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Healthcare reform to be gutted: cost-sharing subsidies NOT EXEMPT from debt deal's automatic cuts

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nashville_brook Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Aug-04-11 07:07 PM
Original message
Healthcare reform to be gutted: cost-sharing subsidies NOT EXEMPT from debt deal's automatic cuts
Those among us still rooting for an Obama win in 2012 should be very concerned about this. Written into the debt deal the mechanism to defund and dismantle Obama's signature policy victory, the Affordable Care Act, otherwise known as healthcare reform (or the offensive, "Obamacare"). Between Thanksgiving and Christmas 2011, well before the program is slated to be implemented, the Supercongress must *successfully* agree to $1.5 TRILLION in cuts or else the ACA gets cut right along with everything else.

The Affordable Care Act doesn't have room for cuts, as the subsidies are far too small as it is. Interestingly, Digby points out that Obama might be willing to ax ACA anyway b/c supposedly it's not polling well among Independents.

Just in case anyone's wondering, health care reform will be the next hostage taken in Obama's Grand Capitulation, er, Grand Bargain. All the GOP has to do is stand in the way of raising revenues and the ACA is history. So, remind me again, what incentive they have to negotiate in "good faith." :rofl:

What's worse, it might actually be that THE DEMOCRATS are hoping for the automatic cuts instead of engaging in another street fight with the Republicans.

Stay tuned.





http://www.tnr.com/blog/jonathan-cohn/93129/debt-ceilin...


Gaming Out the Debt Deal: Will It Hurt Obamacare?

The emerging, if still tentative, conventional wisdom about the debt ceiling agreement is that Democrats may ultimately prefer the plans automatic spending cuts to whatever cuts the new super-committee proposes. As you probably know, the agreement calls for whats basically a two-step process: A bipartisan, 12-member committee will consider ways of reducing the deficit. If the committee fails to make recommendations that would reduce the deficit by $1.5 trillion over ten years, or if makes recommendations but Congress fails to enact them, then the law calls for automatic, across-the-board cuts reducing deficits by $1.2 trillion.

Why would Democrats prefer the automatic cuts? President Obama and the Democrats largely shielded the big entitlements and programs from the poor. Media reports have suggested that Budget Director Jack Lew and National Economic Adviser Gene Sperling were particularly adamant about protecting Medicaid. The super-committee, by contrast, would surely look to these programs for cuts, perhaps substantial ones. Ideas like reducing federal funding for Medicaid or raising the eligibility age for Medicare, both of which figured into earlier negotiations between Obama and House Speaker John Boehner, are sure to get a close look.

But dont kid yourself: The automatic cuts will still hurt, because theyd still affect plenty of important programs. And among them may be the administrations signature legislative accomplishment, the Affordable Care Act. The new health care law will make insurance more affordable by providing subsidies to people who buy insurance on their own. And these subsidies come in two forms. There are tax credits, which people can use to offset the cost of their premiums. And there are subsidies to defray cost-sharing: In other words, the government will help reduce peoples out-of-pocket costs. Under the debt ceiling deal, the tax credits are exempt from automatic reductions, because they are a tax credit and not a form of spending.

But, as both administration and congressional sources are confirming, the cost-sharing subsidies are not exempt. They will decline. And thats worrisome because the subsidies were already pretty low. In fact, many of us were hoping that, over time, lawmakers would see fit to raise them rather than reduce them. I can't be sure how much the subsidies would decline, as nobody Ive contacted seems to have run the numbers yet. And I'm not even positive how reduced subsidies would translate into reduced protection, since technically the subsidies go directly to the insurers. (I don't even want speculate about the impact until I know more. Ill update this item when I do.)

(snip)
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vi5 Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Aug-04-11 07:21 PM
Response to Original message
1. But...but it's on "The List"!
They can't take things of "The List", can they?
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Bluebear Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Aug-04-11 07:39 PM
Response to Reply #1
13. !
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alsame Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Aug-04-11 07:21 PM
Response to Original message
2. But they'll keep the mandate. nt
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area51 Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Aug-04-11 09:11 PM
Response to Reply #2
27. Yep, you know it. n/t
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BlueIris Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Aug-04-11 09:29 PM
Response to Reply #2
29. They can try, but I sincerely doubt it will stay. nt
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amborin Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Aug-04-11 07:23 PM
Response to Original message
3. k and r and here, too:
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nashville_brook Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Aug-04-11 07:35 PM
Response to Reply #3
7. great minds -- :)
i heard this story today on Sam Seder's show, and could barely believe my ears. Astonishing.
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amborin Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Aug-04-11 07:35 PM
Response to Reply #7
8. :)
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McCamy Taylor Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Aug-04-11 07:24 PM
Response to Original message
4. So, the poor will pay a $1000 "poor tax" because they won't be able to afford health insurance.
And we will balance our budget with that.

Did I sum it up accurately?
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nashville_brook Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Aug-04-11 07:36 PM
Response to Reply #4
9. you know, i had not done the math, but that sounds about right. sheesh.
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Raksha Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Aug-04-11 10:47 PM
Response to Reply #4
35. Un-freakin-believable!
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RickFromMN Donating Member (275 posts) Send PM | Profile | Ignore Thu Aug-04-11 07:24 PM
Response to Original message
5. Message to the next President, don't be a compromising, capitulator.

Have principles. Let the people know your principles. Stand up for your principles.

Make sure everyone, including the opposition knows, you won't compromise away your principles.

I'm tired of hearing about Grand Bargains. It's a code phrase for something bad about to happen.

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bvar22 Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Aug-04-11 07:37 PM
Response to Reply #5
10. Obama already had that message.
It was from Democratic President Harry Truman.


"I've seen it happen time after time. When the Democratic candidate allows himself to be put on the defensive and starts apologizing for the New Deal and the Fair Deal, and says he really doesn't believe in them, he is sure to lose. The people don't want a phony Democrat. If it's a choice between a genuine Republican, and a Republican in Democratic clothing, the people will choose the genuine article, every time; that is, they will take a Republican before they will a phony Democrat, and I don't want any phony Democratic candidates in this campaign."

---President Harry Truman
QED:2010




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RaleighNCDUer Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Aug-04-11 07:49 PM
Response to Reply #10
18. I don't think he's read it. nt
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nashville_brook Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Aug-04-11 07:56 PM
Response to Reply #10
20. what would a genuine article even look like...i barely remember.
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DirkGently Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Aug-04-11 07:51 PM
Response to Reply #5
19. But just imagine what the Real Shitty Bargain might've looked like!
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nashville_brook Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Aug-04-11 09:07 PM
Response to Reply #19
24. we are indeed lucky duckies.
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DirkGently Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Aug-04-11 07:34 PM
Response to Original message
6. ... the one thing people have held up as his Great Accomplishment. Trashed in the dark. Questions?
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leftstreet Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Aug-04-11 07:38 PM
Response to Reply #6
12. He's kept 2 promises. Took Michelle on a date, and got the kids a dog
:-(
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nashville_brook Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Aug-04-11 07:48 PM
Response to Reply #12
16. blahhahhhaahhhhaaaa!
:rofl: :rofl: :rofl: :rofl: :rofl: :rofl: :rofl: :rofl: :rofl: :rofl: :rofl: :rofl: :rofl: :rofl: :rofl: :rofl: :rofl: :rofl: :rofl: :rofl:
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DirkGently Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Aug-04-11 07:49 PM
Response to Reply #12
17. Heard the dog's chow may now be "unsustainable." Catfood to be substituted.
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SusanaMontana41 Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Aug-05-11 06:34 PM
Response to Reply #17
51.  ...
:evilgrin:
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Raine Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Aug-05-11 06:49 PM
Response to Reply #12
52. and the dog was provided by Teddy Kennedy
I've sometimes wondered if he would've even kept that promise if Teddy hadn't given BO as a gift.
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Safetykitten Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Aug-04-11 07:38 PM
Response to Original message
11. I specifically posted on this, and was told I was imagining shit.
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DirkGently Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Aug-04-11 07:45 PM
Response to Reply #11
14. You are. Gitmo is closed. We all have National Health cards. GE paid some taxes. Shhhhhhhnow
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nashville_brook Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Aug-04-11 07:47 PM
Response to Reply #11
15. i actually thought i was imagining shit when i heard this on Seder's show...
so i thought i'd look it up. Digby was on and mentioned it, and so i went and found her blog post where she links to the original reporting.

so, we're not the crazy ones...they are!

:evilgrin:
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StarsInHerHair Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Aug-04-11 08:20 PM
Response to Reply #11
21. here or in p gd?
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Safetykitten Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Aug-04-11 09:41 PM
Response to Reply #21
31. In GD. I asked how would it be possible that the new HCR would be untouched...
by the debt deal fiasco. This was a couple of weeks ago.

I was hammered that I was delusional and wtf was I blabbering about.

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StarsInHerHair Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Aug-04-11 11:18 PM
Response to Reply #31
40. yeah, the pres. own fan club is in that other forum, it was prob 1 of them
I had an odd feeling about his health care reform, because of how far off the start date was, you were proven correct.
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kenny blankenship Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Aug-04-11 08:22 PM
Response to Original message
22. Eh. Corporatism giveth. Corporatism taketh away.
Edited on Thu Aug-04-11 08:33 PM by kenny blankenship
Accept that your place in the global spreadsheet is to be buried way, way the hell down under the column heading: "legacy liabilities".
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nashville_brook Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Aug-04-11 09:02 PM
Response to Reply #22
23. this country is acting like their getting ready for an IPO.
i'm pretty familiar with the behavior. Shock Doctrine starts at work.
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DirkGently Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Aug-04-11 09:09 PM
Response to Reply #23
25. Fire all staff, sell the furniture, declare a record year!
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nashville_brook Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Aug-05-11 06:55 AM
Response to Reply #25
42. seriously, that's a pretty good summation of what's happening.
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DirkGently Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Aug-05-11 02:30 PM
Response to Reply #42
49. Looks great on paper. If you're stupid.
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kenny blankenship Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Aug-04-11 09:36 PM
Response to Reply #23
30. Or a Liquidation Sale.
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ProSense Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Aug-04-11 09:10 PM
Response to Original message
26. This is
speculation and it's not going to happen.

But, as both administration and congressional sources are confirming, the cost-sharing subsidies are not exempt. They will decline. And thats worrisome because the subsidies were already pretty low. In fact, many of us were hoping that, over time, lawmakers would see fit to raise them rather than reduce them. I can't be sure how much the subsidies would decline, as nobody Ive contacted seems to have run the numbers yet. And I'm not even positive how reduced subsidies would translate into reduced protection, since technically the subsidies go directly to the insurers. (I don't even want speculate about the impact until I know more. Ill update this item when I do.)

But the point here isn't to second-guess specific trade-offs in the automatic cuts; again, I think Obama and the Democrats did a good job of protecting the most vital programs and the most vulnerable populations. Rather, it's a reminder about the overall structure of the deal. When you decide to reduce the deficit by $2.4 trillion over ten years, with little chance for including new revenue as part of the package, youre going to end up cutting spending in some regrettable ways. No amount of last-minute negotiating was going to change that.

Update: I reworded the ending to emphasize my uncertainty about how exactly the cuts will affect individuals.
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swilton Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Aug-04-11 09:22 PM
Response to Original message
28. Obama's health care reform was a joke and it's
no great loss - perhaps my insurance premiums will now go down by $30/mo rather than increase as they had under Obamacare.
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TheKentuckian Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Aug-04-11 10:57 PM
Response to Reply #28
37. More like keep the crap and cut the subsidies.
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BzaDem Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Aug-04-11 09:52 PM
Response to Original message
32. Your characterization of the consequences is absurd. The vast majority of the ACA is completely
exempt. Premium assistance for example is completely exempt (and that makes up the vast majority of subsidies). The one non-negligible part that is not exempt is the cost sharing subsidies, but these weren't going to go to most people in the first place, were far less than the premium subsidies even for the people it goes to, and would still be significant at 95% of the original amount instead of 100%. For you to say that the ACA will disappear is beyond ridiculous.

It will be interesting to see those who opposed any subsidies to help people get insurance ("profit protection act" or whatever) attack a cut in those very subsidies they opposed.
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dflprincess Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Aug-04-11 10:18 PM
Response to Reply #32
33. I have a real problem with tax money being funneled into the pockets of the health insurers
with no guarantees that the people whose premiums are being subsidized will actually be able to access care. The Profit Protection Act does nothing to outlaw the high deductible plans that are becoming so common.

There was an article in the Mpls Star Tribune a few weeks ago about how the insurance companies are posting big profits because, thanks to large out of pockets, people are not going to the doctor - the article reported on several people with chronic conditions who can't see their providers as often as they should. The Profit Protection act will not help people in these situations no matter how much tax money is used to cover the premiums.

All the bill does is prolong the death of a corrupt and unworkable system so, frankly no, I won't object to a cut in the public money going to the insurers. It's really nothing more than another corporate welfare progam.

BWT calling it the "Affordable Health Care Act" doesn't make it so - anymore than Bush's "Clear Skies Initiative" had anything to do with improving air quality.

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BzaDem Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Aug-04-11 10:43 PM
Response to Reply #33
34. I have more of a problem with people going without care BECAUSE they don't have insurance. YMMV. n/t
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dflprincess Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Aug-04-11 10:54 PM
Response to Reply #34
36. Really?
Because I have a problem with more and more people who are paying for insurance still can't afford care. That's why the insurance companies have been posting such big profits the last few years.

Nothing in the bill outlaws these high out of pocket expenses and nothing in the bill will change the fact that most medical bankruptcies are filed by people who thought they were "covered".

I have a real problem with tax money being used to line the pockets of insurance executives while programs that actually help people face cuts.

I have a real problem with a President that think it's more important to preserve corporate profits than fight for real reform. Remember, his buddy Rahm crowed about how they had "protected the private delivery system" after this scam passed.
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BzaDem Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Aug-04-11 11:03 PM
Response to Reply #36
38. Yes, really. I would prefer policy that helps people, even if it also helps businesses who don't
Edited on Thu Aug-04-11 11:04 PM by BzaDem
deserve it. You can make the argument that not everyone will be helped by this legislation. You cannot make the argument that it doesn't significantly help tens of millions of Americans.

As I said, YMMV.
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dflprincess Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Aug-04-11 11:13 PM
Response to Reply #38
39. There are not tens of millions of people who will be helped by that scam
Edited on Thu Aug-04-11 11:15 PM by dflprincess
there aren't that many insurance executives.

Most people will only be stuck with the mandate - buying the same old crap from the same old crooks and we still won't be able to get care when we need it. Sure, the bill covers screenings and preventative medicine - but it can cost several thousand dollars to find out that spot on mammogram is benign and the follow up tests will not be covered until you've paid your deductible. Screenings don't help much if you can't afford the follow up.

Obama is the one who said we needed a public option to "keep them (the insurers) honest" - so he admitted that they're crooks but in the end he was happy to sell us out to them and hand them not just a whole lot of tax money but also require us to write them checks with no strings attached.

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nashville_brook Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Aug-05-11 06:58 AM
Response to Reply #38
43. does this mean you do not favor policy that helps people w/o helping CEOs?
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nashville_brook Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Aug-05-11 06:50 AM
Response to Reply #32
41. you should take that up with TNR's Senior Editor, Jonathan Cohn
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Renew Deal Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Aug-05-11 07:14 AM
Response to Original message
44. This article is FUD sold as FACTS
There's lots of "may be" and "could be" in this blog post, but not a lot of actual "will be." It's FUD about cuts which BTW makes the subject line that you posted a lie.
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nashville_brook Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Aug-05-11 09:10 AM
Response to Reply #44
45. that Obama's signature policy victory will likely fall victim to his signature negotiating style,
should worry you a lot more than taking issue with the messenger...who, by the way, is the Senior Editor of The New Republic, J Cohn. I'm sure he'd love to hear about your concerns with his thesis.
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Renew Deal Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Aug-05-11 09:34 AM
Response to Reply #45
46. "will likely"
There it is again.

The headline of the article is "Gaming Out the Debt Deal: Will It Hurt Obamacare?"

Your subject line is "Healthcare reform to be gutted: cost-sharing subsidies NOT EXEMPT from debt deal's automatic cuts

The problem here isn't Jon Cohn. It's you.
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nashville_brook Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Aug-05-11 12:42 PM
Response to Reply #46
47. what, in your experience of this administration gives you the impression that negotiation
will yield anything in our favor -- and by "we" i mean the average middle class taxpayer, as well as those of us impovershed by the economy?

these are negotiated victories i'm looking for, whereby the administration goes toe-to-toe with advasaries emerging with tangible benefits for the working people.
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DirkGently Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Aug-05-11 01:46 PM
Response to Reply #47
48. Hear, hear. The tax cuts for the rich only "might" be extended as well.
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nashville_brook Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Aug-05-11 06:20 PM
Response to Reply #48
50. in that case he didn't even have to "negotiate" - he interceded to get them extended.
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