Bruising debate awaits health bill in Senate

Legislation moves to floor after Thanksgiving as Dems overcome key hurdle Associated Press updated 7:17 am ET, Sun. Nov. 22, 2009

Senate Majority Leader Harry Reid, D-Nev., speaks Saturday after the U.S. Senate voted to begin debate on health care legislation on Capitol Hill in Washington. Sen. Chris Dodd, D-Conn., right, and Sen. Tom Harkin, D-Iowa, look on. photo by Jose Luis Magana/AP WASHINGTON - A bruising debate on health care awaits the Senate after Thanksgiving now that the historic legislation has cleared a key hurdle over the opposition of Republicans eager to inflict a punishing defeat on President Barack Obama. The bill would extend coverage to roughly 31 million who lack it, crack down on insurance company practices that deny or dilute benefits and curtail the growth of spending on medical care nationally. In the final minutes of a daylong session, Majority Leader Harry Reid, D-Nev., accused Republicans on Saturday of trying to stifle a historic debate the nation needed. GOP warns of ‘unsustainable debt’ The Republican leader, Sen. Mitch McConnell of Kentucky, said the vote was anything but procedural — casting it as a referendum on the bill itself, which he said would raise taxes, cut Medicare and create a "massive and unsustainable debt." Two final Democratic holdouts, Sens. Mary Landrieu of Louisiana and Blanche Lincoln of Arkansas, announced they would join in clearing the way for a full debate. "It is clear to me that doing nothing is not an option," said Landrieu, who won $100 million in the legislation to help her state pay the costs of health care for the poor. Landrieu and Lincoln, who faces a tough re-election next year, both stressed they were not committing in advance to vote for the legislation that ultimately emerges from next month's debate. Of particular contentiousness to moderates is a provision for the government to sell insurance in competition with private companies, subject to state approval — a part of Reid's bill expected to come under significant pressure as the debate unfolds. Positive response from White House White House press secretary Robert Gibbs said the president was gratified by the vote, which he says "brings us one step closer to ending insurance company abuses, reining in spiraling health care costs, providing stability and security to those with health insurance, and extending quality health coverage to those who lack it." Vice President Joe Biden told Iowa Democrats that the Senate handed the president a big victory with its decision. "Tonight we have more momentum than we've ever had in the history of health care discussions,'" Biden told about 1,000 Democrats in Des Moines. "I see the special interests raising tens of millions of dollars, hundreds of millions of dollars to defeat our agenda," Biden said. "We've never thought change would be easy. You all knew change would be hard. It's hard to change the direction of a nation that's been adrift for at least eight years." The legislation would require most Americans to carry insurance and provide subsidies to those who couldn't afford it. Large companies could incur costs if they did not provide coverage to their workforce. The insurance industry would come under significant new regulation under the bill, which would first ease and then ban the practice of denying coverage on the basis of pre-existing medical conditions. Congressional budget analysts put the legislation's cost at $979 billion over a decade and said it would reduce deficits over the same period while extending coverage to 94 percent of the eligible population. Kennedy’s legacy figures prominently Memories of the late Sen. Edward M. Kennedy, a long-time proponent of health care, figured prominently Saturday night. Sen. Paul Kirk of Massachusetts, appointed to office this fall after Kennedy's death, said he spoke for those "who for so many years revered and loved and elected and re-elected" him. Sen. Chris Dodd of Conn. referred to Kennedy's "lifelong quest" for national health care and said "we will pay him the highest compliment by fulfilling that" goal. Reid said he had talked with Kennedy's widow, Vicki, about the vote and they both agreed "Ted would be happy." © 2009 The Associated Press. All rights reserved.

Moderate Dems wooed in crucial health vote

Key lawmaker annouces he'll vote Saturday to begin debate on the bill Associated Press updated 9:20 p.m. ET, Nov. 20, 2009 WASHINGTON - Suitably opaque, Section 2006 takes up only a few dozen lines in a sweeping health care bill that runs to 2,074 pages and mentions neither Sen. Mary Landrieu nor her state of Louisiana. But the section's purpose is indisputable: to deliver $100 million or more in federal funds to the state. And in the process it could clear the way for one of three moderate Democratic fence-sitters — Ben Nelson of Nebraska and Blanche Lincoln of Arkansas are the others — to help propel the legislation past its initial hurdle in a crucial Saturday vote. Nelson, Landrieu and Lincoln emerged several days ago as the last public holdouts among 58 Democrats and two independents whose votes Majority Leader Harry Reid and the White House must have to overcome the Republicans' attempt to strangle the bill before serious debate can begin. Each has moved carefully with an eye on home-state voters. And inside the Senate, each has taken advantage of the political leverage newly available. Alone among the three, Nelson issued a statement Friday ending any lingering public suspense about his intentions. "The Senate should start trying to fix a health care system that costs too much and delivers too little for Nebraskans," he said, adding his decision should not be seen as an indication of how he will vote on the legislation itself. Nelson had been publicly signaling his intentions for more than a week, and his words presumably came as no surprise to Reid or the White House, which issued a statement Friday saying the bill "provides the necessary health reforms that the administration seeks." Currying votes This sort of political minuet can be delicate, as shown when the Senate's second-ranking Democrat, Dick Durbin of Illinois, said earlier on Friday that Lincoln had already confided to Reid how she planned to vote. Republicans, eager to scuttle the bill — and defeat Lincoln in 2010 — instantly accused the two-term senator of telling Democratic party leaders before informing her own constituents in Arkansas. "No other senator speaks for Senator Lincoln. She is still reviewing the bill," declared the senator's spokeswoman, Leah Vest DiPietro, adding her boss had not yet made up her mind. For his part, Durbin sought to quickly close the loop with a statement saying he had been unclear and misinterpreted. As for Nelson, several officials, speaking on condition of anonymity, said he had insisted Reid omit from the bill any change in the insurance industry's protection from federal antitrust law. The House version of the legislation would expose the industry to scrutiny by both the Justice Department's antitrust lawyers and the Federal Trade Commission. Reid, who spoke out strongly in favor of the change in antitrust treatment earlier in the fall, left it out of the bill he drafted over several weeks and unveiled on Wednesday. Eyes on Lincoln Lincoln has been the most close-mouthed about her intention. As a committee chairman, she is the most powerful of the group. As the only one of the three seeking re-election next year, she is also the most politically vulnerable. In public, she has asked that the bill be available for 72 hours before the vote occurs. In private, her demands have been more substantive, according to officials who did not describe them. She is virtually certain to be criticized no matter what her vote. After the House cleared its version of the legislation this month, a conservative group began airing commercials criticizing Rep. Vic Snyder, D-Ark., for voting in its favor. At the same time, MoveOn.org, a liberal organization, slammed another one of the state's lawmakers, Rep. Mike Ross, for opposing it. A hint: At home, Lincoln has suggested her vote will be influenced by former President Bill Clinton, who was Arkansas governor for 12 years before winning the White House. Clinton recently met privately with Senate Democrats, telling them that passing an imperfect bill was better than nothing. "We don't ever go to Washington with the idea that we're going to create a work of art," Lincoln said afterward. "It's got to be a work in progress." She and the other moderates face pressure from business groups opposed to the legislation. In a statement Friday the Business Roundtable, which represents big company CEOs, said the Senate bill "will not effect the needed changes to measurably improve the American health care system." Democrats and the White House had seized on a report by the same group last week concluding that some of the provisions under consideration by Congress had the potential to tame runaway medical inflation. Section 2006 for Landrieu? Of the three centrists, Landrieu has been the clearest about her intentions, and her interests ranged beyond health insurance to the oysters for which Louisiana is famous. When the Food and Drug Administration proposed banning sales of raw oysters from the Gulf of Mexico during warm weather months, Landrieu and others objected. A week ago, the agency thought better of the idea and shelved the plan in favor of further study. "I'm really thankful that they listened," said Landrieu, who had met with FDA Commissioner Margaret Hamburg to discuss the issue. Over recent weeks, Landrieu has issued a string of statements outlining the areas she wanted addressed for the benefit of her constituents — issues that could be dealt with only after health legislation made it to the Senate floor. After meeting with Reid almost a month ago, she mentioned the "unique challenges Louisiana is facing in terms of Medicaid." In a Senate speech and statement, she noted that Louisiana has the highest breast cancer death rate in the country and the lowest female life expectancy of any state. And she said, "Unless something is done, annual health care costs for small firms over the next 10 years are expected to more than double to reach $339 billion in 2018." Landrieu can point to provisions in the legislation that are designed to attack all three problems. They include Section 2006. Reading it is of little assistance. "Special adjustment to FMAP Determination for Certain States recovering from a Major Disaster" is the title, and about two pages of similarly indecipherable legalese follows. According to the Congressional Budget Office, it will send an additional $100 million to Louisiana to help it cover costs for Medicaid, the federal-state health care program for the poor. Should Landrieu decide to side with Republicans this weekend, she would also be voting to deny her state those funds. Copyright 2009 The Associated Press. All rights reserved.

Democrats have 60 votes to advance health bill

Two remaining Dem holdouts announce they will vote 'yes' to begin debate Associated Press updated 23 minutes ago WASHINGTON - Democratic leaders secured the last votes needed to move ahead on historic health care reform legislation, clearing the way for a Saturday night showdown on President Barack Obama's top domestic policy initiative. In long-awaited speeches, two centrist Democratic senators said they would stand with their party and vote "yes" on the crucial test procedural vote despite deep reservations with parts of the 2,074-page bill to remake the U.S. health care system. "The truth is this issue is very complex. There is no easy fix and it's imperative that we build on what's already working in health care in America," Sen. Blanche Lincoln of Arkansas told her Senate colleagues. Earlier, Sen. Mary Landrieu of Louisiana said she would vote "yes" on the procedural vote to determine whether debate can go forward on the Senate floor on Majority Leader Harry Reid's health care reform bill. Democratic leaders were optimistic they now have the 60 votes needed in the 100-member Senate to go forward. The Senate's 40 Republicans are unanimously opposed. "I've decided that there are enough significant reforms and safeguards in this bill to move forward, but much more work needs to be done," Landrieu said, with the 8 p.m. EST (0100 GMT) vote looming. But the two moderate Democrats both cautioned that while they have agreed to allow debate to continue, their vote Saturday does not commit them to supporting the final bill. At a 10-year cost approaching $1 trillion, Reid's legislation is designed to extend coverage to roughly 31 million who lack it, crack down on insurance company practices that deny benefits to people with preexisting medical conditions, and curtail the growth of spending on medical care nationally. Almost everyone would be required to purchase insurance, and billions in new taxes would be levied on insurers and high-income Americans to help extend coverage. During Saturday's debate on the bill, Democrats called a revamp of the nation's health care system long overdue. The U.S. is the only major developed country that does not provide comprehensive medical coverage for its people, and Obama campaigned on a promise to change that. "The country suffers when there is a failure to act on serious challenges that millions of ordinary Americans face in their daily lives," Sen. Patrick Leahy, a Vermont Democrat, said during the rare weekend session. United in opposition, Republicans cast the bill as a costly government takeover of the health care system, built on budget gimmicks. "Move over, Bernie Madoff. Tip your hat to a trillion-dollar scam," said Sen. Kit Bond of Missouri, referring to the mastermind of a multibillion-dollar Ponzi scheme. The action in the Senate comes two weeks after the House of Representatives approved a health overhaul bill of its own on a 220-215 vote. Major health care reform legislation has now advanced further through Congress than at any time since the 1960s when the government-run Medicare health insurance program for seniors was enacted. After the vote Saturday night, senators will leave for a Thanksgiving holiday recess. Upon their return, assuming Democrats prevail on Saturday's vote, they will launch into weeks or more of unpredictable debate on the health care bill, with numerous amendments expected from both sides of the aisle and more 60-vote hurdles along the way. Democratic centrists from conservative states are particularly wary of provisions to have a government-run plan compete with private insurers to drive down coverage costs. Efforts to insert stricter language to bar federal funds from being used to cover abortions has also become a divisive issue. Senate leaders hope to pass their bill by the end of the year. If that happens, January would bring work to reconcile the House and Senate versions. If a compromise can be reached, it would then have to be approved by both chambers of Congress before a final package could land on Obama's desk to sign. The House and Senate bills have many similarities, including the new requirements on insurers and the creation of new purchasing marketplaces called exchanges where self-employed individuals and small businesses could go to shop for and compare coverage plans. One option in the exchanges would be a new government-offered plan, something that's opposed by private insurers and business groups. Differences include requirements for employers. The House bill would require medium and large businesses to cover their employees, while the Senate bill would not require them to offer coverage but would make them pay a fee if the government ends up subsidizing employees' coverage. Another difference is in how they're paid for. The Senate bill includes a tax on high-value insurance policies that's not part of the House bill, while the House would levy a new income tax on upper-income Americans that's not in the Senate measure. The Senate measure also raises the Medicare payroll tax on income above $200,000 annually for individuals and $250,000 for couples. Both bills rely on more than $400 billion in cuts to Medicare. Copyright 2009 The Associated Press. All rights reserved.

Uninsured ER patients twice as likely to die

New study highlights disparity of care for those who don't have coverage Associated Press updated 4:00 p.m. ET, Mon., Nov . 16, 2009 CHICAGO - Uninsured patients with traumatic injuries, such as car crashes, falls and gunshot wounds, were almost twice as likely to die in the hospital as similarly injured patients with health insurance, according to a troubling new study. The findings by Harvard University researchers surprised doctors and health experts who have believed emergency room care was equitable. "This is another drop in a sea of evidence that the uninsured fare much worse in their health in the United States," said senior author Dr. Atul Gawande, a Harvard surgeon and medical journalist. The study, appearing in the November issue of Archives of Surgery, comes as Congress is debating the expansion of health insurance coverage to millions more Americans. It could add fodder to that debate. The researchers couldn't pin down the reasons behind the differences they found. The uninsured might experience more delays being transferred from hospital to hospital. Or they might get different care. Or they could have more trouble communicating with doctors. The hospitals that treat them also could have fewer resources. "Those hospitals tend to be financially strapped, not have the same level of staffing, not have the same level of surgeons and testing and equipment," Gawande said. "That also is likely a major contributor." Gawande favors health care reform and has frequently written about the inequities of the current system. The researchers took into account the severity of the injuries and the patients' race, gender and age. After those adjustments, they still found the uninsured were 80 percent more likely to die than those with insurance — even low-income patients insured by the government's Medicaid program. "I'm really surprised," said Dr. Eric Lavonas of the American College of Emergency Physicians and a doctor at Denver Health Medical Center. "It's well known that people without health insurance don't get the same quality of health care in this country, but I would have thought that this group of patients would be the least vulnerable." Private hospitals more likely to transfer uninsured Some private hospitals are more likely to transfer an uninsured patient than an insured patient, said Lavonas, who wasn't involved in the new research. "Sometimes we get patients transferred and we suspect they're being transferred because of payment issues," he said. "The transferring physician says, 'We're not able to handle this."' Federal law requires hospital ERs to treat all patients who are medically unstable. But hospitals can transfer patients, or send them away, once they're stabilized. A transfer could worsen a patient's condition by delaying treatment. The researchers analyzed data on nearly 690,000 U.S. patients from 2002 through 2006. Burn patients were not included, nor were people who were treated and released, or dead on arrival. In the study, the overall death rate was 4.7 percent, so most emergency room patients survived their injuries. The commercially insured patients had a death rate of 3.3 percent. The uninsured patients' death rate was 5.7 percent. Those rates were before the adjustments for other risk factors. The findings are based on an analysis of data from the National Trauma Data Bank, which includes more than 900 U.S. hospitals. "We have to take the findings very seriously," said lead author Dr. Heather Rosen, a surgery resident at Los Angeles County Hospital, who found similar results when she analyzed children's trauma data for an earlier study. "This affects every person, of every age, of every race." © 2009 The Associated Press. All rights reserved.

Milbridge Healthcare Workers In Search Of New Contract

by Rob Poindexter · Nov 16th 2009 WABI-TV 5 Workers at a healthcare facility in Milbridge say their being treated unfairly by ownership and they've decided to let their voices be heard. They've decided to take their frustration to the streets. LaVerne Coopersmith, a CNA at the facility, says their demands are not that unreasonable. "Maybe a 2% raise and a signed contract, that doesn't seem like asking too much, it seems fair," she says. The workers say management got a pay raise and they want what they say is fair. Dr. Stephen Weisberger is the owner of the facility and he told TV5 the following over the phone. "To my knowledge, no raises have been given to any administrator or manager since the wage freeze. These are tough times. My workers are fantastic and we're working towards a solution that is financially viable for them." Workers claim management received their pay increases just a month before their own wages were frozen and they say that isn't right. "We realize the economy is bad," says Marie Leighton a CRMA at the facility, "but I guess if management hadn't gotten theirs, it wouldn't have been so bad, but they got theirs in April and we got a freeze in May and I don't think that's quite fair." Patients and their families say the staff here works hard and deserves fair treatment. Jackie Jellison's mother is being treated in the Narraguagus Healthcare Facility and she says the care there is first rate. "The care that these ladies have for these residents is wonderful. I mean they go out of their way and like Marie said, they stop in on their off time to see how patients are." The protestors say they will continue to picket as long as it takes. The two sides are scheduled to sit down at the negotiating table on December 4th. Video for this story is available through this link.

Local 771 - November 21, 2009 Agenda

MSEA-SEIU Local 1989 Local 771 Chapter Meeting November 21, 2009, 10 am to Noon

MSEA Headquarters, 65 State Street, Augusta, Maine

10:00 Welcome Introductions 10:05 Review Minutes from October meeting 10:10 Treasurer’s Report 10:15 Membership Update 10:20 771 Election of 2010 Officers 10:50 MSEA-SEIU Annual Convention Disaffiliation with SEIU 11:00 771 By-Laws: Elections 11:10 Legislative Update Long-Term Care System LEAN Process Worker Taskforce Group, Monday, 11/30, 1pm DHHS 11:25 Bargaining Alpha One 11:40 KVO Annual Fundraising Campaign 771 wish to make a donation? 11:50 Downeast Federation of Nurses & Health Professionals Local 5073 Narraguagus Bay Health Care Facility Picket 11:55 Next Steps Next Local 771 Meeting _________________________ 12:00 Adjourn Be sure to check out your Local’s blog: http://www.unionmaine771news.blogspot.com/. If you need to contact me, Helen Hanson, helen.hnsn@gmail.com.

Minutes October 24, 2009 Meeting

LOCAL 771 CHAPTER MEETING 10/24/2009 MINUTES Attendance: Members: Helen Hanson, Joe Berry, Ted Rippy, Juanita Burtt, Roxann Gargac, Dixie Lewis, Dee Dee Strout Local 771 Field Rep: CJ Betit Local 771 Organizers: Jay Economy MSEA-SEIU Retiree: Phil Wolley MSEA-SEIU 1989 President: Bruce Hodgdon Review of Minutes of 9/19/09 Chapter Meeting Helen Hanson distributed the minutes of the 9/19/09 Chapter Meeting and they were reviewed and accepted. The one change to the minutes was in the Alpha One Bargaining Update that Dennis Fitzgibbons had not been present at the 9/10/09 meeting. National Direct Care Partnership & Voices Institute Local 771 members Ted Rippy and Dee Dee Strout reported on their attendance at the Voices Institute for leadership training in Wisconsin during the week of September 27th.Ted and Dee Dee both reported that this was an invaluable experience in learning how to lobby for change. The Direct Care Alliance is working hard to professionalize the DCW field, and DCW’s from 16 different states were in attendance. Ted and Dee Dee said they saw a lot of change and growth during the week, and very much appreciated the scholarships from MSEASEIU. Ted and Dee Dee will report back to MSEASEIU’s Board of Directors in November regarding their experiences at the Voices Institute. Treasurer’s Report In Pat Crowell’s absence, Helen Hanson reported Local 771 currently has $896.61 in it’s savings account and $105.57 in it’s checking account. LD 1078 Update Helen Hanson reported that the DHHS Lean Study of the long term care system is well under way. There are 18 members on the core committee ( including Helen) , and that Dee Dee Strout, Ted Rippy, and Helen will also be working on the Worker’s Committee which begins meeting on Oct. 26, 2009. Helen related that the study seems to be showing that the system is too top heavy administratively and that the clearing house agency of Elder Independence of Me ( EIM) is being looked at very closely. MSEA-SEIU 1989 Convention 2009 Local 771’s delegates for convention will be Helen Hanson, Joe Berry, Ted Rippy, Sherri Rippy, Dave Levasseur, Carol Ann Cammack, and Dixie Lewis. Carol Ann was elected as a delegate at an emergency chapter meeting held at the Area One Caucus on October 3, 2009. There was a general discussion of the upcoming convention and President Hodgdon reviewed resolutions that were currently scheduled to be raised at convention, including a resolution to consider disaffiliation from SEIU. Local 771 is strongly opposes this disaffiliation resolution, as SEIU has been a strong advocate for health care workers and many of our members take advantage of the health and dental insurance plans offered by SEIU. Pre-Retirement Planning Retiree Phil Wooley gave a presentation on the importance of pre-retirement planning, and reviewed the pre-retirement committee’s training provided to state employees. He emphasized that everyone’s retirement is different and you can not begin planning too early. Phil distributed a survey for members to complete and return. Alpha One Bargaining Update Field Rep CJ Betit reported that the one remaining issue to be resolved in the new A1 contract is the decision of when the closed shop status will go into effect. This issue should be resolved shortly. Labor Management Committee Dixie Lewis and Carol Ann Cammack will serve on the HC4M Labor Management Committee with CJ Betit. Issues to be discussed include scheduling and fill-ins. HC4M has told CJ that if a DCW calls in for a fill in the worker will not get a call back unless they cannot fill the request. This is something DCW’s had not been aware of and expecting and not getting a call back has been very frustrating. CJ reported that on he had received some good news in that HC4M has been over budget in hours of service delivered in July 1491-1403, August 1543-1403 and September 1554-1403. Next Meeting November 21, 2009 , 10AM – Noon at MSEA Headquarters in Augusta. Coffee and refreshments will be provided. Chapter elections for officers and delegates will be held at this meeting.

Why So Many of Us Don't Have Health Care Insurance

Don Krutsinger, 2009 Voices Institute graduate November 11, 2009 I work as a direct support professional with developmentally disabled adults in residential settings. One thing I have in common with just about all my coworkers is that we need to work more than 40 hours a week to make ends meet – and even so, too many of us can’t afford our employers’ health care coverage. With the recent cutbacks by our state (Minnesota), most of our residential programs have cut out overtime and cut down the number of full-time positions, reducing the number of positions that receive health insurance and paid time off. That means nearly all of us have to work two to three jobs to make ends meet. Chances are, we don’t get enough hours from any one of them to qualify for health insurance. That’s a difficult, demoralizing way to live, especially for those of us who are dedicated to direct support work and have invested years of our lives in our careers. I’ve been a direct support professional for 21 years. From 1988 to 2004, I worked in residential and day services programs in Kansas. I received a social work degree and worked as a targeted case manager in Iowa. In 2006, I moved to Minnesota to become a group home supervisor. My supervisory experience has taught me how difficult it is to train and retain quality staff. I’ve found the best way of supporting our residential programs is to float between homes, filling in where I’m needed because someone couldn’t show up that day. For a while, I worked full-time at another residential program on a day shift while floating part-time at my group homes, but the other program had to eliminate their full-time day shift positions after the cutbacks. I now work full-time in my float position while working part-time during the day as a personal care attendant. As a PCA, I help an elderly man with multiple sclerosis get up in the morning. I also help a professional man with cerebral palsy use the restroom at his workplace twice a day. Although I work for fairly good agencies that would provide some benefits if I were full-time, the distance between jobs and the short hours of support with each client make it difficult to put in 40 hours I’d need to be eligible for health insurance – and to afford the premiums. A few of the people receiving PCA services need assistance during every waking hour or around the clock. You might think the PCAs who work with these individuals would qualify for health insurance, but the cutbacks have changed that too. There are now limits on how many hours a week PCAs can work, so agencies don’t have to pay overtime. Some people’s hours are so limited that they don’t qualify for health insurance either. It wasn’t easy to make it on one PCA job before the cutbacks either, but we had it better than most. The only reason we qualify for overtime is that Minnesota requires it, but less than half of the 50 states say home care workers are entitled to overtime pay. If you live in one of the others you’re out of luck. The federal Fair Labor Standards Act, as interpreted by the U.S. Department of Labor (DOL), does not cover workers who provide “companionship services” to people in their homes. http://www.directcarealliance.org/index.cfm?pageId=538#no_minimum_wage The DOL ruling was challenged in court by Evelyn Coke, a home care worker who had been paid only $7 an hour throughout her 30-year career, receiving no overtime pay even though she worked regularly over 70 hours a week. She made it all the way to the Supreme Court, but the court ruled against her. This is an issue that can and must be decided on the federal level. We need legislation to include all home care workers in the federal Fair Labor Standards Act. We need to pay people fairly for the work they have done, so home care workers can afford health insurance and other basic benefits. Until we do, we won’t be able to find and keep enough quality personal care attendants to meet the needs of the elders and people with disabilities who want to remain in their homes. originally published in the Direct Care Alliance e-newsletter

Local 771 holding Elections

Local 771 is holding its elections on Saturday, November 21st, at MSEA headquarters at 65 State Street in Augusta. The meeting will run from 10 to noon. Anyone interested in being an officer or a delegate for 771 can file a nomination. You can do this in person, at the meeting. You can email your nomination to me, helen.hnsn@gmail.com or to Jay Economy at organizing@mseaseiu.org. Any member of 771 in good standing can run.

Error reported with Local 5073 and Narraguagus Bay Health Care

I reported an error with Local 5073 and the Narraguagus Bay Health Care Facility. Local 5073 is not ending their picket. They will be back out on the picket line on Monday. Please keep these workers in your thoughts and prayers.

Local 5073 decides to End Picket at Narraguagus Bay Health Care Facility

Downeast Federation of Nurses & Health Professionals Local 5073 decide to End Picket The picketing by members of Local 5073 has officially come to an end. After the owner of Narraguagus Bay Health asked the union "what would stop the whole uproar", union leaders gave him a list of issues. He said he would look into them. Union leaders made a good faith decision to stop the picketing. Mediation starts on December 4th.

March for Health Care Justice

March for Health Care Justice, today, noon, Kennebec County Courthouse to Senator Snowe's office. Tell Senator Snowe that Athem's suing the state because they were not granted the 18% rate increase for policy holders they asked for. The state told them they could charge 10% more. Anthem says it cannot live with a 3% increase in profits so it is suing the state. Hope you can be there!

Bill Clinton urges passage of health care bill

Former president calls reform "an economic imperative"

Associated Press

updated 25 minutes ago

Former President Bill Clinton arrives on Capitol Hill in Washington on Tuesday, Nov. 10, 2009.

Charles Dharapak/AP

WASHINGTON - Former President Bill Clinton told anxious Senate Democrats on Tuesday to pass a health care bill soon because the U.S. economy can't resist the toxic combination of exorbitant medical costs and nearly 50 million uninsured for much longer.

"My argument was that this is an economic imperative," Clinton said after the closed-door meeting.

Addressing Democrats' insecurities about the complex legislation, Clinton said he told the senators "there is no perfect bill — you'll always have unintended consequences. There will be amendments to this next year. But the worst thing to do is nothing."

Clinton was the last Democratic president to attempt to revamp the health care system to cover all Americans and try to control costs. The spectacular collapse of his plan probably cost Democrats control of Congress in 1994, but Clinton is still admired for having tackled the issue. He went on to win a second term in office.

"People trust him," said Sen. Max Baucus, D-Mont., one of the architects of the current Senate health care bill.

"His argument was that getting the best bill is not only good for the people, it's the best politics," said Sen. Ben Nelson, D-Neb., one of a clutch of moderates who hold the fate of the legislation in their hands.

Clinton said he hoped all the senators understood his bottom line: "It's not important to be perfect here," he said. "It's important to act, to move, to start the ball rolling."

The House passed its health care bill last Saturday by a narrow 220-215 vote. In Senate, Majority Leader Harry Reid, D-Nev., is working on a final Democratic draft. But the combination of divided Democrats, and Republicans determined to force delays under the Senate's arcane rules, is making it less likely that President Barack Obama will get a bill this year.

"Our goal is to make sure it's out of the Senate this year," said Sen. Dick Durbin, D-Ill., the No. 2 Senate Democrat. The Senate bill would then have to be combined with legislation passed Saturday by the House, and the final version passed by both chambers before it could go to Obama's desk. Finishing that whole process before year's end would be tough.

"They want us to finish quickly. We do too. But some of these things are beyond our control," Durbin said of the White House's desire for fast action.

Complicating the effort, abortion opponents in the Senate are seeking tough restrictions in the health care overhaul bill, a move that could roil the shaky Democratic effort.

Nelson, the Nebraska moderate, said he could not support a bill unless it clearly prohibits federal money from going to pay for abortions. He is weighing options, including offering an amendment similar to the one passed by the House this weekend, which had more stringent language than that approved by Senate committees.

"While there may be different views about abortion, I think there's a strong majority against using federal dollars to fund abortions," Nelson said Tuesday on NBC's "Today."

Senate Majority Leader Harry Reid, who is personally opposed to abortion, said the issue was being negotiated.

"I expect the bill that will be brought to the floor will ensure that no federal funds are used for abortions and that the conscience rights for providers and health care facilities like Catholic hospitals are protected," Reid said Tuesday. "I think we can work that out."

The House-passed restrictions were the price Speaker Nancy Pelosi, D-Calif., had to pay to get a health care bill passed. But it's prompted an angry backlash from liberals at the core of her party, and some are now threatening to vote against a final bill if the curbs stay in.

Obama said the legislation needs to find a balance.

"I want to make sure that the provision that emerges meets that test — that we are not in some way sneaking in funding for abortions, but, on the other hand, that we're not restricting women's insurance choices," Obama said in an interview with ABC News.

The House bill would bar a new government insurance plan from covering abortions, except in cases or rape, incest or the life of the mother being in danger. That's the basic rule currently in federal law, under a provision called the Hyde amendment, which Reid said Tuesday had worked well.

"The one thing we're certain to do is to maintain what we've had in the past," said Reid, D-Nev. "The Hyde amendment has been a pretty good way to go."

The House bill would also prohibit health plans that receive federal subsidies in a new insurance marketplace from offering abortion coverage. Insurers, however, could sell separate coverage for abortion, which individuals would have to purchase entirely with their own money. The committee-passed Senate versions differ on abortion, but none would go as far as the restrictive amendment passed by the House.

Copyright 2009 The Associated Press. All rights reserved.

March for Health Care Justice

Hey Folks! We're gearing up for the next escalation against Anthem Insurance and their lawsuit against us, the taxpayers of the state of Maine. Despite the wet weather of last month's Court House Rally, we still brought out more than a hundred people and were covered by MSNBC, CNN, and all the major Maine news outlets. (Check this out for a sample of the coverage: MPBN Coverage of Courthouse Rally) What's Next? We need you to join us for the March for Healthcare Justice on November 12th, Noontime in Augusta. Our Senators need to know what Anthem is doing - suing the state for more profits making health care less affordable - so that they can vote with us on health care reform. And we're delivering this message to them in-person. So, join religious leaders, legislators, activists, and Anthem rate-payers to rally for reform and demand an end to Anthem's abhorrent practices! What: March for Healthcare Justice Who: Leaders of the faith community, legislature, activists, and Anthem rate-payers; and Health Care for America Now! (HCAN) When: November 12, 2009 at 12:00p Noon Where: 95 State St., Augusta ME 04330 Contact: alec.maybarduk@gmail.com (207) 344-7540 Mainers are Begging for Change

Abortion could roil Senate health care debate

Some lawmakers want to prohibit federal dollars from paying for abortions Associated Press updated 1 hour, 17 minutes ago WASHINGTON - Abortion opponents in the Senate are seeking tough restrictions in the health care overhaul bill, a move that could roil a shaky Democratic effort to pass President Barack Obama's signature issue by year's end. Sen. Ben Nelson, D-Neb., said Monday it's unlikely he could support a bill that doesn't clearly prohibit federal dollars from going to pay for abortions. His spokesman said Nelson is weighing options, including offering an amendment similar to the one passed by the House this weekend. The House-passed restrictions were the price Speaker Nancy Pelosi, D-Calif., had to pay to get a health care bill passed, on a narrow 220-215 vote. But it's prompted an angry backlash from liberals at the core of her party, and some are now threatening to vote against a final bill if the curbs stay in. Obama said the legislation needs to find a balance. "I want to make sure that the provision that emerges meets that test — that we are not in some way sneaking in funding for abortions, but, on the other hand, that we're not restricting women's insurance choices," Obama said in an interview with ABC News. Pressure will intensify Senate Democrats will need Nelson's vote — and those of at least a half-dozen other abortion opponents in their caucus. They face a grueling debate against Republicans who are unified in their opposition to a sweeping remake of the health care system. It's unclear how the abortion opponents would line up; the pressure on them will intensify once the legislation is on the floor. "This is a very important issue to Sen. Nelson, and it is highly unlikely he would support a bill that doesn't clearly prohibit federal dollars from going to abortion," said his spokesman, Jake Thompson. An intraparty fight over abortion is the last thing that Majority Leader Harry Reid, D-Nev., needs. Reid is already facing a revolt among Democratic moderates over the government-sponsored health plan that liberals want to incorporate in the legislation as a competitor to private insurance companies. Reid, who is himself opposed to abortion, will have to confront the issue directly as he puts together a Democratic bill for floor consideration. The committee-passed Senate versions differ on abortion, but none would go as far as the restrictive amendment passed by the House. The House bill would bar the new government insurance plan from covering abortions, except in cases or rape, incest or the life of the mother being in danger. That's the basic rule currently in federal law. It would also prohibit health plans that receive federal subsidies in a new insurance marketplace from offering abortion coverage. Insurers, however, could sell separate coverage for abortion, which individuals would have to purchase entirely with their own money. Profound disagreement At issue is a profound disagreement over how current federal restrictions on abortion funding should apply to what would be a new stream of federal funding to help the uninsured gain coverage. Abortion opponents have sought to impose the same restrictions that now apply to the federal employee health plan, military health care and Medicaid, the federal-state health program for the poor. Abortion rights supporters say such an approach would threaten women's right to a legal medical procedure already widely covered by private insurance. The Senate health committee bill is largely silent on abortion, a stance that abortion opponents interpret as permitting coverage by private insurance plans that would receive federal subsidies. The Senate Finance Committee bill attempts to craft a compromise, as the House unsuccessfully tried to do before this weekend's vote tightened restrictions. The Finance plan would require insurance carriers to separate federal subsidy moneys from any funds used to provide abortions, and it would prohibit abortion coverage from being included in a minimum benefits package. It would require that state and regional insurance markets offer one plan that covers abortion, and one plan that does not. An accounting gimmick? Abortion opponents — including U.S. Catholic bishops — rejected a somewhat similar approach in the House, saying that the approach of keeping federal funds separate amounted to little more than an accounting gimmick. For now, the liberals are saying they will fight. Abortion rights supporters in the House were circulating a letter to Pelosi, threatening to vote against a final bill that restricts access to abortion coverage. At least 40 lawmakers had signed by early Monday. "I, along with the other pro-choice members in the House, intend to push very hard to ensure that language is not included in the final conference product," said Rep. Debbie Wasserman Schultz, D-Fla. They're likely to have help in the Senate from two Republican women who support abortion rights, Sens. Olympia Snowe and Susan Collins of Maine. Collins indicated Monday that she thinks the House went too far. "I think the Senate Finance Committee did a good job of putting up a firewall that would prevent federal funds from being used for abortion," she said. "Generally, I prefer the Senate approach." Copyright 2009 The Associated Press. All rights reserved.

Big question mark: Fate of health care in Senate

Landmark health insurance bill passes House late Saturday

A Capitol Hill Police Officer stands guard outside of House of Representatives side of the U.S. Capitol as the healthcare bill is debated, Saturday, Nov. 7, 2009 in Washington. 6:14 p.m. ET, 11/7/09

Alex Brandon/AP

Associated Press updated 4:04 pm ET, Sun., Nov. 8, 2009

WASHINGTON - The glow from a health care triumph faded quickly for President Barack Obama on Sunday as Democrats realized the bill they fought so hard to pass in the House has nowhere to go in the Senate. Speaking from the Rose Garden about 14 hours after the late Saturday vote, Obama urged senators to be like runners on a relay team and "take the baton and bring this effort to the finish line on behalf of the American people." The problem is that the Senate won't run with it. The government health insurance plan included in the House bill is unacceptable to a few Democratic moderates who hold the balance of power in the Senate. If a government plan is part of the deal, "as a matter of conscience, I will not allow this bill to come to a final vote," said Sen. Joe Lieberman, the Connecticut independent whose vote Democrats need to overcome GOP filibusters. "The House bill is dead on arrival in the Senate," Sen. Lindsey Graham, R-S.C., said dismissively. No floor debate scheduled Democrats did not line up to challenge him. Senate Majority Leader Harry Reid, D-Nev., has yet to schedule floor debate and hinted last week that senators may not be able to finish health care this year. Nonetheless, the House vote provided an important lesson in how to succeed with less-than-perfect party unity, and one that Senate Democrats may be able to adapt. House Democrats overcame their own divisions and broke an impasse that threatened the bill after liberals grudgingly accepted tougher restrictions on abortion funding, as abortion opponents demanded. In Senate, the stumbling block is the idea of the government competing with private insurers. Liberals may have to swallow hard and accept a deal without a public plan in order to keep the legislation alive. As in the House, the compromise appears to be to the right of the political spectrum. Republican Sen. Olympia Snowe of Maine, who voted for a version of the Senate bill in committee, has given the Democrats a possible way out. She's proposing to allow a government plan as a last resort, if after a few years premiums keep escalating and local health insurance markets remain in the grip of a few big companies. This is the "trigger" option. That approach appeals to moderates such as Sen. Mary Landrieu, D-La. "If the private market fails to reform, there would be a fallback position," Landrieu said last week. "It should be triggered by choice and affordability, not by political whim." Lieberman said he opposes the public plan because it could become a huge and costly entitlement program. "I believe the debt can break America and send us into a recession that's worse than the one we're fighting our way out of today," he said. For now, Reid is trying to find the votes for a different approach: a government plan that states could opt out of. The Senate is not likely to jump ahead this week on health care. Reid will keep meeting with senators to see if he can work out a political formula that will give him not only the 60 votes needed to begin debate, but the 60 needed to shut off discussion and bring the bill to a final vote. Costs and coverage estimate Toward the end of the week, the Congressional Budget Office may report back with a costs and coverage estimate on Reid's bill, which he assembled from legislation passed by the Finance Committee and the Health, Education, Labor and Pensions Committee. The Finance Committee version does not include a government plan. Reid has pledged to Obama that he will get the bill done by the end of the year and remains committed to doing that, according to a Senate leadership aide. Both the House and Senate bills gradually would extend coverage to nearly all Americans by providing government subsidies to help pay premiums. The measures would bar insurers' practices such as charging more to those in poor health or denying them coverage altogether. All Americans would be required to carry health insurance, either through an employer, a government plan or by purchasing it on their own. To keep down costs, the government subsidies and consumer protections don't take effect until 2013. During the three-year transition, both bills would provide $5 billion in federal dollars to help get coverage for people with medical problems who are turned down by private insurers. Both House and Senate would expand significantly the federal-state Medicaid health program for low-income people. Regulated marketplace The majority of people with employer-provided health insurance would not see changes. The main beneficiaries would be some 30 million people who have no coverage at work or have to buy it on their own. The legislation would create a federally regulated marketplace where they could shop for coverage. The are several major differences between the bills.

• The House would require employers to provide coverage; the Senate does not.
• The House would pay for the coverage expansion by raising taxes on upper-income earners; the Senate uses a variety of taxes and fees, including a levy on high-cost insurance plans.
• The House plan costs about $1.2 trillion over 10 years; the Senate version is under $900 billion

By defusing the abortion issue — at least for now — the House may have helped the long-term prospects for the bill. Catholic bishops also eager to expand society's safety net may yet endorse the final legislation.

Lieberman appeared on "Fox News Sunday," while Graham was CBS' "Face the Nation."

© 2009 The Associated Press. All rights reserved.

Landmark health insurance bill passes House

Tough fight still ahead in Senate, and two versions have wide differences

WASHINGTON - NOVEMBER 7: Rep. John Dingell (D-MI) claps during a press conference after a vote on healthcare on Capitol Hill November 7, 2009 in Washington, DC. The House of Representatives passed the healthcare reform bill 220 to 215 after a late night vote. 1:00 a.m. ET, 11/8/09

Brendan Smialowski / Getty Images

msnbc.com staff and news service reports updated 1:07 a.m. ET, Sun., Nov . 8, 2009 WASHINGTON - In a victory for President Barack Obama, the Democratic-controlled House narrowly passed landmark health care legislation to expand coverage to tens of millions who lack it and place tough new restrictions on the insurance industry. The final vote was 220-215. Only one Republican — Rep. Joseph Cao of Louisiana — voted for the measure; 39 Democrats voted against it. Obama praised the House in a statement and said he is "absolutely confident" that the Senate will pass its version of the legislation. "I look forward to signing it into law by the end of the year," he said.

Passage was an exhilarating triumph for Obama and House Speaker Nancy Pelosi, who earlier likened the bill to passage of the government's Social Security pension program in 1935 and Medicare health insurance for the elderly 30 years later. But the Senate has yet to begin floor debate on its own version of insurance reform. That debate may be weeks away, with Senate Democratic leaders still negotiating over the details of their legislation. If the Senate enacts its bill, conferees from House and Senate would then meet to negotiate a final compromise measure. That compromise would then need to be voted on by the House and Senate. So Democratic members from Republican-leaning districts who cast a difficult vote Saturday night for the House bill will face yet another tough vote in several weeks. The legislation would require most Americans to carry insurance and provide federal subsidies to those who otherwise could not afford it. Large companies would have to offer coverage to their employees. Both consumers and companies would be slapped with penalties if they defied the government's mandates. Insurance industry practices such as denying coverage on the basis of pre-existing medical conditions would be banned, and insurers would no longer be able to charge higher premiums on the basis of gender or medical history. In a further slap, the industry would lose its exemption from federal antitrust restrictions on price fixing and market allocation. Federally regulated marketplace At its core, the measure would create a federally regulated marketplace where consumers could shop for coverage. In the bill's most controversial provision, the government would sell insurance, although the Congressional Budget Office forecasts that premiums for it would be more expensive than for policies sold by private firms. "It provides coverage for 96 percent of Americans. It offers everyone, regardless of health or income, the peace of mind that comes from knowing they will have access to affordable health care when they need it," said Rep. John Dingell, the 83-year-old Michigan lawmaker who has introduced national health insurance in every Congress since succeeding his father in 1955. In the runup to a final vote, conservatives from the two political parties joined forces to impose tough new restrictions on abortion coverage in insurance policies to be sold to many individuals and small groups. They prevailed on a roll call of 240-194. The vote added to the Democratic bill an amendment sponsored by Rep. Bart Stupak, D-Mich., and others, that prohibits individuals who receive insurance subsidies from purchasing any plan that pays for elective abortions. House Democratic leaders agreed Friday night to allow a floor vote on the Stupak amendment to the bill in order to win the support of about three dozen Democrats who feared that the original bill would have subsidized abortions. Ironically, the abortion vote only solidified support for the legislation, clearing the way for the conservative Democrats to vote for it. A cheer A cheer went up from the Democratic side of the House when the bill gained 218 votes, a majority. Moments later, Democrats counted down the final seconds of the voting period in unison, and and let loose an even louder roar when Pelosi grabbed the gavel and declared, "the bill is passed.' From the Senate, Majority Leader Harry Reid of Nevada issued a statement saying, "We realize the strong will for reform that exists, and we are energized that we stand closer than ever to reforming our broken health insurance system." Nearly united in opposition to the health care bill, minority Republicans cataloged their objections across hours of debate on the 1,990-page, $1.2 trillion legislation. "We are going to have a complete government takeover of our health care system faster than you can say, `this is making me sick,'" jabbed Rep. Candice Miller, R-Mich., adding that Democrats were intent on passing "a jobs-killing, tax-hiking, deficit-exploding" bill. But with little or no doubt about the outcome, the rhetoric lacked the fire of last summer's town hall meetings, when some critics accused Democrats of plotting "death panels" to hasten the demise of senior citizens. The bill is projected to expand coverage to 36 million uninsured, resulting in 96 percent of the nation's eligible population having insurance. To pay for the expansion of coverage, the bill cuts Medicare's projected spending by more than $400 billion over a decade. It also imposes a tax surcharge of 5.4 percent on income over $500,000 in the case of individuals and $1 million for families. The bill was estimated to reduce federal deficits by about $104 billion over a decade, although it lacked two of the key cost-cutting provisions under consideration in the Senate, and its longer-term impact on government red ink was far from clear. Democrats lined up a range of outside groups behind their legislation, none more important than the AARP, whose support promises political cover against the cuts to Medicare in next year's congressional elections. The nation's drug companies generally support health care overhaul. And while the powerful insurance industry opposed the legislation, it did so quietly, and the result was that Republicans could not count on the type of advertising campaign that might have peeled away skittish Democrats in swing districts. Campaign Harry Truman began

Overall, the bill envisioned the most sweeping set of changes to the health care system in more than a generation, and Democrats said it marked the culmination of a campaign that Harry Truman began when he sat in the White House 60 years ago. The compromise brokered Friday night on the volatile issue of abortion finally secured the votes needed to pass the legislation.

As drafted, the measure denied the use of federal subsidies to purchase abortion coverage in policies sold by private insurers in the new insurance exchange, except in cases of incest, rape or when the life of the mother was in danger. But abortion foes won far stronger restrictions that would rule out abortion coverage except in those three categories in any government-sold plan. It would also ban abortion coverage in any private plan purchased by consumers receiving federal subsidies. Disappointed Democratic abortion rights supporters grumbled about the turn of events, but appeared to pull back quickly from any thought of opposing the health care bill in protest. One, Rep. Jan Schakowsky, D-Ill., detailed numerous other benefits for women in the bill, including free medical preventive services and better prescription drug coverage under Medicare. "Women need health care reform," she concluded in remarks on the House floor. Republicans offered an alternative that relied heavily on loosening regulations on private insurers to reduce costs for those who currently have insurance, in some cases by as much as 10 percent. But congressional budget analysts said the plan would make no dent in the ranks of the uninsured, an assessment that highlighted the difference in priorities between the two political parties. It fell by a near party line vote of 258-176.

MSNBC.COM'S Tom Curry contributed to this report from The Associated Press.

Congresswoman Chellie Pingree speaks on the floor of the House on historic health care reform

From Congressman Mike Michaud

DEAR Fellow Mainers, Today, I will join my colleagues in taking another important step in a journey that began almost a century ago. After hundreds of meetings, hours of careful consideration, and lots of soul searching, I have decided to lend my support to the historic opportunity that confronts us today. Although I continue to have serious concerns with pieces of the health care reform package, I have decided that being at the table will more effectively advance the interests of the people of Maine than by standing on the sidelines. I will support the bill before the House today because this process must move forward. Three House committees completed their work and blended those proposals into the bill we’re considering tonight. I have taken the time to read and carefully study all 1,990 pages of the bill and the accompanying amendments. This bill is not perfect. Since August, I have raised several concerns over this legislation. Most specifically, I remain concerned about parts of the bill that cut Medicare and Medicaid. These cuts would unfairly impact Maine due to our unique situation as having one of the most efficient health care systems in the country, while receiving some of the lowest reimbursement rates for services provided. These concerns were raised by many in Maine, and I have made sure that they have been heard by the highest levels of government in our nation. This week, I have repeatedly discussed my concerns with the White House and directly with the President. I am pleased that he understood my concerns as they relate to Maine and pledged to work with me to address them in a meaningful way within the context of this bill as it moves forward. I will also redouble my efforts with Senator Snowe to ensure that rural access to health care is protected and strengthened in the State of Maine as both the House and Senate move forward toward a final bill. Let me be clear. My vote today does not guarantee where I will ultimately come down on the future conference report. But this work is too important to fail, and I could not in good conscience let the perfect be the enemy of the possible. To those in Maine who have legitimate concerns over the direction of reform – please know that I have heard them and that I will continue to fight to strengthen this legislation. But we cannot allow unfounded fear of death panels and government takeovers of health care derail this important opportunity. These claims were always untrue, and they are untrue today. We must come together and get the best possible bill passed so that the Mainers I represent not only have more affordable coverage – but coverage that meets their needs. Later tonight, I will say yes to expanding health care coverage to the thousands of small businesses and people in Maine who do not have it and, to those who do, making it more affordable and better. Today, I will say yes to ending the practice of denying coverage due to preexisting conditions and other abusive insurance industry abuses. Being able to get quality health care should never be a question for any American. The bill we passed today is a good step forward. It will help make sure that no American goes broke because they get sick or is ever denied coverage. This is an historic day, but more work lies ahead. I look forward to continuing to work toward meaningful reform that is good for Maine. For more on how the bill will affect Maine’s second congressional district, click here. With warmest regards, Mike Michaud Member of Congress

Decision day for health care overhaul in House

Obama to prod Democrats to push through legislation ahead of likely vote WASHINGTON - President Barack Obama is traveling to Capitol Hill on Saturday to try to close the sale on his signature health care overhaul, facing a make-or-break vote in the House certain to be seen as a test of his presidency. Obama scheduled a late-morning visit with House Democrats convening a rare Saturday session on legislation to remake the U.S. health care system, extending coverage to tens of millions now uninsured and banning insurance company practices such as denial of coverage based on pre-existing medical problems. Late Friday, House Democrats cleared an abortion-related impasse blocking a vote and officials expressed optimism they had finally lined up the support needed to pass Obama's signature issue. Under the arrangement, Democratic Reps. Bart Stupak of Michigan, Brad Ellsworth of Indiana and other abortion opponents were promised an opportunity to insert tougher restrictions into the legislation during debate on the House floor. Democratic unity? The leadership's hope is that no matter how that vote turns out, Democrats on both sides of the abortion divide will then unite to give the health care bill a majority over unanimous Republican opposition. "We wish to maintain current law, which says no public funding for abortion," Stupak said. "We are not writing a new federal abortion policy." Ellsworth added, "From day one, my goal has been to ensure federal tax dollars are not used to pay for abortions and to provide Americans with pro-life options on the exchange. And I am proud to be part of an effort to help make this goal a reality." With Democrats' command of the necessary votes looking tenuous in the final hours, Obama threw the weight of his administration behind the effort to round up support. He and top administration officials worked the phones to pressure wavering lawmakers. Rep. Jason Altmire, D-Pa., said he heard Friday from Obama, White House Chief of Staff Rahm Emanuel, Health and Human Services Secretary Kathleen Sebelius and Education Secretary Arne Duncan. Their message: "This is a historic moment. You don't want to end up with nothing," said Altmire, who remained undecided. Vote could slip to Sunday Democratic leaders hoped to hold the vote Saturday evening, but Majority Leader Steny Hoyer said it could slip. Democrats hold 258 seats in the House and can afford 40 defections and still wind up with 218, a majority if all lawmakers vote. But all 177 Republicans were expected to vote "no," and Democratic leaders faced a series of complications trying to seal the needed votes for their complex and controversial legislation that would affect one-sixth of the economy and touch the lives of countless Americans. GOP to Dems: Rework billIn the GOP's weekly radio address, Mississippi Gov. Haley Barbour said Democrats should scrap their ambitious legislation and concentrate on modest health care changes that could find bipartisan support. The House Democrats' health care bill should be withdrawn and reworked," he said. Tuesday's elections — in which Democrats lost two governors' races — sent a message that voters care about jobs, not growing the size of government, Barbour said. The final hurdle for the Democrats was a controversy over federal funding for abortion, which simmered into Friday night with tensions running high as party leaders shuttled between meetings of anti-abortion and abortion rights lawmakers. Federal law currently prohibits the use of federal funds to pay for abortions except in the case of rape, incest of situations in which the life of the mother is in danger. That left unresolved whether individuals would be permitted to use their own funds to buy insurance coverage for the procedure in the federally backed insurance exchange envisioned under the legislation. Democrats have little room for error, with the prospect of the 2010 midterms looming large and a some of their own moderates already declaring their opposition. The 10-year, $1.2 trillion House bill would create a new federally supervised insurance marketplace where the uninsured could purchase coverage. Consumers would have the option of picking a government-run plan, the most hotly contested item in the legislation. Saturday, MSNBC

Thousands rally to protest health care bill

Obama praises AARP, AMA support; Hoyer predicts bill's passage Saturday msnbc.com staff and news service reports updated 2:26 p.m. ET, Thurs., Nov . 5, 2009 WASHINGTON - Chanting "Kill the bill," thousands of conservatives rallied at the Capitol on Thursday against the Democrats' health care overhaul plan. The campaign-style event kicked off a daylong, Republican protest against the legislation. "This bill is the greatest threat to freedom that I have seen," House Republican leader John Boehner of Ohio told the crowd gathered on the lawn near the West Front of the Capitol. Said Rep. Steve King, R-Iowa: "We're not going to leave this Hill until we kill this bill." Among the signs in the crowd was one reading, "Waterboard Congress," and another saying, "Vote no to government-run health care." The crowd included a significant number of older Americans. Some conservatives oppose increased government involvement as the first step on a slippery slope to "socialized" medicine, a term they use to denigrate other countries' health care systems, and insist on rugged American individualism, in which people should be responsible for their own health care. In addition, millions of Americans get health care from their employers and are reluctant to see any tinkering with that system. Hoyer's prediction However inside the Capitol, legislative action continued in both chambers. House Majority Leader Steny Hoyer predicted the bill will be passed in the House on Saturday. It is aimed at extending coverage to tens of millions of uninsured Americans and banning the medical insurance industry from turning people away. The Senate is working on its own bill, which will have to be reconciled with the House bill for final legislation. Hoyer told reporters House leaders would have the 218 votes needed to pass the sweeping bill that President Barack Obama has made the defining social goal of his young administration — presuming a couple of final issues are resolved. Hoyer acknowledged that the vote could be tight. "I wouldn't refer to it as a squeaker, but I think it's going to be close," Hoyer said. "This is a huge undertaking." Obama praises support President Obama also weighed in on Thursday in a rare appearance at the White House briefing. He trumpted endorsements from the AARP and the American Medical Association of House Democrats' legislation.

Visit msnbc.com for Breaking News, World News, and News about the Economy

Obama told reporters that those endorsement are no small accomplishments. He urged Congress to listen to the AARP and AMA and pass the health care overhaul. Obama says AARP, the nation's premier lobbying group for the elderly, has looked at the bill and is supporting it in the interest of seniors. He also says the AMA wouldn't be supporting the bill it if would lead to health decisions being made by government bureaucrats or damage doctor-patient relationships. But while the House bill is moving, action is slower on the other side of the Capitol, where senators are awaiting a cost analysis from the Congressional Budget Office on Senate legislation written by Senate Majority Leader Harry Reid and others. The timeline there appears likely to spill into next year, posing difficulties for the Obama administration. "We certainly have well over 218 people who say they want to vote for the bill," Hoyer said in an interview with wire service reporters. That is a majority in the 435-member House. Obama also planned a rare trip to the House on Friday to try to win over wavering lawmakers. Potential stumbling blocks With no Republican backing, Democrats will need overwhelming support from within their own caucus. An intraparty disagreement over how to prevent federal funds from being used to pay for abortion has not yet been entirely resolved, though Hoyer said that language being circulated by one anti-abortion Democrat seemed likely to be the basis for an agreement. House leaders are also still grappling with illegal immigration, specifically whether illegal immigrants — who would be barred from getting federal subsidies — should be able to purchase insurance coverage within new government "exchanges," using their own money. The White House does not want this allowed, but some members of the Congressional Hispanic Caucus and other Democrats view that position as too extreme.

Picket for Workers at Narraguagus Bay Health Care Facility

Management wants a three year contract, with a wage freeze!

They haven't had a pay raise in a year. The workers have the support of the town and on Monday, they're going to picket. See below for more information on the situation:

Hi,

Would like to let you know about a Union demonstration to begin on 11.02.09. The place is a little coastal town named Milbridge. Milbridge is a beautiful place and the residents there are friendly and caring. This includes a place called Narraguagus Bay Health Care Facility(NBHCF). It has 65 beds, both nursing home and residential care folks live here. When a family member as well as comes into the facility they are treated like family even if the care givers have never met them before. The residential people are encouraged to do what they can so to keep as much independence, self worth and pride as possible. The nursing home folks are guided through their daily lives as near as normal as can be due to their different disabilities and dementia and health problems. They are treated with respect and dignity.

Now the problem is that in order for this to continue the care givers need a liveable wage and $8.06 an hour for the responsibility and knowledge for medications to the residential care people is not a liveable wage. For a 32 hour position, this equals out to: $515.84 every 2 weeks minus $130.09 for health insurance, and minus approx. $103.16 for taxes. So that is $282.68 for 2 week or $141.34 a week. This is not a liveable wage.

Now what the Downeast Federation of Nursing and Other Health Professionals Union, Local 5073 is going to do is let the folks of this fantastic town know just what is happening.

NBHCF is owned by Dr. Steve Weisburger and Managed by North Country.

This is right from the North Country web site: "Mission Statement-North Country is dedicated to providing quality care in comfortable home-like facilities, to maintaining our facilities in a manner which provides best possible resident care in a progressive working environment, and to the delivery of these goals with a warm positive attitude. We offer our employees a professional environment, filled with the rewards of teamwork and making a difference in the lives of those we care for."

We have had an unsigned contract since June of 2008. Now management wants us to sign a three year contract with a wage freeze in place. No cost of living raise and no step raise (which is in the contract now, through a clause in the contract).

One union member that works in the kitchen is 82 years old. She has been with the company for 28 years. Her wage is $10.40 an hour. Some one off the street can start in her job at $7.50 which is just $2.90 for 28 years of loyalty. Of course I was told by the last administrator that it was her choice to work there all those years. Maybe her choice but many residents have benefited from her kindness and care she has so graciously given for all those years. And just the other day she was asked and worked a double having never in 28 years of service been trained for the evening shift.

Responsibility is a BIG part of this job. We work with elderly people, not items on a grocery store shelf. At WalMarts the starting wage is over $12.00. We have to make sure these people are fed, clean, and as active as they can be. So to enjoy their lives to the fullest possible. We enjoy our jobs and a lot of us have been doing this job for a number of years.

In residential care there is up to 23 residents on the unit. On 3-11 and 11-7 shifts after 5 o'clock there is just 2 staff people on the unit-(this makes it hard to get breaks and now the med person cannot leave the unit unless there is another med person to count and give the keys to so technically med person cannot get a break at all). We have pills, blood sugars to be taken, insulin shots to be given and eye drops. Judgement calls on whether to send some one to the hospital. Communicate with the doctors about residents and relay if there is anything going on with them.

And of course we do have some who can do a lot for them selves but are forgetful. But they are very active in the way of going up and down the hall, walking. Right now 16% need total help getting ready for bed. Each shift has a shower most days to give also, so some one who may be some what independent needs the help with the shower.

Then there is the paper work that needs doing so the bills can be sent out correctly.

In the nursing home unit it is pretty much the aides have to do everything thing for the residents. Some have to be fed, most have to be shown the bathroom, then they have the showers or bath tub bath and most everyone has to be at least washed up and either dressed or dressed for bed on each shift. Some even have to be taken where ever they may need to be for an activity or a meal, or just to look out the window. Sometimes a resident has to be talked into doing what needs to be done, even talk them into eating.

The LPNs talk to the doctors and do dressings and vital signs of folks just out of the hospital.

CMAT pass the meds from the med cart that is in the medication book. This is our expertise personal: Certified Residental Medication Assistant- CRMA- a one week course plus every has to recert with a 8 hour refresher course every 2 years, plus has to be a CNA or a PCA Certified Nurses Assistant -CNA- 6-12 week course plus have 12 hours yearly of updating education, and has to work at least one day every 2 years to keep the certification.

Personal Care Assistant-PCA- 3 days training

Certified Medical Assistant Tech- 6 months of training

Licenced Practical Nurses- LPN- 2 years of training plus different special trainings

Cook 1-on the job training but we do have some experienced cooks

Cook 2- Kitchen Aide 1- on the job training and helps the cooks Kitchen Aide 2

Laundry- does the laundry, sews buttons on and at times patches clothes

Housekeeper-dusts, washes floors, picks up, wipes off tables and changes the cloths, washes the bed each month

ELECTION DAY 2009

Get out and VOTE

Vote NO on 4 and 2

Questions 4 and 2 on the November ballot were written and paid for by nationally funded anti-government groups that want to cute Maine's funding for public services, lay off public workers and cut the pay and benefits of current and retired public workers. Questions 4 and 2 won't solve anything:

Question 4 would lock in the $500 million in cuts in the current two-year state budget.

Question 2 would shift excise taxes away from those who can afford to buy new cars and onto working families and retired workers who driver older cars.

Fortunately our international union, SEIU, is investing over $300,000 right here in Maine this year to defeat these harmful Questions 4 and 2 before they can hurt us and spread to other parts of our nation. SEIU provided similar resources in 2006 when Maine also voted NO on TABOR. These investments are examples of how our affiliation with SEIU protects current and retired workers in Maine and across our nation.

Questions 4 & 2 won't work. They will hurt Maine people and take away local control. Vote NO on Questions 4 & 2.

For more information, go to http://www.votenoontabor.org/ or http://www.nobadroads.org/ or http://www.mseaseiu.org/

Maine State Employees Association, Local 1989 of the Service Employees International Union

65 State Street, P.O. Box 1072, Augusta, Maine 04332-1072

The House Health Care Bill: Read It

Speaker Nancy Pelosi (D-Calif.) officially unveiled the House health care reform bill that is headed to the House floor. The ceremony, held on the West steps of the Capitol, marks the greatest progress toward the Democratic Party's top domestic priority goal in more than half a century. The bill, the Affordable Health Care for America Act -- H.R. 3962 -- includes a public health insurance option that would be required to negotiate with providers -- the top choice of centrist and conservative Democrats. Coming in at just under $900 billion over ten years, the plan would cover 36 million uninsured Americans. House Democrats have posted the bill online. A summary can be read here and the full version is here. The Congressional Progressive Caucus had pushed hard for a "robust" public option that would have reimbursed providers using Medicare rates. Blue Dog Democrats beat back that effort, costing taxpayers $85 billion over ten years -- money that will go to hospitals, doctors and drug makers, increasing the cost of health care. The bill also prevents insurers from discriminating against people with preexisting conditions, caps the financial responsibility that insured individuals will face when medical emergencies strike, bans insurers for dropping folks because they get sick, and proposes a host of other insurance industry reforms. Meanwhile, congressional Republicans are hoping that the historic push will give them an advantage in the 2010 midterm elections. "The lasting image coming out of today's press conference is one of dozens of House Democrats standing proudly behind an incredibly unpopular Nancy Pelosi as she prepares to lead them off a political cliff," said Ken Spain, spokesman for the National Republican Congressional Committee. If anything jumps out at you, let me know at ryan@huffingtonpost.com. The SEIU notes that the bill bans the practice of using domestic violence as a pre-existing condidtion. The Huffington Post first posted 10.29.09 at 11:04 am updated 10.29.09 at 2:57 pm

Pelosi unveils $894 billion House health plan

Would extend coverage to 36 million, require employers to offer insurance NBC News and news services updated 6:42 p.m. ET, Thurs., Oct . 29, 2009 House Speaker Nancy Pelosi of Calif., Rep. John Dingell, D-Mich., left, and others, are seen on Capitol Hill in Washington on Thursday.

Charles Dharapak / AP

WASHINGTON - Cheered by President Barack Obama, House Democrats rolled out landmark legislation Thursday to extend health care to tens of millions who lack coverage, impose sweeping new restrictions on the insurance industry and create a government-run option to compete with private insurers.

But even as party leaders pointed toward a vote next week, there were fresh questions that went to the heart of their ambitious drive to remake the nation's health care system.

Congressional budget experts predicted the controversial government insurance option would probably cost consumers somewhat more than private coverage. At the same time, rank-and-file conservative Democrats sought additional information about the bill's overall impact on federal health care spending. There was no official estimate on the total cost of the legislation, which ran to 1,990 pages. The Congressional Budget Office said the cost of additional coverage alone was slightly more $1 trillion over a decade. But that omitted other items, including billions for disease prevention programs. Yet another $230 billion or more in higher fees for doctors treating Medicare patients, included in an earlier version of the bill, was stripped out and will be voted on separately. Pelosi: Bill would reduce deficits The measure "covers 96 percent of all Americans, and it puts affordable coverage in reach for millions of uninsured and underinsured families, lowering health care costs for all of us," boasted Speaker Nancy Pelosi, D-Calif., at a ceremony attended by dozens of Democratic lawmakers. She spoke on the steps of the Capitol, not far from where Obama issued his inaugural summons for Congress to act more than nine months ago. Pelosi said the legislation would reduce federal deficits over the next decade by $104 billion, and congressional budget experts said it would probably reduce them even further over the following 10 years. House leaders hope to have their bill on the floor late next week, perhaps Thursday, according to House Education and Labor Committee Chairman George Miller. While saying they expected a vote next week, Democratic leaders were careful not to claim they had yet rounded up enough votes to pass the legislation. Still, the day's events capped months of struggle and marked a major advance in their drive — and Obama's — to accomplish an overhaul of the health care system that has eluded presidents for a half-century. Across the Capitol, the Democratic-controlled Senate is expected to begin debate within two weeks on a bill crafted by Majority Leader Harry Reid, D-Nev. It, too, envisions a government-run insurance option, although states could opt out, unlike in the bill the House will vote on. That portion of the Senate version appears likely to be weakened even further, as moderates press for a standby system that would not go into effect until it was clear individual states were experiencing a lack of competition among private companies. Obama called the House legislation "another critical milestone in the effort to reform our health care system." Republican reaction was as swift as it was negative. "It will raise the cost of Americans' health insurance premiums; it will kill jobs with tax hikes and new mandates, and it will cut seniors' Medicare benefits," said the party's leader in the House, Rep. John Boehner of Ohio. He carried a copy of the 1,990-page measure into a news conference to underscore his claim it represented a government takeover of the health care system. GOP to make heath care key election issue Republicans have already signaled their determination to make the health care debate a key issue in next year's congressional elections, when all 435 House seats will be on the ballot. But their ability to block passage in the current House is nonexistent as long as Pelosi and her leadership can forge a consensus among the Democratic rank and file. The party holds 256 seats in the House, where 218 makes a majority. Broad in scope, the House Democrats' bill attempts to build on the current system of employer-provided health care. It would require big companies to cover their employees and include federal subsidies to help small companies provide insurance for theirs, as well. Most individuals would be required to carry insurance, and much of the money in the legislation is dedicated to subsidies for those at lower incomes to help them afford coverage. For those at even lower incomes, the bill provides for an expansion of Medicaid, the state-federal health program for the poor. Adults up to 150 percent of poverty — individuals making up to $16,245 and a family of four up to $33,075 — would be covered, a provision estimated to add 15 million to Medicaid. One of the bill's major features is a new national insurance market, in which private companies could sell policies that meet federally mandated benefit levels, the government would offer competing coverage and consumers could shop for the policy that best met their needs. In a bow to moderates, Democrats decided doctors, hospitals and other providers would be allowed to negotiate rates with the Department of Health and Human Services for services provided in the government insurance option. Liberals had favored a system in which fees would be dictated by the government, an approach that would have been less costly than what was settled on, and also would have moved closer to a purely government-run health care system than some Democrats favor. Enrollment would be only about 6 million The Congressional Budget Office said the result would be fees comparable to those doctors receive from private insurers. But for consumers, government-backed plans "would typically have premiums that are somewhat higher than the average premiums for private plans" sold in competition. As a result, it said enrollment would be only about 6 million. Conservative Democrats known as Blue Dogs reacted to the overall CBO analysis by asking whether the bill would reduce the long-term rate of growth in federal spending. They noted the agency had said last summer that an earlier version would fail to do so, and they said they wanted updated answers "in order to make an informed decision." Thursday's bill includes an array of new restrictions on the private insurance industry, in addition to forcing insurers to compete with the federal government for business. Firms would be banned from denying coverage on the basis of pre-existing medical conditions and limited in their ability to charge higher premiums on the basis of age. They would be required to spend 85 percent of their income from premiums on coverage, effectively limiting their ability to advertise or pay bonuses. Additionally, the industry would be stripped of immunity from antitrust regulations covering price fixing, bid rigging and market allocation. And in a late addition to the bill, 30-year-old restrictions on the Federal Trade Commission's ability to look into the insurance industry would be erased. In response, the industry's top lobbyist, Karen Ignagni, issued a statement containing a somewhat milder version of criticism than recently unleashed against the Senate's version of the legislation. "We are concerned" the House bill will violate assurances that individuals would be able to keep their insurance if they like it, she said. She said it would be responsible for "increasing health care costs for families and employers across the country and significantly disrupting the quality coverage on which millions of Americans rely today." Ignagni added that the presence of a government-run insurance plan "would bankrupt hospitals, dismantle employer coverage, exacerbate cost-shifting from Medicare and Medicaid and ultimately increase the federal deficit." While Democrats touted new benefits for seniors, the bill relies on more than $400 billion in cuts from projected Medicare spending over the next decade. Much of the money would come from the part of the program in which private companies offer coverage to seniors. The bill's other major new source of revenue is from a proposed income tax surcharge of 5.4 percent on wealthy earners, individuals making at least $500,000 a year and couples $1 million or more. The legislation includes other taxes, such as a 2.5 percent excise tax on the makers of medical devices, expected to raise $20 billion over a decade. NBC's Mike Viqueira contributed to this report.