Six Months after the End of adultBasic

A blog post by Sharon Ward, originally published at Third and State.

It has already been six months since Pennsylvania pulled the plug on the adultBasic health insurance program for 37,588 people. The Pennsylvania Budget and Policy Center recently took a look at what happened to the Pennsylvanians who lost their adultBasic coverage on the first of March. While some found health insurance elsewhere, many have simply fallen through the cracks.

In all, fewer than 40% of former adultBasic enrollees have enrolled in Medical Assistance or Special Care, a low-cost, limited benefit product offered by Pennsylvania’s Blue Cross/Blue Shield plans. These were the two options most touted as alternatives for adultBasic enrollees.

According to data provided by the Pennsylvania Departments of Public Welfare and Insurance, only 12,814 former enrollees signed on to the Blues’ Special Care – about 34% of those enrolled in adultBasic when it ended. Special Care came at a cost four times more expensive than adultBasic, and with limits on medical coverage including a four-doctor-visits-per-year cap that may have kept it out of reach for most adultBasic enrollees.

Only 1,513 qualified for health coverage under Medical Assistance – 4% of those enrolled in adultBasic when it ended. AdultBasic was designed to provide health coverage to working adults who didn’t qualify for Medical Assistance but weren’t provided job-based health coverage. Still, many adultBasic enrollees might have qualified due to special circumstances: pregnancy, a diagnosis of breast or cervical cancer, or a disability. Despite a thorough review of cases by the Department of Public Welfare, fewer than expected adultBasic recipients are enrolled.

After six months, 62% of adultBasic enrollees, 23,261 individuals, are not enrolled in the two main alternative programs offered by the Pennsylvania Department of Insurance when the program closed.

Leaving people uninsured brings with it significant costs: to the individuals, and to the public who pays for their medical treatment at hospitals and, when the uninsured become the unemployed, for additional social services.

Under the federal Affordable Care Act, many former adultBasic enrollees will have access to insurance that they can afford when competitive insurance marketplaces open in January 2014. But that is a long time to wait for those who have fallen through the cracks.

Joe Pitts: Renounce Your Government Health Care

Congressman Joe Pitts (PA-16) has been in Congress so long he has lost touch with his constituents.  A man who originally ran on term limits he has grown fat and lazy in Washington.  How lazy is he?  For the last two years he slept on his “NO” button.  There wasn’t one thing on the agenda which he supported.  Now that John “The Crying Game” Boehner is Speaker he’s suddenly voting yes, yes to repeal health care.  Of course Joe has health care.  Not just regular run of the mill health care but GOVERNMENT health care.  He has what he doesn’t want you to have.  If Joe Pitts is so against government health care he should renounce his now.

What would Joe do?  He could always fall back on his Pennsylvania provided benefit since he’s already collecting a state pension from his time in the state legislature.  oops, that’s also GOVERNMENT health care isn’t it?  Perhaps he must do what 59 million other Americans must do:  go without.  Let him see the substandard care one receives when they go for medical care and don’t have health insurance.  Let him see the scores of people in the ER who are there for routine care because they cannot see a regular doctor.  Let him see the millions each hospital loses trying to care for the indigent who come an emergency room when things are horribly bad because they delayed treatment because they couldn’t afford care.

Let the Congressman get bills for his care which are astronomical because there’s no middle agency negotiating lower costs for his care.  Let him see average people die because they didn’t get adequate care.

Joe Pitts and other Republican hypocrites vote against government health care for the rest of us while enjoying their own.  America desperately needs jobs but these folks are voting to repeal health care instead of creating jobs.  Of course they voted against every job creation bill proposed in the 111th Congress too.  Joe Pitts voted against every single one of them.  He should have lost his job too but Lancaster County is so wealthy his constituents can seemingly afford their own transplants, cardiac surgeries and chemo.

A national effort is underway beginning today to raise money to call out these hypocrites.  You can read about it at DailyKos.  You can contribute to target these Republicans here.  Ten dollars is all we’re asking so we can call them out on repealing coverage for us while they get theirs.  Please go here and make a donation.  This is the ad which has been developed for this campaign.

Gov. Rendell to Issue Executive Order on HCR

Now that health insurance reform has passed and is the law of the land implementing it is the next major step.  Much of the onus for implementation will be on the states to create exchanges, expand Medicaid and provide the governmental infrastructure to provide insurance coverage, digitize medical records and so forth.  Gov. Ed Rendell will issue and Executive Order within a week to begin this process in Pennsylvania.  It will create a group headed by Donna Cooper to begin advance planning by the state.  Ann Torregrossa, the head of the Governor’s Office on Health Care Reform made the announcement yesterday at a conference about implementing the new law in Pennsylvania.

This year’s state elections will be critical in determining how Pennsylvania moves forward, or not, under the law.  GOP Gubernatorial candidate Tom Corbett is suing to overturn the law, something ridiculed by constitutional scholars, and couldn’t be expected to implement much of the legislation as Governor.  Therefore it is urgent a successor to Ed Rendell be elected who will fully and completely enact reform so Pennsylvanians can fully benefit from its provisions.  

The state legislature will then begin designing and building the four exchanges which begin operations in 2014.  Whoever controls the State House and Senate will enact the laws creating the exchanges so who is elected to these positions in November is also critical.  Meanwhile the enactment and implementation of the law waits for no election.  Ray Prushnok, Deputy Secretary of the Pennsylvania Department of Aging addressed just a few of these concerns in an interview yesterday:

Sec. Sebelius Does a Victory Lap

Health and Human Services Secretary Kathleen Sebelius did a conference call this afternoon with press and she lauded last night’s House vote saying “it is a great victory for the American people”  She silenced doubters who said it couldn’t be done with a statement that “they thought government was broken and could no longer fix big problems.”  

Actually I think this bad bill proves government is broken because the health insurance industry got more than they lost.  Yes, there are important provisions in the bill but the mandate overshadows them.  Within six months from tomorrow children with pre-existing conditions cannot be denied health care (but it will cost an arm and a leg), children can remain covered on parent’s policies until age 26, insurers cannot rescind benefits to anyone getting sick or seriously injured, tax credits for small businesses kick in so they can begin providing benefits to workers, the doughnut hole for seniors on Medicare Part D begins by reducing it by $250 a year, and insurance companies must publish their medical loss ratios.

So what does all that mean?  First, the pre-existing conditions clause only begins by covering children, not adults.  If you are an adult with a pre-existing condition you still won’t be able to obtain insurance immediately.  Once you can the health insurers can charge you 2-3 times the normal rate.  Young adults, just out of college for example, can stay on Mom or Dad’s insurance until they are 26.  I recall when I graduated from Penn State in 1974 we had a pretty fair recession.  It took me two years to get my first real, professional job working in sales and marketing for a large multinational corporation.  I worked some retail and insurance meanwhile but went without health care benefits because I was over 21.  Now similar young people can remain on their parent’s policies until they are 26.  In this economy that’s significant.

One of the most egregious outrages about the old system was the methods companies used to deny benefits.  When someone got cancer, serious heart disease, diabetes, MS, ALS or other catastrophic illness insurers did everything possible to drop their coverage, refuse to pay for treatment or outright cancel policies.  They were the actual death panels.  Now they are prohibited from doing so though I’m not sure of the enforcement method for implementing this feature.

The tax credit for small businesses will enable more of them to offer health benefits for employees.  Unfortunately it will take several years to set up the exchanges.  It took but one year to set up the Social Security System but this much less complicated program requires 4 years.

The Medicare Part D prescription drug program for seniors has a large “doughnut hole” which continue to cost our elderly a large amount out of pocket each year.  In November this will be reduced by $250 as each year it is again reduced until it disappears.  Sec. Sebelius was asked about the cuts to Medicare Advantage plans which are in the bill.  Opponents to this bill constantly decried these cuts, principally (in Pennsylvania) Jason Altmire and Tim Holden.  This ISN’T Medicare.  These are privatized, private insurance company, for profit programs set up by George W. Bush and the GOP to privatize Medicare.  These are NOT government run Medicare.  They are 9% more expensive than traditional Medicare because seniors are paying for profits for the health insurers.  This bill cuts subsidies to Medicare Advantage for this reason.

Medical loss ratios tell us how much of an insurer’s revenues are actually paid out in benefits.  Traditionally these were in the mid 90% range.  As the corporations shifted more and more of the financial burden to us they have fallen to about 85%.  Think in terms of charities:  you don’t want to give your money to a charity if most of the money goes to salaries and overhead.  It’s the same thing here:  they will have to publish these figures.   Ironically a “Medicare for all” plan of true universal coverage could be paid for with this differential.  The bloated salaries, marketing expenses, overhead and waste present in today’s broken system could cover every American for all their medical needs with no copays or deductibles.  Unfortunately the Senate refused to even consider such a plan.

These provisions are mostly good but are outweighed by the bad:  the forced mandate.  Had the House had some option other than approve the Senate bill perhaps we could have had a robust public option so Americans would have an alternative.   Thank the good people of Massachusetts.  Ironically this bill is modeled after the Massachusetts bill which was championed by then Gov. Mitt Romney.  Now Republicans hate the concept.  Go figure.  Forcing Americans to purchase high cost health insurance for private profit is not going to sit well with the voters.

Sen Casey Responds About Using Reconciliation

About two weeks ago I contacted Sen.Casey’s office in Washington about supporting Sen. Bennet’s letter calling for the use of reconciliation to pass health insurance reform.  You might recall the several articles because Sen. Specter did decide to sing on.  I identified myself as a blogger (I’ve met the Senator a few times and he knows who I am).  Today I received this cryptic response:

Dear Mr. Morgan:

Thank you for taking the time to contact me about the performance of Congress and the need for a clean, accountable government. I appreciate hearing from all Pennsylvanians about the issues that matter most to them.

As a United States Senator, I take very seriously the responsibilities that come with my job as a public official. Sadly, all too often I hear from constituents across Pennsylvania who fear that Congress has lost sight of its mission to represent the American people and solve the serious problems facing our Nation today. They express concern about fiscal responsibility, failed congressional oversight, earmark reform, partisanship and reports of corruption or conflicts of interest on the part of other members. While I can’t speak for my colleagues or how they manage their offices, I can assure you that I am vigilant in making sure that my Senate office, which truly belongs to the people of Pennsylvania, is run transparently and without undue influence from special interests.

The Nation’s fiscal health is of the utmost importance to me. I, too, am concerned about the escalating amounts of debt incurred by our government, particularly over the last eight years. Moving forward, we must develop a policy that is responsible both in terms of spending and paying down our accumulated debts.

I am proud to support targeted initiatives designed to promote economic growth and improve the quality of life in Pennsylvania, but recognize that federal spending, including some contained in earmarks, has been wasteful in recent years. Each project submitted to my office is subjected to considerable scrutiny, and I have made it a point to provide the public with timely information on the projects I have sponsored in federal spending bills.

More of the letter, remember I wrote asking him to support reconciliation for health insurance reform:

While earmarks represent a small portion of the annual federal budget (about one half of one percent of all spending in fiscal year 2009), the need for transparency and accountability is essential to ensuring the public’s confidence in this process. In 2007, I joined my colleagues in enacting new rules designed to strengthen the public’s ability to identify the Congressional sponsors of these projects. As a result of these efforts, the name of the Member(s) of Congress who have advocated for a particular project now appear in the text of the statement accompanying the bill. Additionally, reforms that I supported now require Members of Congress to certify that they have no financial interest in the projects they have sponsored. These changes constitute an unprecedented commitment to reforming Congressionally-directed spending practices. As the 111th Congress continues its work, I will continue to support steps to further increase the transparency of this process.

I have also been gratified to hear from my constituents regarding the need to put partisanship aside, and I wholeheartedly agree that the challenges facing our country leave little room for partisan squabbling. I have cosponsored important bills with Independent, Republican and Democratic Senators in both the 110th and 111th Congresses, and I will continue to reach across the aisle to find legislative solutions to the problems facing Pennsylvania.

Again, thank you for sharing your thoughts with me. As your Senator, I highly value hearing what Pennsylvanians think about the actions of Congress as well as my own performance here in Washington. Please do not hesitate to contact me in the future about any matter of importance to you.

If you have access to the Internet, I encourage you to visit my web site, http://casey.senate.gov. I invite you to use this online office as a comprehensive resource to stay up-to-date on my work in Washington, request assistance from my office or share with me your thoughts on the issues that matter most to you and to Pennsylvania.

Sincerely,

Bob Casey

United States Senator

Why even respond to me if this is the best you can do?  His letter has nothing to do with what I requested and it reads like a generic constituent letter.  Does he even have a press assistant? Perhaps he should, this is an embarrassment.

The Economic Cost of Healthcare Is Becoming Crippling

I keep hearing from Republican leaders that we shouldn’t reform health care because it is 16% of our economy and tinkering with such a major sector is dangerous.  Today we learned it is now 17.3% of gross domestic product.  This illustrates exactly why we must.  As the cost of health care continues rising we have fewer dollars for manufactured goods.  It is the purchase of autos, appliances, furniture and other consumer goods which drives our manufacturing sector and that is what drives jobs and incomes.  The more jobs, the more income, the more Americans have to spend and increase our economic engine.  

We must reform health care and decrease until it is no longer the major driving force of our economy.  Health care is strangling us.  As its costs continue rising 18-30% per year we are losing ground.  If you get a raise of 3%/year but your health care costs rise 10% you lose ground economically every year.  This is what has been happening and why health care has risen to 17.3% of our total economy.  It is unsustainable.  As these costs rise each of us has less and less disposable income.  This is what we spend on consumer goods, manufactured goods.  No one buys a new television or refrigerator when confronted with a $5,000 deductible for a routine hospital visit and when faced with something serious requiring $10-40,000 out of pocket they go bankrupt and lose everything.  Few of us can afford such financial hits.

The Senate health care bill will do nothing to control costs and fix the current problems.  In fact it may make them worse.  Because it mandates every American to purchase insurance from the same seven corporations who have seemingly colluded to divide current markets you will have no option, save going to prison, than to buy coverage.  If you have a pre-existing condition, as many of us do, you can be charged three times the rate for your coverage.  For example if you are a single individual the average cost of insurance now is around $850.  Triple that and you’ll be paying $2550.  At an annual average increase of 20% you shortly will have nothing of your income remaining for much else.  This will devastate our economy.

So it appears we’re doomed if we do and doomed if we don’t.  Not quite.  There are other solutions.  The House health insurance bill is much more progressive than the Senate version.  It’s far from perfect but substantial improvement.   The only real solution is an expanded Medicare For All.  Because too many people in DC have been bought by the insurance industry they will not vote for such a plan.  Heck we cannot get one passed in Harrisburg yet.

There is something you can do.  This is a major election year.  As you meet and/or talk to every candidate you must ask them if they support a single payer system like Medicare.  If they say support them and tell your friends.  If no tell them why and do not give them anything.  You can also support the public financing of campaigns.  Taking money out of politics will reform much of the system and make your lawmakers more responsive to you instead of the powerful interests which finance their campaigns.  The outrage and pushback from the recent Supreme Court decision is providing impetus for such reform and we must use this opportunity to get it right.

The alternative is doing nothing and watching as health care eats more and more of our economic dollars until our system is paralyzed.  Of course by then we won’t be able to afford the necessary surgery.

Health Reform Needed to Lower Costs, Bring Peace of Mind

The Pennsylvania Budget and Policy Center is a member of the Pennsylvania Health Access Network (PHAN). Today, PHAN put out a news release responding to an anti-health reform rally at the State Capitol in Harrisburg. Read below and please pass it on.

HARRISBURG, PA (January 27, 2010) – Health care reform is needed to rein in unsustainable costs and give hardworking Pennsylvanians greater freedom to care for their families and themselves, according to the Pennsylvania Health Access Network (PHAN).

Members of PHAN, a coalition of 50 organizations from across Pennsylvania, addressed the need for health reform, while several Pennsylvania state representatives and their supporters staged an anti-reform rally at the Pennsylvania Capitol Wednesday. The rally promoted state legislation that would hamper federal reform efforts from taking hold in the Commonwealth.

Without health reform, many more Pennsylvanians and their families will join the ranks of the uninsured, as the economy stagnates, people search for work and health care costs continue to rise.

“It’s getting tougher to afford quality health care, no matter how hard we work, even when we take responsibility for our health and make good decisions for ourselves and our families. But we can build on our health care system with uniquely American ideas to provide quality, affordable health care for everyone,” said Georgeanne Koehler of Pittsburgh, a member of SEIU who has worked to pass health reform. Her brother, Billy Koehler, after losing his job and his health insurance, died last March because he couldn’t afford to replace a heart defibrillator battery.

Over the past decade, nearly 700,000 Pennsylvanians have lost employer-sponsored health insurance, sending more people onto public health plans or forcing them to join the ranks of the uninsured. U.S. Census Bureau data put the current uninsured rate in Pennsylvania at 1.2 million – a jump from 8.3% of the state population in 2000-01 to 9.7% in 2007-08.

More Pennsylvanians would have found themselves uninsured were it not for public coverage options, such as Medicaid and the Children’s Health Insurance Program (CHIP). Between 2000-01 and 2007-08, the share of the Pennsylvania population with coverage through Medicaid and CHIP grew from 10% to 14.3%.

“Many faith groups continue to urge members of Congress to keep up the current effort for meaningful health reform,” said Rev. Amy Reumann, Director of the Lutheran Advocacy Ministry of Pennsylvania and a member of PHAN. “We believe reform remains necessary to address some of the deep problems with our current health system. Reforming health care is a moral issue as long as people continue to die needlessly for lack of access to care and others remain uninsured and without necessary health services.”

Health reform will allow Pennsylvanians to choose the private health plan that works best for them at an affordable cost. Providing affordable coverage to the uninsured is also the first step to reducing health system costs. Right now, the cost of treating uninsured patients – who go to hospitals when they are sicker and more costly to treat than those with insurance – adds to the cost of insurance premiums. A basic insurance plan will provide uninsured Pennsylvanians with access to preventive care that will save money as well as lives.

“Health care reform bills that have passed the U.S. House and Senate will also pay for themselves and reduce the deficit over the next 10 years,” said Sharon Ward, Director of the Pennsylvania Budget and Policy Center.

Important insurance market reforms, like ending coverage bans for pre-existing conditions, are also needed, Ward said.

“Insurance companies should not be able to deny you coverage when you get sick or refuse you care because of your age,” she said. “Health care reform will give you the peace of mind of knowing that you will always have quality, affordable health care – no matter what happens with your job or your health.”

Seniors will also benefit from reforms aimed at expanding Medicare to cover more preventive health procedures and closing the doughnut hole in Medicare prescription drug coverage.

The Pennsylvania Health Access Network (PHAN) is a coalition of 50 groups from across the Commonwealth working to improve access to quality health care through the expansion of health insurance coverage. Learn more at www.pahealthaccess.org.

FDL Action Health Care Update: Friday (12/18/09)

Here are the FDL Action health care reform highlights for Friday, December 18.

1. Jon Walker is concerned that Ben Nelson could get his way and gut “the single best remaining piece of reform, Medicaid expansion.” Walker concludes that “If using reconciliation is the only way to protect the Medicaid expansion, the decision to use it should be a no-brainer for every real Democrat.”

2. Jon Walker suggests that “if you are are going to tax ‘Cadillac’ plans, you need to index it to make sure it only ever taxes actual ‘Cadillac’ plans.” To accomplish this goal, Walker suggests “index[ing] the cap to roughly 165% of the average premium on the Federal employer health benefit (FEHB) exchange.”

3. Jane Hamsher points to a new poll indicating that 38% of Americans favor the individual mandate to buy insurance, while 51% oppose it. Hamsher adds, “When it appears in the ads of a Republican challenger who notes that the IRS will act as Aetna’s collection agency, I bet those numbers get dramatically worse.”

4. Jon Walker calls Ben Nelson’s latest idea – to make states “opt in” to health reform – “literally and completely insane.” C’mon, tell us how you really fell about Ben Nelon’s stupid idea, Jon. :)

5. Jon Walker writes that “Ezra Klein has a new, strange, and incorrect defense of the individual mandate in the Senate bill.” Walker argues that “[t]he argument that removing the individual mandate would price unemployed people, like the reader, out of the individual market is not true.”

6. Jane Hamsher discusses “the impoverished left/right dialectic that dominates the media coverage of politics, and its inadequacy when it comes to discussing the dynamics of the health care debate.” It’s a fascinating discussion; here’s a sampling. “With unemployment at 10%, the idea that you can pass a bill whose only merit is that ‘liberals hate it’ just because the media will eat it up and print your talking points in the process is so cynical and short-sighted it’s hard to comprehend anyone would pursue it. It reflects a total insensitivity to the rage that is brewing on the popular front, which is manifest in every single poll out there.”  Good stuff.

7. Jon Walker goes after Ezra Klein again, this time for “[doing] the discussion on health reform a big disservice by making false claims about what could, in fact, start a race to the bottom in the insurance market.”

8. Jon Walker argues that the fact there is a “hardship waiver,” as well as restrictions on undocumented immigrants to buy insurance on the new exchange (“even if they were willing to pay full price with no tax credits”) both “undercut arguments for an individual mandate.”

9. Finally, I’ve got a state blog roundup, including lots of discussion about “Liebercare,” “Loserman,” and Jane Hamsher taking “a corporate conman to the woodshed.”  

This was a fascinating, sometimes infuriating, occasionally highly entertaining week in health care reform. Next week promises to be more of the same.  Stay tuned!

FDL Action Health Care Update: Thursday (12/17/09)

Here are the FDL Action health care reform highlights for Thursday, December 17.

1. Jon Walker discusses “The Unholy Trilogy For Insurance Profits: Individual Mandate, Broad Age Rating, And Hardship Exemption.” According to Walker, “Forcing the young to buy coverage with huge government subsidies, but having a way to price the old out of the market, is in fact the health insurance companies’ dream.” Is that the way to keep them from running a 2009 version of “Harry and Louise,” to make their “dream” come true? Hmmmm.

2. Jane Hamsher reports on her MSNBC appearance this morning with Dylan Ratigan, at which time he made her argument for her, that “40 million new customers forced to buy your product with no competition and no regulatory body to oversee it is a pretty sweet deal.” For more, see item #1, above, on the “health insurance companies’ dream.”

3. Jon Walker continues his back-and-forth on whether or not to “kill the bill” with Nate Silver of 538.com. In this installment, Walker accuses Silver of responding to his answers, “but only to a straw man, crib notes version of my answers.” Who knew that dueling, wonky, blogger diaries on the intricate details of health care reform legislation could be so enthralling? :)

4. Speaking of exciting, I definitely recommend that you check out the heated exchange between Mary Landrieu and Howard Dean last night on Hardball. Jane Hamsher transcribes it, which is particularly cool given that it’s not easy to transcribe spittle flying around a TV studio. Heh.

5. Jon Walker responds to an article by Jonathan Cohn, which tries to “defend the individual mandate in this bill by claiming the Netherlands also has an individual mandate.” According to Walker, “The problem is the health care system produced by the Senate bill would be nothing at all like the health system in the Netherlands,” and he lays out exactly why that is the case.

6. Jon Walker reports that Ben Nelson “has rejected Harry Reid’s latest compromise on the abortion language,” and that Nelson “is trying to go for the full Stupak amendment.” Walker adds that “[w]e wouldn’t need to be worrying about Ben Nelson’s mountain of demands right now if they would just go with reconciliation.” So true.

7. Jon Walker rebuts one of the “better-sounding arguments for passing the Senate bill”, that “we can fix it later.” The problem with that argument, of course, is that Walker “can’t imagine there being a time anytime soon where the Democrats have more power.” Neither can anyone else, which is why they need to get as much done now as possible, on health care reform and on a whole host of other issues.  But they won’t get those things done if they keep letting John McCain’s Best Friend Forever pull a “Liebercare” on everything. Once again, if this hasn’t been stressed enough, it’s time to go to reconciliation and pass strong, progressive health care reform legislation now, not “later.”

8. Last but not least, do NOT miss Scarecrow’s post on the confrontation between Lanny Davis and Jane Hamsher on the Ed Show this evening. According to Scarecrow, “After just one round with Jane on the Ed Show, Lanny’s credibility was in need of a waaaambulance. He was last seen being wheeled out on Joe Lieberman’s gurney, on the way to the emergency ward.”  Ouch!

FDL Action Health Care Update: Wednesday (12/16/09)

Here are the FDL Action health care reform highlights for Wednesday, December 16. We’ll call this the “Joe must go” edition.

1. Jon Walker writes about the “sad defeat of Dorgan’s drug re-importation amendment, which would have saved American consumers billions on their prescription drugs.”  Walker notes that “[a]llowing Americans to buy cheaper drugs from Canada or Europe was one of Obama’s campaign promise on health care,” and also that this is a “very popular, bipartisan idea that would actually help ‘bend the cost curve’ on our health care spending.” But now, it looks like it’s not going to happen, and that’s extremely unfortunate.

2. Jane Hamsher comments on the story that the White House is “very not pleased…with Dr. Dean speaking out about health care reform and this plan.”  The amazing thing is that the White House isn’t upset with Joe Lieberman for all the bad stuff he’s been doing, but is upset with Howard Dean for saying that we should scrap the current Senate bill, go to reconciliation and get a much stronger bill with public option, Medicare buy-in, etc.  It’s surreal.

3. Jane Hamsher reports on remarks by Sen. Russ Feingold, who said, “This bill appears to be legislation that the president wanted in the first place, so I don’t think focusing it on Lieberman really hits the truth.”

4. Jon Walker demolishes the “great big myth that reconciliation would not work for health care reform.” According to Walker, “That is pure nonsense,” as “reconciliation would still protect the guts of reform.” In addition, “provisions [not related to the budget] will only be removed if they fail to get 60 votes to wave the Byrd rule for those provisions.”  So why aren’t they doing this?

5. Jon Walker argues that the health care “bills could easily be redesigned to increase insurance coverage by roughly 30 million Americans at a fraction of the cost if we drop the massive giveaway to the insurance companies, and the individual mandate.” A new, revamped bill would contain “insurance market reforms,” “the House’s employer mandate and slightly increased small business tax credits,” “Medicaid expansion to 150%-200% FPL,” “Maintaining or expanding CHIP program,” and a “permanent COBRA expansion with subsidies.”  According to Walker, such a bill, “depending on design, should cover close to 30 million more Americans, and for less than a net cost of $500 billion” – “a fraction of the cost to the government (with a bill done through reconciliation), and without enriching the health insurance companies trying to kill real reform.”  Again, why aren’t they doing this?

6. Jon Walker writes that Bernie Sanders isn’t buying “the myth that reconciliation would not work for real health care reform.” Unfortunately, Harry Reid is buying it. Sigh.

7. Michael Whitney comments on “Jello Jay Rockefeller’s rant against Howard Dean on MSNBC this afternoon,” in which he asked, “So what do I do? do I take my football and run home and sulk?” Whitney’s punchline: “No, you’re going to kick it!”  Heh.

8. Jane Hamsher notes that Robert Gibbs never called Joe Lieberman “irrational,” as he essentially did about Howard Dean earlier today.

9. Jon Walker answer Nate Silver’s “20 questions for the ‘bill killers.'”

10. Jon Walker explains “How CBO Director Doug Elmendorf Wrote The Health Care Bill.”  In brief, Elmendorf put together a memo last May which “basically put the absolute limits on what Democrats would even attempt in health care reform.” According to Walker, “There is no real logic to it, he simply decided what he thought was enough regulation to make something part of the budget.” Somehow, given where we are right now, ending today’s health care update with the words “no real logic” seems highly appropriate.