Abstinence program aid rescued in bill
WASHINGTON – A little-noticed provision of the health legislation has rescued federal support for a controversial form of sex education: teaching youths to remain virgins until marriage.
The legislation restores $250 million over five years for states to sponsor programs aimed at preventing pregnancy and sexually transmitted diseases by focusing exclusively on encouraging children and adolescents to avoid sex. The funding provides at least a partial reprieve for the approach, which faced losing all federal support under President Barack Obama’s first two budgets.
“We’re very happy to see that funding will continue so the important sexual health message of risk avoidance will reach American teens,” said Valerie Huber, executive director of the National Abstinence Education Association, a Washington-based lobbying group. “What better place to see such an important health issue addressed than in the health legislation?”
But the funding was condemned by critics, who were stupefied by the 11th-hour rescue.
“To spend a quarter-billion dollars on abstinence-only-until-marriage programs that have already been proven to fail is reckless and irresponsible,” said James Wagoner of Advocates for Youth, a Washington group. “When on top of that you add the fact that this puts the health and lives of young people at risk, this becomes outrageous.”
During President George W. Bush’s administration, abstinence-only programs received more than $100 million a year directly in federal funding and about $50 million each year in federal money funneled through the states. But the effort came under mounting criticism when independent evaluations concluded that the approach was ineffective and evidence began to emerge that the long decline in teen pregnancies was reversing.
As part of Obama’s first budget, Congress approved a request for more than $110 million for a new “teen-age pregnancy prevention initiative” that would fund only programs that have been “proven effective through rigorous evaluation,” which would effectively exclude abstinence programs.
The initiative includes $25 million for new, innovative programs that could potentially embrace those encouraging abstinence. A University of Pennsylvania researcher reported last month that a carefully designed, morally neutral abstinence-focused approach can work. But the program does not earmark funding for programs focused on maintaining virginity.
During the health legislation debate in the Senate Finance Committee, however, Sen. Orrin Hatch, R-Utah, added $50 million in annual funding for five years to states for abstinence programs – a provision that survived the tumultuous process that ensued.
“There’s very little good, as far as I’m concerned, to be found in this … health care bill that raises taxes, increases the debt and slashes Medicare for a new, unaffordable entitlement,” Hatch said in a statement. “Given recent studies that have proved that abstinence education is effective at reducing teen pregnancy, it’s no wonder this funding was included in the bill.”
House Democrats to vote Sunday on revamped health care bill
WASHINGTON – Democrats plan to vote Sunday in the House of Representatives on a revamped health care overhaul bill aimed at insuring millions more Americans, providing more Medicare drug benefits and reducing federal budget deficits by $138 billion over the next 10 years.
On Thursday, President Barack Obama canceled his Asia trip, which had been scheduled to start Sunday, so he could make a last-minute push for the 216 House votes that are needed to pass the most important initiative of his 14-month-old presidency.
New Congressional Budget Office cost estimates Thursday triggered a new wave of debate, as the CBO put a $940 billion, 10-year cost on the legislation and forecast it would reduce federal budget deficits by $138 billion over 10 years.
The No. 3 Democrat in the House, Rep. James Clyburn of South Carolina, said, “We are absolutely giddy” over the CBO report.
However, Republicans and some independent analysts questioned the numbers.
As of early Thursday evening, Obama had met with or called more than three dozen members of Congress to try to win their support, said White House Press Secretary Robert Gibbs. Gibbs declined to confirm or deny lawmakers’ accounts that Obama considers the fate of his presidency at stake.
Though they appeared still short of the votes they need, House Democratic leaders were increasingly confident. Thirty-nine Democrats opposed the House version of the bill in November, but two more of them – Reps. Bart Gordon of Tennessee and Betsy Markey of Colorado – said Thursday that they’d switch. They joined Rep. Dennis Kucinich, D-Ohio, who said Wednesday that he’d vote yes.
In addition, the 23-member Congressional Hispanic Caucus announced Thursday that it backs the bill. The caucus said that while the legislation wasn’t perfect, it would provide help to nearly 9 million American Latinos who are currently uninsured.
If the House approves the package, it will go to the Senate, where leaders hope to dodge procedural hurdles that Republicans are threatening and finish the bill next week. Republicans warned they’ll fight hard to derail the plan.
“The American people are saying, ‘Stop!’ and they’re screaming at the top of their lungs,” said House Minority Leader John Boehner, R-Ohio.
At the Concord Coalition, an independent budget watchdog, executive director Robert Bixby questioned whether the legislation would produce the savings it claims from Medicare, and whether some claimed future tax revenues really will materialize.
An excise tax on high-end insurance policies, for instance, wouldn’t kick in until 2018.
“It’s already unpopular,” Bixby said, particularly with labor unions, which raises questions about whether a future Congress would let it take effect in eight years.
The legislation would make historic changes to health insurance coverage, the most in decades. Insurers no longer would be able to deny coverage to anyone because of pre-existing conditions starting in 2014, and the provision would apply to children six months after enactment.
Also, health insurers would no longer be able to put lifetime caps on coverage. Children would be able to stay on their parents’ policies until their 26th birthdays. Most people would be required to have health insurance by 2014, and most employers would be required to offer policies.
Under the legislation, an estimated 32 million people now uninsured would gain coverage, expanding it to about 95 percent of all Americans.
The House plans to consider the legislation in two stages Sunday, after allowing 72 hours for the new bill’s provisions to be reviewed.
First, it will vote on the rule governing debate – a rule that will say the health care version that the Senate passed Dec. 24 is deemed passed by the House upon adoption of the rule. If the rule is approved, the House later will vote on the changes to that Senate bill that were announced Thursday; the bill containing those changes is called a reconciliation package.
The changes, which the Senate would consider next week, include:
• Broadening the reach of the Medicare payroll tax to cover wealthier people’s unearned income, such as capital gains, dividends and interest. Singles with annual incomes above $200,000 and families that earn more than $250,000 would pay a 3.8 percent tax, up from the 2.9 percent that Obama originally proposed.
• Picking up all state costs of Medicaid, the state-federal program for lower-income people, from 2014 to 2016. The federal government then would pick up 95 percent of the costs in 2017, and reduce that share on a sliding scale until it hits 90 percent in 2020.
• Scaling back a new excise tax on high-end insurance policies so it wouldn’t take effect until 2018. The Senate had wanted it to begin five years sooner. The tax would be applied to most premiums above $10,200 for singles and $27,500 for families.
• Helping families that earn up to about $88,000 annually pay insurance premiums. The new bill would assure that no family that earns less than that pays more than 9.5 percent of its income for health insurance.
Valley Democrats Cardoza and Costa are key to big health care vote
WASHINGTON – With a Capitol Hill showdown only days away, two San Joaquin Valley congressional Democrats remain crucial and undecided votes on a controversial health care bill.
The pressure is building on Reps. Dennis Cardoza of Atwater and Jim Costa of Fresno. In some ways, they hold the bill’s fate in their hands – as well as several political futures: the president’s, the party’s and their own.
The White House has summoned both in recent days. Television ads and Republican talking points target them.
“I have had good friends who have called me in recent weeks, who have made good arguments on both sides,” Cardoza said.
Costa went to the White House on Thursday night. A week ago, it was Cardoza’s turn. As a counterweight, corporate opponents of the health care bill have been running television ads urging viewers to tell Cardoza to vote no. Phone bank operators have been deluging both offices, also urging a no vote.
Inevitably, bargaining over one issue blends into another.
Costa said last week that he used some of his time with President Barack Obama to urge more consideration for the valley’s water and employment needs. Obama said he understood, Costa reported.
In a memo, Republican leaders identified the two Valley lawmakers as among those who would ultimately determine the success or failure of the legislation. They are both part of the Blue Dog coalition, whose members have more moderate voting records than other Democrats.
In November, Cardoza and Costa joined the majority in approving the initial House bill by a 220-215 margin.
Since then, negotiators have revised the package, but the final bill, well over 1,000 pages, isn’t expected to be available for inspection until Monday. The Valley lawmakers say they can’t commit until then.
“We’ve gotten the summaries, but we don’t know what the actual language is going to be yet,” Cardoza said.
Costa, too, stressed that “I want to see the bill in print, what we’re actually voting on,” before making a decision.
Costa and Cardoza both support elements in the health care package, including insurance coverage for those with pre-existing conditions and portability of coverage when employees change jobs. The bill’s final cost remains a potential concern for both.
Both lawmakers oppose federal funding of abortions, though they are leaving to others the details of how to write the necessary legislative language.
Because of congressional vacancies, House Speaker Nancy Pelosi needs 216 votes. No Republican is expected to vote for the health care package, leaving Democrats to pick their own way.
Politically, legislators see danger everywhere.
Failure to pass the bill would invariably brand Obama and congressional Democrats as weak or inept. That would hurt the party in November’s elections. But in conservative-leaning San Joaquin Valley districts, support for Obama and Pelosi could also be costly.
In this environment, even modest clues invite interpretation. Cardoza, for one, seemed to emphasize last week the problems of uninsured San Joaquin Valley residents and the pain of rising insurance costs.
“We have real problems with a lot of my folks not having insurance,” Cardoza said.
An estimated 28 percent of the residents of Costa’s congressional district in Fresno, Kings and Kern counties lack health insurance, according to the Physicians for a National Health Program.
An estimated 22 percent of the residents of Cardoza’s congressional district in San Joaquin, Stanislaus, Merced and Fresno counties are uninsured.
The Valley’s uninsured population is much higher than in other parts of the country.
Cardoza and Costa both cited funding for new medical schools in their votes in November. The original House bill authorized $500 million over five years for new medical schools in underserved areas.
The University of California, Merced, was an unnamed but presumed beneficiary.
The health care package to be considered next week omits the medical school funding.
Instead, Cardoza noted, the Obama administration in its fiscal 2011 budget request is seeking $100 million next year for the same purpose.
Cardoza serves on the leadership-controlled House Rules Committee, which will play a crucial behind-the-scenes role in coming days. The panel sets rules for how bills are put together and debated, and often is lambasted by Republicans for cutting off GOP alternatives.
Congressional action is expected to be concluded by next Sunday.
Moderate Democrats feel the heat on health care bill
WASHINGTON – As a historic vote on sweeping health care legislation nears, Democratic moderates in the House of Representatives face relentless pressure as they juggle personal pleas from President Barack Obama, a multimillion-dollar ad barrage and constituents who are fed up with the convoluted congressional process.
In the spotlight are 39 Democrats who voted against the House’s original health care measure Nov. 7. Democrats hold 253 of the House’s 431 currently filled seats, and 216 votes are needed for passage. The bill won’t pass unless some of those 39 switch their positions.
Democratic leaders hope to vote by this weekend, but they’re finding it difficult to push wavering members off the fence.
“I’ll vote the way my district wants me to vote,” said Rep. Jason Altmire, D-Pa., after hearing from Obama this week. Rep. Adam Smith, D-Wash., emerged from an Obama meeting saying that he remained undecided. Rep. Walt Minnick, D-Idaho, a freshman who was elected in an overwhelmingly Republican district, says he won’t vote for the bill.
Altmire, a second-term congressman, said Obama’s pitch Tuesday was that “the economy will turn around and people will judge the effects of the health care bill in that context.”
Sometimes colleagues apply the heat. Minnick said pressure to fall in line with other Democrats usually came at House caucus meetings, but mostly he was listening to his Idaho constituents.
“That is more the pressure that I tend to pay attention to,” he said. “I try pretty hard to be more responsive to that than I do to arm-twisting from colleagues or leadership here.”
The pressure will only grow. Interest groups on both sides plan to spend at least $10 million on ads.
The National Republican Congressional Committee vowed Tuesday that “any Democrats who might think they can get away with a ‘yes’ vote for the Obama-Pelosi health care bill should brace themselves for an all-out blitz courtesy of the NRCC.”
Also raising concerns about the bill are Employers for a Healthy Economy, a U.S. Chamber of Commerce-led coalition of business groups that plans to spend $4 million to $10 million on a TV ad in 17 states and on national cable. The ad, which will run through Saturday, charges that the bill would mean “billions in new taxes … more mandates on businesses.”
America’s Health Insurance Plans, the industry trade group, is spending a seven-figure amount for a cable TV ad that’s running nationwide.
Pressure is also strong from the other side. Health Care for America Now, a coalition of liberal groups and labor unions, launched a $1.4 million ad buy Tuesday that runs through Friday in 11 swing districts, including Altmire’s. The coalition and like-minded groups plan to spend $11 million overall.
MoveOn.org, another liberal group, plans to spend $300,000 on ads in swing districts in Pennsylvania, North Dakota and New York.
Obama has met with blocs of liberals and members of the Congressional Black and Hispanic caucuses, and had one-on-ones with lawmakers.
Obama is scrambling to push the bill through the House in time to salvage his trip to Guam, Indonesia and Australia, postponed by three days. He’s set to leave Sunday.
White House Chief of Staff Rahm Emanuel, a key enforcer on health care votes, will stay behind, as will Vice President Joe Biden, should his vote be needed to break a Senate tie.
Rival camps ramp up efforts
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Supporters of President Barack Obama’s health care overhaul protest Tuesday outside a hotel in Washington, D.C., where a health insurance industry group was meeting.
WASHINGTON – Thousands of liberal public-option backers and conservative tea partiers launched last-chance campaigns Tuesday in the nation’s capital to persuade Congress to pass – or reject – sweeping health care legislation.
Democratic congressional leaders conceded that they may not have the votes for final passage of the overhaul by March 26, when Congress is to break for spring recess. They’re trying to persuade party moderates and abortion foes to go along. President Barack Obama wants final votes even earlier, before his March 18 departure on an overseas trip. That appears unlikely.
Republicans launched an all-out effort to derail the bill, urging congressional candidates to hold town hall meetings, organize voters over the Internet and denounce any special deals that may be cut to grease Democrats’ votes.
“A vote for this bill opens an entirely new line of attack on House Democrats,” wrote Johnny DeStefano, deputy director of the National Republican Congressional Committee, in a memo to candidates.
The U.S. Chamber of Commerce said it will spend as much as $10 million on a television ad claiming that Obama’s plan will only worsen the bad economy and job market.
And Obama senior adviser David Axelrod, on a conference call Tuesday, told advocates of the legislation, “What happens in the next 10 days will be critical.”
Despite their divergent goals, what these camps share is an acute understanding of what happened last year after Democrats failed to pass the health care overhaul before the monthlong congressional August recess. In the boisterous town hall meetings and small-government tea party protests that followed, all sides learned that delaying a big vote until after a recess buys the opposition time, and that public demonstrations can have an impact on the political process.
“Our intent and our hope is to have no vote take place before recess,” said Mark Skoda, founder of the Memphis Tea Party and a spokesman for the “Take the Town Halls to Washington” campaign that began Tuesday.
The group’s Web site asked volunteers to travel to Washington before the two-week spring recess to lean on 66 Democratic lawmakers in the House of Representatives that they consider to be wavering on Obama’s plan: “We want to let them know there is only one vote their constituents will support: No on Obamacare.”
Organizers plan to videotape the meetings and release them to constituents.
In the pro-legislation camp, thousands of supporters of Obama’s plan – many organized by unions and some dressed in hospital gowns with tubes taped to their faces – protested outside a Washington hotel where a meeting was being held by America’s Health Insurance Plans, the trade group of health insurers.
Ten protesters crossed a police line saying they were there to make citizens’ arrests of insurance officials. Police hauled the 10 away.
At an earlier rally nearby, Howard Dean, the physician, former Vermont governor and 2004 Democratic presidential candidate, declared that Republicans are in the bag for insurance companies. He said the question for wavering Democrats is: “Are you for the insurance companies or the American people?”
Sen. Barbara Boxer, D-Calif., a supporter of the overhaul, said demonstrations do sway congressional votes.
“The more people rally, the more it shows people here they care,” she said. “It adds to the excitement. It tells you people are engaged.”
But Sen. Ben Nelson, D-Neb., a moderate, added that “you have to remember that there are those who are quiet who merit consideration.”
Republicans remain united against the legislation.
Sen. John Thune, R-S.D., said lawmakers who support Obama’s plan will be casting a vote for “higher taxes, Medicare cuts and higher premiums for most Americans. Those core elements and core features of that bill have not changed.”