2681

MSNBC said that Republicans are already planning to try everything possible to prevent the reconciliations from coming to the floor. I don’t know enough about parliamentary procedure to know if anything they can do can be ultimately effective because the Democrats already have the votes to pass the reconciliation package by simple majority. Republicans cannot filibuster this because it’s part of the reconciliation procedure, not a new bill.

2682

The bottom line is that CBO believes preventative care increases costs. As do most people who study it. What you’re arguing for is trying to determine which elements of care could be cost-effective. But you have the ability in hindsight to judge what was cost-effective. In short, the idea that preventive care using screenings etc will reduce costs is a fallacy.

Let me quote from Elmendorf in the earlier post: Preventive medical care includes services such as cancer screening, cholesterol management, and vaccines. In making its estimates of the budgetary effects of expanded governmental support for such care, CBO takes into account any estimated savings to the government that would result from greater use of preventive care as well as the estimated costs of that additional care. Although different types of preventive care have different effects on spending, the evidence suggests that for most preventive services, expanded utilization leads to higher, not lower, medical spending overall.

2683

What’s this talk of a states’ lawsuit? For ex., i read a twitter and a blog about the Texas Attorney General vowing to join a multi-state lawsuit “the moment Obama signs the bill”.

2684

The NEJM seems pretty uncontroversial:

These results are consistent with earlier reviews but cover a larger sample of studies and quantify benefits in terms of QALYs. Some preventive measures save money, while others do not, although they may still be worthwhile because they confer substantial health benefits relative to their cost. In contrast, some preventive measures are expensive given the health benefits they confer. In general, whether a particular preventive measure represents good value or poor value depends on factors such as the population targeted, with measures targeting higher-risk populations typically being the most efficient. In the case of screening, efficiency also depends on frequency (more frequent screening confers greater benefits but is less efficient). Third, as is the case for preventive measures, treatments can be relatively efficient or inefficient.

Sometimes it works, sometimes it doesn’t.

2685

Idaho’s AG is bound by a wackjob law to challenge things with a suit as well, and Virginia’s AG has threatened a lawsuit.

Problem: The Supremes from John Marshall on down to today have consistently affirmed the supremacy of the federal government over that of the states.

2686

No.

  1. You get subsidies based on your income. If you’re at 133% of the poverty line or below you get Medicaid. If you’re at 133%-300%, you get subsidies. This is regardless of how much your insurance is costing. NOTE: these subsidies should be more generous; the reconciliation fix helps with that. Hopefully it can be improved in the future.
  2. If insurance is going to cost you more than some percentage of your family’s income (I think it’s 8%, not sure) then you are totally exempt from the individual mandate.
  3. The fine for violating the mandate never ends up being that much; it starts off super low and tops out somewhere around 800-900 dollars.

edit: extarbags’ arguments are, as usual, based on him not understanding the bill: The bill requires the state-run exchanges to improve all rate hikes. It also requires insurers to spend some percentage of premiums received (90% I want to say) on payments to providers. It’s structured to prevent insurers from using the mandate to gouge consumers.

2687

It’s unpredictable of course because I don’t think anyone really understands Senate rules. But the consensus seems to be that they can’t.

2688

Exactly that’s what i was wondering about, the basis of such a lawsuit and under what pretexts it would supposedly be filed. I mean, if states could just sue because they didn’t like something we probably wouldn’t have Medicare or payroll taxes, so i was curious if there was talk of this lawsuit being anything more substantial than a useless base-pandering fillip.

2689

10% tax on tanning beds. Ha ha. Did the Dems throw that in just to personally irritate John Boehner? That’s hilarious.

2690

Yeah, Article 6 of the Constitution (IIRC) pretty much makes these lawsuits a non-starter. Even with the current court makeup, I can’t see the SCOTUS agreeing to even hear such challenges. Its just stupid grandstanding on the part of some red-staters to keep their constituents happy.

2691

So Nancy Pelosi is so effective the GOP wants her fired. Naturally what they really mean is to regain the majority in the House, but I think it’s pretty funny that instead of saying that (omg a fact) they have to again resort to fear and hate to get anything done. Very very sad.

2692

GOPBoehner tweets: Dreamt that Jesus was watching me pull the plug on my own grandma. A single tear fell from his eye. We won’t stand for this, America.

(hilarious parody twitter account)

2693

Perhaps it is my naivete, but, before your edit, I had to double check to see if that actually came from the real Boehner.

2694

Presenting Rep. Randy “Baby Killer” Neugebauer.

2695

“Randy Neugebauer” sounds like a character Mark Metcalf would have played in an 80s sex comedy.

2696

How do the Republicans decide which one of them gets to yell something during high profile sessions of Congress for the donation boost?

2697

Although…

2698

Good stuff from Ezra Klein today:

A reader writes in:

[QUOTE] I do not understand how this bill will affect my family and me. I am a self-employed single mother. I cannot afford health care for myself and my children. I made $38,000 last year and I expect to make less than $35,000 this year. What does this health care reform mean for me? Will I be able to get coverage for my children and myself in this first year?

Not in the first year, necessarily. But when the bill goes into effect in 2014, your situation will change dramatically. Using the Kaiser Family Foundation’s premium calculator and a slightly stylized version of your situation (the calculator is not terribly flexible), here’s what I can say:

First, you’ll be buying insurance on the exchanges. That means no discrimination based on preexisting conditions, insurers who are being watched and regulated, lots of choices, and the buying power that comes from being part of a large risk pool rather than being on your own.

More specifically, your income would make you eligible for substantial subsidies. About $11,571 worth, to be precise (this is keyed to a family of four, I should say). The cap on your premium payments as a percentage of your income would be 4.4 percent. You’d be paying about $1,540 a year.[/QUOTE]

2699

Caught a little snippet of a TV report on Rush Limbaugh’s show and his reaction is, as always, to frame this as the opening salvo of a race war. I’m sure there’ll be a transcript available somewhere soon.

2700

Shouldn’t he be moving to Costa Rica by now?