Editorial November 21, 2014



“…this new symbiotic relationship between insurers and the White House…has proven to be far less apocalyptic than skeptics warned.”

Politics do indeed make strange bedfellows as evidenced in recent reports on the relationship between the White House and health insurers regarding the Affordable Care Act (ACA).

Robert Pear  reported in The New York Times recently that while the President, during the run-up to passing the Affordable Care Act, scolded health insurers for bad behavior, the relationship has taken a 180 degree turn. Pear reported that “…insurers in turn have provided crucial support to Mr. Obama in court battles over”…the ACA, and “a unit of one of the nation’s largest insurers, UnitedHealth Group, helped the administration repair the HealthCare.gov website after it crashed in the opening days of enrollment.”

The reason for this new relationship was certainly predictable and is based on one simple fact; the ACA is profitable for insurers and is expected to be more so over time; Pear quoted Michael J. Tuffin, a former executive vice president of America’s Health Insurance Plans, the main lobby for the industry. “There will be nearly $2 trillion of subsidized coverage through insurance exchanges and Medicaid over the next 10 years. These are pragmatic companies. They will follow the customer.”

The Republican House in particular has gone out of its way during the 113th Congress to repeal the law or modify it in many ways to diminish its chances for success. Republican governors mostly have or would like to have rejected the ACA increase in Medicaid funding despite that the federal funding which would normally cover a smaller percentage of the cost of Medicaid would cover 100% of the cost to the states for about three years and then would cover 90% of state outlays for the program thereafter.

That and the long history of the Republican Party supporting the health insurance industry makes this newest turn of events interesting. While the Republican Party was the go-to Party for getting what health insurers wanted and efforts by Democrats over decades presented legislation that neither the Republicans or health insurers wanted (See Senate history, this page) this new symbiotic relationship between insurers and the White House and the Party that finally accomplished what insurers and their supporters didn’t want has proven to be far less apocalyptic than skeptics warned. In fact it has proven to be a boon for insurers, some seeing a significant percentage of their revenues from ACA participants for traditional coverage and the expansion of Medicaid.

What can Republicans still opposed to the ACA do if repealing or neutering the law is opposed by one of their strongest business allies? They could continue to try repealing the ACA and face resistance from insurers protecting their profits; they could amend the bill such that insurers would see even higher profits but that would not seem to be immediately necessary and would be a political tightrope considering that their political base opposes the law.

One possibility not likely to happen considering House Republican intense and consistent opposition to the law since its enactment would be to improve the law for the benefit of the consumers. Perhaps it would be best if Republicans let go of this dog-chasing-its-tail issue when there are so many other important issues to address. But letting go of the unsuccessful effort to repeal since 2010 may not be in their DNA. The Serenity Prayer comes to mind; Republicans on this issue should change the things they can,  accept the things they cannot change and, hopefully, gain the wisdom to know the difference. ##


Publisher’s Letter

FISA Reform a Small Step to Ease Post-Snowden Suspicions but Real Concerns Go Unaddressed

“It’s the aftermarket for this data that should concern everyone who is not a terrorist.”



The Senate this week did not pass S 2685, a bill to reform the authorities of the Federal Government’s surveillance programs that were expanded and further defined under the PATRIOT Act passed into law in 2005.

The PATRIOT Act is an enormously complicated and far reaching law that was sought by the US intelligence agencies after the 911 attacks as a way to prevent further attacks by monitoring telephone calls, emails, and other forms of electronic communications. The bill was debated for weeks. The reporting of that bill on this website alone took hundreds of pages. Due to those complications media tended to focus not on details but the hot button issues, mostly personal privacy. But it was soon made clear that thousands of government bureaucrats were not sitting in windowless rooms reading your emails or listening to your phone conversations because, unless the government had cause, the only information collected in bulk would be, essentially, who called or emailed or texted who, not what was said or written.

Perhaps because the PATRIOT Act was beginning to add up as a giant step towards George Orwell’s ‘Big Brother’ scenario there was the promise that the only time a US citizen was monitored would be because of communications from here to overseas or overseas communications ending in the US with the understanding that such monitoring was not to be routine but rather the government had interest in the communicator on the overseas side of the equation unless, of course, the US citizen was suspected of an association with terrorism.

Some question if the rules governing bulk data collection have been adhered to. Since the primary agency involved is the National Security Agency (NSA) we only know that whatever is being done at NSA is done well beyond the sunlight (for security reasons) and even if the FISA court has approved of those activities, its actions, too, remain secret to the general public.

When Edward Snowden stole and released surveillance data from the NSA revealing the extent of the NSA surveillance program it was quite an eye opener to many and immediately fueled those who distrust the government anyway. Thus this bill. S 2685 is limited in its reforms, merely cracking the door a bit to answers about what the NSA is doing and it would have ended bulk data collection, sort of; the government would not collect the bulk data but the telecoms would be required to store all data for a period of time and the government would request data it needs from those companies.

One element of the S 2685 debate centered on the storage of that metadata; all of that information on who contacted who electronically. Senator Feinstein, in the floor debate, noted that there are four big telecoms who were contacted to see how long they would be willing to hold data that the government might later want or has yet to extract. All, according to Feinstein, said two years. S 2685 also requires the government to come up with a time period within which to destroy data collected if it is found not to have any significance to the war on terror. What the bill does not make clear is if that data stored by the telecoms is not sought by the government within two years would it be deemed as not relevant and destroyed? By who, then, and how?

It’s the aftermarket for this data that should concern everyone who is not a terrorist. That brings to mind a PATRIOT Act supporter’s question back in 2005; “If you have nothing to hide what do you care if your communications are monitored?” The response from one writer whose identity has been lost to me over the years was, “I don’t have anything to hide but I can’t think of any reason I want you to know those things about me.” It was an argument that didn’t gain much traction then, but now seems very relevant for this reason; if Edward Snowden could steal trillions of bytes of data from the tightest cyber security system in the world, ever, how protected is that data from an interested telecom employee who sees some value in it for his or herself? S 2685, if it ever returns to the Senate, should protect us from that. Robert McElroy  ##


Health Care Clash

April 2, 1946

“Chairman Murray’s 1946 bill targeted $50 million to finance health insurance programs for low-income Americans, for maternal and child care, and for medical research and education grants to states.”

The end of World War II brought unprecedented peacetime challenges to the Senate. The Republican minority, under the leadership of Ohio’s Robert Taft, savored the prospect of victory in the upcoming 1946 midterm elections. For their part, many Democrats struggled to revive the spirit of New Deal progressive legislation.

 On April 2, 1946, Montana Democrat James Murray convened his Committee on Education and Labor for the first hearing on comprehensive national health insurance. A resident of Butte, Montana, Murray had in the 1920s witnessed the manipulative practices of the Anaconda Copper Company. He consequently became a New Deal advocate for organized labor, small farmers, and other victims of big business.

 Chairman Murray’s 1946 bill targeted $50 million to finance health insurance programs for low-income Americans, for maternal and child care, and for medical research and education grants to states. He began his April 2 hearing by citing a Washington Post editorial that warned against applying the word “communistic” to programs designed for full employment, veterans’ housing, and health insurance. He urged senators to avoid the American Medical Association’s tactic of labeling health care legislation as “socialized medicine.”

 Murray’s request brought an immediate objection from Robert Taft, the committee’s second ranking Republican. “I consider it socialistic! It is in my mind the most socialistic measure ever considered by the Congress!” Murray advised Taft to wait his turn later in the hearing. Pointedly ignoring his chairman, Taft began reading a statement. Murray exploded, saying to Taft, “I don’t propose to let you bluff me on a grandstand play. You have so much gall and nerve that you won’t let anybody [else] complete a statement.” After a 15-minute shouting match, the chairman bellowed, “Shut up right now, or I’ll call the officers and have you removed from the room.” Explaining that he had another meeting to attend in a few minutes, Taft continued speaking. Murray glared at Taft and said, “Shut your mouth up and get out of here.” Taft responded by asking Murray for a committee recess until “you have recovered your temper.” The chair lashed back to this son of a former president and chief justice, “You are so self-opinionated and think you are so important that you can come into any committee and disrupt it.

 Taft stalked from the room with a promise to boycott all future hearings and to block the bill if it ever surfaced on the Senate floor.

Taft’s promise, opposition by the AMA, and Republican gains in Congress delayed major health care legislation for another 18 years. Only in 1964, after the Democrats had rebuilt a sizable majority, was Congress able to enact Medicare.##

Courtesy Senate Clerk