adults who lose their jobs and collect more than, say, $260 a week in unemployment benefits can't get into PAC. The best they can do is pick up some temporary help with medical bills through charity.
Westcoat offered Ann some relief from an emergency prescription fund supported by HealthCare Access donors.
"We can help her with her prescriptions for a month or two," she says.
But what about Obamacare?
What happens to Ann when the law takes effect? Will someone in her shoes be better off?
"It depends on her income level," says Westcoat, "but if she's a single adult and makes $15,000 a year or less, she gets into Medicaid, starting in 2014. But if she makes more than that and doesn't have insurance, she can get into a health insurance exchange, and receive a subsidy. ... She'll be able to buy health insurance at a fraction of what she's paying now in medical bills."
And she won't have to worry about paying a tax penalty for not having insurance.
It's nonsense to even think about repealing a law that would make all that happen.
House Republicans Push Obamacare Delay as Shutdown Nears
The U.S. government lurched toward a partial shutdown Oct. 1 as House Republicans planned to attach a delay of Obamacare to a bill to keep the government open and Senate Democrats said they will reject the proposal.
“Republicans have tried and failed to defund or delay the health care law more than 40 times, and they know this demand is reckless and irresponsible,” Jay Carney, the White House press secretary, said in a statement today. “Any member of the Republican Party who votes for this bill is voting for a shutdown.”
The developments dramatically raise the likelihood of a shutdown. The fiscal year ends Sept. 30, and the policy divide is wide, because congressional Democrats and President Barack Obama say they won’t accept any of the conditions Republicans are uniting around.
“The American people don’t want a government shutdown and they don’t want Obamacare,” House Speaker John Boehner and other Republican leaders said in a statement today. “We will do our job and send this bill over, and then it’s up to the Senate to pass it and stop a government shutdown.”
Military PayHouse Republicans plan to pass a separate bill to ensure that U.S. troops, along with some civilians and contractors who work for the military, are paid if the government shuts down. The House began debating the spending issue just before 8 p.m. Washington time, with a final vote set for later tonight.
Budget brinkmanship has become routine in Washington, particularly since Republicans gained control of the House in the 2010 election. A last-minute deal before Oct. 1 is still achievable, and one possible move is for both chambers to pass a short-term funding measure -- for a few days to a week -- to keep the government open and leave more time for debate.
The House Republican leadership doesn’t expect to pass a clean spending bill or have enough Republicans who would want to do that, according to a leadership aide who spoke on condition of anonymity to discuss party strategy.
Government ContributionThe House probably will amend the spending bill one more time. A likely option would eliminate the government’s contribution to the health insurance of members of Congress and staff, as a way of testing Democrats’ willingness to make any change to the health law, the aide said.
Right now, there is no desire or plan for a one-week extension of funding, the aide said.
Many Senate Democrats oppose the medical device tax, and a repeal garnered a 79-20 vote earlier this year. That doesn’t mean they want to attach it to the spending bill. The leading Senate advocate, Democrat Amy Klobuchar of Minnesota, rejected the idea this week.
“We continue to be willing to debate these issues in a calm and rational atmosphere,” Senate Majority Leader Harry Reid said in a statement today that called the Republican plan “pointless.” He added, “The American people will not be extorted by Tea Party anarchists.”
The Senate yesterday passed a bill that would fund the government through Nov. 15, omitting Republican language to choke off funds for the 2010 health-care law.
Senate ResponseReid yesterday warned that House revisions to the spending bill would lead to a shutdown. A Senate Democratic aide who spoke on condition of anonymity said it was unlikely the Senate would return before Sept. 30 to consider the House plan.
The Senate could reject the House’s amendments and send the bill without the Obamacare-delay provisions back to the House with hours remaining before a shutdown.
“Let’s keep this government running,” Democratic Senator Mark Begich of Alaska, who is up for re-election in 2014, said yesterday. “Look at the markets the last few days. The shenanigans they’re playing are causing the markets to falter and that’s bad for the economy and bad for jobs.”
Concerns that the budget impasse will hurt economic growth helped push the Standard & Poor’s 500 Index to its first weekly decline since August. The index fell 0.4 percent to 1,691.75 yesterday, and dropped 1.1 percent for the week. The rate on 10-year Treasury notes fell three basis points to 2.62 percent yesterday.
Economic GrowthA shutdown could reduce fourth-quarter economic growth by as much as 1.4 percentage points, depending on its duration, according to economists. The biggest effect would come from the output lost from furloughed workers.
Even if Congress resolves the spending fight, lawmakers would immediately move to the next fiscal dispute over raising the $16.7 trillion debt ceiling. Unless Congress acts, the U.S. won’t have enough money to pay all of its bills at some point between Oct. 22 and Oct. 31, according to the Congressional Budget Office.
House Republicans have voted more than 40 times to delay, defund or repeal all or part of the 2010 health-care law, which is designed to expand coverage to at least 30 million people. Some of the narrower proposals became law. The U.S. Supreme Court upheld the law in June 2012.
Sharp TurnToday’s move marks a sharp turn for Boehner and Republican leaders, who earlier this month tried to pass a plan that would have let the Senate strip out anti-Obamacare language and send the spending bill directly to Obama.
Tea Party-backed lawmakers rejected that approach, forcing Republican leaders to tie government funding to provisions aimed at stifling the health law.
Representative Nancy Pelosi of California, the House Democratic leader, opposed the Republican plan in absentia; she’s celebrating her 50th wedding anniversary.
The proposal under consideration today would delay the individual mandate along with many taxes and fees from the health law. It’s based on a proposal from Representative Marsha Blackburn, a Tennessee Republican.
“It’s exactly what we asked for and we got it,” said Republican Representative Michele Bachmann of Minnesota.
Republicans, torn by internal strategic and policy disputes, are choosing to make their stand against the health law. The first insurance exchanges open Oct. 1 and other portions of the law already have taken effect.
‘A Jerk’“Harry Reid has been a jerk, and I think he’s done nothing but unify the Republican House, saying ‘Look, we’re going to do what’s right,’” said Representative David Schweikert, an Arizona Republican.
At the White House, Obama accused House Republicans of “political grandstanding” that has hurt economic growth. He urged Congress to work together to pass a spending plan and then adopt legislation to increase the nation’s borrowing authority.
“Do not shut down the government. Do not shut down the economy,” Obama said yesterday. “Pass a budget on time. Pay our bills on time. Refocus on the everyday concerns of the American people.”
Republicans have been infuriated by Obama’s unwillingness to negotiate, pointing to his conversation yesterday with Iranian President Hassan Rouhani.
“It’s really interesting that the Democrats are willing to negotiate with Iran,” said Representative Richard Hudson, a North Carolina Republican. “But they won’t negotiate with us.”
In a government shutdown, essential operations and programs financed with permanent streams of money would continue, meaning that Social Security checks would be delivered and military personnel would still work. National parks, Internal Revenue Service call centers and passport offices are among the federal facilities that could close.
The bill is H.J. Res. 59. The troop funding bill is H.R. 3210.
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Harry Reid throws down gauntlet on budget: ‘This is it’
The continuing resolution to fund the government and keep Obamacare intact is on its way back to the House, where representatives will be faced with a do-or-die decision.
If the House, led by Republicans who have declared themselves determined to defund the health care law, votes for the Senate-passed bill, Congress will avert a government shutdown.
If they change the bill significantly and send it back to the Senate, there will likely not be enough time left to reach an agreement before the budget runs out Sept. 30.
“This is it,” Senate Majority Leader Harry Reid told reporters Friday, standing in front of a digital clock ticking down the days, hours, minutes and seconds left until the shutdown deadline. “They need to accept what we just passed.”
Republicans and Democrats are still bitterly divided over the contents of the budget, and especially the provisions involving Obamacare.
Republicans have waged their budget fight primarily on the question of defunding Obamacare.
Not a single Republican senator voted in favor of the Senate budget, which the party had declared anathema because it did not strip fiscal 2014 funding from the provisions intended to help implement the health care law. It passed 54-44.
Most Republicans voted in favor of procedural motions setting up the vote, despite threats from Sen. Ted Cruz, R-Tex., that such votes were essentially selling out their cause.
A vote for the procedural motions translated as “then you are willing to fund Obamacare,” Cruz warned his colleagues earlier this week.
Most Republicans chose to ignore him. The final procedural vote Cruz had warned against ended up 79-19, more than enough to give Democrats the opportunity to then pass the Senate-favored budget resolution by a simple majority.
But not all of those who sided with Cruz credited his reasoning for having swayed their vote.
Nevada’s Sen. Dean Heller voted against all four measures the Senate considered Friday, both procedural and substantive.
He cited the short-term nature of the bill — not Obamacare — as his reason for doing so.
“For years, Congress has depended on short-term bills just like the one the Senate voted on today rather than doing its job,” Heller said in a statement released after the vote. “Washington, D.C. insists on moving from crisis to crisis without ever really finding the solutions America deserves.”
Heller went on to talk up his No Budget, No Pay Act, which would withhold lawmakers’ pay for any period Congress is expecting the government to operate under a continuing resolution and not a formal budget.
Heller reintroduced No Budget, No Pay as an amendment to the continuing resolution on Tuesday. But two weeks ago, he had already admitted on the Vegas PBS program “Nevada Week in Review” that he was unlikely to vote for any measure that left funding for Obamacare intact.
The House is expected to resume consideration of the budget on Saturday.