Updated August 15, 2011 @ 12:37am
Texas Gov. Rick Perry (R) thinks Texas should be able to opt out of Social Security, Medicare and Medicaid.
In an interview with the Daily Beast’s Andrew Romano, Perry claims that Social Security and Medicare are unconstitutional:
The Constitution says that “the Congress shall have Power To lay and collect Taxes… to provide for the… general Welfare of the United States.” But I noticed that when you quoted this section on page 116, you left “general welfare” out and put an ellipsis in its place. Progressives would say that “general welfare” includes things like Social Security or Medicare—that it gives the government the flexibility to tackle more than just the basic responsibilities laid out explicitly in our founding document. What does “general welfare” mean to you?
[PERRY:] I don’t think our founding fathers when they were putting the term “general welfare” in there were thinking about a federally operated program of pensions nor a federally operated program of health care. What they clearly said was that those were issues that the states need to address. Not the federal government. I stand very clear on that. From my perspective, the states could substantially better operate those programs if that’s what those states decided to do.
So in your view those things fall outside of general welfare. But what falls inside of it? What did the Founders mean by “general welfare”?
[PERRY:] I don’t know if I’m going to sit here and parse down to what the Founding Fathers thought general welfare meant.
But you just said what you thought they didn’t mean by general welfare. So isn’t it fair to ask what they did mean? It’s in the Constitution.
The Constitution gives Congress the power to “to lay and collect taxes” and to “provide for the…general welfare of the United States.” No plausible interpretation of the words “general welfare” does not include programs that ensure that all Americans can live their entire lives secure in the understanding that retirement will not force them into poverty and untreated sickness.
The Republican-controlled House of Representatives voted 245 to 189 Wednesday to repeal the Patient Protection and Affordable Care Act of 2010 passed by the last Congress and signed into law by President Obama less than one year ago.
Three blue dog Democrats joined the 242 Republicans in voting to repeal health care reform -- Rep. Boren (Oklahoma), Rep. McIntyre (North Carolina) and Rep. Ross (Arkansas).
Before the final vote, Rep. Rob Andrews (D-New Jersey) proposed that the bill be amended to not go into effect until a majority of Congress gave up their taxpayer paid health insurance ($700 a month of which is paid by American taxpayers). Eight Republicans have already done this, but the other 234 Republicans have decided to keep their taxpayer paid health insurance.
Original Post Tuesday January 18, 2011 @ 9:59am
A government study released today shows that up to 50 percent of Americans under age 65 have some type of preexisting health condition. The study predicts that 30 percent of currently healthy Americans will likely develop a preexisting condition over the next eight years.
Under the Affordable Care Act of 2010 -- the president's signature health care reform legislation -- policies set to be in place by 2014, these 129 million Americans can receive health coverage despite their previous conditions; if the new law is repealed, millions could risk losing health care or being forced to pay more.
An estimated twenty-seven percent of working-age Texans, or more than 6.1 million people living in Texas, were uninsured in 2010. That's the highest rate in the nation and the second-highest number to California's 7 million people. Under Medicaid expansion provisions of the act, an estimated 2.5 million additional Texans would qualify for health insurance.
But Texas Gov. Rick Perry (R) has been a staunch opponent of health care reform and his administration has indicated a willingness to opt out of the Medicaid expansion. For Texas hospitals, which absorbed $4.6 billion in unpaid bills and charity care in 2010, that's a problem, Hawkins said.
The AP today delivered an awkward fact-check that effectively dismantles the GOP's central argument against the the Affordable Care legislation kills jobs.
The Republican repeal bill, if passed by the Sentate and signed by Pres. Obama, would add roughly $230 billion to the deficit by 2021 and leave about 54 million non-elderly Americans uninsured by 2019, according to CBO projections.
Here are some of the private health insurance industry reforms mandated in the legislation that Republicans want to repeal:
- Health Insurers cannot deny children under age 19 health insurance because of preexisting conditions. (Reference) A ban on preexisting condition exclusions for adults will take effect in 2014.
- Small businesses will get tax credits covering up to 50% of employee premiums for 2009 and 2010. (Reference)
- Seniors will get a rebate to fill the so-called "doughnut hole" in Medicare drug coverage, which severely limits prescription medication coverage expenditures over $2,700. As of 2012, 50 percent of the doughnut hole will be filled. (Reference)
- The cut-off age for young adults to continue to be covered by their parents' health insurance rises to the 27th birthday. (Reference)
- Lifetime caps on the amount of insurance an individual can have will be banned. Annual caps will be limited, and banned in 2014. It says that health insurance companies can no longer tell customers that their health care coverage will be terminated because they have hit a "lifetime limit" on claims. And there are now restrictions on yearly spending limits. too. (Reference)
- Adults with preexisting conditions may buy into a temporary national high-risk pool, at different rates than people without them, until health insurance exchanges come online. While high-risk coverage will not be cheap, it is still better than total exclusion from health care access. And the high-risk pools provide some cost benefit from a wider pool of insured adults. This is a way to phase out the old "preexisting conditions" exclusions insurance companies use to use to deny health care coverage. Health insurance exchanges will eliminate the program in 2014. (Reference)
- Free preventative care - New plans must cover checkups and other preventative care (mammograms, colonoscopies, etc.) without co-pays. All plans will be affected by 2018. (Reference)
- No more rescission. Effective immediately, insurance companies can no longer cut someone when he or she starts filing claims for high treatment cost diseases like cancer. (Reference)
- Insurers have less ability to change the amount customers have to pay for their plans. (Reference)
- Authorizes early funding of community health centers in all 50 states. Community health centers provide primary, dental and vision services to people in the community, based on a sliding scale for payment according to ability to pay.
- Insurers must now reveal how much money is spent on overhead - All insurers must post their balance sheets on the Internet and fully disclose administrative costs, executive compensation packages, and benefit payments. (Instead of just "administrative fee", they have to be more specific).
- Any new plan must now implement an appeals process for coverage determinations and claims. Insurers need to have an appeals process for when they turn down a claim, so customers have some manner of recourse other than a lawsuit when a claim for coverage is denied. (Reference)
- This tax will impose a ten percent tax on indoor tanning services. This tax, which replaced the proposed tax on cosmetic surgery, would be effective for services on or after July 1, 2010. (Reference)
- New screening procedures will be implemented to help eliminate health insurance fraud and waste. (Reference)
- Medicare payment protections will be extended to small rural hospitals and other health care facilities that have a small number of Medicare patients. (Reference)
- Non-profit Blue Cross organizations will be required to maintain a medical loss ratio -- money spent on procedures over money incoming -- of 85 percent or higher to take advantage of IRS tax benefits.
- Chain restaurants will be required to provide a "nutrient content disclosure statement" alongside their items, so people can have an easier time making choices to eat healthy. Expect to see calories listed both on in-store and drive-through menus of fast-food restaurants sometime soon. (Reference)
- The bill establishes a temporary program for companies that provide early retiree health benefits for those ages 55-64 in order to help reduce the often-expensive cost of that coverage.
- The Secretary of Health and Human Services will set up a new Web site to make it easy for Americans in any state to seek out affordable health insurance options The site will also include helpful information for small businesses. (Reference)
- A two-year temporary credit (up to a maximum of $1 billion) is in the bill to encourage investment in new therapies for the prevention and treatment of diseases.
- The Medical Loss Ratio Provision of the Act requires health insurance companies to spend 80% of the consumers’ premium dollars they collect — 85% for large group insurers — on actual medical care rather than overhead, marketing expenses and profit. Failure on the part of insurers to meet this requirement will result in the insurers having to send their customers a rebate check representing the amount in which they under-spend on actual medical care. (Reference)
- The Act allows the Food and Drug Administration to approve more generic drugs (making for more competition in the market to drive down prices) (Reference)
- The Act establishes a non-profit group, that the government doesn't directly control, PCORI, to study different kinds of treatments to see what works better and is the best use of money. (Reference)
- Insurance companies can no longer deny insurance coverage because of a "preexisting" disability, or because they are, or have been, a domestic abuse victim. (Reference)
- People in a "Medicare Gap" get a rebate to make up for the extra money they would otherwise have to spend. (Reference)
- For people who make over $200,000 a year, taxes go up less than 1 percent after January 1, 2013. (Reference)
- High preexisting condition insurance coverage rates are totally eliminated. Everyone pays the same rate the same regardless of their medical history beginning on January 1, 2014. (Reference)
- Beginning on January 1, 2014, if you can afford insurance but do not get it, you will be charged a fee. If you opt to not buy insurance, you'll have to pay a penalty fee on your tax form, unless you just can't afford it. The Supreme Court ruled this mandate is Constitutional, as long as it's considered a tax on the uninsured and not a penalty for not buying insurance. (Reference)
- Medicaid can now be used by everyone up to 133% of the poverty line (basically, a lot more poor people can get insurance) (Reference)
- Businesses with over 50 employees must offer health insurance to full-time employees, or pay a penalty.
- Insurers now can't do annual spending caps. Their customers can get as much health care in a given year as they need. (Reference)
- The Act limits how high of an annual deductible insurers can charge customers. (Reference)
- The Act establish health insurance exchanges and rebates for the lower and middle-class, basically making it so they have an easier time getting affordable medical coverage. (Reference)
- The Act requires Congresspersons and Congressional staff to use the same insurance offered to people in the insurance exchanges, rather than Federal Insurance. Basically, we won't be footing their health care bills any more than any other American citizen. (Reference)
- If any state its own health insurance that gives citizens the same level of care at the same price as the Affordable Care Act, they can ask the Secretary of Health and Human Resources for permission to do their plan instead of the Affordable Care Act. So if they can get the same results without, say, the mandate, they can be allowed to do so. Vermont, for example, has expressed a desire to just go straight to single-payer (in simple terms, everyone is covered, and medical expenses are paid by taxpayers). (Reference)