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Nelson 'not content to sit on sidelines"
Invoking two homestate icons, Sen. Ben Nelson said he was not content to sit on the sidelines and do nothing and risk having a bad bill become law through the reconciliation process with a simple majority.
Nelson spoke with the Gazette Wednesday to explain his vote for a health care reform bill that many of his constituents oppose.
The senator was one of the final hold-outs for the required 60 votes needed to take the bill to a conference committee, where the Senate and House versions will be merged. Like Sen. George W. Norris, he worries that the law that comes out of the conference committees might look nothing like the health care reform bills passed by the two branches of Congress.
"If it is significantly different, then it's going to be very difficult, perhaps even impossible to be supportive of it," said Nelson.
Like a football coach he knows "you've got to play all 11 games" to have a winning season. Winning, in this case, will be enactment of health care reform bill that is too good to let die.
But the law could easily lose his support if it comes back from the conference committees with a "public option of some sort," which would also cost the vote of Independent Connecticut Sen. Joe Lieberman, Nelson told the Gazette.
Other deal-breakers could result if they "start fooling with taxes and come up with a new tax scheme or the House scheme" or the bill comes back without suitable language prohibiting federal funding of abortion.
Unfortunately, he said too many pro-life forces suffer from "pride of authorship" and are unwilling to support measures with language they didn't write but which achieves the same goal, banning federal funding for abortion.
"If they (the conference committee) try to weaken it in any way, I'm not going to be able to support the conference bill."
The so-called "Cornhusker Kickback" was simply a last-minute "marker" added to the legislation in response to state concerns about unfunded federal mandates.
The marker ensures the conference committee deals with increasing Medicaid costs to states, according to Nelson. "Usually you have to have something in one of the versions, the House version or the Senate version, and not bring in something brand new. So we put that in recognizing that we were always going to fix it."
The concession "was not a pot of money" for Nebraska, but a simple delay in implementation of new rules.
The Senate bill does accomplish important things like using free market forces to lower health insurance and allow competition across state lines, strengthens rural hospitals in Nebraska by extending certain funding from one year to five years so they can stay current with technological improvements, and avoids shifting the cost of medical care to private pay insured patients the way a public option would.
Citing a Christmas card from a neighbor in an affluent Omaha neighborhood, Nelson emphasized the importance of eliminating pre-existing condition exclusions from health insurance, a factor in 4,000 medical bankruptcies in Nebraska this past year.
"You're going to eliminate about 15 to 20 percent, at least that, of what your current premium charge is because that pays for uncompensated care," Nelson said. "In addition, there's a great emphasis on preventative care."
Excessive health insurance company profits should be controlled by medical loss ratio requirements that a high level of income must be paid back in benefits.
"If they don't meet that medical loss ratio, then they can't raise their rates. I think we've got it (profits) capped," Nelson said.
Nelson felt that information about Medicare cuts have been misunderstood. "It's a bit of a misnomer. It (the bill) does not cut benefits in Medicare. It reduces the amount that Medicare pays for health providers."
Since hospitals will now have more insured patients and will not be providing uncompensated care, they will take a lower payment for their services.
"I am concerned, and we have to make sure that reducing those payments to providers will not cause providers to stop treating Medicare patients," said Nelson.
"This affects everybody in the United States directly, one way or another ... When you boil it down, there are a lot of benefits and a lot good reasons to do it. It's unfortunate that it's gotten so politically charged and so radioactive, but it has."