Mitch McConnell Versus Barack Obama In A Pre-Existing Condition Smackdown

It doesn't get better than this (I am sorry to say...) - Senate Permanent Minority Leader Mitch McConnell and Barack Obama have vastly different understandings of a highly touted provision of the newly-enacted health care reform.  They can't both be right!  Let's roll the tape.  OK, roll the transcript - here is the Senator, from last weekend:

Just one day after the president signed this bill into law, we got word that one of its celebrated early features -- a ban on discriminating against children with pre-existing conditions -- won’t immediately protect children after all.

The Senator is referring to this AP story which was supported a few days later by Kaiser Health News.

But my goodness - Barack Obama has been telling people since December that children with pre-existing conditions cannot be denied coverage.  Here is in on December 19 2009, discussing the Senate "managers's amendment", one of the last acts before the final Senate vote:

And a recent amendment has made these protections even stronger.  Insurance companies will now be prohibited from denying coverage to children immediately after this bill passes. 

Here he goes again in a weekly radio address on January 9, describing the immediate benefits of the health reform bill:

Uninsured Americans with a pre-existing illness or condition will finally be able to purchase coverage they can afford.

Children with pre-existing conditions will no longer be refused coverage, and young adults will be able to stay on their parents’ policy until they’re 26 or 27 years old.

Obama made the claim in Iowa after the bill was passed.  And the White House talking points released after the bill was signed led with the same claim:

Let's start with how health insurance reform will expand and strengthen coverage:

This year, children with pre-existing conditions can no longer be denied health insurance coverage. Once the new health insurance exchanges begin in the coming years, pre-existing condition discrimination will become a thing of the past for everyone.

So who is right?  And how did we reach this level of misunderstanding?  I can help.

First, the AP, Kaiser Health News and Mitch McConnell are correct.  Folks reassured by an appeal to authority will note that the AP has quotes from two Democrats supporting their interpretation:

Under the new law, insurance companies still would be able to refuse new coverage to children because of a pre-existing medical problem, said Karen Lightfoot, spokeswoman for the House Energy and Commerce Committee, one of the main congressional panels that wrote the bill Obama signed into law Tuesday.

...Full protection for children would come in 2014, said Kate Cyrul, a spokeswoman for the Senate Health, Education, Labor and Pensions Committee, another panel that authored the legislation. That's the same year when insurance companies could no longer deny coverage to any person on account of health problems.

Folks who distrust authority and want to see for themselves will be fascinated by the supplement to this post, where we dig through the text of various bills to piece the arguments together.

What went wrong?  Basically we have witnessed a communications breakdown between people who speak English (like Barack Obama, who is not a student of insurance arcana) and the people who speak "Insurance".

The Senate manager's amendment was described in their December 19 press release thusly:

Immediate ban on preexisting condition exclusions for children. Health insurers will be immediately prohibited from excluding coverage of preexisting conditions for children.

We can find a similar description from the House, released in February:

No Pre-existing Coverage Exclusions for Children

The President's proposal eliminates pre-existing condition exclusions for all Americans beginning in 2014, when the Exchanges are operational. Recognizing the special vulnerability of children, the plan prohibits health insurers from excluding coverage of pre-existing conditions for children, effective six months after enactment and applying to all new plans.

Now a speaker of English might not recognize that "pre-existing condition exclusion" has a specific meaning and legislative history (e.g., 2007, 2009) within the health insurance field; HIPAA imposed new Federal standards in 1996.  Put simply, insurers deny coverage to people; they exclude coverage of conditions.

A pre-existing condition can affect your health insurance coverage. If you are applying for insurance, some health insurance companies may accept you conditionally by providing a pre-existing condition exclusion period.

Although the health plan has accepted you and you are paying your monthly premiums, you may not have coverage for any care or services related to your pre-existing condition. Depending on the policy and your state’s insurance regulations, this exclusion period can range from six to 18 months.

So previously a health insurer could simply refuse to enroll a particular applicant or they could accept an applicant subject to restrictions on coverage of the applicant (or in this case, an applicant's child).  If we are talking about a group plan offered by an employer, turning the applicant down is not an option; HIPAA regulated the waiting periods during which a pre-existing condition exclusion could be applied, and this new bill reduces those waiting periods to zero for children (after it takes effect in September 2010).

Anyway, the manager's amendment came out and speakers of English took "no more pre-existing coverage exclusions for children" to mean "children could not be excluded from coverage on the basis of pre-existing conditions".  The self-styled Wonk Room at Think Progress provides an example; Barack Obama himself provided another.

Which takes us where?  My guess is that the people who do this for a living have known for a while that Obama was just making stuff up.   (How Mitch McConnell and his fellow Attack Senators missed this is an annoying puzzle.  I know they were not involved in the final negotiations that led to this text, but still - they should feel free to read the bill and hold the other side accountable before the final vote.)

And what happens next?  MSNBC got a response from HHS saying all would soon be well:

"Under the Act, plans that include coverage of children cannot deny coverage to a child based upon a pre-existing condition. To ensure that there is no ambiguity on this point, the Secretary of HHS is preparing to issue regulations next month making it clear that the term 'pre-existing exclusion' applies to both a child's access to a plan and his or her benefits once he or she is in the plan for all plans newly sold in this country six months from today."

Nonsense - if HHS could solve this by regulatory fiat, why would Congress vex themselves by passing bills?  This will require a legislative fix (Some Democratic Congressman was quoted as saying just that, and I managed to lose the link.)

If, I say if this was an actual oversight by Congress then they will need to pass new legislation to fix it.  Republicans risk being painted as ogres if they oppose it, but Obama risks being mocked as Biden-esque for touting benefits that weren't actually in the bill.

Based on the structure of the bill (as described below), I don't think this was any sort of oversight or drafting error; I think Congress took a small, simple step towards immediate reform so they could point to something that would actually happen in 2010, and Obama misunderstood and misoverrsold it.

INTO THE BILL:

The text of the Senate bill can be found here.

The structure of the bill is that parts of it modify existing legislation (the Public Health Service Act); the relevant passage being modified is here.

Page three of the Senate bill provides a table of contents we can use as a bit of a road map for the bill:

‘‘SUBPART I—GENERAL REFORM
‘‘Sec. 2704. Prohibition of preexisting condition exclusions or other discrimination
based on health status.
‘‘Sec. 2701. Fair health insurance premiums.
‘‘Sec. 2702. Guaranteed availability of coverage.
‘‘Sec. 2703. Guaranteed renewability of coverage.
‘‘Sec. 2705. Prohibiting discrimination against individual participants and
beneficiaries based on health status.
‘‘Sec. 2706. Non-discrimination in health care.
‘‘Sec. 2707. Comprehensive health insurance coverage.
‘‘Sec. 2708. Prohibition on excessive waiting periods.

Section 2704 (p. 81 and following) addresses the pre-existing condition exclusions; 2705 disallows pricing differences (including rebate awards to the healthy) based on health status.  2702 says insurers must issue to anyone in their region, and 2703 says they must renew.  The net effect of 2701 to 2705 is that insurers must offer and renew insurance with anyone, can't price differently based on pre-existing conditions, and can't decline to cover (i.e, exclude) specified pre-existing conditions.  All of this takes effect on January 1, 2014.

But wait!  Much later (p. 2065, line 14) we come to an amendment moving forward the effective date of Section 2704 for children under the age of 19:

(e) Section 1253 of this Act is amended insert before the period the following: ‘‘, except that— ‘‘(1) section 1251 shall take effect on the date of enactment of this Act; and ‘‘(2) the provisions of section 2704 of the Public Health Service Act (as amended by section 1201), as they apply to enrollees who are under 19 years of age, shall become effective for plan years beginning on or after the date that is 6 months after the date of enactment of this Act.’’.

Well, that is something - Section 2704 was accelerated for children.  But what about Sections 2701, 2702, 2703 and 2705?  Nope.  If insurers offer coverage it cannot be subject to exclusions, but nothing in these laws obliges them to offer anything.

As the AP noted, this is not a big deal for people operating in the employer group market, where HIPAA guidelines are already in place.  However:

The coverage problem mainly affects parents who purchase their own coverage for the family, as many self-employed people have to do. Families covered through employer plans typically do not have to worry about being denied coverage because of pre-existing conditions.

Parents whose kids are turned down by an insurer would still have a fallback under the law. They could seek coverage through state high-risk insurance pools slated for a major infusion of federal funds.

Presumably the Obama fallback spin will be that, net of the changes in the employer group market and the increased funding for high-risk pools, kids ought to be able to get coverage.  Of course, that is different from Obama's claim that "Children with pre-existing conditions will no longer be refused coverage", but maybe it's close enough.

WORDS MEAN WHAT HE WANTS THEM TO MEAN:  It's Obama in Wonderland, but it's the rest of us that are left wondering what he means.   I think that Obama, by merrily conflating "pre-existing condition exclusion" with denial of coverage, is trying to make domestic policy by gaffe the same way he has tried to make foreign policy by gaffe.

DID CONGRESS UNDERSTAND THE BILL?  Maybe!  In rationalizing the need for an individual mandate, the bill includes this (p. 320):

(G) Under sections 2704 and 2705 of the Public Health Service Act (as added by section 1201 of this Act), if there were no requirement, many individuals would wait to purchase health insurance until they needed care.

From which we infer that Congress understood that Section 2705 was an important part of the new protections for people with pre-existing conditions.  But they didn't accelerate it for children.

REPEATING FOR EMPHASIS:  A year ago S 643 was introduced in the Senate.  Do you think these people believed they were eliminating any right of insurers to deny coverage outright?

Children's Health Protection Act of 2009 (Introduced in Senate)

S 643 IS

111th CONGRESS1st Session

S. 643

To amend title I of the Employee Retirement Income Security Act of 1974, title XXVII of the Public Health Service Act, and the Internal Revenue Code of 1986 to prohibit pre-existing condition exclusions for children in group health plans and health insurance coverage in the group and individual markets.

Comments

[Rick Ballard]

"I think that Obama, by merrily conflating "pre-existing condition exclusion" with denial of coverage, is trying to make domestic policy by gaffe the same way he has tried to make foreign policy by gaffe."

Perhaps. Alternatively, BOzo is lying through his fangs about this in the same way that he did in describing the failure of his liability coverage to cover collision damage caused by another driver.

The debate then becomes "Is the President as stupid as he appears or is he simply mendacious scum?" I have difficulty deciding between the two and wonder if I may have inadvertently introduced a false dichotomy.

[Jane]

Now that is one thorough post.

During reconciliation I implored a Judd Gregg staffer to put this change in amendment form and let the democrats vote against it.

He should have done it.

The debate then becomes "Is the President as stupid as he appears or is he simply mendacious scum?"

No need to compromise. I'm pretty sure he is both.

[MarkO]

Yawn. Obama is a liar. Next witness.

[Steve C.]

Will anyone bother to ask about this at the next press conference? Major Garret?

[Danube of Thought]

Look, when this clown demonstrated to the entire nation that, after graduating from the Harvard Law School, he did not understand the difference between liability coverage in collision coverage in his own auto insurance policy, we were all on notice.

[Charlie (Colorado)]

I thought the fallback spin was that Obama's critics were racists?

[Danube of Thought]

...liability coverage *AND* collision coverage

[Jane]

I hate to admit it, but I think I'm a lot like Obama - I never know details and don't care about them. I have always practiced 1 kind of law at a time, and never know anything about any other kind. I see the big picture but am an idiot when it comes to the minutia. And that appears to me exactly how Obama operates.

I would make a terrible president altho probably not as bad as he is.

[maryrose]

Once again Joe Wilson's charge of "You Lie" bears fruit. Remember the Alinsky rule of the end justifies the means. Obama will lie about anything if he thinks it will get him what he wants. I just finished reading "Game Change" It was very illuminating and I have to say there must be a better way to get really qualified people to run for office. This collection of retreads including the neophyte Obama not ready for prime time is just pathetic. Crist lied to Guiliani and he like a dope based his whole campaign on thinking he had Crist's endorsement locked up. One person should never be regarded as a king-maker.

[Porchlight]

I have to say there must be a better way to get really qualified people to run for office.

It's tough when you look at the gauntlet they have to run. It pretty much guarantees that we get either idiots or ones that are only in it for money, power and perks. Increasingly, honorable people stay away to protect their reputations and their families.

[narciso the harpoon]

Well sadly Jane, he's not even that fluent in his area of expertise, constitutional law. hence the Alinsky power relationships in that
supposed seminar that Jodi Cantor captured for
her profile. I'm sure you'd do much better

[rse]

Looks like Aetna is not trying to go after the administering claims market since their CEO is openly being quoted that you are not going to be able to keep your current coverage.

I wonder if we will get a piling on effect since there has been no Obamacare bounce.

Companies will start openly describing the coming parade of horrible consequences.

[matt]

Obumble lied again?

I'm shocked, shocked.....

[Jim Ryan]

Precision and even accuracy become unimportant when your goal is to drive a large steamroller straight ahead and keep going.

So some of the lies don't stick? People are used to the lies by now and take them in stride. With Congressional majorities and a 40% die-hard base of leftists and dolts, it's no big whoop. The steamroller plows forward.

Even Obama doesn't know whether he was lying or mistaken. It doesn't matter to him. It got the job done.

[Appalled]

Nice post, Tom. I think you nailed the issue, and agree that it will be tough for HHS to assert there is ambiguity on the effective date. That said, this simply looks like a drafting error, where somebody lost track of what Section 2704 of the Public Health Act actually said. (The Obamacare bill is a drafting nightmare -- the fact that it is the productr of periodic allnighters really does show.)

By the way, there has been a talking point lately about the earnings hits certain large companies are taking as a result of the health bill. I think its a mistake to make too much of that. The provision of the health bill that is causing the earning warnings is a change in the law that allowed an employer to deduct their payments to employees for post-retirement drug coverage. Under current law, employers who provide post-retirement drug coverage receive a subsidy from the federal government, and are also able to deduct the payments from their tax return. After Obamacare, the employers no longer get the deduction, thouh they still get the subsidy.

I think, on the issue causing the earnings heartburn, the Obamacare bill removed some corporate welfare unwisely granted by the Bush administration.

[Porchlight]

Companies will start openly describing the coming parade of horrible consequences.

I hope so. But they may be cowed by Waxman/Stupak hauling them in front of cameras. Which is of course the intention of the haulers.

[Appalled]

The "keep your own coverage" thing is not, in any real sense, accomplished by this act. If your medical program never really changes, then, indeed, the Obamacare law will not apply to it. But if your program changes in any way (like, say a doctor is added to the network, or a new procedure is covered), the full panoply of Obamalaw applies to it.

[Jane]

he's not even that fluent in his area of expertise, constitutional law.

Oh that's not his area of expertise - campaigning is his area of expertise.

[Pteus]

'an act of America wanting to expand its influence'
I guess health care was this and now it's come back from overseas. O is too scared, I mean busy, with health care to go and visit the places he sends his employees. Now, he'll go after we waited and got attacked. The Russians and Americans have been mining the arctic for years with subs and Canada's attempts to catch up with subs and RCMPs livings there is ridiculous. It's all mapped and mining has been under way. The natives never really had a claim to the underwaters anyway. O should have been on this with all that funding for the geo spacial intelligence agency and those arctic spy meetings, I mean summits and studies. Global warming and all that funding and this got missed by O, the dems, and the intelligence committee? Health care.

[maryrose]

The eternal campaigner is what has been elected. The foreign policy goofs are what really traumatize me. This goof is clueless and rogue nations are going to school him in the folly of so-called Smart diplomacy. Unfortunately Hillary is the fall guy here as she lurches from crisis to crisis. A seder dinner tonight for Obama to make up for the snub to Bibi.

[hit and run]

TM:
My guess is that the people who do this for a living have known for a while that Obama was just making stuff up

Obama may have a piece of paper that says he graduated from Columbia and Harvard. He may have an entry on his resume that says he was a professor instructor at the University of Chicago.

But he really is a product of MSU (no,not the one in the final four).

Making Shit Up University.

He graduated summa commie laude from MSU.

And like Jim Ryan says,he couldn't care less whether we know it or not,because 30-40% of our fellow citizens,the less sentient among us,wouldn't or couldn't tell the difference between the shit he makes up and their reality-based existence.

[Clarice]

I am NOT talking to DoT for a while. It's not that I stopped loving him. It's just that it's so like a man to cut out a bit here and there and lose 13 lbs in two weeks doing that. And then have the nerve to brag about it.

PHeh

[Buford Gooch]

"campaigning is his area of expertise."

I think we may be confusing "experience" with "expertise". Obama is not a great campaigner. He had the full weight of the press behind him, or he would have been laughed off the stage. He did some rabble rousing, but he wasn't really very good at that either.

[Jim Ryan]

DATELINE Washington DC. The Democrats in Congress repealed the so-called ObamaCare law today, just six weeks before the 2010 midterm elections and just days after Moody's revised credit ratings for the U.S. came out at single-A.

"It was not the right law for American families," House Speaker Nancy Pelosi said. "It was a bipartisan bill, but it was really a boondoggle for big insurance companies. It was the same-old-same-old with Republicans and their corporate masters."

"Today is a proud day when we are able to step forward and protect working American families," President Obama said during the signing ceremony.

Recent polls show that with the CPUSA candidates for Congress receiving 20% of likely voters' support, the GOP with 60%, undecided voters representing 15%, the Libertarian candidates again running on the "legalize it" platform garnering 1% support, Democratic candidates are looking at only 4% of the vote in the coming elections.

[MarkO]

In almost every other aspect of life, lying has consequences. Lying about greatly important things generally has heavy consequences. No lying while President. There is no consequence. Can't sue. Can't prosecute. Can't really even get anyone to notice. Isn't that why Clinton was caught lying, he was so used to doing it without repercussion that he just did it.

Conservatives need to call it what it is (not something cute like a "statement expiration date") make a large list and hammer on about it and how the election would have had consequences if Obama were not such a liar. Then, more of the above.

Someone has to make it stick to start with. That person cannot be president.

[Frau Geschäft]

Valerie Jarrett was just on a business channel, pointing out her business experience, thus hoping to counter the charge that Pres.Sux's administration lacks such real experience. Hers was part of the Chicago machine's hold on housing: 1995, CEO of The Habitat Co., a real estate development and management company.
Business the Chicago way has a different meaning for most of us.

[Pofarmer]

If your medical program never really changes, then, indeed, the Obamacare law will not apply to it. But if your program changes in any way (like, say a doctor is added to the network, or a new procedure is covered), the full panoply of Obamalaw applies to it.

Somebody has been practicing Obamaspeak.

If you have a policy, it will be affected. Check out Title IX.

[Captain Hate]

I hate to admit it, but I think I'm a lot like Obama

LOL, no...

[Janet]

MarkO - I elect you to take Michael Steele's place. You have great STRONG ideas.

[Jeff]

apalled ...

they are going to lose the deduction and many will choose to drop the coverage ...

so getting rid of the "horrible corporate subsidy" will end up cost us taxpayers more money since those seniors dropped will be paid for by you and me at a higher cost than the subsidy ...

[EBJ]

"I think, on the issue causing the earnings heartburn, the Obamacare bill removed some corporate welfare unwisely granted by the Bush administration"

And I thought the issue was that the Dems just passed a major bill and were surprised one week later that companies would be taking charges in the next accounting quarter. Or is it just Waxman who's confused?

[Soylent Red]

Wait a doggone minute...

Do you mean to tell me that our Democratic Congress and President are

a. liars
b. stupid
c. some toxic combination of both?

The hell, you say!

[Jim Ryan]

..."We're going to keep fighting the bastards!" said CPUSA presidential candidate Jane Hamsher. Hamsher has been garnering 17% of likely voters in recent polls, well ahead of Democratic nominee Joe Biden's 4% but trailing GOP nominee Chris Chistie who has 67% of likely voters at this point.

Hamsher recently won her party's nomination by cunningly taking the moderate ground away from her opponent, Dennis Kucinich. "Mr. Kucinich wanted to pull this party way to the left, and I think CPUSA voters sent him a clear message that we are a big tent of moderate, sensible communists," Hamsher said. "I think by the time voters get to the polls next week, they're going to have taken a look at the Communist Party and have decided that yes, this is the party that truly stands up for American values," she added. "Americans say no to private property and I think we're going to see results next week bear that out."

President Biden was unavailable for comment as he was needed as a witness in the ongoing indictment hearings of former-president Obama.

[Rick Ballard]

I've read both of today's posts re the Democrats doing it to the children - again - twice and I remain unsure as to why the desired objective could not be obtained through passage of legislation of rather limited length.

Does 'No parent[s] or legal guardian[s] of a child of less than 19 years of age shall be denied the opportunity to purchase coverage for any child due to any pre-existing medical condition nor shall any health insurance policy issued exclude any pre-existing medical condition which any child may have.' have any gaping loopholes which are obvious at a glance?

Unless the "desired objective" is actually screwing the kids and protecting the insurance companies, of course.

[[email protected]]

(How Mitch McConnell and his fellow Attack Senators missed this is an annoying puzzle. I know they were not involved in the final negotiations that led to this text, but still - they should feel free to read the bill and hold the other side accountable before the final vote.)

It wasn't available for most of the "debate" period. There were dozens of different draft bills of thousands of pages and no consensus on which would be the actual proposed legislative text.

[Clarice]

Very good, Jim.

[Rick Ballard]

"There were dozens of different draft bills of thousands of pages and no consensus on which would be the actual proposed legislative text."

The President ran half way 'round the world like a scalded rat to avoid questions concerning the content of his "victory". The key Maladministration suckups who compose the Journoliarlist don't even know which talking point to babble next. Kinda tough to pick on McConnell for not having all the jots and tittles down.

[drjohn]

Democrats are going to blame insurance companies for their own incompetence?

That's going to go well.

[PDinDetroit]

Wait a doggone minute...

Do you mean to tell me that our Democratic Congress and President are

a. liars
b. stupid
c. some toxic combination of both?

The hell, you say!

The Answer is always C, mixed in with a little traitorous stomping on the US Constitution.

[Janet]

This whole bill is too convoluted to understand...for me anyway. I just oppose the whole darn thing on the grounds that the federal government has no business in our health care. They never should have begun at all...medicare, medicaid, mediwhatever. It is a fiasco.
Our federal government needs to get their nose out of our business. Congress should be a part-time job. Meet 1 or 2 months a year and maybe some weekends.
This 24/7 "idea mill" is killin us.

[Soylent Red]

the federal government has no business in our health care.

Damn skippy, Janet.

[Danube of Thought]

"I think, on the issue causing the earnings heartburn, the Obamacare bill removed some corporate welfare unwisely granted by the Bush administration" and a bipartisan congressional vote in both houses.

[MayBee]

Don't you worry. Sebilius has now written a letter to the insurance companies imploring them to ignore the law just passed and instead do what they want.

[MayBee]

Do what the administration wants, I mean.

[Janet]

What are the laws? Does anyone know? How are Americans suppose to obey laws that the writers do not even understand?
Really, This is a fiasco.
I thought we were a nation of laws...not a nation of how a woman named Sebelius is feeling. Is she our national prophetess? our Seer?
Perhaps we should build some temple on a mountain and consult her when we need an answer...."Oh wise Sebelius, can I have a band aid?".

[Old Lurker]

"Unfortunately Hillary is the fall guy here"

Not gonna buy that.

Never.

Did you catch her dissing the Canadians today concerning their artic resource conference? She was a witch. She is a witch. She will be a witch. And a dumb one at that.

Plus, she's shrill and ugly.

That she is tied to a garbage truck is a fact of her own making.

Again.

What did I leave out?

[Rick Ballard]

"What did I leave out?"

The time she turned you into a newt?

[Ignatz]

--The time she turned you into a newt?--

She did that to that Gingrich dude too.

[Soylent Red]

The time she turned you into a newt?

Well...I got better.

[Old Lurker]

:-)

[Hillary]

That hurt my feelings. I have feelings you know.

[Hillary]

Just kidding!

[rse]

Janet-

The bill is so poorly drafted that the lawyers who know this area keep pointing out the discrepancies. (I get nerdy emails).

It was about political power and a story MSM could run with.

Those are poor terms for taking over 1/6th of the economy.

[Old Lurker]

It is quite telling that in this biggest of deals, when the boss could only recite four or five things about it, that his team could not even be sure to get those few things right in 2400 pages.

That is the story of Obama.

[Danube of Thought]

I love all this confusion. The more sturm und drang there is about what the hell this bill does and does not say between now and November, the better. Doesn't matter who's right on any particular issue--the more the perception grows that the whole thing is a rat's nest, the better.

[Mark Buehner]

Somebody is going to have to dig up the anonymous Congressional staffer that wrote that page of the bill and ask him what his intentions were for reorganizing 1/6th of the US economy. Since nobody else in DC has a clue.

[mark l.]

no pre-existing conditions...

so basically, if you are a smoker, you'll get thousands off the cost of private insurance with the govt plan.

so much for one the biggest reasons to quit.

[Csmith]

Obama lied - Children died

[Purple Pimpernel]

p