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Tuesday, March 22, 2011

Rehberg still working to defund health care


 
Written by
LEDYARD KING 
Tribune Washington Bureau


WASHINGTON — Denny Rehberg has been told that his proposal to defund the sweeping health care law President Barack Obama signed last year would add billions of dollars to the federal deficit and prevent senior citizens from using the Medicare Advantage program. He also was told that it has no chance of getting past the Democrats who run the Senate.

No matter. The Montana Republican and his fellow GOP lawmakers are committed to euthanizing "Obamacare," as Republicans dubbed the law, because they believe it represents an overreaching, unaffordable use of federal power, and because that is what they say the voters elected them to do.

"It's a national problem that needs a national solution," Rehberg said of health care. "We're just trying to reason with the members of the Senate that we believe that this is not going to work out the way they want it to, and I think we have the American public on our side on this."

Wednesday will mark the one-year anniversary of a law officially known as the Patient Protection and Affordable Care Act that continues to consume Congress.

Tea-party backed Republicans, such as Rehberg, see repeal of the act as their No. 1 priority.

Democrats, including Sen. Max Baucus, D-Mont., who helped lead the bill's passage, are fierce in its defense. The law figures to occupy a prominent role in the 2012 race between Rehberg and Sen. Jon Tester, D-Mont., a backer of the law and the man Rehberg hopes to replace.

Last week, Rehberg and 53 other conservative Republicans broke from GOP leadership to oppose a temporary spending bill that avoids a government shutdown — for now — in part because defunding of health care was not part of the package.

Democrats and supporters of health care reform have been aggressive about highlighting recent reports suggesting that even the act of barring the administration from using money this year to carry out the law's gradual implementation poses unintended consequences that will cost money and hurt senior citizens.

The nonpartisan Congressional Budget Office projects defunding would have some initial savings this year, but then add $5.7 billion to the deficit over the next decade, partly because it would postpone efficiencies the law tries to achieve, according to an analysis Rehberg requested. Rehberg said the March 10 analysis is based on faulty assumptions. And even the budget office cautions that the budgetary effects of defunding the law are "highly uncertain and depend largely on how the administration would interpret the legislation."

Supporters often point to the long-term savings the bill is advertised to achieve more than $1 trillion over the next 20 years, according to the budget office, as it expands coverage to Americans. But skeptics such as Rehberg say nobody truly believes that providing coverage to millions of previously uninsured people will do anything but cost taxpayers in the long run.

Rehberg also isn't buying Health and Human Services Secretary Kathleen Sebelius' assertion that defunding would preclude her agency from carrying out certain programs, notably Medicare Advantage, which offers supplemental medical services to about 26,000 senior citizens in Montana. In a March 8 letter to Baucus, who is the Senate Finance Committee chairman, Sebelius said Rehberg's defunding proposal would strip the agency of the authority to pay Medicare Advantage providers, and there would be no way to go back to the former payment method because it was abolished by the new health care law.

"Reasonable people can disagree about elements of the health care reform law, but we can't let politics get in the way of the health department's ability to provide Medicare for seniors," Baucus said Friday.

Rehberg disagrees with Sebelius' conclusion, saying his plan touches only discretionary spending, and therefore shouldn't impact mandatory programs such as Medicare Advantage. He said he believes the assertion is political and meant to scare people into opposing his plan.

"You have to assume that the administration and the Democratically controlled Senate are going to do everything to protect the program that they passed, so they will portray it in the best light they possibly can, whether they fudge the numbers or they use accounting gimmicks or not," Rehberg said. "They are going to defend Obamacare in every way, shape or form."

Jessica Santillo, a spokeswoman for Health and Human Services, said defunding would have a "very negative impact on Medicare beneficiaries."

The law "made numerous improvements to payment formulas for hospitals, physicians and other providers, and created important new benefits for seniors, including an annual wellness visit and waiving cost-sharing for critical preventive services," she said. If defunding went forward, it "would delay payments to providers, delay new benefits for seniors and increase the deficit. These delays and cutbacks would inevitably hurt health care providers and negatively affect beneficiaries' access to care."

Rehberg said he is particularly perplexed over the administration's defense of Medicare Advantage, considering that the health care law will cut tens of billions of dollars from the program.

Opponents of defunding say the law reforms the program and stops huge overpayments to private insurance companies without reducing benefits. Cutting back on payments to insurers is expected to prolong the life of Medicare by at least 12 years, according to an analysis by the Centers for Medicare and Medicaid Services.

Rehberg said he is not an opponent of government health care. Quite the contrary, as he views his fight against the health care reform law as a fight to protect the long-term viability of Medicare, even if it earns him some political bruises.

"I have a responsibility to do the right thing whether it helps or hurts me. That does not matter," he said. "I lay awake thinking about if I don't help try and stop the kinds of changes they're trying to make in health care, I will look back some day and have to look my children in the eye and say, 'I'm so sorry for what we did in 2011 or we did in 2012 to affect your health care."'

Doing Nothing

The most interesting thing about the UN Security Council's Resolution 1973 is that it was passed at all. Both Russia and China have said explicitly that they do not support any kind of intervention in Libya, and each could have vetoed, and thus killed, the no-fly zone. But they didn't. Instead, they joined 3 others (Brazil, India and Germany) in abstaining, and the measure passed. But neither the resolution, nor the cease-fire declared by the Libyan government, will do much for the fortunes of the rebels, and they are the big losers in this sharp-elbows international battle.
Much of the world's media have been tracking the fast-moving events in Libya for many weeks. So powerful was the story that it could be displaced only by the catastrophe in Japan. But while the tsunami took its toll and nuclear reactors began to explode, Qaddafi's* forces have been systematically routing the rebels. Lacking supplies, training and coherent leadership, the rebels have been driven far to the east and out of the cities they had captured weeks ago.
The assumption has been that the margin of difference is air power, that were it not for Qaddafi's attack aircraft the rebels would win. But the rebels' other weaknesses will not be addressed merely by slowing or even stopping the government's pressure on them, and it will be very interesting to see if the rebels' battlefield situation improves during this cease-fire. It probably won't. Confined to a relatively small area, they may become something of a rump Eastern Libya under UN protection, but it now seems unlikely that they will prevail in the near term.
Since the rebellion began, the prevailing sentiment has been on the side of the rebels, but it was not translated into any action to assist them. As sympathetic as the United States government has been, it has also been reluctant to project any power in Lybia. Indeed, both Secretary Gates and Admiral Mullen have spoken derisively about the ease with which many think a no-fly zone can be established and maintained, and General Mattis, the boss of Central Command, has been an even more outspoken opponent of using American assets in Libya.
We and our allies certainly have the resources to attack many selected targets, including airfields, formations of troops, rocket launchers and artillery. And in any case the establishment of any restrictive zone of operations must include the suppression of anti-aircraft sites. Most of this can be accomplished from the sea and air, using remotely piloted vehicles and precision-guided munitions. It is almost guaranteed that there will be some combat involving allied resources.
But the arrangement as it is now---a relatively small number of rebels cornered in a confined area---is more stable that the one several weeks ago, and, ironically, it is preferred by most of the parties parties. Russia and China are satisfied that there will be no allied ground involvement; Qaddafi has the upper hand militarily; and the governments involved in enforcing Resolution 1973 look like they are taking positive and meaningful action. But since none of this could have occurred without the passage of weeks, while the allies dickered and dithered and Qaddafi pounded the hell out of his adversaries, it all came at the expense of the rebels. For some, time doesn't heal all wounds---it causes them.
*There are numerous English transliterations of his name. He pronounces it "Kadaffi." In many dialects, it is "Qaddafi." In classic Arabic, it is "al-Gazzafi," which means something like "the driving force" or "the motivator."

Walker gives himself more power to fill high state jobs

Move extends trend; critics argue it politicizes posts

March 17, 2011
Madison — Gov. Scott Walker will be able to name political appointees to fill three dozen civil-service jobs that handle open records requests from the public under the budget-repair law he signed last week.
The changes affecting 15 state agencies and offices are among the provisions of the law that drew less attention over the past month because of the epic fight over its provisions stripping public employee unions of most of their bargaining power.
Walker's separate 2011-'13 budget proposal would also make a political appointment out of another key civil service job - the top lawyer spot at the agency overseeing state labor law.
Jay Heck, executive director of the Wisconsin affiliate of the liberal group Common Cause, said the change to political appointments didn't save the state any money and shouldn't have been included in the budget-repair bill. The measure continued a process - begun under previous Republican and Democratic governors - to exert political influence over more public jobs, said Heck, whose group advocates for taxpayer funding of political campaigns and openness in government.
Heck said political appointees may be more interested in fulfilling the letter of the law in open records cases than the spirit.
"I don't think there's any question that a political appointee, their inclination is going to be more toward protecting their boss than complying with an open records request," Heck said.
Dane County officials - County Executive Kathleen Falk and District Attorney Ismael Ozanne, both Democrats - have filed separate court actions seeking to block the law from being published on March 25 and taking effect the following day. Hearings in those cases are scheduled for Friday, and a ruling is expected from Dane County Circuit Judge Maryann Sumi on whether to issue a temporary restraining order to block the law from being published.
The law would make existing civil-service positions into 37 new political appointments, including 14 general counsels, 14 communications positions in state agencies and other positions, including legislative liaisons doing lobbying for agencies. That would allow Walker and agency secretaries to hire and fire employees in those positions at will.
Walker spokesman Cullen Werwie said that made sense because workers in those jobs represent Walker as part of their work.
"These positions, by their very nature, represent the governor and the administration to legislators, members of the media and other members of the general public. It is reasonable to have them appointed," Werwie said.
Most of the positions have at least some duties providing information to the public. For instance, the general counsels serve as their agencies' top lawyers and handle requests under the state's open records law as well as a host of other issues, from advising agency secretaries to personnel matters.

Political considerations

"I think it's important that agencies have public spokespeople who feel a sense of responsibility to the public and the public's right to know. Anything that erodes that is bad for Wisconsin," said Bill Lueders, president of the Wisconsin Freedom of Information Council.
Lueders is the news editor of Isthmus, which along with The Associated Press sued Walker on March 4 to win the speedy release of e-mails sent to Walker by the public commenting on the budget-repair law. Walker's office agreed Wednesday to release the records and pay attorney's fees but admitted no fault.
Under the law, the civil-service jobs would be classed as division administrator jobs, a kind of political appointment, and would increase that class of political appointments in the affected agencies by about 50%, according to the nonpartisan Legislative Fiscal Bureau.
Republicans argue that those civil service positions have already been politicized because some Democrats and former aides to Gov. Jim Doyle now occupy them, including former spokesmen for Doyle such as Carla Vigue and Lee Sensenbrenner. Democrats say those positions were awarded through a competitive process.
Rep. Robin Vos (R-Rochester), the co-chairman of the Legislature's budget committee, said that he thought that a governor and agency secretaries are entitled to have legal and public relations staff that share their vision.
"You want somebody on the same page," Vos said.
In the past, general counsels have faced political pressure over issues such as open records.
Jim Thiel was general counsel at the Department of Transportation for 31 years but was moved into a staff attorney job in 2004 after angering then-Secretary Frank Busalacchi - a Doyle appointee - over the release of department records under the open records law. Thiel filed and lost a complaint with the Wisconsin Employment Relations Commission saying he was unfairly demoted under the civil service system.
"My opinion frankly is that it would be better if they were not (politically) appointed," Thiel said of general counsel jobs.
But the move toward political appointments could be good for Thiel personally.
Thiel said he filed paperwork last week to retire. But then on Friday Bob Jambois - the general counsel who replaced Thiel - stepped down from his job. Secretary Mark Gottlieb then asked Thiel to take over as chief counsel, at least for the interim, according to Thiel. Thiel said he may also be considered for the job permanently once the job is converted to a political appointment.

Value in move seen

Meanwhile, the departing Jambois said political appointments are a good idea despite his own decision.
Jambois, who served as the Democratic district attorney in Kenosha County for more than 17 years, said he retired both because he was told he wouldn't be appointed and because he "couldn't stomach" some of Walker's policies.
"I have to say that I'm not opposed to the idea of the general counsel being appointed. I felt it was my job to assist the secretary to implement the policies of the governor of the state," Jambois said.
Jambois noted that Doyle had also sought unsuccessfully in the 2009-'11 budget bill to make the general counsel positions at certain major agencies a political appointment. As the top DOT lawyer, the general counsel works on everything from open records requests to the acquisition of private property for highways through eminent domain to cases involving the State Patrol, he said.
"Pretty much everything that DOT does goes through the general counsel's office," Jambois said.
Jambois said he did see one state agency where the general counsel should be insulated from politics - the top legal job at the Wisconsin Employment Relations Commission. That agency, headed up by three commissioners appointed by the governor to staggered six-year terms, handles union bargaining disputes and oversees state labor laws - the focus of most of the controversy over Walker's recently passed legislation.
Walker's 2011-'13 budget bill would also make the agency's general counsel, now a civil-service position, into a political appointment.
"That is one that absolutely should be a civil-service position," Jambois said. "The WERC has to stand up to the governor on occasion, and the general counsel has had to stand up to the commission on occasion."
At least one other position in state government, a legislative liaison at the Department of Workforce Development, would be made into a political appointment as well.
Peter Davis has held the WERC's civil-service general counsel position for three decades. He said he would be able to retire or bump into another civil-service job and wasn't concerned for himself.
But "clearly I think it's a bad policy judgment to politicize an agency in that way," Davis said.
Judy Neumann, who was appointed chairwoman of the commission by Doyle, said the general counsel deals with both labor and management groups with often conflicting interests. She said it was important for the general counsel to be seen as fair and unconcerned about whether his advice would lead to his dismissal.
"It's bound to affect the soundness and the reliability of the advice," Neumann said of the proposed move.

#Wisconsin in Peeps, Walker in power

It turns out that Wisconsin Governor Scott Walker's budget repair bill, now law, allows him to appoint whomever he wishes to 37 posts handling open records requests -- jobs that used to be plain old civil-service gigs. The Milwaukee Journal-Sentinel also reports that Mr. Walker now gets to make the top attorney job for state labor law his own political appointment, even though that agency sometimes has to face down the governor.
What's that got to do with repairing the budget? Maybe not much. It would seem to have much more to do with power, namely Mr. Walker's. "I don't think there's any question that a political appointee, their inclination is going to be more toward protecting their boss than complying with an open records request," says Jay Heck of the local Common Cause affiliate.