Insurance mandates spark GOP fight while proposed insurance pools, abortion issues are examined

The Wall Street Journal: "As congressional Democrats try to iron out differences in the House and Senate health-care bills, Republicans are attacking the legal premise of the legislation, saying Congress has no power to make people carry health insurance or pay a penalty or tax." The article also notes that some experts say the provision — if passed — could become fodder for a constitutional challenge on congressional authority. "However, courts usually defer to lawmakers, and Democrats could smooth the way further by using language in the final version that clearly asserts Congress's power under the Constitution to levy taxes — which the House bill already does." Democrats are saying the Republican argument that such a mandate is unconstitutional is just one more way the GOP is trying to hold up the health care reform bills since Congress's charter by the Constitution is to "regulate interstate commerce, collect taxes and 'provide for the general Welfare'" (Bravin, 1/11).

In the meantime, the Los Angeles Times reports on how the health legislation's proposed insurance pool would work, who would be eligible and just what might be included in the different plans. "Both the House and Senate bills would provide $5 billion to create a temporary insurance pool until an insurance exchange is up and running. Under the House bill, this program would be available to people who have a preexisting condition or have been uninsured for at least six months. Under the Senate bill, individuals would have to meet both requirements to be eligible. ... The bronze and basic plans would offer the lowest premiums and restricted benefits, while the platinum and premium plans would be more expensive but would cover more, as well as offer such extras as dental and vision coverage" (Geiger, 1/11).

The Associated Press/Billings Gazette reports that a so-called "frontier" amendment to the Senate health care reform bill that would boost Medicare reimbursement rates for some rural states is being proposed by North Dakota's two Democrat senators, Kent Conrad and Byron Dorgan. "The so-called frontier states amendment would increase Medicare reimbursement rates for some doctors and hospitals in Montana, Wyoming, North Dakota, South Dakota and Utah. At least half of a state's counties must have a population of six people per square mile or less to qualify for changes in the average wage index. The payments would amount to $2 billion over 10 years." But it remains unclear how popular the provision is, even in "frontier" states (1/10).

Finally, The Wall Street Journal reports in a separate story that Democratic Rep. Bart Stupak's push for greater restrictions on federal funding for abortion in the House bill still divides members looking for a fragile coalition on health reform, but that it is indicative of where Stupak comes from — Michigan's Upper Peninsula. "Now his antiabortion values and party loyalty are colliding, potentially to his advantage. … Mr. Stupak said sentiment on the overall health bill is evenly split in the 10,000 to 15,000 messages he has been getting from constituents each week on the matter. That makes his support for the bill a political gamble" (Belkin and Adamy, 1/11).


Kaiser Health NewsThis article was reprinted from khn.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.

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