The House of Representative by a vote of 152-4 approved and sent to the Senate a bill that would ban junk food in schools and require new and healthy nutritional standards to be developed for food sold in all school cafeterias and vending machines.

The Senate rejected a proposed comission to tackle the deficit, largely because it would have required Congress to either completely accept or reject its recommendations without the ability to make changes. President Obama has issued an executive order to create something similiar, however. The Senate did accept pay-as-you-go limits on federal spending and to raise the debt ceiling without a single Republican vote on either. The Senate also confirmed (with a bipartisan mix of votes) Ben Bernanke for a second term as chairman of the Federal Reserve.

As for health care reform? Who the hell knows.

On the one year anniversary of President Barack Obama’s election, Democrats aren’t feeling as great about things as they probably hoped:

In a stunning upset, Republican Scott Brown, a little-known state senator just weeks ago, Tuesday trounced Democrat Martha Coakley to win a Massachusetts U.S. Senate seat and jolt Washington’s Democratic leaders with a victory that imperils President Barack Obama’s agenda, led by his bid to overhaul the nation’s health care system.

Brown, 50, mobilized voters in one of the nation’s most Democratic states — voters frustrated by the sluggish economy, angry about big government and uneasy about changes in health care. He led Coakley, 56, who conceded defeat shortly before 10 P.M., by 52 to 47 percent with 99 percent of precincts reporting.

With his victory, the first time since 1972 that a Republican has won a Massachusetts Senate race, Brown will take the “Kennedy seat” occupied by Sen. Edward Kennedy for 47 years before his death in August and once held by John F. Kennedy before he became president in 1961.

What went wrong?  Most agree Coakley ran a simply awful campaign, and the Republican base was much more energized. This is definitely a wake up call to President Obama and Congressional Democrats to start delivering if they don’t want to to risk losing control this November.

The irony cannot be lost that Senator Kennedy, who long championed health care reform, was replaced by a Republican who opposes it and will deny Senate Democrats the 60 votes needed for its passage. But all hope is not lost:

To their credit, Washington Democrats haven’t given up. The White House is weighing a plan to pass the Senate bill immediately through the House, which would, with Obama’s signature, make it law automatically without Scott Brown or anyone else in the Senate getting another crack at it. Then the Democrats would use “reconciliation” budget rules to fix problems in the Senate version with 51 votes, per the agreement Obama has been working on for the last couple of weeks. This is a messy approach but doable.

Indeed, this will require holding moderate Democrats who fear they will suffer the same fate as Coakley if they support health care reform, while convincing House liberals to go along with the Senate version of the bill with the promise of improving it later.

If I were them, I’d do it. The Senate bill is far from perfect but still better than nothing. And its problems can be fixed through separate legislation. Let’s pass this thing and move on.

From TNR:

According to a pair of senior Capitol Hill staffers, one from each chamber, House and Senate Democrats are “almost certain” to negotiate informally rather than convene a formal conference committee. Doing so would allow Democrats to avoid a series of procedural steps–not least among them, a series of special motions in the Senate, each requiring a vote with full debate–that Republicans could use to stall deliberations, just as they did in November and December.

“There will almost certainly be full negotiations but no formal conference,” the House staffer says. “There are too many procedural hurdles to go the formal conference route in the Senate.”

One reason Democrats expect Republicans to keep trying procedural delays is that the Republicans have signaled their intent to do so. On Christmas Eve, when the Senate passed its bill, Minority Leader Mitch McConnell memorably vowed in a floor speech that “This fight isn’t over. My colleagues and I will work to stop this bill from becoming law.”

Sounds like a good plan to me and hopefully this means final passage will happen significantly sooner than it otherwise would. My only concern would be if this means that the Senate bill is less likely to get changed as House Dems just to agree go with it for the sake of saving time, but we can’t really speculate until we get more details on this.

Nelson finally gave in, and now Senate Democrats have their 60 votes:

Because the Democrats nominally control 60 seats in the Senate — the precise number needed to overcome Republican filibusters — every senator in the Democratic caucus effectively has veto power over the bill. No Republican is willing to support it.

The legislation, the most sweeping overhaul of the nation’s health care system in more than a generation, seeks to extend health benefits to more than 30 million uninsured Americans by expanding Medicaid and providing subsidies to help moderate-income people purchase private insurance.

The bill also imposes tight new regulations of the health insurance industry, barring insurers from denying coverage based on pre-existing medical conditions and limiting how much extra they can charge for people based on their age.

The majority leader, Harry Reid of Nevada, racing against the clock to complete the bill by his self-imposed holiday deadline, introduced a 338-page package of last-minute amendments, including the key provisions needed to win Mr. Nelson’s support.

[...]

Mr. Reid’s amendment includes tighter restrictions on insurance coverage for abortions sought by Mr. Nelson. Health insurance plans would not be required or forbidden to cover abortions, but states could prohibit the coverage of abortions by plans that are offered for sale through new government-regulated marketplaces.

The amendment also includes a special extension solely for Nebraska: increased federal contributions to the cost of an expansion of Medicaid, the state-federal insurance program for the poor.

Can the Democrats deliver on the desire to pass a greatly-watered-down-reform-bill-hijacked-by-”centrist”-Democrats-in-the-Senate-that-progressive-are-divided-in-support-of by Christmas? One can only hope, sort of.

I think I understand the rationale for cuts to Medicare spending as part of the overall health care reform package, but I have to admit I don’t understand the rationale behind this:

Home care shows, in microcosm, a conundrum at the heart of the health care debate. Lawmakers have decided that most of the money to cover the uninsured should come from the health care system itself. This raises the question: Can health care providers reduce costs without slashing services?

Under the legislation, home care would absorb a disproportionate share of the cuts. It currently accounts for 3.7 percent of the Medicare budget, but would absorb 10.2 percent of the savings squeezed from Medicare by the House bill and 9.4 percent of savings in the Senate bill, the Congressional Budget Office says.

The House bill would slice $55 billion over 10 years from projected Medicare spending on home health services, while the Senate bill would take $43 billion.

Democratic leaders in the House and Senate justify the proposed cuts in nearly identical terms. “These payment reductions will not adversely affect access to care,” but will bring payments in line with costs, the House Ways and Means Committee said. The Senate Finance Committee said the changes would encourage home care workers to be more productive.

The proposed cuts appear to be at odds with other provisions of the giant health care bills. A major goal of those bills is to reduce the readmission of Medicare patients to hospitals. Medicare patients say that is exactly what home care does.

“It helps me be independent,” said Mildred A. Carkin, 77, of Patten, Me., as a visiting nurse changed the dressing on a gaping wound in her right leg, a complication of knee replacement surgery. “It’s cheaper to care for us at home than to stick us in a nursing home or even a hospital.”

Delmer A. Wilcox, 89, of Caribou, lives alone, is losing his vision, uses a walker and has chronic diseases of the lungs, heart and kidneys. He said his condition would deteriorate quickly without the regular visits he received from Visiting Nurses of Aroostook, a unit of Eastern Maine Home Care.

I have always heard that the rationale for emphasizing home health care was twofold, to grant patients more independence and more time at home, and to cut the excessive costs of hospitalization or hospice care. Is that wrong? If not, then why are the cuts focused disproportionately on services that lower the cost of health care overall? Someone smarter than me will have to explain this, because frankly I don’t get it.

Paul Krugman, on what I believe is the single most powerful argument for health care reform:

… the proposed health care reform links the expansion of coverage to serious cost-control measures for Medicare. Think of it as a grand bargain: coverage for (almost) everyone, tied to an effort to ensure that health care dollars are well spent.

Are we talking about real savings, or just window dressing? Well, the health care economists I respect are seriously impressed by the cost-control measures in the Senate bill, which include efforts to improve incentives for cost-effective care, the use of medical research to guide doctors toward treatments that actually work, and more. This is “the best effort anyone has made,” says Jonathan Gruber of the Massachusetts Institute of Technology. A letter signed by 23 prominent health care experts — including Mark McClellan, who headed Medicare under the Bush administration — declares that the bill’s cost-control measures “will reduce long-term deficits.”

The fact that we’re seeing the first really serious attempt to control health care costs as part of a bill that tries to cover the uninsured seems to confirm what would-be reformers have been saying for years: The path to cost control runs through universality. We can only tackle out-of-control costs as part of a deal that also provides Americans with the security of guaranteed health care.

And the tactics of those renowned fiscal disciplinarians, the Republican party:

…in the closing rounds of the health care fight, the G.O.P. has focused more and more on an effort to demonize cost-control efforts. The Senate bill would impose “draconian cuts” on Medicare, says Senator John McCain, who proposed much deeper cuts just last year as part of his presidential campaign. “If you’re a senior and you’re on Medicare, you better be afraid of this bill,” says Senator Tom Coburn.

If these tactics work, and health reform fails, think of the message this would convey: It would signal that any effort to deal with the biggest budget problem we face will be successfully played by political opponents as an attack on older Americans. It would be a long time before anyone was willing to take on the challenge again; remember that after the failure of the Clinton effort, it was 16 years before the next try at health reform.

That’s why anyone who is truly concerned about fiscal policy should be anxious to see health reform succeed. If it fails, the demagogues will have won, and we probably won’t deal with our biggest fiscal problem until we’re forced into action by a nasty debt crisis.

This charge is being led by that maverick McCain, who was for Medicare cuts (last year!) before he was against them. So remember guys: the GOP is the party of fiscal discipline…unless a Republican president is office, Medicare spending will win some voters, or scaring old people about cuts to Medicare will derail health care reform.

1. Nicholas Kristof, on how Republican have been scare-mongering Americans into voting against their own interests for eighty years now. History has proven them wrong, every single time.

2. Perhaps you heard about the “Hand of Frog” that secured France a berth in the World Cup over poor Ireland. Ireland’s petition to FIFA for a replay has been denied, proving that FIFA is an organization mired in the past, both rejecting modern instant replay technology and favoring the world’s powerhouses (particularly the Western ones) over the rest of the world.

3. No one sitting on death row in Texas can expect any sort of clemency from Gov. Perry right now…the man has a primary to win!

4. Short-term lenders in Texas are getting what they pay for with their campaign contributions: zero regulation. As I have said before and will say again, our democracy will forever be corrupted by money until the Supreme Court wises up and decides that money is not the exact equivalent of speech, or political campaigns become publicly funded.