Capuano to Vote "No" on Health Care? Friday Health Care Megapost

Is everybody's favorite foul-mouthed Somervillian congressman about to vote "no" on health care reform? Report has leaked out that Michael Capuano, our congressman and possibly yours, might not vote with the Democrats to pass Obama's health care bill. And bloggers are freaking out.

The source of the concern is an e-mail Capuano sent to his supporters yesterday, in which he expressed his misgivings about both the viability of Democrats' legislative tactics and substantive issues in the health care reform act itself. He wrote:

Therefore, I have been focusing on how exactly the Senate bill affects Massachusetts before I decide how much I will leave to "trusting" the reconciliation process. Trust is hard to find in Washington these days and I will have to make that decision myself.

Among his substantive objections are the lack of a public option to control insurance costs, cuts to funding for "disproportionate share hospitals," those hospitals that most frequently serve the indigent, and a "value index" that would adjust payments to doctors to the detriment of those working in Massachusetts. He also fears that payments to Massachusetts, as an "early expansion state," will be lost during Senate reconciliation, when state-specific benefits are expected to be slashed.

Capuano is not alone in his concerns about the affects that Senate reconciliation might have on funding for Massachusetts. John Kerry, an "ally" in Obama's health care efforts, has reportedly gained assurances that $500 million in Medicaid funding for Massachusetts will not be absent from the final bill. Our other Senator was uncharacteristically silent on the issue.

Meanwhile, Massachusetts health care experiment is about to fizzle out and die. Massive health insurance costs have driven state regulators to revisit the income floor under which residents are required to have health insurance. Though the move will not affect those receiving health insurance throught their employer, predictably, the state's poor will be among the screwed as the state's landmark safety net lets them drop.