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The $100 Million Health Care Vote?

November 19, 2009 3:03 PM

Karl 2 ABC News' Jonathan Karl reports:

What does it take to get a wavering senator to vote for health care reform?

Here’s a case study.

On page 432 of the Reid bill, there is a section increasing federal Medicaid subsidies for “certain states recovering from a major disaster.” 

The section spends two pages defining which “states” would qualify, saying, among other things, that it would be states that “during the preceding 7 fiscal years” have been declared a “major disaster area.” 

I am told the section applies to exactly one state:  Louisiana, the home of moderate Democrat Mary Landrieu, who has been playing hard to get on the health care bill.

In other words, the bill spends two pages describing would could be written with a single world:  Louisiana.  (This may also help explain why the bill is long.)

Senator Harry Reid, who drafted the bill, cannot pass it without the support of Louisiana’s Mary Landrieu.

How much does it cost?  According to the Congressional Budget Office: $100 million.

Here’s the incredibly complicated language: 

SEC. 2006. SPECIAL ADJUSTMENT TO FMAP DETERMINATION FOR CERTAIN STATES RECOVERING FROM A MAJOR DISASTER.

Section 1905 of the Social Security Act (42 U.S.C. 1396d), as amended by sections 2001(a)(3) and
2001(b)(2), is amended— (1) in subsection (b), in the first sentence, by striking ‘‘subsection (y)’’ and inserting ‘‘subsections (y) and (aa)’’; and (2) by adding at the end the following new subsection:

‘‘(aa)(1) Notwithstanding subsection (b), beginning January 1, 2011, the Federal medical assistance percentage for a fiscal year for a disaster-recovery FMAP adjustment State shall be equal to the following:
‘(A) In the case of the first fiscal year (or part of a fiscal year) for which this subsection applies to the State, the Federal medical assistance percentage determined for the fiscal year without regard to this subsection and subsection (y), increased by 50 percent of the number of percentage points by which the Federal medical assistance percentage determined for the State for the fiscal year without regard to this subsection and subsection (y), is less than the Federal medical assistance percentage determined for the State for the preceding fiscal year after the application of only subsection (a) of section 5001 of Public Law 111–5 (if applicable to the preceding fiscal year) and without regard to this subsection, subsection (y), and subsections (b) and (c) of section 5001 of Public Law 111–5.

‘‘(B) In the case of the second or any succeeding fiscal year for which this subsection applies to the State, the Federal medical assistance percentage determined for the preceding fiscal year under this subsection for the State, increased by 25 percent of the number of percentage points by which the Federal medical assistance percentage determined for the State for the fiscal year without regard to this subsection and subsection (y), is less than the Federal medical assistance percentage determined for the State for the preceding fiscal year under this subsection.

‘‘(2) In this subsection, the term ‘disaster-recovery FMAP adjustment State’ means a State that is one of
the 50 States or the District of Columbia, for which, at any time during the preceding 7 fiscal years, the President has declared a major disaster under section 401 of the Robert T. Stafford Disaster Relief and Emergency Assistance Act and determined as a result of such disaster that every county or parish in the State warrant individual and public assistance or public assistance from the Federal Government under such Act and for which— ‘‘(A) in the case of the first fiscal year (or part of a fiscal year) for which this subsection applies to the State, the Federal medical assistance percentage determined for the State for the fiscal year without regard to this subsection and subsection (y), is less than the Federal medical assistance percentage determined for the State for the preceding fiscal year after the application of only subsection (a) of section 5001 of Public Law 111–5 (if applicable to the preceding fiscal year) and without regard to this subsection, subsection (y), and subsections (b) and (c) of section 5001 of Public Law 111–5, by at least 3 percentage points; and ‘‘(B) in the case of the second or any succeeding fiscal year for which this subsection applies to the State, the Federal medical assistance percentage determined for the State for the fiscal year without regard to this subsection and subsection (y), is less than the Federal medical assistance percentage determined for the State for the preceding fiscal year under this subsection by at least 3 percentage points.

‘‘(3) The Federal medical assistance percentage determined for a disaster-recovery FMAP adjustment State under paragraph (1) shall apply for purposes of this title (other than with respect to disproportionate share hospital payments described in section 1923 and payments under this title that are based on the enhanced FMAP described in 2105(b)) and shall not apply with respect to payments under title IV (other than under part E of title IV) or payments under title XXI.’’.

November 19, 2009 in Congress, Democratic party, President Obama, Senate | Permalink | Share | User Comments (240)

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I'm just going to quit working and let the government take care of me...

Posted by: Shane | Nov 19, 2009 3:21:47 PM

God forbid the previous administration should have helped that town.

Posted by: jaxparrothead | Nov 19, 2009 3:44:02 PM

@Shane: You know, it's funny; I never heard a liberal in my life seriously say he'd prefer to relax on government benefits and do nothing. Usually, it's more like "those women are raising children on their own, we should support them," or "medical care is so expensive that young people are pulling teeth out of their heads with pliers rather than pay thousands in medical bills," or "maybe we ought to regulate the financial sector..."

It's always folks with a right lean who seem to be so terrified of this prospect. It's like they're afraid that if it isn't necessary to struggle viciously, all the time, to get such basics as "the ability to go to the doctor," maybe... they'd go soft?

Posted by: T | Nov 19, 2009 3:44:05 PM

I'm just going to quit working and let the government take care of me...
Shane | Nov 19, 2009 3:21:47 PM

Do it then. If you think government cheese and housing is such a cushy life, do it.

Actually, if you look at the numbers from the Tax Foundation the majority of strong Red states are dependent upon Federal tax dollars collected/redistributed from Blue states - whose 'wasteful socialist programs' oddly correlate well with modern, vibrant industries that bring in a lot of federal tax revenue.

Posted by: jhw539 | Nov 19, 2009 4:15:27 PM

I don't know about the accuracy or substance of this charge-but I will say that getting health care reform passed would be worth the money. So we leave Iraq 8 hours earlier. That should cover it.

Posted by: Biff | Nov 19, 2009 5:11:19 PM

if every county qualifies, then what is the point of the provision? senate staffers aren't paid by the word, there must be some reason they stuck that in.

Posted by: steve | Nov 19, 2009 5:13:44 PM

here ... let me fix that for you T ---

Usually, it's more like "those women are raising children on their own, somebody else need to be taxed more to support them," or "medical care is so expensive that young people are pulling teeth out of their heads with pliers rather than pay thousands in medical bills, so somebody else needs to be taxed to support them because they can figure out how to budget and insure their car, but not their own body" or "maybe we ought to regulate the financial sector...because only some people are making money in it and people who can't read contracts or calculate risks can't figure out how to do it"

There ... that's more accurate.....

Posted by: JohnF | Nov 19, 2009 5:15:35 PM

political bribes. SO the bill doesn't warrant support unless there is a payoff. I hope the people of LA. vote her out.

Posted by: brian | Nov 19, 2009 5:16:23 PM

Hope and change? More like, "Politics as usual". Nothing to see here, People, move along.

Posted by: Eddysmom | Nov 19, 2009 5:16:52 PM

Except for one provision that is a very clear condition in the clause, not addressed by your link, jhw.. "...determined as a result of such disaster that every county or parish in the State warrant individual and public assistance or public assistance from the Federal Government under such Act..."

How many of those disasters were "every county or parish" warranted help?

I could be wrong, but i'll bet you won't find any except La. At least not many. That's the catch, it's right there.

Posted by: dcon | Nov 19, 2009 5:19:21 PM

So I ask, what's new about this story except the year and then name? Our corrupt Federal govt. has done this for a looonngg time. We're way past due in refreshing the tree of Liberty.

Posted by: TWilliam | Nov 19, 2009 5:19:46 PM

...looks like it's getting pretty close to being time for some good ol' fashion MAJOR civil disobedience in this country.

Anyone for NOT signing up for health care?

Posted by: One More Patriot | Nov 19, 2009 5:22:17 PM

jwh539, you could not be more wrong. It is not enough that a major disaster be declared somewhere in a state in order to trip the boost in funding, it requires that the major disaster be declared and that it is determined that "EVERY county or parish in the State warrant individual and public assistance or public assistance from the Federal Government under such Act." How many times has that happened in the past 7 years? Certainly not 411 times.

Posted by: Anon | Nov 19, 2009 5:22:19 PM

I am so tired of whining little babies crying for the government option. Stop asking everyone else to take care of you. Stand up like a "Man" or "Independent Woman" and take care of yourself. The opportunities are there if you work hard. The government can't take care of everybody. GROW UP YOU LITTLE BABIES!!

Posted by: TReicher | Nov 19, 2009 5:22:43 PM

All those that want federal government to do something for them, will be crying when all is said and done.

That is unless you are a congress man or woman.

They know SS and Government is broke. They need to do a little zig zag before that rooste comes home to nest.

They have about 4 years to get her done.

Posted by: DixHistory.com | Nov 19, 2009 5:22:46 PM

Hey Chris Kromm, the bill's language states that it only covers certain states, and "state" is defined as a state where "every county or parish in the State warrant individual and public assistance or public assistance from the Federal Government under such Act.." Only one state meets that definition in the last seven years, where every county in said state falls under the disaster relief act. Louisiana. The article is correct. Your link is incorrect. Read the above article's language.

Posted by: TF | Nov 19, 2009 5:23:10 PM

Political payoffs. The face of Change in Washington.

Posted by: Nathan | Nov 19, 2009 5:24:13 PM

I feel hopey changey all over.

Posted by: John Galt | Nov 19, 2009 5:24:36 PM

"those women are raising children on their own, we should support them," or "medical care is so expensive that young people are pulling teeth out of their heads with pliers rather than pay thousands in medical bills," or "maybe we ought to regulate the financial sector..."

You know, the problem is, when you say "we", you speak for me. And I don't buy into any of your sob-story crap. So don't impinge upon my freedoms in the name of a cause I don't believe in. Fund it yourself.

Posted by: sickofthis | Nov 19, 2009 5:25:12 PM

The United States has had it's share of traitors to the nation and the citizens within in it's history, Benedict Arnold, Ethel and Julius Rosenberg, Aaron Burr, Alger Hiss, Aldrich Ames, nearly all sold out their country for either money, power, revenge, or all of those reasons combined, and not for some wayward ideology, now I believe we can add the name of Democrat Mary Landrieu to this infamous list. What a despicable piece of trash. Congratulations on making the list Mary.

Posted by: enigmaforever | Nov 19, 2009 5:27:06 PM

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