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Healthcare reform has split Fisher, Portman

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By Jack Torry and Jonathan Riskind, Washington Bureau Updated 3:35 PM Saturday, August 21, 2010

WASHINGTON — With more than 200 Democratic lawmakers cheering and applauding in the East Room of the White House in March, President Barack Obama signed into law a major health care bill that had sharply split both political parties for more than a year.

That should have ended it. As Senate Finance Committee Chairman Max Baucus told the New York Times that day, “Now it is a fact. Now it is law.’’

Yet more than four months after that ceremony, the health care law has emerged as a defining issue in the U.S. Senate campaign between Democrat Lee Fisher and Republican Rob Portman.

Fisher said he would have voted for the law, which when fully implanted in 2014 will provide health care coverage to millions of uninsured Americans. But Portman has assailed it as a “new entitlement program we can’t afford,’’ and is vowing to vote to repeal the measure and “replace it with something better.’’

The “repeal and replace’’ line has become a rallying cry for Republican House and Senate candidates across the country. With Americans still deeply divided about the law, GOP strategists are convinced that type of clear message will resonate with conservative and independent voters.

“Portman is in the position of saying let’s do more of nothing and Fisher may be in the position of trying to defend things you haven’t gotten yet,’’ said Dennis Eckart, a former Democratic congressman from Cleveland. “That’s the big problem with health care politically. It’s not that it’s wrong or right. It’s just that nobody has felt the impact of it yet.’’

The Republican challenge to a recently passed law, while not unheard of, is a rarity in American politics. After ferocious battles over civil rights, Medicare, Medicaid and Social Security, both political parties rather quickly moved on to other issues.

“I think it is unfortunately typical of what Congressman Portman and his Republican colleagues are doing,’’ Fisher said. “They are literally folding their arms, standing on the sidelines and rooting for failure.’’

The new law, which costs $940 billion over 10 years, will extend health care coverage to 32 million of the 46 million people in America without any insurance. It does so through federal subsidies to help middle income people buy private insurance and by expanding eligibility for Medicaid, the joint state-federal program that covers health care costs for the poor.

The law imposes fines on individuals who fail to buy insurance, as well as companies with 50 or more workers that do not offer coverage to their workers.

To pay for the law, the government in 2018 will tax individual insurance plans with high premiums, starting with individual plans that have annual premiums of $10,200. In addition, Congress will reduce Medicare spending by $500 billion during the next 10 years, including $132 billion in cuts to Medicare Advantage, a privately run, subsidized plan that is a hit with many seniors.

Fisher has been an enthusiastic backer of the law and to illustrate why, he likes to tell this story: In 1970, just after his freshman year in college, he and his brother were injured in a “terrible car accident’’ while camping in Idaho.

For a time, Fisher said, nobody was quite certain if he would live and, if he did, whether he would walk again. But, Fisher goes on to say, his family could afford the best doctors and health care and three months later he was able to leave Idaho and return home.

“I was very fortunate to have health care coverage,’’ Fisher said

He supports the individual mandate, saying that “if you are going to be able to truly lower costs then it’s important that everyone be in the pool. It is not at all different from what we do in Ohio by requiring someone to have auto insurance before they can drive.’’

But Fisher opposes financing the bill’s cost through lower Medicare payments to physicians and a tax on expensive health plans, saying “at a time when millions of families are struggling to make ends meet we shouldn’t penalize workers for receiving quality benefits.

Instead, he insisted the law can be paid for by ending the 2001 and 2003 tax cuts on the wealthy and cracking down on Medicaid and Medicare fraud. But analysts doubt whether either approach would be enough to pay for the costs of extending insurance to so many people.

By contrast, Portman focuses on the costs of the law. The Medicaid expansion will cost Ohio taxpayers $1.45 billion from 2014 through 2019, according to state officials, who estimate by 2014 an additional 554,000 people will be added to the 2.1 million people currently on Medicaid in Ohio.

“If you look at how this legislation impacts Ohio, you cannot avoid the fact that it increases Medicaid costs in Ohio and we cannot afford it,’’ Portman said.

He added: “The No. 1 problem with health care is that it is too expensive. This legislation not only doesn’t address it, but makes it worse. Everyone should have access to affordable health care.’’

He ticks off a list of ideas he insists would reduce crushing health care costs – limiting damage awards on medical malpractice lawsuits, offering refundable tax credits to help low and middle income people buy insurance, allowing small businesses to band together to buy less expensive policies, and permitting insurance companies to sell across state lines.

Last year, however, the non-partisan Congressional Budget Office analyzed a House Republican health plan similar to Portman’s and concluded by 2019 only an additional three million people would receive insurance.

“Congressman Portman and his colleagues are opposing things they have historically supported only to score cheap political points,’’ Fisher charged. “If Congressman Portman wants to stand for an insurance company to deny you coverage because of a medical condition, I’ll let the voters decide who is on their side.’’

Where Democrat Lee Fisher and Republican Rob Portman agree and disagree on health care:

Would you have voted for the health-care reform Congress passed in March?

Fisher: Yes

Portman: No

Should the bill have had a government-run health plan, the “public option?”

Fisher: Yes

Portman: No

Do you support the law’s mandate for individuals to buy health insurance?

Fisher: Yes

Portman: No

Do you support the 2.9% tax on medical devices that will help pay for coverage for the uninsured?

Fisher: No