Late last night, in the midst of Election Day, the House leadership revealed the “manager’s amendment” that would represent the final changes to their health care bill before a vote. It is likely this vote could come as early as Friday. Nancy Pelosi released this statement.
Tonight, we have filed a manager’s amendment to the Affordable Health Care for America Act, which is the next critical step toward comprehensive health insurance reform that ensures affordability for the middle class, provides security for our seniors, and protects our children’s future by not adding to our deficit. Our bill covers 96 percent of Americans, makes coverage more affordable for all, and creates new consumer protections that will end discrimination by insurance companies against the sick and cap what Americans pay out-of-pocket.
So what’s in the manager’s amendment? Pelosi highlights the following: strengthening state regulations against price gouging by insurance companies by providing $1 billion in grants; clarifying the repeal of the insurance industry’s anti-trust exemption (that part is based on language from Republican Dan Lungren that would allow insurers to continue to work together to collect historical loss data); more oversight; and setting limits on insurers from entering the insurance exchanges without compliance to regulations (they actually could be excluded now if they raise premiums too high).
What ELSE is in the manager’s amendment? A lot.
There are some changes to the eligibility requirements in one section as it relates to undocumented immigrants, but those changes look to be largely cosmetic. It also looks like the NAIC may NOT set the rules for insurance regulations, based on the line: “Page 203, line 6, strike ‘NAIC’ and insert ‘Secretary’. That’s a win for progressives. So is the strengthening of the Office of Minority Health, something sought by the Progressive Tri-Caucus and the CPC in recent days.
However, there are no changes to the public option, including one sought to put a different ceiling on provider rates. And Bart Stupak’s bluff has been called, as the language around abortion coverage has not been changed.
There is, however, one peculiar addition to the bill: a second-generation biofuel producer tax credit. As Jon Walker says:
That is right. The health care reform will be used as a vehicle to change the tax credit treatment of cellulosic biofuel. Ironically, this means development of second generation biofuel will be overseen by the Secretary of HHS, although they must consult with the Secretary of Energy and head of the EPA on the matter.
While this is not my expertise, it seems the amendment would allow the tax credits meant to encourage the develop of cellulosic ethanol to be used to help develop multiple types of “second generation biofuels.” That would include biofuels made from cultivated algae or cynobacteria. At first glance, this seems like a good thing. The more possible routes explored the better chance of finding one that works. I’ve seen research indicating that hydrocarbons produced by cultivated algae may have greater potential as a economically viable future biofuel than cellulosic ethanol. Of course, this is not my expertise, so there might (and probably is) some huge industry give away that I’m missing.
Interestingly, Chris Van Hollen, the head of the DCCC, introduced a bill on the biofuel producer credit just yesterday. That language appears to have been swallowed whole by the health care bill. Van Hollen’s release claims that the credit would “raise approximately $24 billion over ten years.” I think I’ve figured out how that can be.
The bill actually follows up on and clarifies an existing tax credit for second-generation biofuels that was being exploited by the paper industry. This “black liquor” credit was being used by pulp producers to get renewable energy tax credits for burning wood, something they were doing anway. By mixing a tiny amount of diesel fuel into what’s left over after making paper and burning it for power generation, they were getting a tax windfall. Greenwire explains:
Last month, news of an Internal Revenue Service memorandum surfaced saying the the paper industry could be eligible for the credit with its wood-pulping byproduct that is burned as fuel to produce electricity for paper mills.
The industry already receives a 50-cent-per-gallon credit for its production of the mixture, black liquor, through a separate credit for alternative fuels mixtures set to expire at the end of this year. Bank of America analysts estimate the industry will receive about $2.5 billion from that credit in 2009.
Industry analysts reported many paper and forest stocks were up sharply after the IRS memo surfaced last month, and some reports pegged the potential windfall for the industry at $25 billion.
This credit actually disadvantages recycled paper mills in favor of those using wood, which can get this “black liquor” tax credit.
So this looks to me like a way to wring $24B in savings out of the health care bill, reducing concerns about it busting the deficit and aiding the CBO score. It also fixes an unintended consequence of previous energy policy.
But we should also ask who benefits. In this case, that would be recycled paper mills, and the advanced biofuels industry, thanks to some other pieces in the bill. At first blush, I would guess that advanced biofuels producers are located in rural areas with lots of farmland – in other words, the kinds of places that Blue Dogs inhabit.
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Thanks for investigating this. It seems recapturing the $24 billion was the main driver behind the biofuels amendment. Which may be helpful since this bill is going to get blasted for going over Obama’s arbitrary $900 billion sticker price.
Thumbs down to the language weakening antitrust. Any antitrust suit would be very hard to prove, and if you let insurers share data I think it will be just like old times. Whose vote does this get anyway? Lungren’s not voting yes is he?
So this is a bone to Blue Dogs?
or am I reading too fast?
actually Dos, probably the opposite in that it would be Blue Dogs pushing for these crappy tax credits
as David says, they closed a loophole in some recent legist. and, by putting it in the HCR bill, they can claim another $24B in “savings”
ExxonMobil is already making a play in algae biofuels. So although I applaud the effort to plug the “black liquor” loophole, my guess is that any worthwhile IP surrounding algae biofuels will wind up in the hands of big oil. Not that I’m a cynic or anything, but they really should limit the tax credits to start-ups not related to mega corporations.
sometimes I really wonder just how corrupt this country really is… Is there anything hidden in this zillion-page bill for the banksters? new tax cuts for the wealthy? torture immunity for shrubco members? Will the Senate bill contain language for a spanking new submarine base in Lieberman’s Connecticut?
I’m working on this angle. Mother Jones had a piece on this recently. Still trying to connect which no or maybe vote in the House this actually supports.
sorta related: my congressmember, jim mcgovern, is having a telephone “town hall” tonight on the health insurance reform bill. any suggestions/requests for questions or comments? i’ll check back later….. thanks!
Wonderful touch. Why not bring the troops home too, then we’d have all the funds needed.
please go vote at http://www.cnn.com – for the first time they have a GOOD quick vote question:
Quick vote
Are you satisfied with the pace of “change” delivered by the Obama administration?
Yes No
Funding by bringing home our troops would appeal to Mcgovern, he’s even mentioned that would do the trick.
Thanks for that link. It confirms my prejudice that if there is any money to be made here, the vultures will find it. We’ll know there’s promise in the technology if the Exxon venture starts buying up other companies before they go under (buying remains of dead ones is just standard vulture practice).
Here’s Brad Long on the bailouts.
Actually made me feel a tad better. (But not about the salaries/bonuses)
Take achievements where you can. Boosting use of algae-to-fuel is good. Kudos to E$$on for going this direction.
He could tell people the Republicans think this reform is going to be sooo great they don’t want Dems to get credit for it AND that the whole time they had control of gov’t they didn’t think to do reform.
Isn’t the funding for that borrowed? Not sure of the funding, but bringing them home is certainly going to stop some hemorrhaging of blood and money and foreign goodwill.
My suggested line of inquiry (focusing on where he has the most power):
The Rules Committee will be voting on the rule for this bill this Friday, at 2 p.m.:
http://rules.house.gov/bills_details.aspx?NewsID=4465
i got the first question and asked about his commitment per july 30 letter to vote against any bill that did not meet his criteria for a “robust” public option.
he said that this bill was better than nothing, that he is not the only one writing the bill, that it’s necessary to control costs and this bill would do so. i tried to challenge that statement with the cms report, but apparently that is considered a second question and he moved on. hopefully there will be an audio (they said that the call would be recorded).
i can not believe the level of bs my congressman is selling. and he is one of the better ones.
third question was on abortion and he reassured the caller that abortion services will not be covered.
….
says the public option is important because costs are too high. gives the whole neoliberal competition argument (which is nonsense).
doesn’t mention that the public option as it now exists is not expected to offer insurance at lower rates (because of weak risk adjustment).
… i’ve never been so convinced that our gov does not work. this is insane. i don’t think jim knows what he is talking about (some details yes, but fundamentally about the policy this bill is based on). so very very sad.
….
if i get another question, i’m going to ask about the kucinich amendment. third choice is rules committee question from pow wow. fourth, i’d like to ask about costs.
i’d like to also ask about the kucinich amendment, the rules committee (pow wow’s question) and the cost issue per cms report.
don’t know if there will be a chance.
i’ve never been so convinced our gov. does not work. this phone “town hall” is so very very sad. and jim is one of the better congressmembers.
The Kucinich amendment is dead in the House. The managers did not reinstate it.
Yesterday, 12 protesters were arrested at Pelosi’s San Francisco office, demanding restoration of the Kucinich amendment and the HR 676 floor vote.
According to an email from the Kucinich campaign, the only hope for restoration of the state single-payer amendment is now in House/Senate conference.
As I insisted recently, and reiterate now, protests and civil disobedience need to be redirected immediately from private insurers (whom everyone already knows are villains) toward Senate and House leadership.
In my view, this is the moment for public option boosters and single-payer activists to join forces to demand, at minimum:
* Opening of the exchanges (and through them the PO) to all Americans not otherwise covered by public programs from in year 1
* Redesignation of year 1 from 2013 to first quarter of 2011
* Restriction of income-based subsidies on the exchange to the public option only (one of the original Hacker criteria)
* Public option operated as an extension of the CMS infrastructure (another Hacker criterion for a truly “Medicare-like” PO)
* Medicare + 5% reimbursement rates on the PO
* Making physicians’ continued participation in Medicare, Medicaid, or SCHIP contingent on their acceptance of PO patients (so docs pay a price for attempting to duck out of seeing PO patients)
* Restoration of the state single-payer waiver amendment
hi ralphbon. the phone call is over and i’m trying to digest what i heard…. not to worry, fed law prevents abortions from being covered. not to worry, there are all kinds of protections so that illegal immigrants can’t get access any of the benefits. blah, blah…
your ideas all sound good to me, i’d just add that i would like to see the po pre-populated, maybe with medicaid and schip? maybe kip has some ideas to share.
i would also like to see his staff publish on his website the estimated costs (premiums and out of pocket) for the various income levels. i think that will show how very NOT affordable the reform may be (it will also let MA residents compare it to our current system of subsidies).
after listening in on the town hall though, my impression is that there is not much (any?) interest in making this a better bill. it’s already so wonderful and historic and blah blah.
sorry for the ramble. and even more sorry not to have much of anything useful to say at this moment. maybe a couple of hours of wallowing in despair are needed to purge the defeatism. actually what i need is something to do that might possibly be constructive. i think i will call his office tomorrow to pitch the cost by income level idea for posting on his website.
do you think there is any possibility of a consistent set of demands by both po and sp advocates? if so, what might i do to help that along?
I don’t know; I just thought I’d throw out some demands that push the envelope in the direction of what many people think they’re already supporting. I doubt PO and SP activists could join forces per se, but if they converged on the same targets with overlapping demands, it would amount to the same thing.
I was surprised to see a DKos diary by Eve today that pounded on the inadequacy of delaying the PO and other key reforms to 2013. She cited the speed with which Taiwan initiated its single-payer system. This sounded weirdly like the good old nyceve, I thought, yet how can she be bringing this up now, when it’s all but too late?
With supposed reformers like Grayson crowing about how great the House bill is, in its current hobbled form, and with other reps tossing off the sound bites you just got on your conference call, does Eve seriously think that the deficiencies in the House bill, which people like you and I have been screaming about for months, are going to succumb to a phone-banking effort?
These bills are all but out of our elected representatives’ hands now. They’re in the hands of leadership. If health care activists of whatever stripe don’t organize to scare the shit out of leadership to inject actual substantive reform into these bills, Americans will remains fucked for years — with greater numbers insured, to be sure, but in a manner still rigged to bleed them dry.
Corruption remains our nation’s preeminent preexisting condition.
It’s stunning really, how willing these…people…are to behave like a bunch of barking trained seals upon command – simple-minded apologists for power, robotic seat-warmers, who checked their independent will and thought at the door.
But thank you so much for trying, selise. All we really have is the ability, on rare occasions, to throw their deeds in their sheltered faces to show them we know what they’re playing at, and what utter contempt we have for their sick games. And you succeeded in doing that much with McGovern – you knew he’d signed the letter, he knew you know, and he had to try to BS his way out of it – and everyone listening heard him dissembling, right from the top.
I can’t fathom the abdication of responsibility that an incumbent is willing to countenance by silently watching a bill of this magnitude and import being “debated” – WITHOUT POSSIBILITY OF AMENDMENT – on the floor of the House for less than ONE full day. “Debated” that is, in 2-3 minute soundbites, by a fraction of House members talking past each other, in an attempt to score Party PR points, rather than engaging in any sort of actual debate on the LEGISLATIVE merits – which are already a pre-ordained backroom done deal. The PARTIES and their shoulder-shrugging members for whom THE PARTY WIN trumps all, have cheapened our legislature to such an extent that The Lobbyist Branch, as emptywheel called it today, is a far more fitting name.
ralphbon said:
But it’s worse than that. These bills never were “in the hands” of (most of) our representatives, aside from a tiny minority of members of the House sitting on the committees of jurisdiction and those who could coax favors from the powerful committee chairs and Party leaders. And yet, watching the House Judiciary Committee markup of important legislation today – the ONLY chance these representatives are going to get to have ANY impact on the legislation, as they know – John Conyers couldn’t wait to gavel down the debate to get to his rubberstamped Party-line votes, after never holding a full-committee hearing on the legislation, and cobbling together a product behind closed doors without full committee participation. The freshmen legislators were at sea, without any reference points or experts to lean on, and the veterans (Nadler and a couple of others excepted) were too busy posing for the camera and playing Party tic-tac-toe to care.
“Does not work” is an understatement.
There are some Senators (Whitehouse and Casey tonight, Cardin, Klobuchar, and Kaufman last night, Feinstein Monday) showing real passion and humanity about this issue on a sustained basis. We can only hope, plead, beg that THEY will insist on the right to genuinely debate and amend the bill on the Senate floor, without agreeing to intentionally misleading UC Agreements that make amendments futile, by mandating 60 votes for anything that seems in danger of passing by simple majority.
So here’s my “hope, plead, beg,” Senators: It’s only good faith deliberative, democratic debate and amendment in public that I’m begging for – isn’t that precisely what the chamber we pay you to periodically visit was custom-designed for??
pow wow, just a short note… i want to thank you once again for your analysis and advocacy. i remember your help in trying to deconstruct the PAA vote during the summer of 2007, little did i know then what a model the subterfuge and kabuki of that vote would be for so much of what we’ve seen from our congress since.
and if anything could be a sadder commentary on our politics, the good faith deliberative, democratic and honest debate you pow wow call on our congress to engage in is something we citizens have been unable or unwilling to do for ourselves this past year.
as ralphbon writes above,
finally, to both pow wow and ralphbon, if the only way someone like jim mcgovern has to sell this bill to his constituents is to lie about it (i actually don’t think he knows what he was doing, i expect he in good faith believes what he is being told), then this bill may in fact be worth trying to block. i don’t know, still on the fence here, but as we learn more about the hidden details (is fairleft correct about the schip issue?!) the defects we know about in this legislation mount as well as my growing belief that this bill was not written with the healthcare of americans in mind, i am more and more convinced that the solutions to our current troubles are not to be found in deecee. instead, for our all our flaws and ignorance, we must rely on the american people for a populist uprising and do everything we are capable of to assure it is a liberal, progressive one and not a reactionary, rightwing movement.
Is there any way to scare leadership, other than a campaign that lets them know they will be primaried, and perhaps defeated if they don’t improve this bill. Harry and Nancy have to be persuaded that progressives can defeat them if we’re angry enough. It should be easier with Harry since he’s already vulnerable. But Nancy has a really safe district.
A conclusion and line of reasoning with which I entirely agree.