Alex Miller's Black Hole Astrology

Black Hole Case Study: The Health Care Reform Saga

by Alex Miller on April 1, 2010

Obama signs healthcare bill

“So this isn’t radical reform. But it is major reform. This legislation will not fix everything that ails our health care system. But it moves us decisively in the right direction. This is what change looks like. … In the end, what this day represents is another stone firmly laid in the foundation of the American Dream. Tonight, we answered the call of history as so many generations of Americans have before us. When faced with crisis, we did not shrink from our challenge—we overcame it. We did not avoid our responsibility—we embraced it. We did not fear our future—we shaped it.” (Barack Obama, on House passage of the Healthcare Reform Bill, 21 March 2010)

“This is a big fucking deal!” (Vice President Joe Biden, sotto voce to the President, White House signing ceremony, 23 March 2010)

At 10:45 PM EDT on Sunday, 21 March 2010, a resounding shout of “Yes we can!” went up from House Democrats as the 216th, deciding vote was cast, effectively passing the Healthcare Reform Bill. The final tally was 219 in favor, 212 opposed, coming just two minutes later. The moment marked what may be the final stage in a process that began more than a year earlier, when President Obama headed a White House forum on Health Care Reform on March 5, 2009. The ensuing 12 months were frittered away in partisan debate and name-calling, outrageous inside deals made to secure votes, and equally outrageous misrepresentation of the bill’s effects, in an effort to kill it.

The story doesn’t end here; in order to avoid a Republican filibuster, the House voted to pass the Senate’s version verbatim, something unacceptable in itself to many members. They followed this with a second legislative package applying “fixes” to the bill, which will now have to be passed by the Senate using an obscure budget-passing measure called “reconciliation,” which allows approval by a simple majority of 51, as opposed to the 60 votes required to break a filibuster. If Republicans manage to insert so much as one new line into the package the House sends over, then another House vote will be required to finalize the bill, straining the delicate coalition of Democrats which threatened to derail the bill until the last moment.

[Author’s Note: Senate Republicans did in fact do their best to alter the supplemental bill, offering dozens of amendments, some substantive, many frivolous, all of which had to be voted on by the full Senate before final passage could be achieved, a process which dragged out a further three days. In the end, none of these were allowed, but Republicans did find an ally in the Senate Parliamentarian (the official adjudicating legislative form disputes), who concurred that certain measures in the bill regarding student loans were not properly a part of health care reform, and did not belong in the bill. The supplemental bill was then returned to the House, which easily passed it Thursday night the 25th of March, putting an end to the legislative process.]

On Tuesday, 23 March, 2010, beginning at 11:55 AM EDT during a signing ceremony at the White House, Barack Obama signed the Healthcare Reform Bill into law; the signatory process took a full two minutes, with Obama using 22 pens in total to sign his name, providing a plethora of keepsake presentation pens to supporters of the bill instrumental in its passage.

The House and Senate had already passed differing versions of the bill last year, but the differences were deemed too severe to survive the required re-vote in both chambers after a conference committee attempted to reconcile the two bills. Specifically, conservative House Dems objected to the looser abortion funding language in the Senate bill, while Senate Dems could not all be brought on board to support the public option included in the House version. And once Republican Scott Brown succeeded to the late Ted Kennedy’s Massachusetts Senate seat in January 2010, splitting that body 59/41, there was no chance of getting any House changes through the Senate without filibuster.

None of these bills, in either body or at any time, has received so much as one Republican vote. Squabbling Dems almost brought the bill to ruin. Intraparty rifts were so entrenched that at one point, Speaker Pelosi considered using the controversial “Deem and Pass” rule to push through the legislation. Deem and pass, also known as a “self-executing rule,” would not require an actual vote of approval on the Senate bill; rather, the vote would come on the more popular ancillary bill to “fix” that legislation, which within its structure would incorporate the Senate bill, “deemed” as already passed. But the passage of major legislation in such a manner was considered too volatile, and at the eleventh hour Sunday night, President Obama gave assurances to seven hold-out conservative House Dems, led by Michigan Representative Bart Stupak, that he would sign an executive order guaranteeing that in no way, shape or form would public funds ever be used to provide abortion services, at which point final passage by the House was assured.

House Dems are taking a leap of faith that the more objectionable portions of the Senate bill will be revised, including the egregious special deals given to states represented by recalcitrant Dems. These include the so-called “Louisiana Purchase,” a $300,000,000 subsidy garnered by Louisiana’s Mary Landrieu for Medicaid funding; the “Cornhusker Kickback,” a similar deal brokered by Nebraska’s Ben Nelson which underwrites that state’s Medicaid bill in perpetuity (a deal later repudiated by Nelson and removed from the final bill); and the “Gator Aid,” Florida Senator Bill Nelson’s special deal preventing South Florida Medicare Advantage customers from experiencing the same funding cuts as seniors nationwide.

Now law with Obama’s signature, the bill will be phased in over four years, and is ultimately expected to cover an additional 32 million Americans, now uninsured, largely via mandates to require the purchase of insurance, and federal subsidies for those who cannot afford it. The mandate portion of the bill doesn’t kick in until 2014, but immediately, insurance companies would not be allowed to drop customers who become ill, can no longer refuse to insure sick children, or enforce annual or lifetime caps on policy benefits. Parents can also include their adult children on their policies until age 26. As of 2014, insurers will no longer be able to deny coverage on the basis of pre-existing conditions, but they will be allowed to charge more to those individuals, and the legislation currently does not cap those amounts.

The infamous “doughnut hole” in the current Medicare Part D prescription drug coverage will be phased out, with seniors receiving a $250 rebate for their expenses in 2011, and the gap gradually filled entirely by 2020. Medicaid will be expanded to include individuals and families earning up to 133% of the federal poverty line (100% of the increased costs to states absorbed by the federal government until 2016), and federal subsidies to purchase insurance will be available for those earning less than four times the federal poverty level, with policy premiums capped at 6% of income for families earning less than $44,000 per year. Businesses will not be required to provide health coverage, but there is an annual fine of $2000 per employee for those businesses which fail to do so. Businesses employing less than 50 persons would be exempt.

The Congressional Budget Office scores this package at a cost of $940 billion over the first ten years, but the CBO also asserts a net reduction in overall federal health care costs by as much as $138 billion in that same first decade, and perhaps a trillion dollars in the following ten years.

This is hardly sweeping reform, and certainly nothing close to government-run health care. There is no single-payer system such as most industrialized nations now provide; there is no public option to compete with the insurance industry in lowering costs; while insurance companies cannot deny coverage based on pre-existing health conditions, there is no restriction on what they can charge individuals who have them.



Throughout the year and more of negotiations, compromise, and debate, the healthcare reform saga has been framed celestially by deep space points, indicating its transcendent importance, and by key asteroids of our own system, named for mythic figures or flesh-and-blood individuals who resonate strongly to the process. I chose to focus on asteroids named for healing deities—Apollo and his son Asclepius, Greek gods of healing; Panacea and Hygiea, Greek goddesses of medicines and sanitation, respectively.

I also used those personal named asteroids which reflect the principle players in the drama—Barry (for Barack Obama, the name by which he was known in youth); Nancy (for Nancy Pelosi, House Speaker); Reid (for Harry Reid, Senate Majority Leader), and House (representing the House of Representatives).

I also looked at Sisyphus, named for that Hadean worthy doomed to forever roll a rock uphill, only to have it roll down again, necessitating an endless repetition of this action, to symbolize tedious and pointless effort; Pandora, who unleashed the ills of mankind upon the world when she opened her box, to symbolize unintended consequences; and Damocles, to symbolize the doom that hangs overhead unawares.

When Obama first held his White House Forum on Health Care Reform, 5 March 2009, the Sun at 15 Pisces was broadly conjoined asteroid Sisyphus at 5 Pisces, itself conjunct a spotlighting Quasar and squared a reality-twisting Black Hole, indicating both the high level of public attention (Quasar) and the multiple upsets and reversals (Black Hole) to a tedious process that seemed to drag out forever and require constant reiteration and reappraisal.

Sisyphus, supervised by Persephone in Hades

Sisyphus, supervised by Persephone in Hades

Sisyphus is also precisely conjoined Obama’s natal Chiron, representing healthcare matters, which in itself being conjunct a Quasar in Obama’s First House, shows the high profile this issue will have in how others view him. Asclepius at 19 Capricorn is exactly conjunct a Black Hole, Apollo at 1 Aquarius opposes another at 3 Leo, Panacea at 10 Cancer exactly squares a Quasar at 10 Aries, and Hygiea at 8 Gemini conjoins the volatile, controversy-evoking Maser at 7 Gemini, making a Grand Slam of health-related asteroids in contact with galactic points.

Pandora (John William Waterhouse, 1896)

Pandora (John William Waterhouse, 1896)

Asteroid Pandora, opening that can of worms with its attendant unforseen consequences, conjoins Apollo from 29 Capricorn, also conjunct a newsy, media-agitating Pulsar; while an exact combination of asteroid Icarus with Jupiter and the Black Hole at 13 Aquarius suggests a rash willingness (Icarus) to rush in where political (Jupiter) angels fear to tread. A tight grouping of Damocles at 19 Aquarius, Chiron and Mars both at 22 Aquarius, Neptune at 24 Aquarius, and Mercury at 25 Aquarius exactly conjunct a Quasar, well prefigures the year ahead: intense public scrutiny (Quasar) regarding health matters (Chiron), fraught with anger, frustration and combativeness (all Mars), deception, disillusionment and confusion (all Neptune), focused on details and minutia (both Mercury), with the potential to destroy one party or the other (Damocles).

The principal players are all tapped in as well. House at 27 Sagittarius conjoins the supermassive Black Hole at the Galactic Center, an indication of the universal importance of this legislation, while Nancy at 7 Taurus conjoins a controversial Maser at 8 Taurus, Reid at 21 Capricorn conjoins the Black Hole at 19 Capricorn, and Barry at 11 Capricorn squares the Black Hole at 13 Libra and the Quasar at 10 Aries, and opposes Panacea at 10 Cancer, creating a Galactic Grand Cross which threatens to crucify the Obama presidency.

Obama’s first Gethsemane-like attempt to dash the bitter cup from his lips occurred in the aftermath of this meeting, when he unwisely chose not to present a White House version of the bill, and instead turned over the reins of this project to congressional leaders, stating he expected a bill on his desk before the August recess. At 11 Capricorn for the start of this process, asteroid Barry exactly squared asteroid Sisyphus at 11 Libra in Obama’s natal chart, an early indicator of just how much wasted effort this endeavor would entail, compounded by the White House’s decision not to direct or interfere with the process.

There are times when detachment works, and times when it doesn’t. This was one of the latter. Throughout that spring and early summer of 2009, as asteroid Barry struggled to catch up with the celestial healthcare bundle in late Aquarius, depicted by the triple conjunction of Chiron (health), Neptune (deception and universality) and Jupiter (bombast and politics), President Obama remained seemingly above the fray, little commenting on the developing morass, and even less frequently intervening. Once asteroid Barry turned retrograde at 22 Aquarius in July, just short of conjunction, things really went south, with explosive town hall meetings that August across the country and Republican legislators warning of death panels who would pull the plug on granny, while attempting to define the legislation as total government take-over of America’s healthcare system.

By 9 September, when Obama finally addressed a joint session of Congress on the healthcare issue, Barry at 11 Aquarius was conjunct an energy-sucking Black Hole and hitting off a spectacularly apt Grand Cross in Obama’s natal chart, composed of his Sun at 12 Leo exactly squared both asteroids Reid at 12 Taurus and Nancy at 12 Scorpio, and opposed Damocles at 12 Aquarius, now conjoined by transit Barry. It did indeed seem as if his doom had come upon him, facilitated by the two congressional leaders to whom his fate was celestially yoked, and to whom he had unadvisedly consigned his power. During the speech, South Carolina Representative Joe Wilson gave voice to the country’s angst, and GOP animosity, when he heckled Obama with a cri de coeur of “You lie!”

But matters were about to get even more complicated. The new target date for this legislation became Christmas. The House passed its version of the bill on November 7, 2009. In this chart, Sisyphus has fittingly transferred his allegiance to Speaker Pelosi, combining with asteroid Nancy at 12 and 9 Virgo respectively, with Nancy exactly on a Black Hole. Apollo and Hygiea trail behind at 26 and 20 Leo, with Panacea just ahead at 20 Virgo. Apollo/Hygiea conjoin Obama’s natal Uranus/North Node at 25 and 27 Leo, suggesting a drive to positively innovate and reform (Uranus) health care issues (Apollo/Hygiea) for future generations (North Node). But Apollo/Hygiea also opposes an Aquarian cluster of Damocles (16), Reid (19), Chiron (21) Neptune, Pandora and Barry (all at 23), suggesting an impending doom (Damocles) for healthcare reform (Chiron) in the confused, disorganized (Neptune) Pandora’s box of the Senate (represented by Reid, its Majority Leader), with unintended consequences (Pandora) for Obama (Barry).

And such indeed proved to be the case. The House bill was far too liberal for conservative Dems in the Senate, incorporating as it did a robust public option and other trappings which one after another of the right-leaning Dems objected to, each reaping a sweetheart deal as salve for their voting conscience. This poisoned the bill for many Americans on both sides of the aisle, sickened by the usual Washington insider trading and the spectacle of votes openly and brazenly bought and paid for.

Even with this, the Senate struggled to produce its own version of the bill by the Christmas deadline, failing to pass any legislation until that very eve, December 24. Asteroid Reid at 6 Pisces now reiterates Sisyphus’ degree from the start of this process the previous March, with transit Barry at 15 Pisces now highlighting the Sun’s degree from that first health care forum. Transit Sisyphus at 24 Virgo is still traveling with asteroid Nancy at 22 Virgo, these points now conjunct Obama’s natal Mars at 22 Virgo, itself conjoined the nation’s Neptune at the same degree, all these points exactly opposed transit Uranus, which at 22 Pisces was still filling the exact same degree as it had for both the opening salvo of the forum and the passage of the House bill, indicating a total lack of movement during the interim for the cause of reform (Uranus). Obama’s leadership skills (Mars) certainly appeared absent (Neptune), as the White House continued its policy of virtual non-interference.

Things began to change in late January 2010, when Scott Brown’s upset win in the Massachusetts special election for Ted Kennedy’s old Senate seat destroyed the tenuous grasp Democrats held on filibuster-free debate. White House advisors began to see that Obama’s active engagement would be necessary to avoid political disaster, and the specter of a full year wasted in debate with no viable healthcare legislation to show for it. On February 24, Obama held a bipartisan healthcare summit at the White House in a last attempt to garner GOP support (or at least to show that he had tried to do so). Then the President went on the road in campaign-style appearances nationwide to sell the bill, while Party leadership in Washington desperately tried to find some way of actually passing it.

That moment finally came at 10:45 PM EDT on Sunday, 21 March 2010, when the House squeaked through approval of the Senate bill verbatim, followed by a supplemental bill intended to fix its ills for those still in doubt. Astoundingly, the 13 Scorpio Ascendant shows Obama’s natal asteroid Nancy in close conjunction, reflecting the House Speaker, with Leader Reid represented by Obama’s natal asteroid Reid on the 13 Taurus Descendant.

Chiron and Neptune are still traveling together, and at 27 and 28 Aquarius respectively now conjoin the Black Hole at 28 Aquarius, depicting the moment when change was enacted and a new reality inaugurated, after the grueling vivisection of the topic granted by their prior union on the spotlighting Quasar. Jupiter, that third member of the celestial triumvirate that had evoked so much passion and debate over the past year, has now moved on to 14 Pisces, to conjoin the Sun of the health care forum that had initiated all the wrangling more than a year before. Uranus has finally vacated its 22 Pisces stump, and at 26 Pisces is now exactly squared the Galactic Center, an indication of the universal nature of the reforms. The Sun at 1 Aries is exactly opposed Saturn on the supermassive Black Hole at 1 Libra, with asteroid Barry at 1 Taurus exactly inconjunct Saturn, and Mars at 1 Leo exactly squared Barry and exactly sextile the Sun, trine Saturn, an homage to the anger and combativeness (Mars) directed toward the Chief Executive (Saturn/Barry) over the previous year.

Asteroid Apollo conjoins Mars from the Black Hole at 3 Leo, indicating the departure from the healthcare status quo and the likelihood that, although the legislation has passed, the fighting about it is not yet over (as witnessed by the almost immediate unveiling by Senate Minority Leader Mitch McConnell of the GOP’s fall election slogan “Repeal and Replace!”).

Asteroid Asclepius at 25 Capricorn is squared the Black Hole at 24 Aries and exactly conjoins Obama’s natal Saturn. Asteroid Panacea at 25 Virgo opposes Uranus (filling in the gaps in the Medicare Part D “doughnut hole” for medications—Panacea—was an important adjunct to the reforms—Uranus), conjoins Obama’s natal Mars, trines his natal Saturn, and squares the Galactic Center. Asteroid Hygiea at 11 Leo squares the chart’s horizontal axis and conjoins Obama’s natal Sun.

In addition to its contact with the Sun/Saturn polarity, asteroid Barry is also conjoined by asteroid Achilles at 3 Taurus, suggesting that this bill may yet prove a weak spot in Obama’s public image or presidency. Asteroid Nancy at 12 Virgo falls in the Tenth House, and opposes Jupiter for the bill’s passage, while asteroid Reid at 16 Aries conjoins asteroid Pandora at 18 Aries and minor planet Eris at 21 Aries, indicating the tough row still to hoe in steering the supplemental bill through the fractious (Eris) Senate, with all its attendant pitfalls and evils (Pandora). Asteroid Sisyphus, the ceaseless struggle against the inertia of pointless, repetitive effort, claims the place of honor; at 27 Leo it is the most elevated point in the chart, conjunct the MC from the Tenth House, and further conjoined Obama’s natal Uranus (reform)/North Node (future).

Well, they did it. But at what cost? More than a year of wrangling, dispute, dirty deals, misrepresentation, fearmongering and distortion, and all they’ve really accomplished is to guarantee 32 million more customers for the insurance companies. But then again, these are Democrats. What did we expect?

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