Justin's Political Corner

(KMOV.com) — A state lawmaker has come under fire after comparing Missouri’s poor to animals in an interview with KMOX Radio.

“There’s a sign that says please don’t feed the animals,” said Rep. Paul Fitzwater, a Republican from Potosi. “There’s a reason. They keep coming back.” 

Fitzwater used the analogy during a discussion on whether to expand Medicaid under the Affordable Care Act, which goes into effect in January of 2014. News 4 went to Potosi to talk with Fitzwater, but he declined to go on camera. Some residents said they were not offended by the quote, but thought Fitzwater could have used better wording.

“I don’t think the poor are animals, but i think he was saying the poor need to help themselves too,” said Potosi resident Vicki Brand.

Fitzwater later agreed to speak to a reporter on the phone, and admitted to using a poor analogy.

“The example I was using is, if we continue to hand out funds and give people everything in society, they will continue to depend upon it,” said Fitzwater. “And I didn’t mean nothing by that, and I think you’re just taking it out of context.”

H/T: KMOV.com

As the country prepares to celebrate the third anniversary of health care reform, Rep. Michele Bachmann (R-MN) insisted on Thursday that the Affordable Care Act will “kill” vulnerable women and children during a speech on the floor of the House.

In a long diatribe against the law, Bachmann predicted that the American people will “pay more” and get less, before suggesting that the provisions of Obamacare will “literally” kill people:

BACHMANN: That’s why we’re here because we’re saying let’s repeal this failure before it literally kills women, kills children, kills senior citizens. Let’s not do that. Let’s love people, let’s care about people. Let’s repeal it now while we can.

Watch it:

H/T: Igor Volsky at Think Progress Health

Now that Obamacare has survived at the Supreme Court and the ballot box, proponents and opponents of the law agree it’s here to stay. But Republicans remain committed to botching its implementation, which — along with inherent complexities in implementing parts of the law — leaves in place significant obstacles to achieving its key goals.

Although the GOP’s efforts to repeal, invalidate and defund the law have not succeeded, here are the four biggest obstacles the law faces in meeting its key goals:

1) Ongoing Disapproval Of The Law

Two leading health policy experts argue that the overarching threat to Obamacare is the fact that many Americans continue to disapprove of it.

“I would rank the number one obstacle to be ‘social acceptance,’” said Jonathan Gruber, a professor at MIT who helped craft the Affordable Care Act and the Massachusetts health care law that inspired it. “When we put in the mandate in Massachusetts we were worried that it would cause protests. None came. This was partly because we did a terrific job of advertising and promoting reform. The same is unlikely to be true in all other states. If folks are protesting, it undercuts the whole reform — if folks don’t sign up, then prices are higher, which leads to more protests, and so on.”

If the public doesn’t come around (supporters of the law are convinced it will), that could also encourage congressional Republicans to keep threatening to withhold funds for implementation, as they have been wont to do in recent years. In the future, with a Republican president or GOP-controlled Senate, they may seek to deny appropriating money for the ACA’s essential functions.

Adding to his ever-growing list of fears, conservative commentator Erik Rush suspects that President Obama will work with the American Psychiatric Association to classify Christianity as a mental illness in order to take away their rights and detain them indefinitely. Rush, who ironically encouraged a possible Romney administration to begin prosecuting and disenfranchising liberals, writes that the health care reform law will be the mechanism that will enable Obama to begin targeting Christians for persecution.

Some of Rush’s insane rant in the far-right Canada Free Press site that he posted on:

Now, while the APA is the premier psychiatric association in America, driving what passes for all conventional wisdom with regard to mental illness, in recent years it has been accused of being more agenda-driven than representing hard, scientific and medical assessments of mental disorders. Decidedly liberal-leaning, in recent decades it has essentially redefined such things as homosexuality, gender identification disorder, and pedophilia to reflect what pressure groups and the liberal intelligentsia wish, rather than continuing to describe them as psychologically aberrant.

One begins to see how having such a biased organization whimsically defining and re-defining mental illness in light of recent political developments might be, shall we say, troublesome to say the very least.

For example: It has been established that the oxymoronical Patient Protection and Affordable Care Act (Obamacare) signed into law in 2010 is anything but affordable. Worse, its detractors rightly indicated that then-House Speaker Nancy Pelosi’s admonition that it must be passed so that we could see what was in it was dangerous as well as idiotic. Well, the poison pills therein are already being revealed in the form of hidden regulations that either incur cost, or impinge upon constitutional protections.

…

Along with his disdain for European society and what Obama perceives as the vestiges of imperialism, colonialism, and white supremacy (which includes America), he also despises that which gave rise to it, which serves as its cultural adhesive, and which stands as the chief impediment to a Marxist America: Christianity.

In the case of those who pose the most dire threat to Obama’s designs – Christians – these will certainly be targeted. After all, who more demonstrably epitomizes mental instability in the eyes of the Marxist atheist than those who commune with and rely upon that which is unseen? To the Marxist, God is no more real than Elwood’s “Harvey,” and even more antiquated than the Constitution.

Hey - did you hear they carted Mr. Rush off in a straitjacket last night? I had no idea he was mentally ill! Well, better that than he shoots up a school or something…

h/t: Brian Tashman at RWW

The Affordable Care Act’s biggest year is, without a doubt, 2014: That’s when the federal subsidies to purchase health insurance roll out. It’s also when penalties for not buying coverage kick in. 

But many of the big changes will start gradually in 2013. They range from increasing payments to Medicaid doctors to upping Medicare taxes to the exchanges’ very first open-enrollment period. Here’s a quick guide to what will happen in health care in the next year1. Health-care cost growth will slow to a new low. The United States is expected to spend a $2.9 trillion on health care in 2013, according to actuaries at the Center for Medicare and Medicaid Services. That would be 3.8 percent more than then $2.8 trillion that CMS estimates we spent in 2012.

That 3.8 percent growth rate, if it actually happens, would be the slowest health-care growth in decades. That has little to do with the Affordable Care Act, the CMS actuaries explain, and a lot more to do with slow income growth.

2. Your Medicare taxes will increase. Some people mark the turning of the new year with champagne and kisses. The Affordable Care Act has something slightly different in mind: Two new taxes to finance Medicare. Both are meant to bring in additional revenue to continue funding the health-care program for seniors.

Employers already take out 7.65 percent of workers’ wages to support the elderly and disabled. Of that, 1.45 percent goes toward paying Medicare’s hospital bills. Obamacare increases the Medicare hospital tax by 0.9 percent, beginning in 2013, for anyone who earns more than $200,000 ($250,000 for joint filers). It also creates a new, 3.8 percent tax on investment income, setting income thresholds at the same $200,000 and $250,000 levels mentioned above. Taken together, those two provisions are expected to generate $210.2 billion over the next decade. 

. Your insurance plan will be explained in plain English. Say goodbye to insurance forms with 8-point font that stretch on for dozens of pages. Starting in 2013, the Affordable Care Act requires insurance companies to send their subscribers a standardized, four-page summary of benefits and coverage that runs through the health plan in easy-to-understand terms. Think of this as a nutrition label for health insurance. Here’s what one page of thesample summary looks like.

This requirement actually kicked in a few months ago: Health insurance plans with open enrollment periods after Sept. 23, 2012, were required to offer this information. For anyone buying insurance from a plan with earlier open enrollment, these summaries will show up for the first time in 2013.

4. Primary care providers in Medicaid will get a 73 percent raise. The Congressional Budget Office estimates that Medicaid will gain 7 million new enrollees in 2014, as a result of the health law expanding the program up to 133 percent of the poverty line. The federal government wants to make sure that doctors keep serving that population, even though the Medicaid program tends to pay physicians less than private insurance. That’s why the health-care law includes a provision that boosts primary care reimbursements in Medicaid to match those of Medicare for 2013 and 2014. On average, that will mean a 73 percent raise for Medicaid doctors, according to researchers at the Urban Institute. As you can see in the map below, there’s lots of variation between states in terms of the size of this pay raise. 

5. The Obamacare exchanges will open for business. We often talk about January 1, 2014 as the date that states need to be ready for the health reform law. But when you talk to the states actually working to roll out the law, they often talk about October 1, 2013 as a much more significant deadline. That’s the day when the health exchanges open for business, when any American can go online, compare plans and, if they want, purchase health insurance. This is true for state-operated health exchanges as well as those being run by the federal government. 

h/t: WaPo

The possibility that Democratic and Republican leaders will agree to slowly increase the Medicare eligibility age to 67 is creating strange bedfellows: liberals — both in and out of Congress — and the health insurance industry.

A well-placed industry source tells TPM insurers haven’t taken a public position but are skeptical of the idea, particularly those insurers that don’t cover elderly patients via Medicare Advantage, supplemental Medigap coverage or prescription drug coverage.

House Republican leaders want to avoid the fiscal cliff with a proposal that would gradually raise the Medicare eligibility age to 67. Democrats are broadly reluctant to cut benefits, but President Obama was willing to accept the policy last year in failed deficit reduction talks with House Speaker John Boehner, and top Democrats have left the door open to including that measure in a grand budget bargain.

It may seem counter-intuitive: why would an industry threatened by government insurance not want it to shrink?

The reason: hiking the Medicare eligibility age would throw seniors aged 65 and 66 off Medicare and into the private market, forcing insurers, who will soon be required to cover all consumers regardless of health status, to care for a sicker, more expensive crop of patients.

The policy would save the federal government $113 billion over a decade, according to theCongressional Budget Office. But it achieves that by raising the cost of private insurance: theKaiser Family Foundation projected that a Medicare age of 67 would raise costs for under-65 patients by an average of $141 in 2014. (In practice it would be phased in.)

Starting in 2014, the Affordable Care Act will forbid insurers from turning people away or charging them different prices on the basis of age or health status. So for the first time in about half a century, they’d be chiefly responsible for patients aged 65 and 66. The specter of rising costs worries insurers, who see the ongoing spiral as an existential threat to their industry.

The age hike would have other ripple effects. Businesses that provide insurance would have to pay for two more years of coverage for elderly employees when their medical expenses tend to be highest. The higher overall costs would be borne by individuals who purchase insurance on the exchanges as well as employers who provide it.

h/t: Sahil Kapur at TPM

On Wednesday afternoon, the White House shot down Speaker John Boehner’s (R-OH) call for chopping Obamacare in upcoming debt reduction negotiations. Indeed, neither party expects the major pieces of the law to suffer in any deal. But various smaller items will be part of the discussions as the two parties look for savings in the federal budget.

Democrats aren’t ruling out the prospect of cuts to parts of the law, as long as they don’t weaken its overarching goals — and Republicans will push hard for them. Even minor cuts to the law’s spending would earn GOP lawmakers political points among their conservative constituents, something that’ll be valuable if they have to swallow tax increases.

The Prevention And Public Health Fund

The prevention fund was designed to help local communities combat disease and promote wellness. Republicans deride it as a “slush fund.”

Overpaid Premium Subsidies

The ACA provides subsidies to help Americans within 400 percent of the poverty line buy insurance on the exchanges. Republicans see that as a major source of potential savings.

Democrats have previously agreed to alter the formula to save money, and Republicans see further opportunities. 

Center For Medicare And Medicaid Innovation

The ACA allotted $10 billion to create an agency called the Center For Medicare And Medicaid Innovation, which would be tasked with testing payment reforms and new delivery system models to improve efficiency. Republicans see the money as a waste.

Top Republicans have floated the idea before in previous debt reduction talks and, with the fiscal cliff negotiations coming up, will hope to reduce the funding for CMMI.

H/T:  Sahil Kapur at TPM