Obamacare is kind of like the Wizard of Oz, says a Texas congressman.
On Wednesday, Department of Health and Human Services secretary Kathleen Sebelius testified before the House energy and commerce committee regarding problems with the rollout of the Affordable Care Act. Here are the highlights, both factual and theatrical:
1. Sebelius says she's responsible for healthcare.gov's failures. At a similar congressional hearing last week on the failures of the federal exchange website, contractors that built the digital infrastructure blamed HHS leadership, but not Sebelius herself. "Hold me accountable," she said Wednesday. "I'm responsible." But Rep. Greg Harper (R-Miss.) pressed Sebelius to place blame squarely on President Barack Obama. "No sir, we are responsible," Sebelius answered. Harper kept pushing. Sebelius finally retorted: "You clearly—whatever. Yes, he is the president. He is responsible for government programs."
2. Why some Americans may be losing coverage: It's complicated. GOP members on the committee emphasized the president's long-standing promise that "If you have a plan you like, you can keep it," and then argued that many Americans are now seeing their insurance plans canceled. But as Sebelius further explained, if you had a plan that you liked before the Affordable Care Act passed, you can keep it, because it was grandfathered in. If your insurance company changed the plan after the law went into effect, however, it is no longer exempted and has to comply with new protections offered under the Affordable Care Act, such as the prohibition against dropping a patient once he's sick, or charging a woman more because she's a woman. Plans that don't comply must be canceled—but as Rep. John Sarbanes (D-Md.) pointed out, that's a good thing, because such plans don't provide adequate coverage anyway. "The notion that people are being turned way from an affordable plan the provides good quality care is preposterous," he said.
Since then, those Dems must have had a change of heart. On Tuesday, nearly all of them flip-flopped, and voted against a House bill that would have undermined the same safeguards the letter opposed.
Here's some background, which was covered in our August report: The Department of Labor, which oversees the law that sets minimum standards for many retirement plans, is considering a rule that would simply require retirement investment advisers to act in the best interest of their customers. The letter, which was signed by 28 out of the 43 members of the Congressional Black Caucus (CBC)—a group of lawmakers that advocates for low-income people and minorities—and four other Democratic lawmakers, sought to delay and weaken the rule. Consumer advocates and government officials argued the rule could provide much need protection for small investors:
The current law doesn't do enough to prevent unscrupulous investment brokers from parking Americans' hard-earned cash in high-fee investments that benefit themselves, even if it's not in their customers' best interests, argues Barbara Roper, director of investor protection at the Consumer Federation of America...
"This rule is about protecting people from conflicts of interest," says Phyllis Borzi, the Department of Labor's assistant secretary for employee benefits security, who is spearheading the push for a stronger investment adviser rule. "Those conflicts harm everyone who is doing the right thing and trying to save."
The bill that passed the House on Tuesday by a largely party-line vote would, just as the letter urged, also have delayed and weakened the rule. But negative attention to the lobbyist's letter (our scoop was noted by MSNBC's Chris Hayes, among others) may have helped change some of the Democrats' minds.
Only two of the letter-signers voted with Wall Street: Reps. Gwen Moore (D-Wisc.) and Jim Costa (D-Calif.). A short time ago, the letter and other sources suggested at least 60 Democrats would support the bill; in the final tally, only 30 supported it. This was a "shockingly bad vote for Wall Street," one House staffer said.
Even though the vast majority of its signatories voted against the bill, the lobbyist-written letter was still being used to win over Democrats in the last hours. According to an email reviewed by Mother Jones, Rep. Patrick Murphy (D-Florida), who co-sponsored the bill with Rep. Ann Wagner (R-Mo.), circulated it to Democratic staffers just before the vote Tuesday, as evidence of Democratic support for the bill.
Despite the House bill's passage, the investment industry's chances of delaying the rule through legislative action are slim: the Democratic-controlled Senate is unlikely to pass the measure, and the White House is also opposed. And on Tuesday, Wall Street found out that its influence among House Democrats wasn't as strong as they'd once thought.
Congress resolved the shutdown and debt ceiling crisis (for now) by agreeing to hash out a budget agreement by mid-December. Already, hopes are dim. Budget experts say that if any deal at all is worked out to replace the deep budget cuts that went into effect in March, the most likely outcome will be a short-term plan involving slightly less severe spending cuts—but with no new revenue, a big Democratic priority. Now, several prominent economists, along with a coalition of labor, health, and community groups are pushing progressive lawmakers to aim higher, calling for what they term a "Robin Hood tax" on the rich.
On Wednesday, economist Jeffrey Sachs briefed members of Congress on the Robin Hood tax, also known as a financial transaction tax, which would charge Wall Street investors a fraction of a penny on the dollar value of each trade they make. Given the mind-boggling number of trades that occur each day, the tax could rake in as much as $700 billion a year. That would increase federal revenues by about 24 percent.
"We are calling on Congress and the White House to refocus on a human needs budget, not just an endless cycle of more austerity and more cuts," says Karen Higgins, RN, co-president of National Nurses United, one of the groups backing the tax. "We need the Robin Hood tax."
Scott Messick is a 54-year-old retired health insurance consultant from Conroe, Texas. His wife runs a small yarn shop. They're both on his former employer's health insurance plan for retirees, and Messick says that he and his wife together pay $964 a month in premiums, and a $12,000 annual deductible (the amount of money they have to pay out-of-pocket each year before the insurer will pay any expenses). Starting in January, their premiums will shoot up to $1,283 a month, he says.
Earlier this month, Messick logged on to the federal insurance exchange website to shop for a new plan. (The federal government's health insurance website has so many problems that many Americans are not able to register for the site, let alone compare plans. But Messick got through.) Although the Messicks' income is too high to qualify for a subsidy, they found a plan that would save them $6,000 a year in premium payments, and another $5,000 or so on their deductible.
Despite the fact that Obamacare could cut their health care costs almost in half, the Messicks might not switch plans. Why? Because Republicans might repeal the law. "My wife is concerned that Republicans will try to get rid of this thing, and if they do, we've jumped out of a retiree plan," Messick says. "We'd be left with nothing."
Many retiree health plans stipulate that you can only enroll in the plan once, and if you drop coverage—say, by buying cheaper insurance on the exchange—you're out for good. "The door swings one way," Messick explains.
That one-way door could be a problem for many Americans if Obamacare is repealed, says Tim Jost, a health care law scholar at Washington and Lee University School of Law who has consulted with the administration on the implementation of the law. If people like the Messicks buy cheaper insurance on the exchange and Republicans gut the Affordable Care Act, insurance industry prices and practices could return to what they were pre-Obamacare. That means insurers could go back to rejecting older folks, who tend to have chronic health problems, or charging them astronomical prices. Messick has chronic back problems; his wife has suffered a minor stroke and has migraines. "Both my wife and I are uninsurable" in the private market, Messick says, adding that a few years ago he ran an "experiment" and tried to purchase insurance outside of his employer plan and was "turned down flat."
On Thursday morning, Republicans on the House energy and commerce committee held a hearing about what is wrong with the federal health insurance exchange site, who is responsible, and what needs to be done to fix it. In attendance was Cheryl Campbell, the senior vice president at CGI Federal, the main contractor building the website, as well as three other top executives from smaller contractors working on the federal insurance site. Although members of Congress managed to pry some key information out of the witnesses—the contractors, predictably enough, pinned blame on the Department of Health and Human Services (HHS) for failing to adequately test the whole system early enough—a good part of the hearing was devoted to partisan bickering, sometimes only tangentially related to the problem-plagued website.
Here are four topics addressed in Thursday's hearing that had nothing to do with fixing healthcare.gov:
1. Delay Obamacare, because why not: The GOP failed in its effort to delay Obamacare by shutting down the government and threatening default. But Republicans are not dissuaded. Some, like Sen. Marco Rubio, (R-Florida), have suggested delaying the individual mandate for six months because of the problems with the website. Rep. Joe Pitts (R-Penn.) and other Republicans at Thursday's hearing echoed this proposal. (The White House already announced Wednesday night that it will compensate for the delays caused by the website by giving Americans up to six extra weeks to sign up for insurance.)
2. Obamacare Could Steal Your Data: Both Rep. Marsha Blackburn (R-Tenn.) and Rep. Joe Barton (R-Tex.) used the hearing to heap another healthy dose of Obamacare fear-mongering on Americans. Barton said that Obamacare violates the Health Insurance Portability and Accountability Act (HIPAA), the law that protects Americans' personal medical information, because Healthcare.gov requires applicants to enter personal information into site. "Do you think that should be a requirement to sign up for Obamacare?" Barton demanded of the contractors. "You know [that's] not HIPAA compliant… It's a direct contradiction of privacy and you know it!"
Except that the health insurance website only asks for very basic personal data, not medical information. "There is no health information in the process," Rep. Frank Pallone (D-N.J.) snapped in response. "You're asked about your address, your date of birth. You are not asked health information. So why are we going down this path? Because you are trying to scare people so they don’t apply, and so therefore the legislation gets delayed, or the Affordable Care Act gets defunded, or it’s repealed. That’s all it is, hoping people won’t apply."
Blackburn raised the HIPAA issue, too, asking if all the contractors had been trained in HIPPA compliance, if they have physical access to HHS's databases, and how many separate servers were being used to store Americans' medical information.
3. Remember the Government Shutdown?: Toward the end of the four-and-a half hour hearing, Rep. David McKinley (R-W.Va.), expressed annoyance that he had not yet heard an apology from any of the contractors for screwing up uninsured Americans' ability to finally get health coverage. "I've not heard the word I'm sorry," he said. "I know men have a hard time saying that, but the whole panel." Rep. Henry Waxman (D-Calif.), the top Democrat on the committee, jumped at the opportunity to skewer Republicans over the government shutdown. "Can we get an apology for shutting down the government because people didn’t like the health care bill?" he asked.
4. What About Climate Change?: Campbell of CGI and the representatives for the other website contractors divulged as little information as they possibly could about the missteps and confusions that contributed to a barely functioning health exchange website. Committee members asked how many total applicants had registered so far through the site, what kind of hacking protections each contractor uses, and who exactly at HHS was in charge of ensuring that the website was adequately tested before the launch date. Each time Republicans received an "I don't know" from the contractors, they demanded the information be furnished by "9 a.m. tomorrow."
In response, Waxman noted that he and fellow energy and commerce committee member Rep. Bobby Rush (D-Ill.) have asked Republicans on the committee numerous times to hold climate change hearings,and said it would be nice if GOP committee members would respond to their requests by "9 a.m. tomorrow," too. In the last Congress, Waxman and Rush sent 21 letters to Chairmen Fred Upton (R-Mich.) and Ed Whitfield (R-Ky.) requesting that the committee hold hearings on climate change, and received no response. In the current Congress, Waxman and Rush have sent seven letters requesting hearings on this topic, and the committee has held one hearing.