Bush to Lay Out Healthcare Plan Alternative to Obamacare

Jeb Bush, who’s described Obamacare as a political “loser,” will unveil his plan Tuesday to replace the health insurance law with a system that he believes will cut back on regulation and lower health care costs.

The Republican presidential candidate said as recently as last week that he believes the law can be repealed, and he plans to lay out a proposal for undoing the law at the New Hampshire Institute of Politics at Saint Anselm College.

“I think Obamacare will collapse under its own weight,” he said in Oskaloosa, Iowa. “Politically, it doesn’t get better with time. It actually, I think, is likely to get worse.”

But, he has argued, Republicans need to offer a viable replacement.

For Bush, that means allowing state exchanges to continue to exist, if they so choose, but they would not be mandatory. He wants to enable access to affordable, catastrophic plans and provide a tax credit to purchase policies that protect Americans for costly medical events, according to his campaign.

Bush also wants to expand Health Savings Accounts, one of his elder brother’s pet programs. He would increase contribution limits and uses for these accounts, which must be paired with high-deductible health plans. Enrollees can use the funds in their accounts to pay for medical care.

“We’re going to call for moving to a system that is consumer driven with a lot more transparency,” he said in Iowa. “No employer mandate, no employee mandate, no mandated benefits.”

Bush doesn’t favor doing away with everything from the current law. He supports the continuous coverage guarantee provision for people with pre-existing conditions, and previously Bush has said he favors allowing kids to stay on their parents’ insurance plans until the age of 26.

To promote innovation, he also wants to reform the Food and Drug Administration’s regulatory policies and increase funding and accountability at the National Institutes of Health, according to the campaign.

And he’d like to see more leaders in the private sector figure out ways to enable better access to patient de-identified Medicare and Medicaid claims data.

Repealing Obamacare will not be a simple task. There are more than 10 million people enrolled in the federal and state Obamacare exchanges. Some 87% of them are receiving federal subsidies averaging $272 a month, to lower the cost of their premiums. And 56% of them receive separate subsidies to reduce their out-of-pocket expenses.

Also, Bush would jettison the expansion of Medicaid to all Americans under age 65, which 31 states and Washington have adopted. Nearly 13 million people have joined Medicaid since October 2013, when expanded enrollment began. Prior to Obamacare, it was difficult for adults, particularly childless adults, to sign up for the safety net program in many states.

But in an interview this weekend Bush described Medicaid and its expansion as “one of the worse insurance programs in the country.”

Bush’s plan also shifts away from Obamacare’s focus on preventative care. Under health reform, insurers must provide so-called essential health benefits, including mental health counseling, maternity coverage and emergency services. Also, enrollees in Obamacare plans can get an array of free annual screenings for conditions such as diabetes and high blood pressure and vaccines. Women can get an annual gynecological visit and mammograms.

Bush’s campaign says he would allow employers to use financial incentives to encourage wellness programs.

 

Kasich Takes Major Step Towards Presidential Run

Ohio Gov. John Kasich took a major step toward running for president Monday, as a nonprofit to help him fund travels to explore a presidential bid registered with the IRS, the Cincinnati Enquirer reported. The nonprofit, called New Day for America, was set up last week, and the IRS registration allows it to start raising unlimited amounts of money, according to the Columbus Disptach.

Kasich was one of 19 possible GOP candidates who appeared Saturday in New Hampshire to address the state Republican Party’s leadership summit. The same day, he visited South Carolina, another early primary state. But the Ohio governor and former congressman and Fox host told NBC’s “Meet the Press”that he was still not officially a candidate.

“I still haven’t decided,” Kasich told Chuck Todd. “I’m more and more serious, or I wouldn’t be doing these things. … The reason why I feel I should be in there is I’ve had foreign policy, national security experience. I was chairman of the Budget Committee, we actually balanced the budget, got results and the economy got better. As governor of the state, I inherited a total mess, and at the end of the day we’re running surpluses.”

Kasich was elected governor of Ohio in 2010 and was re-elected in 2014 by a more than 40-percentage-point margin in the key swing state, which led to inevitable presidential talk Republicans need to carry Ohio to have a realistic chance at winning the White House. Conservative on fiscal issues, Kasich has also been an advocate for the working poor and controversially supported the Medicaid expansion component of the Affordable Care Act.

As Kasich continues to test the waters for a presidential campaign, even Democrats have said he would be a formidable candidate.

“John Kasich presents an interesting option for Republicans. I think he’s somebody who very much marches to his own beat, and sometimes that ruffles Republican feathers, such as the Medicaid expansion,” Alan Melamed, an Ohio Democratic political strategist, earlier said, “If Gov. Kasich stays with some of the approaches here in Ohio, it may present a challenge, but I think that he offers an interesting alternative, and in this stage of the game, it’s kind of open to anything.”

 

CNN Debate Fact summary by FACTCHECK.ORG

 

Summary

Facts were sometimes used as blunt instruments as the four remaining GOP presidential candidates hammered away at each other in the last debate before Saturday’s South Carolina primary.

• Santorum and Romney tangled on the Massachusetts health care law. Santorum wrongly claimed it was a “government-run” program. Romney erred when he said everybody was covered by private insurance, ignoring Medicare and his own expansion of Medicaid.
• Santorum also fouled up when he claimed the state has “the highest health insurance premiums of any state in the country.” Seven states and Washington, D.C., were higher in 2010, the most recent year for which figures are available.
• Gingrich claimed Romney appointees “funded” an abortion clinic. The truth is that an autonomous state agency approved a tax-exempt loan — not direct taxpayer funding — and Romney said he wasn’t aware until after he left office.
• Gingrich, slamming Jimmy Carter, said “unemployment went to 10.8 percent.” It did — nearly two years after Ronald Reagan took office. But it never exceeded 7.8 percent under Carter.
• Gingrich claimed that “none” of the ideas on the website of his Center for Health Transformation resemble Obama’s program. Actually, we found a call there for an individual mandate, which Gingrich himself repeated as recently as last May.
• Romney slammed Gingrich’s claim to have “helped” Reagan create jobs, saying Reagan mentioned Gingrich only once in his published diaries. That’s true. Reagan wrote that the young congressman’s 1983 suggestion to freeze spending “would cripple our defense program,” and he rejected it.
• Ron Paul, a physician, claimed medicine “worked rather well” in the early 1960s. That was before Medicare, when in fact rising health care costs were forcing many of the elderly onto public assistance or charity care.

Analysis

They met in Charleston, only hours after Texas Gov. Rick Perry announced he was suspending his campaign and endorsing former House Speaker Newt Gingrich.

Romney vs. Santorum: Massachusetts Health Care

Former Sen. Rick Santorum and former Massachusetts Gov. Mitt Romney both strayed from the facts at times as Santorum tried to bolster his claim that Romney’s health care law was a “disaster,” and Romney fought back saying Santorum’s claims were “wrong.” We’ll take that spirited exchange point by point:

Santorum wrong on “government-run” health care: Santorum called the law “a government-run health care system.” That’s not true. Like the federal law signed by Obama, the Massachusetts law doesn’t create a system in which the government is the insurer, or provider of health care. Instead, both laws mandated that all residents have insurance, expanding business for private carriers. They also offered subsidies to help lower-income residents buy private insurance, and they expanded Medicaid.

Romney wrong on “private” insurance: Romney was correct when he shot back that 92 percent of Massachusetts residents already had insurance in the state before the law went into effect. But he went too far when he said, “They still had the same private insurance. And the 8 percent of the uninsured, they bought private insurance, not government insurance.” Neither statement is entirely true.

Many of those insured previously were covered by Medicare (for those age 65 or older) or Medicaid (for low-income residents), which are both government programs, not “private insurance.”

Santorum right on added coverage (with a caveat): And as Santorum correctly noted, Romney’s program covered the uninsured in part by expanding Medicaid for some, and by providing state subsidies for the purchase of private insurance for some others.

Santorum: “[O]ver half the people that came on the rolls since you put Romneycare into effect are fully subsidized by the state of Massachusetts. And a lot of those are on the Medicaid program.

That’s correct: Of the 411,722 individuals who have gained insurance since the law was passed, 47 percent, or 193,393, have joined MassHealth, the state’s Medicaid and Children’s Health Insurance Program. The rest are on private insurance, with 77,330 buying their own insurance on the individual market and 158,973 getting plans with the help of state subsidies, as of Dec. 31, 2010.

In Romney’s defense, however, it should be noted that the ailing economy played a role in boosting the number of persons on Medicaid. In fact, the Massachusetts Medicaid Policy Institute estimates that 76 percent of the increase in Medicaid and CHIP beneficiaries would have happened without the law, and that only 61,000 of new MassHealth enrollees can be attributed to the legislation.

Another 75,000 are on fully subsidized plans, according to the Health Connector, the state exchange. All told, 65 percent of the newly insured are on fully subsidized insurance, whether through Medicaid or private insurance. So Santorum is correct, with the caveat that much of the Medicaid expansion would have occurred with or without Romney’s law.

As for Romney’s claim that “nothing changed” for the 92 percent of residents that already had insurance, that ignores the fact that they, too, are subject to the law requiring them to continue to have insurance — even if they leave their jobs, which is where most gained their coverage.

Santorum’s Dubious $8 Billion Claim: Santorum also said the state law was “$8 billion more expensive than under the current law.” (We assume he means the previous law.)

That questionable number comes from a conservative think tank that tallied not just the cost to the state government since the law was enacted in 2006, but also “new health care costs to the federal government and on state residents and businesses.” The June 2011 study came from the Beacon Hill Institute at Suffolk University.

A much lower estimate was issued by the nonpartisan Massachusetts Taxpayers Foundation, whichestimated that the law cost $707 million in fiscal 2010, with the state paying half of that and the federal government paying the rest.

Santorum wrong on premium costs: Santorum claimed Massachusetts premiums are the highest in the country, 27 percent more than average. Neither claim is true.

Santorum: Massachusetts has the highest health insurance premiums of any state in the country. It is 27 percent more expensive than the average state in the country.

In fact, seven states and the District of Columbia, which got top honors, had higher premiums for family coverage, according to a report by the Commonwealth Fund. Massachusetts had held the No. 1 spot in 2008 and 2009, but family premiums fell slightly to $14,606 in 2010. That’s only 5.3 percent more than the state average, nowhere near Santorum’s figure of 27 percent.

Romney’s right on premium costs: Romney responded to Santorum by saying:

Romney: Massachusetts, by the way, had the highest insurance costs before the plan was put in place and after. But fortunately, the rate of growth has slowed down a little less than the overall nation.

That’s right. The state’s slide in premium costs for 2010 does indeed mean the “rate of growth has slowed down,” as Romney said. We’d also note that premium costs in the state accounted for a lower percentage of the median household income than many other states.

Santorum misleads on waiting times: Santorum also gave a misleading view of the law’s impact on waiting times to see doctors:

Santorum: Over 50 percent of the doctors now are not seeing new patients — primary care doctors are not seeing new patients. Those who do get to see a patient are waiting 44 days on average for the care.

Those numbers come from reports by the Massachusetts Medical Society, which said in 2009 that the average wait time in the state for both family medicine and internal medicine was 44 days. But the group has been lamenting long wait times and doctor shortages for many years, since before the law was enacted, a point it noted in a 2011 report titled “Access to Health Care in Massachusetts: The Implications of Health Care Reform.” The medical society said that “primary care shortages continue in Massachusetts, but they predate health reform by many years, and mirror shortages in many other areas of the country.”

Also, the average wait time for family medicine physicians was down to 36 days on average in 2011, but the wait time for internal medicine physicians was up to 48 days. It’s hard to draw firm conclusions on the law’s impact. The wait time for internal medicine was 47 days in 2005, a year before the law was enacted. Santorum is correct that more than half of primary care physicians are no longer accepting new patients.

The medical society said the issues of doctor shortages and primary care physicians not seeing new patients weren’t solely due to the health care law, but it had contributed to the problem. “Although these challenges are not all a direct result of health care reform, in some cases health care reform has exacerbated the situation,” the society said.

Romney’s rosy view of premiums: Romney also used the most favorable estimates in describing a decrease in premiums for plans on the individual market:

Romney: Individuals who wanted to buy their own insurance saw their rates — when they were not part of a big group — saw their rates drop by some 40 percent with our plan.

It’s true that MIT economist Jonathan Gruber, who advised the Romney administration on the health care law, told us that individual market premiums dropped by as much as 40 percent. But some of that was due to young, healthy persons buying cheaper plans in that market after the law. That brought the average price down. He told us the decrease would be smaller if an adjustment was made for the less generous benefits in many of the newly purchased policies.

We found an 18 percent decrease in premiums when we looked at the individual market premium in 2006, per person per month, and compared that with the premium in 2008.

Santorum’s “failure” claim: Finally, Santorum said the Massachusetts law was “an abject failure.” In fact, the law succeeded in achieving its main goal: reducing the number of uninsured. As of the end of 2010, 98.1 percent of state residents, and 99.8 percent of children, had insurance.

Gingrich vs. Romney: Funding Abortion

Gingrich revisited an issue that came up in 2007, saying that when Romney was governor — and after he had become an abortion opponent — “a branch of the government which included his appointees did agree to fund an abortion clinic for Planned Parenthood.” That’s true as far as it goes — but there’s more to the story.

Two months before Romney left office, Massachusetts’ economic development agency granted initial approval to a $5 million tax-exempt bond — not direct taxpayer funding — for a Planned Parenthood clinic in Worcester that would provide abortions, according to the Boston Globe.

And though Gingrich is correct that the agency, MassDevelopment, was controlled by Romney appointees, it was an autonomous authority and not under the governor’s direct control.

Romney campaign spokesman Eric Fehrnstrom said in 2007 that Romney was simply unaware the project was under consideration, and that Romney would have attempted to block it if he had known about it.

In a statement to the Globe, Ranch Kimball, the chairman of the authority and a Romney appointee, said he did not brief the governor’s office on the initial approval of the loans in late 2006. Final approval of the project came in February 2007, a month after Romney left office, and was ultimately approved by Democratic Gov. Deval Patrick, an abortion rights supporter.

Gingrich Flunks History

Gingrich claimed that unemployment hit 10.8 percent under Democratic President Jimmy Carter:

Gingrich: Under Jimmy Carter, we had the wrong laws, the law regulations, the wrong leadership, and we killed jobs, we had inflation, we went to 10.8 percent unemployment. Under Ronald Reagan, we had the right jobs, the right laws, the right regulators, the right leadership. We created 16 million new jobs.

That’s wrong. The jobless rate never was higher than 7.8 percent during Carter’s presidency, and was as low as 5.6 percent.

The rate did later rise to 10.8 percent in November and December of 1982 — but that was nearly two years into Reagan’s first term. The rate declined slowly from there, and was still 7.3 percent when Reagan was sworn in for his second term. It did not get below 6 percent until late 1987, and was 5.4 percent when Reagan left office in January, 1989.

Romney vs. Gingrich: Reagan’s Diaries

With Gingrich claiming credit for helping create jobs during Reagan’s presidency, Romney cracked that Gingrich rated just one mention in the Reagan diaries, and not a particularly flattering mention at that.

Romney: I mean, Mr. Speaker, it was — you talk about all the things you did with Ronald Reagan and the Reagan revolution and the jobs created during the Reagan years and so forth. I mean, I looked at the Reagan diary. You’re mentioned once in Ronald Reagan’s diary.

And in the diary, he says you had an idea in a meeting of young congressmen, and it wasn’t a very good idea and he dismissed it. That’s the entire mention.

Just to check, we did a quick word search on the The Reagan Diaries – a daily diary President Reagan kept by hand — and as Romney said, there was but one mention of  Gingrich by name. It came in an entry for Monday, Jan. 3, 1983 — when Gingrich had been in the House barely four years.

The Reagan Diaries: A tough budget meeting & how to announce the deficits we’ll have — they are horrendous & yet the Dems. in Cong. are saying there is no room for budget cuts. Met with a group of young Repub. Congressmen. Newt Gingrich has a proposal for freezing the budget at the 1983 level. It’s a tempting idea except that it would cripple our defense program. And if we make an exception on that every special interest group will be asking for the same.

Given his tough budget-cutting stance in the 2012 campaign, Gingrich might be quite proud his budget-freezing proposal then as a young congressman from Georgia’s 6th district. But at the time, the Gipper didn’t think the idea was too practical.

Gingrich vs. Obama: Health Care

Gingrich — under attack from Santorum for once supporting a government mandate requiring individuals to obtain health insurance — denied that anything like Obama’s health care program could be found on the website of Gingrich’s Center for Health Transformation.

Gingrich: And the fact is, I helped found the Center for Health Transformation. I wrote a book called “Saving Lives and Saving Money” in 2002. You can go to healthtransformation.net and you’ll see hundreds of ideas, none of which resemble Barack Obama’s programs.

That’s not quite true. Wayne Oliver, a former lobbyist for the Georgia Pharmacy Association and a vice president at the center, wrote an op-ed that appeared in the Atlanta Journal Constitution April 23, 2009 on the so-called public option. Oliver wrote in opposition to a public-option plan, which was one of the options being considered by the Democrats at the beginning of the debate on a federal health care law. In the op-ed, Oliver says: “Everyone should be required to have health insurance coverage; or, if they are opposed to insurance, they should post a bond.”

That same position was also voiced by Gingrich — most recently during a May 15, 2011 interview on “Meet the Press.” He said, “I’ve said consistently we ought to have some requirement that you either have health insurance or you post a bond … or in some way you indicate you’re going to be held accountable.” And he acknowledged that would be “a variation” of the individual mandate idea.

In addition, the center published a book called, “Paper Kills 2.0: How Healthcare IT Can Save Your Life and Your Money.” The book, which is promoted on the center’s website,  advocates for improving patient outcomes by upgrading and expanding the use of electronic patient records. Gingrich and former Democratic Senate Leader Tom Daschle wrote the book’s foreword. Daschle was Obama’s first choiceto become the health and human services secretary and oversee his administration’s effort to change the health care laws to make insurance more affordable and accessible. The Affordable Care Act contains numerous health information technology provisions, as did the American Recovery and Reinvestment Act, which is known as the stimulus bill.

Paul: Medicine ‘Worked Rather Well’ Before Medicare

Texas Rep. Ron Paul, a physician, claimed medicine “worked rather well” in the early 1960s:

Paul: I had the privilege of practicing medicine in the early ’60s before we had any government. It worked rather well and there was nobody out in the street suffering with no medical care.

That was before Medicare was signed into law in 1965. But as early as 1959, during the Republican administration of President Dwight D. Eisenhower, the Department of Health, Education and Welfare issued a report to Congress stating that the rising cost of health care was forcing some people onto public assistance or charity from hospitals, and more so for the elderly than for younger persons:

HEW, 1959: The rising cost of medical care, and particularly of hospital care, over the past decade has been felt by persons of all ages. Older persons have larger than average medical care needs. As a group they use about two-and-a-half times as much general hospital care as the average for persons under age 65, and they have special need for long-term institutional care. Their incomes are generally considerably lower than those of the rest of the population, and in many cases are either fixed or declining in amount. They have less opportunity than employed persons to spread the cost burden through health insurance. A larger proportion of the aged than of other persons must turn to public assistance for payment of their medical bills or rely on ‘free’ care from hospitals and physicians.

Santorum vs. Obama: Cutting Veterans’ Benefits

Santorum criticized Obama for proposing cuts in military veterans’ benefits.

Santorum: We have the president of the United States who said he is going to cut veterans benefits, cut our military, at a time when these folks are four, five, six, seven tours, coming back, in and out of jobs, sacrificing everything for this country.

Much has been written about the president’s plans to reduce the size and cost of the U.S. military, but what about veterans’ benefits? The president’s deficit reduction plan does indeed propose some changes in military health and retirement programs.  The plan would:

• Impose a $200 annual fee on TRICARE for Life recipients. TRICARE for Life is a supplemental health insurance program for veterans 65 and over. It covers certain out-of-pocket expenses not covered by Medicare. Currently, TRICARE for Life does not charge fees or premiums. The administration estimates the proposal would save about $6.7 billion over 10 years.
• Increase prescription drug benefit co-pays. The administration estimates this proposal would save $20.6 billion over 10 years.
• Create a commission to study military retirement benefits. The deficit-reduction plan says the current benefits are “generous” and “out of line with most other Government or private retirement plans.”

The proposal was submitted in September, and has not become law.

– by Lori Robertson, Robert Farley, Eugene Kiely, Brooks Jackson and D’Angelo Gore.

Source:http://factcheck.org/2012/01/south-carolina-smackdown/

RON PAUL “PLAN TO RESTORE AMERICA”

Executive Summary

Full details of Rep. Paul’s plan are available at: http://www.ronpaul2012.com/the-issues/ron-paul-plan-to-restore-america/

SYNOPSIS: America is the greatest nation in human history. Our respect for individual liberty, free markets, and limited constitutional government produced the strongest, most prosperous country in the world. But, we have drifted far from our founding principles, and America is in crisis. Ron Paul’s “Restore America” plan slams on the brakes and puts America on a return to constitutional government. It is bold but achievable. Through the bully pulpit of the presidency, the power of the Veto, and, most importantly, the united voice of freedom-loving Americans, we can implement fundamental reforms. DELIVERS A TRUE BALANCED BUDGET IN YEAR THREE OF DR. PAUL’S PRESIDENCY: Ron Paul is the ONLY candidate who doesn’t just talk about balancing the budget, but who has a full plan to get it done. SPENDING: Cuts $1 trillion in spending during the first year of Ron Paul’s presidency, eliminating five cabinet departments (Energy, HUD, Commerce, Interior, and Education), abolishing the Transportation Security Administration and returning responsibility for security to private property owners, abolishing corporate subsidies, stopping foreign aid, ending foreign wars, and returning most other spending to 2006 levels. ENTITLEMENTS: Honors our promise to our seniors and veterans, while allowing young workers to opt out. Block grants Medicaid and other welfare programs to allow States the flexibility and ingenuity they need to solve their own unique problems without harming those currently relying on the programs.

CUTTING GOVERNMENT WASTE: Makes a 10% reduction in the federal workforce, slashes Congressional pay and perks, and curbs excessive federal travel. To stand with the American People, President Paul will take a salary of $39,336, approximately equal to the median personal income of the American worker. TAXES: Lowers the corporate tax rate to 15%, making America competitive in the global market. Allows American companies to repatriate capital without additional taxation, spurring trillions in new investment. Extends all Bush tax cuts. Abolishes the Death Tax. Ends taxes on personal savings, allowing families to build a nest egg. REGULATION: Repeals ObamaCare, Dodd-Frank, and Sarbanes-Oxley. Mandates REINS-style requirements for thorough congressional review and authorization before implementing any new regulations issued by bureaucrats. President Paul will also cancel all onerous regulations previously issued by Executive Order. MONETARY POLICY: Conducts a full audit of the Federal Reserve and implements competing currency legislation to strengthen the dollar and stabilize inflation. CONCLUSION: Dr. Paul is the only candidate with a plan to cut spending and truly balance the budget. This is the only plan that will deliver what America needs in these difficult times: Major regulatory relief, large spending cuts, sound monetary policy, and a balanced budget.