Where The Rubber Meets The Road (12/11/09)

As reported in last Sunday's Philadelphia Inquirer, here is how Philadelphia-area members of Congress were recorded on major roll-call votes last week.

House

Estate taxes. Voting 225-200, the House passed a bill (HR 4154) to permanently extend the estate tax at a top rate of 45 percent and with provisions to limit it to individual estates above $3.5 million and joint estates above $7 million. Initially, the bill would exclude more than 99 percent of estates from taxation, including nearly all family-owned small businesses and farms. But that figure would gradually diminish because the exemption levels are not indexed for inflation. The bill's cost of nearly $237 billion over 10 years would be added to the national debt.

A yes vote was to pass the bill.

Voting yes: John Adler (D., N.J.), Robert E. Andrews (D., N.J.), Robert A. Brady (D., Pa.), Chaka Fattah (D., Pa.), Tim Holden (D., Pa.), Patrick Murphy (D., Pa.), Allyson Y. Schwartz (D., Pa.), and Joe Sestak (D., Pa.).

Voting no: Michael N. Castle (R., Del.), Charles W. Dent (R., Pa.), Jim Gerlach (R., Pa.), Frank A. LoBiondo (R., N.J.), Joseph R. Pitts (R., Pa.), and Christopher H. Smith (R., N.J.).

I have to admit that I’m confused by that last sentence; how on earth can reinstituting a tax add to the national debt?

According to this document, though, a total of $237 billion in net interest payments was added on the national debt in 2007 as a result of the wars and Repug tax cuts. I don’t know if one $237 billion figure is related to the other one here (and the figure above is a “cut and paste” mistake from the ’07 figure), but I’m just wondering about that, that’s all.

And of course, we have the predictable party line BS on display here from the Repugs, as usual.

GOP estate-tax plan. Voting 187-233, the House defeated a GOP motion to HR 4154 (above) that sought to eliminate the estate tax in 2010 and 2011, but allow it to return in 2012. Republicans settled for this approach after the Democrats' deficit rules blocked their bid for a permanent repeal of the estate tax.

A yes vote backed the GOP motion.

Voting yes: Adler, Castle, Dent, Gerlach, LoBiondo, Pitts, and Smith.

Voting no: Andrews, Brady, Fattah, Holden, Murphy, Schwartz, and Sestak.

So Adler votes for both the correct thing in reinstituting the estate tax and the highly questionable Repug alternative?

I’m sure Jon Runyan will have fun beating up Adler over that one.

Senate

Medicare cost controls. Voting 42-58, the Senate refused to strip a pending health-care bill (HR 3590) of its nearly $500 billion slowdown in Medicare spending growth over 10 years. The proposed fiscal controls would help pay the $848 billion cost of the bill while imposing long-term structural changes and securing the Medicare trust fund. Although the cuts target waste rather than benefits, critics say they could lead to a rationing of care. By category, the two largest reductions would lower subsidies of private Medicare Advantage policies by $118 billion and reduce payments to hospitals by $105 billion.

A yes vote opposed the bill's Medicare cuts.

Voting no: Thomas Carper (D., Del.), Bob Casey (D., Pa.), Ted Kaufman (D., Del.), Frank Lautenberg (D., N.J.), Robert Menendez (D., N.J.), and Arlen Specter (D., Pa.).

(Boy, between the “rationing of care” remark above and the $237 billion thing earlier, I would say there’s a lot of editorializing in these writeups this week.)

Anything to put Medicare Advantage on the road to extinction is a good thing in my book; as noted here…

Advantage plans have not lived up to expectations. Advantage insurers charge the government more money, not less, requiring a taxpayer subsidy that averages 14 percent more per-patient on top of what traditional Medicare pays providers. That's an extra $1,138 per Advantage enrollee nationwide, or $1,166 for those in Ohio, according to a George Washington University analysis.

Medicare Advantage plans also tend to limit the doctors that seniors can see, just as traditional insurers do.

The U.S. Government Accountability Office has noted that many Advantage seniors wind up paying high co-payments when hospitalized…

So, I assume that those senators who voted No here favored the Medicare Advantage cut, then.

My compliments.

Women's health screening. The Senate voted, 61-39, to make women's medical screenings more affordable under HR 3590 (above). The amendment sought to eliminate or reduce copayments and deductibles that the bill's "essential benefits package" sets for screenings to detect breast, cervical, colorectal, and ovarian cancer; diabetes; heart and vascular ailments; and other diseases that take a high toll on women.

A yes vote backed the amendment.

Voting yes: Carper, Casey, Kaufman, Lautenberg, Menendez, and Specter.

Again, a good thing, but I just can’t help but wonder how much lowering the co-payments without offsetting cost somewhere else will drive up the price tag on this thing, though that’s a secondary consideration IMHO (and no, I won’t use this as an excuse to rail about the public option again, though I’d like to).

This week, the House took up a bill to regulate financial institutions, while the Senate continued to debate health care (this is a recording).