Source: House Speaker Nancy Pelosi from industry data sources Wellpoint, Cigna, Humana and United Health.

While President Obama and Congress duke it out at the televised Health Care Summit and state lawmakers sweat how to fix insurance coverage gaps this handy chart on health insurers’ annual profits puts things into demoralizing perspective.

We, fellow policy holders, Medicare/Medicaid recipients and COBRA payees, are being punked.

While Congress and the White House dither on health care reform, state lawmakers across the country grapple with the practicalities of the uninsured, discriminatory gender rating and mandated care.

In Colorado, a seemingly feel-good bill, HB 10-1021, to require insurance plans to cover maternity care and contraception is fraught with problems that could have and should have been solved by the long-delayed federal legislation.

However, in today’s highly charged political realm with spiraling state budget deficits and the lingering effects of a recession that just won’t quit, even motherhood and apple pie can’t get a unanimous vote in a crucial election year.

A reproductive health care mandate bill passed its first major hurdle on a largely party line 37-27 vote Tuesday in the Colorado House with some surprising defections by pro-choice lawmakers.

A peek behind the legislative sausage-making curtain exemplifies the deep political divisions being created with incremental approaches by states to fix an intractable and unsustainable national health care crisis.

Emilie Ailts, executive director of NARAL Pro-Choice Colorado, laid down a pre-vote challenge to conservative lawmakers to channel their much ballyhooed family values:

“Will the anti-abortion, anti-birth control, anti-comprehensive sex education politicians vote their purported values, which they claim are about healthy babies and healthy families? House Bill 1021 provides a clear opportunity for these anti-choice lawmakers to enact responsible policies that can reduce the need for abortion by ensuring women have access to the prenatal care they need for healthy pregnancies.”

Twenty six of the “no” votes were cast by GOP members. None of the dozen Republican House members with longstanding anti-choice records who voted against the bill, including some who amended and approved it in committee days before, returned calls for comment. The amendments that significantly watered down the bill and specifically noted that abortion care was not covered were eventually thrown out by the House after flexing its 11-vote majority.

However, the biggest danger with the bill is the caustic stew of ideological posturing, political gamesmanship and over-promised and under-delivered health care reform that could leave a bitter taste in the mouths of an increasingly surly mid-term electorate.

Two unexpected opposition votes from pro-choice lawmakers are especially telling about the skittish local mood.

Both national conservative leaders and a number of state legislators have attacked the current federal health bills as infringing on “state sovereignty.” Yet they oddly ignore the fact that two of the main planks in conservative health proposals proposed by Congressional leaders — allowing insurance companies to sell across state lines and overriding state medical malpractice laws through “tort reform” — are far clearer attacks on state authority.

The main difference is that the progressive health reform bills already passed in Congress would strengthen consumer rights, while the conservative counter proposals would benefit corporate interests and weaken state consumer protections.

Take the proposal to allow insurance companies to sell across state lines. The Right has been shopping this scam for years; it sounds good until you recognize that what the right-wing is proposing is for those insurance companies to be able to sell insurance in a state while ignoring all state regulations. Companies could ignore rules prohibiting gender discrimination, charge the elderly more for insurance than allowed under state community rating rules, eliminate maternity benefits, or ignore rules requiring annual reviews of insurance increases. Insurance companies could essentially pick their own regulations by setting up shop in a state with weak consumer protections, then sell policies that violate local state law in every other state in the nation.

Similarly, “tort reform” is just a code word for the federal government gutting state medical malpractice laws. Patients would lose legal rights they previously had under individual state law. Despite medical malpractice being a tiny percentage of health care costs — less than two percent of overall spending — conservatives blithely see striking down state laws across the country as a top priority.

And the reality is that neither solution will cut medical costs in any significant way; in fact, the proposal to allow insurance companies to sell products across state lines would actually increase insurance costs for many consumers, especially the sick and the elderly who would see premiums skyrocket, as documented in this New America Foundation report.

Part of Larger Trend of the Right-Wing’s “States Rights” Hypocrisy

This hypocrisy is part of a broader trend of the right-wing using “states rights” rhetoric to mask a pro-corporate, anti-consumer rights agenda. From 2001 to 2006, the right-wing majority in Congress voted over 57 times between 2001 and 2006 to preempt state laws, including action to preempt state limits on air pollution, to preempt state regulation of contaminated food, and to block tougher state regulation of Internet “spam.”

Some grassroots conservatives may believe the “states rights” rhetoric around health care reform, but they are being used by corporate interests promoting federal laws that would actually further the weakening of state consumer protection laws — all without providing significant additional coverage and hurting the sickest and most vulnerable patients who most need strong patients’ rights.

Read more at the Progressive States Network

East Coast politics have become an issue ‘down on the farm’ in Montana. The Massachusetts election results are being called a sign that health care reform is dead, or may need to start over. But, John Crabtree, a director for the Center for Rural Affairs, says those comments ignore the fact that reform is still on the top of the wish list for rural Montanans, who, unlike most urban Americans, do not have coverage through a workplace.

“The legislation on the table is nowhere near perfect, but they do address that affordability for the lion’s share of people currently struggling with it. What we need to do is move it forward.”

The reality that farmers, ranchers and small business owners have been facing can’t be ignored, says Crabtree, and reform is the only solution.

“In Montana, the backbone of the rural economy can’t afford a thousand dollars a month for a high-deductible, low-benefits insurance package. It’s just not sustainable.”

The current legislation is a “first step” in the reform process, he adds, which leaves room and time to continue to work on what’s best for people and most fiscally responsible.

Listen to the Big Sky Connection podcast podcast by Deborah Smith.

Click the image above to try your hand at the Kaiser Family Foundation calculator.

This tool illustrates premiums and government assistance under the types of reform proposals being considered in Congress for people under age 65 who purchase coverage on their own in an Exchange and are not covered through their employer, Medicare or Medicaid. While the proposals considered would not take effect for several years (2013 in the House and 2014 in the Senate), the results are presented in terms of 2009 premium and income levels to enable better comparisons to current circumstances. The tool allows the user to start with the provisions from one of several proposals and examine the impact at different income levels. Advanced settings allow users to change assumptions to show the effect of different policy choices.

A few caveats:

• Specific subsidies for cost sharing and what people might pay out-of-pocket for deductibles and coinsurance are not illustrated on the calculator.
• In many cases coverage will be more comprehensive and accessible than what is typically available today in the non-group market, so premiums cannot easily be compared to what people buying insurance on their own are now paying.
• The calculator does not apply to people with coverage available through an employer, where the firm is generally paying for a substantial portion of the insurance premium.

Click the image to activate the visualization. Source: General Electric, Medical Expenditure Panel Survey (MEPS).

The Medical Expenditure Panel Survey (MEPS), from the Agency for Healthcare Research and Quality, is a set of large-scale surveys of families and individuals, their medical providers, and employers across the United States. MEPS is the most complete source of data on the cost and use of health care and health insurance coverage.

h/t FlowingData.com

Physicians for a National Health Program has easy step-by-step directions on calculating the number of uninsured by congressional district.

Try it yourself or peruse the data calculated by PNHP for people under age 65:

Number of Insured/Uninsured by District in Rocky Mountain States: