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The health bill passed by the House of Representatives Sunday would cost Nevada taxpayers an extra $613 million from 2014-2019, to provide health care to the needy.

According to early state estimates, the bill would make an additional 70,000 residents eligible for Medicaid. The state would be mandated to cover another 8,000 individuals who are now eligible but have not applied to be covered by the state health insurance program for the poor.

About 209,000 Nevadans are currently covered by Medicaid.

Including state and federal money, “the total cost of reform is $2.3 billion,” said Mike Willden, director of the state Department of Health and Human Resources.

Willden went through the numbers for the Nevada Vision Stakeholder Group, formed to develop a plan for the future, looking ahead as much as 20 years.

Meanwhile, Gov. Jim Gibbons railed against the costs of the bill in a written statement Monday: “The bill disguises its true cost by shoving Medicaid expansions down to the state level and shuffling Congressional Budget Office estimates into later years so it appears to save federal tax dollars. It is an insult to those who truly care about meaningful health care reform.”

But Jon Sasser of Washoe Legal Services said during the Vision Stakeholder meeting the bill will expand the number of people eligible for Medicaid and that should put less stress on counties, which handle medically needy cases. “It means extra millions of federal dollars coming into our state,” Sasser said.

Most of the health care bill doesn’t kick in until 2014, Willden said. Some states are starting early, but Willden said he doesn’t see Nevada doing that because of its budget shortfall.

The federal-state dollar match for Medicaid is 50-50. Federal stimulus funds pushed that to a 64 percent federal match, saving the state $40 million to $45 million a quarter. But after the stimulus money expires Nevada will be back to picking up the 50 percent share, Willden said.

Willden said only 8 percent of the population is covered compared to 14 percent in other states. The state spends $435 per capita compared to the national average of $1,021.

This Week in Health Reform

Republican Scott Brown’s victory over Massachusetts Attorney General Martha Coakley (D) in the January 19 special election to fill the seat of the late Senator Edward Kennedy (D) might prove to be a game-changer for the health care reform debate. The loss of the 60th Democratic vote now robs Senate Democrats of a filibuster-proof majority. Last week, Democrats were rushing to wrap up a House/Senate agreement on the bill, likely due to reports that Coakley’s lead had diminished.

Congressional leaders are still aiming to have the controversial points in the health care reform bill settled as soon as possible, so they can send the compromised bill to the Congressional Budget Office (CBO) for scoring. The CBO will then need 12 days to analyze the legislation.

In addition to Senate Majority Leader Harry Reid (D-NV) and Speaker of the House, Nancy Pelosi (D-CA), lawmakers participating in the White House meetings include: House Majority Leader Steny Hoyer (D-MD), House Majority Whip James Clyburn (D-SC), House Energy and Commerce Committee Chairman Henry Waxman (D-CA), House Ways and Means Committee Chairman Charlie Rangel (D-NY), House Education and Labor Committee Chairman George Miller (D-CA), Assistant Senate Majority Leader Richard Durbin (D-IL), Senate Finance Committee Chairman Max Baucus (D-MT), Senate HELP Committee Chairman Tom Harkin (D-IA), and Senate Banking Committee Chairman Christopher Dodd (D-CT).

A main point of contention between the two houses of Congress pertained to the
40 percent excise tax on high-cost health insurance plans passed by the Senate. Since many labor union members would be affected by the tax on high-cost health insurance plans, the House of Representatives was not supportive of this provision in the Senate bill. Union leaders have also been included in key negotiations on this provision, and on January 14, signaled that they are ready to support the merged legislation with the compromised provision.

The main revenue source for the Senate’s health care reform bill (H.R. 3590) would be from an excise tax – beginning in 2013 – on employer-provided, high-cost health insurance plans costing more than $8,500 for individuals and $23,000 for a family. The reported compromise on the legislation now makes the tax kick-in on policies costing $8,900 for individuals and $24,000 for families. The tax threshold would still rise at inflation plus one percentage point, as is currently written in the Senate bill. Additionally, dental and vision benefits would be removed from the calculation of threshold costs, and plans offered by state and local governments, as well as plans covered by collective bargaining agreements, would be exempted from the excise tax until 2018. This would allow current agreements to expire and allow for negotiation of new contracts.

In an effort to make up the lack of revenue from the modification of the excise tax provision, leadership will have to come up with new funding to finance the merged bill. Some reports have mentioned that the pharmaceutical industry has agreed to provide more money than the $80 billion they have already negotiated with the White House. Medical device companies could also face additional fees. Portions of the main revenue source in the House bill – a Medicare payroll tax on wealthy U.S. residents – could be added as well.

On January 14, Richard Trumpka, president of the AFL-CIO, said, “Union leaders approached negotiations with the White House and congressional leaders with one overriding goal in mind – getting a bill signed into law.” Gerald McEntee, president of the American Federation of State, County and Municipal Employees (AFSCME), said, “We do like the way it’s shaping up, but it’s still not finished. We’ve got to see a final product.”

There also has been significant discussion – but no resolution so far – about the question of whether to establish a single national health insurance exchange or allow each state to operate its own exchange. Blue Cross and Blue Shield of Texas continues to support a state-based approach to exchanges.

Herbal Cure

Eighty percent of adults will get hemorrhoids. If this is your first time hemorrhoid experience then you need to know how to treat the symptoms for quick relief. It’s also a good idea to understand what to do to avoid them in the future.

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Stress diet constipation and diarrhea are all causes of hemorrhoids causing you increase the strain or push while you are having a bowel movement. When you increase your internal pressure to push you are also increasing your internal pressure on the blood vessels nears your anus. When that internal pressure causes the vessels to bulge it is called a hemorrhoid and they are very painful with common symptoms of itching swelling and bleeding.

It is a frustration when you are suffering from hemorrhoids and is unable to get rid of the condition. Like any individual would do you would likely try out different types of treatments like creams suppositories and other medications out there that are promoted and marketed in the market as a cure for hemorrhoids.

Did you know that Navy fighter pilots consider hemorrhoids as an occupational hazard? Why are these totally physically fit guys subject to this totally sedentary condition? Find out why and how you can avoid the pain and aggravation with these simple tips.

Hemorrhoids can be cured in various ways. With the advent of new technologies and state-of-the-art medical equipment a thing such as hemorrhoids can be subjected right away to proper medical treatment. Finding centers to cure them are also not a stressful thing to do nowadays since there are already many medical centers right now that specialize in treating them

Bleeding hemorrhoids are very uncomfortable for the sufferers. Often the bleeding is not only the thing the sufferer has to content with the other symptoms are itching swelling and painful bowel excretion.

Health insurance is a kind of agreement between you and your insurance company that you need in case you get sick and need medical help. Unfortunately, usually people get interested in their health insurance only when something bad happens – only to find out that they have a 3,000 deductible or some important things you need (such as a wheelchair) are not included into the policy. Before you get a health insurance policy it’s recommended to review all of them and find the one that will give you most coverage.

Almost all health insurance policies cover emergency services and whenever you have to go to the hospital and receive the treatment the cost will be covered less the deductible specified in the policy. A basic deductible for emergency room treatment can start at $50 and it should be mentioned that insurance companies are very particular about conditions that can be considered an emergency. If you have flu it’s probably not going to be covered, unless your fever is way too high. Your health insurance is likely to cover annual check-ups, with their number specified by the policy. If you need to see your doctor more often than it’s usual you need to look for a health insurance policy that soul be more comprehensive and would provide you with more coverage. Vision services are usually covered, including one visit to the eye doctor a year, while glasses and contact lenses are not covered in most cases, especially if you have a basic health policy.

Hardware coverage is required for people wearing glasses or contact lenses. Certain diagnostic services that are considered to be reasonable by your insurance company (X-rays and other procedures intended to diagnose certain conditions). You may not qualify for coverage if the symptoms you have are not considered to be serious enough – so it’s always best to call our insurance company with this question. If you are planning to have a surgery a pre-authorization from you insurance company is required. The necessity of the surgery will be evaluated by the doctor and the request is supposed to be sent by your health care provider. This can take up to 30 days. So, in general you need to keep in mind that most insurance companies will not be paying 100% of your medical costs, and in most cases you will have to co-pay from 10 to 50% of each medical bill you get. Before you purchase a health insurance policy it’s worth thinking about how much you are ready to pay out of your pocket for the service provided, and if that amount is not too high be ready to purchase a standard or above health insurance policy with maximum coverage.

Scott P. Brown’s win yesterday may be a harbinger of things to come for Obama’s health care reform plan; the idea of universal health insurance first touted in Obama’s platform for change seems to be on the verge of severe change itself. One question Republicans will likely concentrate on at present is whether mandatory private insurance violates the constitution or not.

The shock of a Republican winner in Massachusetts, a traditionally very, blue, very Democratic state is just beginning to be felt. One thing, however, is sure – voters are angry. The Obama administration’s focus on passing health care reform to make affordable health insurance more accessible to masses seems to have caused ire in his constituency. With the effects of the recession still on everyone’s mind, the concentration on health care has hampered Obama’s plans. Now Republicans have the power to impede those exact plans.

Republicans have plenty to discuss. Many Republicans have seen the health care plan from the get-go as a travesty to local governments. It would put a tax burden on small businesses, the rich, as well as unions. The cost of these new taxes may be more of a hindrance than a blessing. Furthermore, Republicans fear it would put Big Brother at the helm.

The big question remains: is mandatory private health insurance constitutional? Democrats cite the case of Social Security, which was approved by the Supreme Court in 1937 as a tax and spending program to provide insurance for the retired. No doubt, Social Security is not the most perfect plan, but has thus far worked.

The only problem with the Social Security argument is that Social Security remains a federal insurance, whereas the proposed Obama insurance is a private affair. American citizens, would essentially, be forced to buy their own private health insurance.

Republicans fear large government interference in the private lives of its citizens. Too much regulation takes away the freedoms of Americans as stated in the Constitution itself. Democrats would argue that it counts as economic activity, which can be regulated by Congress. Others find that argument to be rather flimsy. Where exactly does the Federal government have the authority to force its citizens to buy private insurance? What will the Supreme Court have to say? States already regulate car insurance, but that is on a state-to-state basis.

This is, by no means, a new issue. In November, Republican Senator Tom Coburn of Oregon and Representative John Shadegg of Arizona began a push to force Congress to have to consider the authority of any legislation put forth. The legislation entitled “The Enumerated Powers Act”, has brought with it a large amount of discussion, however not much action.

Senator Obama has many challenges ahead. The Republican win last night indicates that people want a change. The question of the constitutionality of mandatory private health insurance looms. Republicans are expected to press the issue. However, many liberals and progressives have also questioned it. This may prove difficult for any health care reform – at least as it exists now – to succeed. Health care talks in the Senate are expected to come to a close soon.

The federal health care reform legislation, known as the Patient Protection and Affordable Care Act, signed by the President on March 23, 2010, and the Health Care and Education Reconciliation Act approved by Congress, signed by the President today, will expand the availability of health care coverage to millions of Americans. While some of the measures will be implemented this year, many do not take effect until 2014 and some extend out to 2020.

Below is a high-level overview of the timeline.  It is important to note that many of these reforms and their effective dates are subject to the rules and regulations process both at the state and federal levels – which could alter the intended timing of implementation.

2010

New Programs:
* Temporary retiree reinsurance program is established
* National risk pool is created, small business tax credit is established
* $250 rebate for Medicare members who reach the “doughnut hole”

Insurance Reforms:
* Prohibits lifetime benefit limits – based on dollar amounts
* Allows restricted annual limits on the dollar value of certain benefits
* Coverage rescissions/cancellations are prohibited (except for fraud or intentional misrepresentation)
* Cost-sharing obligations for preventive services are prohibited
* Dependent coverage up to age 26 is mandated
* Internal and external appeal processes must be established
* Pre-existing condition exclusions for dependent children (under 19 years of age) are prohibited
* New health plan disclosure and transparency requirements are created

2011

Insurance Reforms:
* Uniform coverage documents and standard definitions are developed
* Minimum medical loss ratios are mandated

Medicare Reforms:
* Medicare Advantage cost sharing limits effective
* Medicare beneficiaries who reach the doughnut hole will receive a 50% discount on brand name drugs
* A 10% Medicare bonus will be provided to primary care physicians and general surgeons practicing in underserved areas, such as inner cities and rural communities.
* Medicare Advantage plans would begin to have their payments frozen.

Other:
* Employers are required to report the value of health care benefits on employees’ W2 tax statements.
* Annual industry fee for pharmaceutical manufacturers of brand name drugs.
* Voluntary long term care insurance program would be made available to provide cash benefit for assisting disabled individuals to stay in their homes or cover nursing home costs. Benefits would start five years after people begin paying a fee for coverage.
* Funding for community health centers would be increased to provide care for many low income and uninsured people.

2012

* Hospitals, physicians, and payers would be encouraged to band together in “accountable care organizations.”
* Hospitals with high rates of preventable readmissions would face reduced Medicare payments.

2013

* Individuals making $200,000 a year or couples making $250,000 would have a higher Medicare payroll tax of 2.35% on earned income —up from the current 1.45%. A new tax of 3.8% on unearned income, such as dividends and interest, is also added.
* Medical expense contributions to flexible spending accounts (FSAs) limited to $2,500 a year—indexed for inflation. In addition, the thresholds for claiming itemized tax deduction for medical expenses rise from 7.5% to 10% of income.
* Medical device manufacturers would have a 2.9% sales tax on medical devices; devices such as eyeglasses, contact lenses, and hearing aids would be exempt.
* Eliminates deduction for expenses allocable to Medicare Part D subsidy for employers who maintain prescription drug plans for their Medicare Part D eligible retirees.

2014

Coverage Mandates & Subsidies:
* Individual and employer coverage responsibilities are effective. 
* Individual affordability tax credits are created and small business tax credits are expanded.

Health Insurance Exchange & Insurance Reforms:
* State individual and small group health insurance exchanges operational.
* Guaranteed issue, guaranteed renewability, modified community rating and minimum benefit standards (“essential benefits” plan) effective. 
* Lifetime and annual dollar limits are prohibited for essential benefits.
* Pre-existing condition exclusions are prohibited.

Taxes & Fees:
* Addition of new taxes on health insurers

Medicaid and Medicare Reform:
* Medicaid expanded to cover low income individuals under age 65 up to 133% of the federal poverty level—about $28,300 for a family of four.
* Minimum medical loss ratio of 85% required for Medicare Advantage plans

2018

Taxes & Fees:
* Tax (“Cadillac tax”) imposed on employer sponsored health insurance plans that offer policies with generous levels of coverage.

2020

Medicare Reform:
* Doughnut hole coverage gap in Medicare prescription benefit is fully phased out. Seniors continue to pay the standard 25% of their drug costs until they reach the threshold for Medicare catastrophic coverage.

Author  Resource: Easy To Insure ME http://www.easytoinsureme.com/

Let’s face it. The best men’s natural skin care treatment contains nourishing ingredients that improve the skin’s health, while delaying and countering the affects that age has on your appearance. There’s no reason to look older, before your time, if you take the right skincare approach.

Let’s start with cleansing. Most cleansers designed for men contain triclosan, an antibacterial agent. Environmentalists disapprove of the rampant use of triclosan, because it ends up in the water supply and damages the delicate ecosystem.

The affect that triclosan has on the skin’s health is a subject of some debate. It may have carcinogenic affects on the cells. In my opinion, there is no reason to take the risk. There are ingredients like manuka honey and tea tree oil that have antibacterial, antifungal and antioxidant activity. Those are the ingredients that you want in your daily cleansers.

Shaving the face is the next step in the average routine. As I lubricant, I would recommend plain grape seed oil. The ingredients in the shave gels on the market vary, but most of them are drying and likely to cause irritation.

Once you have shaved, the best men’s natural skin care treatment is a daily facial fluid that contains witch hazel, vitamin B5, grape seed oil, Babassu wax, capuacu butter, wakame kelp, natural vitamin E, coenzyme Q10 and CYNERGY TK. That may sound like a lot of ingredients to remember and look for. But each one provides specific benefits.

Witch hazel, for example, is a non-drying astringent that prevents infection in shaving nicks, cuts and scrapes and has anti-inflammatory activity. Capuacu butter and vitamin B5 are effective for moisturizing and healing razor burns.

When it comes to countering the affects of age, men’s natural skin care treatment containing CYNERGY TK is the most effective. In clinical trials, the compound has been shown to reduce wrinkles and sagging, while acting as an antioxidant to prevent and repair free radical damage.

Free radicals are one of the causes of aging, in general. They damage the cell’s DNA. When that occurs, the new cells that are created when the cell splits are “mutated”. Mutated cells can become cancerous or simply weak, causing sagging and wrinkles.

All of the different ingredients mentioned above have antioxidant activity. But repairing and preventing free radical damage is only one of the things that an effective anti-aging men’s natural skin care treatment can do.

Another of the causes of wrinkles and sagging is decreased production of collagen and elastin fibers. CYNERGY TK has been shown to increase fiber production, by stimulating skin cell production. This is due to a protein peptide that it contains.

Peptides are short chains of amino acids. They combine with molecules produced by the skin’s cells to form fibrils and eventually fibers. Long-chained proteins, like collagens, cannot be used for this purpose. They are simply too large.

So there you have it. When you find a men’s natural skin care treatment that contains the ingredients mentioned above, you will be amazed by the difference. Treat your face well and you can always look more youthful.

To learn more about vitamins for healthy skin, and other incredible natural substances for natural healthy skin care, visit my website today.

I am not an affiliate marketing Guru (In fact, I am miles far away from being called one), but in the short amount of time I have spent with this niche of money making, I have uncovered few things that have helped me make money. Again – I am not richer by millions for sure, but at least I have made a start in this supreme GET RICH QUICK method.

My first step into affiliate marketing was in promoting health affiliate products. I was clear on one thing – That this niche would always be in demand, recession or no recession. Secondly, if the product I was promoting was indeed good, I knew I could make a lot of money. As it turned out, three months of marketing on the Internet, and I have made a good way!

No – I am not going to make false promises on how I made millions in 12 weeks of implementing the formula. The truth is – All I have managed to do is make couple thousand bucks, but that’s about it. In the process though, I realized that was not a bad start for the kind of effort I had taken to promote my affiliate products.

All it took from me was to write 10 articles on the different health affiliate products I was promoting and paste them on article directories. The content was fresh and that helped greatly. In the last 2 months, I have accumulated 2,000 views on all my articles and about 70 of the 2000 bought my product. With average commissions of about $40, you could see how much I made over the last 2 months of affiliate marketing.

Two things made the difference for me

I was working for the best health affiliate programs. These programs not only had the best products, but they also had products that would convert well. I personally checked the websites of each of the product that was promoted there, before deciding to take the plunge.

The content I wrote was highly informative. Look – I am no web designer and I didn’t have the money to spend on websites at all. All I could do was write good content and post them on article directories. As it turned out, it was a masterstroke for me.

If you wish to make money promoting health affiliate programs, think of enrolling with the best selling health affiliate programs. These programs will not let you down at any point of time. I don’t know how those Super Affiliates made their money, but looking at how my affiliate programs have performed, I have all reason to believe that if I could take this effort to another level, I could succeed too.

The best selling health affiliate programs would have

Variety of good health products

Products that convert well

Help affiliates with links, resources, banners and templates

Sellhealth.com is one such good health affiliate program. It has plenty of health products you could promote and importantly, it has products that convert well. Most of my promoted products from Sellhealth.com convert at 3.5% CTR, which I believe is acceptable to me.

If you wish to know more about Sellhealth.com, visit www.sellhealth.com/ct/135202.

Most Americans who have health insurance are covered through an employer’s plan. However, some employers do not offer health insurance coverage. If you work for one of these companies, you will need to purchase private individual health insurance.
There are certain advantages to purchasing health coverage in the private market. Instead of choosing from plans pre-selected by an employer, you decide which plan features you want, and pick a plan accordingly. For example, by choosing a plan with a higher deductible, or one that doesn’t cover certain services, you may realize a substantial premium savings each month.
Instead of having your coverage tied to a place of employment, coverage through a private health plan is yours to keep no matter where you work. A health insurer can’t drop you as long as you pay your premiums on time.
But along with these advantages come some potential disadvantages—

• Employer plans provide considerably more coverage than individual plans, even when you are paying the same premium rate. That’s because with an individual policy, a larger percentage of the premium goes to pay for such operational costs as marketing and paying claims.
• A group plan generally must insure all employees and family members, while individual plans can reject applicants who aren’t in perfect health. They can also offer plans that exclude coverage for certain pre-existing conditions.
• In most states, private health insurance plan premiums increase as you age. Initially, you can avoid these rate increases by periodically changing plans, because new rates tend to be lower than renewals. However, as you get older, it will become more difficult to find a company to insure you and individual policies will get more expensive.
If you do need to shop in the private health insurance market, you first need to find a competent insurance agent.  Determining what kind of insurance you need and how much coverage to buy are complex issues. A good agent will help you assess your situation, and work with you to find the right coverage for your specific needs. The key to a successful working relationship with aninsurance agent is trust. You should be able to trust your agent’s knowledge, experience and professional judgment, and you should always feel secure that your agent is acting in your best interest. But keep in mind that trust is a two-way street: Your agent also needs to trust you to provide information that is truthful and complete.
If you are comparing several plans, you need to know what to look for before making a decision. When choosing a health plan ask your health insurance agent the following questions:

·   Will the plan cover me for the specific doctor or hospital I would like to use?
·   How does the referral system work?
·   What pre-existing conditions would affect coverage?
·   How will the plan handle care if I (or a family member) am away from home?
·   What is the plan’s monthly premium, and what deductible and coinsurance am I required to pay?
·   Are there other fees, such as copayments and any additional charges if I use providers that are out-of-network?
·   Is there a maximum amount the plan will pay over a year or a lifetime?
·   What types of benefits are specific to this plan?
The purchase of individual health insurance in the private market can seem confusing. Approach its purchase like you would that of any important item—research your options and compare prices, and get the best advice and assistance you can, in this case, the services of a qualifiedinsurance agent.

For almost 35 years, the law of the land has been an explicit prohibition against federal taxpayer dollars being used to pay for elective abortions, known as the Hyde amendment, after the late great Illinois congressman. This is a policy supported by the majority of the American people.

In fact, this hard-fought explicit ban was included in the health care bill that passed the House last year. Regrettably, the Senate did not follow suit and instead passed a bill that would allow hard-earned taxpayer dollars to pay for elective abortion. That is a simple fact. Unfortunately, in a mad rush to secure enough votes, leading House Democrats now intend to take up the Senate-passed bill, arguing that the Senate language prohibits federal funding of abortion. Besides that fact that this simply not true, it also demonstrates the lengths the president and his allies will take to pass this bill against the will of the American people.

Just this week, Cardinal Francis George, president of the U.S. Conference of Catholic Bishops, issued a statement saying, “Notwithstanding the denials and explanations of its supporters, and unlike the bill approved by the House of Representatives in November, the Senate bill deliberately excludes the language of the Hyde amendment. It expands federal funding and the role of the federal government in the provision of abortion procedures.”

First, the Senate bill allows elective abortions to be offered through the newly-created individual state health insurance exchanges and multi-state health plans administered by the Office of Personnel Management (OPM), and through federally-subsidized plans in already-existing community health centers.

Second, there is nothing in this legislation that requires any of these programs to live up to both the spirit and letter of the Hyde amendment that Congress has included each year in spending bills that fund the government. This not only prevents federal funding of elective abortions, but also erects an iron-clad firewall against any private money for abortion being mixed with any federal or state health program receiving federal dollars. This applies, for example, to Medicaid, a health program for the economically disadvantaged that is funded by both federal and state governments. If any resources are used for elective abortions that money must be kept completely separate from Medicaid. This is sound policy that must be maintained.

Regrettably, the Senate-passed bill doesn’t include this firewall. Anyone who doesn’t earn enough money would qualify for a federal subsidy to help pay for their health plan in the state exchanges, including plans offering elective abortion coverage. Some argue that under the Senate-passed bill, federal funding would be “segregated” so no federal money would pay for abortions. But this is a violation of the Hyde amendment, which also prevents the federal funding of insurance that covers elective abortion.

Furthermore, it is entirely possible that there would only be one health plan in any given state that does not include elective abortion. And even if you are opposed, you may well be railroaded into choosing a plan that covers it, because you might be looking for the best plan to treat a sick child or your own health condition.

What’s more, passing a new state law is the only way an individual state could truly ensure that elective abortions are not included in the plans offered through a state insurance exchange. That would be easier in some states than in others, but that’s unfair to those who are morally opposed to federal funding of abortion and happen to live in states where passing such a law would be extremely difficult.

Lastly, under this proposal, community health centers would receive a dedicated stream of money outside the annual congressional process to fund the government which is where the Hyde prohibition is maintained. So that means that for the first time federal money could be used to fund abortion at a community health center.

Those are the facts, and anyone who thinks the Senate abortion language is strong enough should think again. That is because, regardless of one’s position on this controversial issue, it is entirely reasonable to expect that a person who is fundamentally and morally opposed to abortion should not have to sanction its use with their hard-earned tax payer dollars.