Senate moves forward on debate over Obamacare

WASHINGTON — The Senate easily overcame Wednesday’s first hurdle to a fizzling GOP strategy to strip funding for President Obama’s healthcare law in exchange for keeping the government running.

Top Republicans are now for a new — more modest — way to chip away at the Affordable Care Act.
Time is not on their side after Sen. Ted Cruz (R-Texas) monopolized the floor in his lonely filibuster-like campaign. Money for routine government operations is set to run out Oct. 1, unless Congress acts.

The rare 100-0 vote to end this first round of debate showed how eager senators were to move the bill forward.

Republicans realize that because they are in the minority in the chamber, Democrats will eventually be able to eliminate the Obamacare provision to protect the president’s signature law. Republican leaders want Cruz to wrap up his time in the limelight so the Senate can dispatch the legislation back to the House in time to give Speaker John A. Boehner (R-Ohio) ample opportunity to attach new amendments that might have a better chance at eventually ending the healthcare law.

“My own view is it would be to the advantage of our colleagues in the House, who are in the majority, to shorten the process,” said Senate Republican Minority Leader Mitch McConnell of Kentucky, who has distanced himself from Cruz’s strategy. “If the House doesn't get what we send over there until Monday, they're in a pretty tough spot.”

Republicans in the House and Senate believe a do-over in the House could have better results, if they attach a healthcare provision that would be difficult for Democrats to oppose — such as a repeal of the new tax on medical device manufacturers that some Democrats dislike, or a delay of the individual mandate that all Americans carry health insurance in 2014.

After Republican senators convened for back-to-back closed-door strategy sessions earlier this week, many, if not most, embraced the emerging plan. “It seems to some of us the sooner you get it over to the House, the sooner they can address it,” said Sen. John McCain (R-Ariz.)

Cruz initially showed little interest in yielding, promising to use every procedural tool necessary to stop what others in his party viewed as inevitable.


But after finishing is 21-hour talkathon late Wednesday morning, Cruz suggested speeding up the next key vote to Friday, rather than Saturday as scheduled. That vote is viewed as the Republicans’ last chance to stop the bill before the Democrats gut the health provision.

Cruz said he wanted to make sure Americans were tuned in to watch it. Senate Majority Leader Harry Reid (D-Nev.) initially declined the offer, but conversations are expected to continue.

Under Senate rules, the chamber will now spend 30 hours in debate before the next vote, Thursday morning, to proceed to the legislation. Final passage, without the healthcare provision, would not come until Sunday evening — with hours to go before a possible shutdown.

California reveals details of health-law insurance plans

Consumers are getting their first glimpse at what health insurance will look like in California as the state prepares to implement the federal healthcare law. On Wednesday, state officials will spell out the details on policies available next year to people buying their own coverage. In January 2014, most Americans will be required to have health insurance or face a penalty.

Federal law established four broad plans of coverage — Platinum, Gold, Silver and Bronze — whose benefits vary based on the level of out-of-pocket expenses that consumers are required to pay. A Platinum plan, the most expensive, would require policyholders to pay about 10% of the cost of care, while the Bronze plan, the least expensive, pegs the patient share at 40%.

Now for the first time, California is laying out the specific co-pays and deductibles that many policyholders will face when going to see a doctor, get a lab test or visit an emergency room.

Nationwide, President Obama's Affordable Care Act requires insurers to cover certain services, such as maternity care and prescription drugs, and they must accept all applicants regardless of preexisting medical conditions. But the federal law allows states to go beyond those minimum standards and set stricter rules.

State officials said they took this extra step to help Californians get the best deal when they shop for insurance. Consumers will be able to buy these policies through Covered California, the state-run marketplace for health insurance.

"For the first time, all Californians will be able to make an apples-to-apples comparison of their health plan choices in 2014," said Peter Lee, executive director of Covered California. "Today's health insurance market is a shell game where insurers are trying to avoid paying for expensive care and consumers don't know what's covered or not covered."

Consumer advocates applauded California's move. But some healthcare experts warned that policyholders will still have to navigate a lot of jargon. And the ultimate cost of this coverage won't be known until the state negotiates rates with health insurers later this year.

To help Californians get some idea of what they might pay, officials are launching a website Wednesday to provide estimates of monthly premiums. The federal law grants premium subsidies to families earning up to about $93,000 a year to make coverage more affordable. It also expands Medi-Cal coverage to lower-income people. California estimates take those subsidies into account.

For example, the state says that a family of four earning $35,000 would pay less than $120 a month for health insurance with the help of federal subsidies. At $47,000 a year, a family's monthly premiums would be $247 a month.

Premiums are just one factor in the health insurance cost equation. Patients must also pay out of pocket for a wide range of medical care.

Under the state requirements to be issued Wednesday, for example, a Silver plan would have a $2,000 annual deductible and a $45 co-pay for a primary-care visit. A more expensive Platinum plan would have no deductible and a $25 co-pay for a regular doctor's visit. Lower-income policyholders would pay substantially less because of federal aid.

via The LA Times