Cornyn Watch, Update: Senator Cornhole Changes To The Other Side On Medicare

But the question is, will he change back?

Sen. John Cornyn, R-Texas, was one of several Republican senators who finally decided to vote against the Bush administration's Medicare cuts Wednesday, when the Senate cast another vote on the bill. Could it be that Senator Cornhole has carefully considered the ramifications for his re-election campaign?

Both Cornyn and Sen. Kay Bailey Hutchison, R-Texas, were among the 40 who earlier kept the Senate from reaching the 60 votes to invoke cloture the last time this bill came to a Senate vote. It was 58 for, 40 against. This time, enough of the GOPhers switched to make it 69-30, seemingly a veto-proof majority for H.R 6331, the Medicare Improvement for Patients and Providers Act of 2008.

But what if Il Doofus comes through with the anticipated veto? Will Senator Cornhole, or for that matter, 1962 edition UT cheerleader Kay Bailey (H), stick with the majority, or cave? (Cue in cheesy organ music.)

This may be interesting to watch. As mentioned on this blog before, Cornyn has a very credible challenger in his bid for a second Senate term. State Rep. Rick Noriega, D-Houston, trails by only single digits in most Texas polls -- pretty good for a Texas Democrat in recent years.

"Go Team" Kay has a rep for being almost a "moderate" Republican by contemporary standards, so her switch in time wasn't shocking. Senator Cornhole has been a more of a reliable water boy for Il Doofus' team, so that switch actually surprised me a bit. But of course, he wants a second term. And when the Texas Medical Association withdrew an endorsement of him after the first vote, that probably made an impression.

Let's see what he does when this comes to brass tacks. But no matter what Cornhole does, if I were Rick Noriega, I wouldn't let the old people or the medical establishment of this state forget about that first vote. Stay tuned.

Postscript: Sen. John McCain, R-Ariz., the presumptive Republican presidential nominee, was absent for this vote.

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The AARP is going to roll over the republicans like a Mack truck this fall

In what has to be absolutely the most utterly stupid political move of the modern era, the Senate republicans have used their penchant for obstructionism and obstreperation to cut Medicare payments to physicians. (It passed the House in a bipartisan landslide.) I first posted about this a week ago, and at that time I said "I'll be keeping an eye on the AARP website after the recess. If they get in on the act and start calling out Senators by name, Katy bar the door."

Well, they didn't even wait until Congress is back next week. The AARP has already taken after Arlen Specter.

"We are deeply troubled that Senator Specter voted to block a bill with bipartisan support that would have preserved patients’ access to their doctors and improved Medicare for the 44 million Americans who depend o­n it,” said Estella Hyde, AARP Pennsylvania State President. “For the sake of older Americans, people with disabilities and military families, we urge Senator Specter to listen to his constituents and reconsider his vote when the bill comes up again after the congressional recess.”

In addition to preventing a 10 percent cut to payments to doctors, the Medicare bill would have: helped keep premiums fair; strengthened protections for lower income beneficiaries; improved Medicare’s coverage of preventive services, and made Medicare more efficient through electronic prescribing. The Senate is currently scheduled to reconsider H.R. 6331 immediately following the July 4th recess.

“Because of this vote, the Senate went home for July 4th recess leaving care for our nation’s seniors, disabled individuals, and military families hanging in the balance,” said Peter Lund, M.D., president of the Pennsylvania Medical Society. “We call o­n Senator Specter to reconsider his vote and return to Washington to do what’s right – vote to ensure patient access to care and improve health security for 44 million Americans.”

Throughout the debate o­n Medicare legislation, AARP, AMA, and the Pennsylvania Medical Society have engaged their members in the fight to keep Medicare fair and protect access to doctors.

Hundreds of thousands of AARP supporters, including 36,826 in Pennsylvania, called and emailed Congress, signed petitions, wrote letters to their local papers, and participated in Keep Medicare Fair events around the country over the last several weeks.

In addition, more than 41,000 patients and physicians called Congress in June through the AMA grassroots hotline, and the AMA is airing new radio and television ads that urge opponents of H.R. 6331 to put patients’ access to care before insurance profits by voting for the bill as soon as they return to Washington from their holiday recess.

Now I am not one to look a gift horse in the mouth - and the republicans have delivered us a fine filly with this latest bit of wingnutty goodness. But how unbelievably out of touch are the Senate republicans that they would pull this stunt?

At least the Democrats don't seem to be pissing away this opportunity. Dick Durbin went on the attack today, using a national radio address to call out republicans for failing to back the bill to stave off the Medicare cuts. "It's time for the Republican senators who are filibustering this measure to put our seniors and our military families ahead of private insurance companies and let the Senate pass this bill as soon as possible," Durbin said.

The current occupant and the obstructionist pricks on the right side of the aisle in the upper chamber don't like the bill because it includes offsetting cuts to insurance companies that use Medicare money to offer private health care coverage to about 20 percent of seniors.

I find the whole spectacle surreal. I am loving the show, but that doesn't mean I understand thing one about the thinking that went into this idiotic move.

Seniors vote. They never miss a chance to cast a ballot. They are also more likely to live on a fixed income and to rely on "safety net" programs, so the prices of food and fuel have already taken a toll on Seniors and affected the chances of Seniors voting for republicans in November. The same costs that are squeezing the budgets of Seniors are squeezing the estimated 20,000 senior nutrition programs across the country that serve millions of elderly and frail Americans. Most needs are still being met, but advocates for the elderly and the disabled are worried that the ability to continue meeting those needs is in peril, and Seniors could end up going hungry. The worries are compounded by spiraling prices coupled with the flat funding, and donations are off thanks to an ailing economy.

"All of that is generating a lot of anxiety," said Bob Anderson, associate director of the Metropolitan Area Agency on Aging in Minneapolis-St. Paul.

Across the country, nearly 60 percent of the estimated 5,000 programs that belong to the Meals on Wheels Association of America have lost volunteers who can't afford gas, said Enid A. Borden, president and CEO of the program that has been providing meals to Americans in need since 1954.

Nearly half the programs have eliminated routes or consolidated meal services. Some 38 percent have switched to delivering frozen rather than hot meals, while about 30 percent are cutting personal visits from five days a week to one.

"We're in a crisis and it's just getting worse and worse," said Borden, who is urging Congress to increase money for senior nutrition programs by at least 10 percent.

Two pending bills don't come close to that amount, said Peggy Ingraham, the association's senior vice president for public policy. A House subcommittee is considering a 6.5 percent increase for senior nutrition programs for the fiscal year that begins Oct. 1, while a Senate subcommittee is considering a 5.7 percent increase. The federal earmark for the current fiscal year is $758 million.

Cuts are already inevitable in New York City, said Marcia Stein, executive director of Citymeals on Wheels, where meetings are under way this week to work out details such as who will no longer receive meals.

"We have no choice," she said. "It's like trying to take a size 10 foot and putting it into a size 7 shoe."

Meals on Wheels volunteers have already started dropping out of the program, unable to afford the gasoline to deliver the hot meals to the seniors they serve. Other agencies have altered routes and schedules and changed the way they deliver the necessary nutrition and transportation services that allow seniors to stay in their own homes.

And all of this is going to impact how the demographic with the highest turnout of all votes this fall. Mitch McConnell, you magnificent bastard, don't you never die...

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Cornyn Watch: Losing The Doctors AND Older People Could Prove Terminal For The Senator

There are two constituencies that right-wing Republicans have generally been able to count on in Texas: doctors and other medical professionals, and people 65 and older. This election year, most of the Republicans in the U.S. Senate, including Texas Sen. John Cornyn, have managed to royally piss off both groups.

This is not unimportant for Cornyn, who is facing surprising opposition in his bid for a second term in the Senate. State Rep. Rick Noriega, D-Houston, trails Cornyn, but only by single digits in most polls. He's within striking distance of Cornyn.

You Texans out there: Our glorious senator was one of 40 who kept the Senate from reaching the 60 votes needed Thursday night to invoke cloture and end Republican obstruction of a bill to avert the Bush administration's 10.6% cut in Medicare payments, set to go into effect today. (Sen. Barack Obama showed up and was one of 58 who voted yes; Sen. John McCain was one of two senators who did not vote.)

This bill, to forestall the cuts by 18 months, had passed in the House by a vote of 355-59. Only the most kook-right Republicans there opposed it. But just enough Senate Republicans caved in to the most loathed administration in U.S. history to kill what could have been an easy veto override.

In response, the political committee of the Texas Medical Association has rescinded its support of Cornyn for re-election to the Senate. ("Senator Noriega." I like the sound of it.)

The San Antonio Express-News reported Friday:

Medical association officials said the cut, which is set to take effect July 1, will force them to choose between their finances and their elderly patients.

Cornyn said he voted against the measure because it was a partisan ploy and "election year grandstanding" by Democrats rather than a real effort to solve the problem.

The physicians group began the day criticizing both Cornyn and senior U.S. Sen. Kay Bailey Hutchison for their votes against the bill on Thursday. Association President Dr. Josie R. Williams of Paris said they "chose to protect insurance companies profits instead of protecting our patients’ health."

By the end of the day, the association’s political committee, TEXPAC, had withdrawn its backing of Cornyn, saying its board was "outraged."

"That (planned Medicare cut) will force physicians into an impossible choice: face financial crisis by continuing to see their Medicare patients or protect their practice and cut off those patients," the political committee’s chairman, Dr. Manuel Acosta of El Paso, wrote to Cornyn in a letter made public by the association.

"We expect our elected officials to show leadership and do the right thing," Acosta said. "Absent that, TEXPAC has rescinded our endorsement of your candidacy."

Noriega didn't pick up an endorsement, but the challenger's campaign had a rapid response. The Express-News again:

"Cornyn has failed Texas families again and again - from rejecting health care for children to medicare votes that prioritize big insurance companies over doctors and seniors, to cutting veterans’ benefits and health services," said Noriega spokeswoman Holly Shulman. "Texans are ready for a change from a senator that continues to choose to vote with special interests instead of Texas families."

The Bush administration had threatened a veto because the bill included payment reductions to Medicare Advantage, which some senior citizens use as a private, fee-for-service alternative. Yep -- somebody's profits were being affected. For the Bush administration, it's business as usual.

But in this state, as in others, medical professionals and senior citizens are two groups that show up on Election Day. They also sign checks. Both of our GOP mannequin senators -- Kay Bailey Hutchison also voted no -- may live to regret this vote. But in an election year in which Cornyn is no shoo-in according to the polls, it could cost him everything politically.

Postscript: This is also one vote McCain may wish he hadn't missed.

P.S. II: Go here for Blue Girl's take on this.

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I hope the republicans aren't counting on the "senior vote" in November

Because if they are, I think they are going to come up short and be left bewildered at the outcome. I mean really...How stupid does a politician have to be to mess with Medicare in a tough election year? Somewhere north of "stupid" and well into "hubris" is where I would place the peg.

Trust me when I tell you that this will get noticed by a group of voters who never pass up a chance to cast a ballot. And here is something else you can take to the bank - people in that age group listen to their doctors.


They are not like us. They respect the white coat, and the AMA. So when the AMA blasts the Senate and singles out the republican party by name, the republican party just bought a heap of trouble that they can ill afford with the senior vote.

"The physicians of America are outraged that a group of Republican senators followed the direction of the Bush Administration and voted to protect health insurance companies at the expense of America’s seniors, disabled and military families.

"These senators leave for their 4th of July picnics knowing that the most vulnerable Americans are at risk because of the Senate's inability to act to stop drastic payment cuts for health care services that are needed by our Medicare and TRICARE patients.

"The House voted to preserve access to care for Medicare patients in a bipartisan landslide vote to pass H.R. 6331 by an overwhelming margin of 355 to 59. The House made seniors, the disabled and military families a top priority. The AMA appreciates the courage of the 59 Senators, including 9 Republicans, who voted to put patients ahead of partisan politics and vote for H.R. 6331.

"Today, thanks to some senators, we stand at the brink of a Medicare meltdown. On July 1 – just four days from now – the government will slash Medicare physician payments by 10.6 percent, forcing many physicians to make the difficult choice to limit the number of Medicare patients in their practices.

"The Senate must return from their recess and make seniors’ health care their top priority. For doctors, this is not a partisan issue - it's a patient access issue."

If this is not dealt with immediately after the recess, we just got within striking distance of 60 votes in the Senate. If I learned one thing in my years of healthcare and dealing with seniors, it is that you don't fuck with them. You don't fuck with Social Security and you sure as hell don't fuck with Medicare. They are truly the "third rail" of American politics.

If the Medicare provider reimbursement cuts take effect, the calls will go out within hours. Doctors will cancel patient appointments and those seniors will be calling their senators office and raising hell the minute they hang up the phone. There will be blue-haired ladies outside local senate offices with picket signs in hundred degree heat, and they will be all over the local news within 72 hours. It will be a continuous loop and every Democrat running for office, from president on down to dogcatcher, will be using it in campaign ads.

The hubris these republican senators display in this instance is breathtaking. The doctors who take Medicare and TRICARE are already getting reimbursed less for seeing us than they would if we were privately insured. In fact, before these cuts went into effect I was shunted into the public health system for my orthopedic care. I used to have an orthopedic surgeon who had an office full of autographed pictures of professional athletes gushing their thanks for his carpentry skills. Today, I got my injections from a resident at Truman. I'm a healthcare pro myself, and I had to practice on patients, too, and in my professional capacity, I have had a hand in training a lot of eventual nurses, doctors and laboratory sciences types. I'm not bitching about the quality of my care, in fact I am impressed with Truman since getting bumped to them at the first of the year. Hell, I'm grateful to have any care at all, when millions don't. I'm just illustrating the point that I used to have my pick of any doc I wanted, that was one of the perks of service. Now, fuggedaboudit.

Anyway, all that aside, it is my considered and professional opinion that this is going to take a huge bite out of some republican asses, and it couldn't happen to a more deserving bunch. I'll be keeping an eye on the AARP website after the recess. If they get in on the act and start calling out Senators by name, Katy bar the door.

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New EEOC rule might cost many retirees their health benefits

I predict that we are going to hear a lot of howling from retiree quarters when the inevitable letters start landing in mailboxes that inform retirees that their health bennies are being cut.

The Equal Employment Opportunity Commission said Wednesday that employers could reduce or eliminate health benefits for retirees when they turn 65 and become eligible for Medicare.

The policy, set forth in a new regulation, allows employers to establish two classes of retirees, with more comprehensive benefits for those under 65 and more limited benefits — or none at all — for those older.

More than 10 million retirees rely on employer-sponsored health plans as a primary source of coverage or as a supplement to Medicare, and Naomi C. Earp, the commission’s chairwoman, said, “This rule will help employers continue to voluntarily provide and maintain these critically important health benefits.”

Premiums for employer-sponsored health insurance rose an average of 6.1 percent this year and have increased 78 percent since 2001, according to surveys by the Kaiser Family Foundation. Because of the rising cost of health care and the increased life expectancy of workers, the commission said, many employers refuse to provide retiree health benefits or even to negotiate on the issue.

In general, the commission observed, employers are not required by federal law to provide health benefits to either active or retired workers.

The new regulation was published Wednesday in the Federal Register. The EEOC was quick to get it on the record that the new regulation is not intended to “encourage employers to eliminate any retiree health benefits they may currently provide.” (Even though everyone with more than three functioning neural synapses knows that will be the net effect, and it will occur in short order.)

[Keep reading...]

An EEOC lawyer, Dianna B. Johnston, said that many employers and labor unions had reported to the commission that if they were required to provide identical health benefits for retirees over 65 (those eligible for Medicare) and those under, they would simply drop coverage for both groups, because the cost of health care is prohibitively expensive. The new rule will allow employers to, at their own discretion, provide retiree health benefits “only to those retirees who are not yet eligible for Medicare.” After age 65, retiree health benefits can be “altered, reduced or eliminated” when retirees become eligible for Medicare.

Employers will also be able to reduce or eliminate entirely health benefits for spouses or dependents of retirees over 65, regardless of whether the retiree benefits are changed. (Many of whom do not have their own coverage, especially housewives and part-time workers.)

The AARP attacked immediately. “This rule gives employers free rein to use age as a basis for reducing or eliminating health care benefits for retirees 65 and older,” said Christopher G. Mackaronis, a lawyer for the organization. “Ten million people could be affected — adversely affected — by the rule.” He also asserted that the new rule was a direct violation of the Age Discrimination in Employment Act of 1967.

It is a given that people over 65 consume more medical services than those under 65, and it is common knowledge that Medicare is available for all U.S. citizens 65 years of age and older. For several years employers have been trying to reduce benefits or shift some of the burden to the retirees themselves. The Medicare Part D drug benefit (donut hole and all) provides the cover necessary to make the change.

President of the American Benefits Council, James Klein, asserts that the new regulation is "a victory for common sense and for retirees. Retiree health coverage has been declining for many years. Without this rule, many more retirees, especially early retirees, could find themselves without employer-sponsored coverage.”

I appreciate the arguments being made - and I understand acutely the difficulties of the health care delivery system - I'm one of those youthful retirees, and I retired from a health care career - But I am not so sure that anyone affected is going to be convinced that it is a "victory for common sense and retirees. "

Come on! Seriously! If this wasn't a classic case of pissin' on my leg and tellin' me it was raining, do you really believe the announcement would be made the day after Christmas, in the midst of the slowest news week of the year? Because if you do, contact me immediately about this bridge I have for sale...

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Dems Want Gov't. to Negotiate Lower Drug Prices

The House will vote Friday on a Democratic plan to require the government to negotiate for lower Medicare drug prices. The proposal is a response to the Republican/drug company created Medicare prescription drug program. That program included a provision barring the government from negotiating with the drug companies for lower prices.

Democrats opposed the legislation and now have a chance to rewrite the law. Party leaders say this is only a minor alteration, but Rep. Charles B. Rangel (D-N.Y.), chairman of the House Ways and Means Committee, says it is a first step.

According to the Washington Post:

The House proposal would require the government to negotiate with the pharmaceutical industry for lower prices on behalf of the private insurers that run the drug benefit program. The impact on prices could be small, however, since the government does not buy drugs directly for Medicare and manufacturers could ignore federal pressure to lower prices without consequence.

The Bush administration has long opposed the idea of direct government negotiation with drug companies for Medicare, asserting that it would impede competition among the private drug plans. Mike Leavitt, the secretary of health and human services, has said he does not want to implement such a measure.

The bill leaves intact three provisions of the 2003 law that industry analysts agree played a more direct role in boosting pharmaceutical profits. These include a controversial ban on the importation of cheaper medicines from Canada, a provision that forces roughly 7 million Medicaid patients to buy drugs that are not subject to price limitations, and provisions requiring private insurance plans to remain small and numerous, which dilutes their leverage in price negotiations with drugmakers.

Rep. Marion Berry (D-Ark.), a registered pharmacist, lined up more than 170 House Democrats last year to support a Medicare-run drug plan meant to force sharply lower prices, and he said the House leadership considered seeking it now but set it aside. "It was primarily a judgment call from the speaker, to keep everybody on board," Berry said. Pelosi aides confirmed the account.

The nonpartisan Center for Responsive Politics says drug companies spent more on lobbying than any other industry between 1998 and 2005 -- $900 million. They donated a total of $89.9 million in the same period to federal candidates and party committees, nearly three-quarters of it to Republicans.

Keep an eye on Rep. John Conyers Jr. (D-Mich.), the new chairman of the House Judiciary Committee, who received $8,500 during the 2006 election cycle from the political action committee of the drug company Amgen.

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