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Good News for Rare Diseases: Big Profits

For people who had a rare disease, defined as an ailment that strikes less than 200,000 Americans, there was often little hope, at least when it came to pharmaceuticals.  Drug companies didn’t see much profit in sinking resources into developing drugs to treat them.

Thankfully, that’s changing. As the Wall Street Journal notes:

Incentives from the U.S. Food and Drug Administration to develop so-called orphan drugs can mean quicker approval, tax benefits for the developer and seven years’ protection from competition after approval. Conventional drugs typically get five. Patient groups have raised hundreds of millions of dollars to give to firms for development of orphan drugs, defined as experimental treatments for diseases with fewer than 200,000 patients at any one time.

But perhaps most persuasive: Drug companies have found that they can charge towering prices for such drugs, which often treat deadly conditions for which there are few or no options.

Those “towering” prices may seem undesirable, but they are in part responsible for the big profits on these drugs.  And it is the profits which will drive innovation.

When companies and their investors realize there is a lot of profit to be made in a certain area, they will start directing resources to that area in hopes of reaping some of the profits.  This leads to competition which, eventually, will help lower the drug prices.

But if it wasn’t for the ability to make a profit, drug companies wouldn’t be moving into the area of rare diseases.  Right now, there is no drug therapy to treat primary-progressive multiple sclerosis, the worst kind of MS.  Now that drug companies have an incentive to make money off of it, one can hope there will soon be some drug treatments for primary-progressive MS.

I’ve occassionally heard people on the political left decry profits in health care.  Companies should make a profit off of people’s illnesses, they argue.  But that’s incorrect.  Companies aren’t making a profit off of illness; they are making a profit from curing illness.

So here’s hoping that many areas of health care become very profitable.  Profit is what attracts investment in cures.


Winter Blues Can’t Be Blamed for Poor Economy — “About Those Jobs Numbers” For March 2015

It’s not a good Friday for the Obama Administration.  A new report on jobless numbers, compiled by the federal government, came out today.

The official unemployment rate is 5.5 percent.  That’s unchanged from last month, and that’s no cause for celebration.  Even though this official number did not go up, the more complete and nearly double alternative unemployment measure and the workforce participation rate still points to peril.  There are even more reminders that the American economy continues to underperform despite the assurances from the Obama Administration that things are getting better.

As he does every month, Project 21 member Derryck Green provides his monthly analysis of these unemployment statistics and the general state of the economy in the Obama era:

Spring is finally here, but the harsh winter is no real excuse for the poor economy.

Bad weather — snow, in particular — often gets blamed for a lull in economic activity.  That is being used as an excuse right now, and there was plenty of snow across the United States this past winter to take the blame.

That being said, a lot of the problems with the American economy likely have more to do with Barack Obama’s fiscal stewardship than Jack Frost’s prolonged and prodigious visit.

Today’s report on jobless figures issued by the federal Bureau of Labor Statistics helps make that point.

According to the official government estimate, there was an unemployment rate of 5.5 percent in March.  But this unchanged rate pales to the alternative — and much more sobering — U-6 jobless rate of 10.9 percent.  This is the rate that tends to be a clearer indicator of the employment situation because it includes those who are unemployed, underemployed and have removed themselves from the job market altogether.

As Jim Clifton of the Gallup polling firm recently pointed out, this official unemployment rate can be made to seem lower than it may truly be through all sorts of manipulative trickery.

And that more unforgiving alternative rate is, per usual, around twice the official rate the media will focus on and the Obama Administration will cite.  Disappointment will likely be explained away as a result of a bad winter.  For example, state labor reports in Massachusetts and Connecticut already blame snow for slowed job growth and even losses.

But any positivity or assurances of a snowy anomaly cannot cover up how the labor force participation rate is an appallingly low 62.7 percent and has been no higher than 62.9 percent through many seasonal changes of the past year.  Nothing can deny that the estimated 126,000 jobs created in March fell below expectations and marked the end of a year-long streak of monthly job creation over 200,000 jobs.  ADP, a private company that works in payroll processing, was actually optimistic earlier in the week when it estimated 189,000 jobs were created.  Both numbers are below the 225,000 that were projected.

There’s also should be concern about joblessness in key demographics that are long-term and hurting constituencies allegedly of the utmost concern to this presidency.  For example, the black teen unemployment rate was 25 percent — a sky-high number that improved but has nonetheless hovered around 30 percent for much too long.  Overall black unemployment was also way too high at 10.1 percent, which was a slight decrease from February.  Hispanic unemployment was up to 6.8 percent.

These higher-than-average unemployment rates were not just during the winter months.  Black unemployment, for example, was 11 percent in November of 2014, before a lot of snow began falling.  The unemployment rate has been dismal, whether there was snow or leaves on the ground.

These unemployment numbers could be getting worse in the future as more illegal immigrants come “out of the shadows” to benefit from the President’s recent executive action allowing some families to benefit from what’s everything short of full amnesty.  In news that should not surprise anyone, the Center for Immigration Studies revealed that Department of Homeland Security statistics indicate that over 2,000 youth are still crossing the border into the United States each month.  The lure of what is believed to be real amnesty is obviously an incentive to those flooding the border.

According to the CIS, 84 percent of these kids currently crossing the are teenage boys.  They are, or soon will, be competing in the workforce — legally or not — rain, snow or shine.  And they will be going head-to-head with unemployed American citizens for similar jobs.

It’s clearly a build-up for disaster.

Getting back to the change in seasons, unemployment is not the only poor economic indicator being blamed on the snow when it really should not.

Construction of new homes, for instance, fell the furthest in February than in the previous four years.  Housing starts were down 17 percent from January and, according to IHS Global Insight, this “poor” Commerce Department report suggests that reduced spending on construction could drag down the entire economy for the first quarter of 2015.

Bank of America’s Michelle Meyer dispelled the weather myth as it pertains to housing, telling Bloomberg: “While the initial reaction is to dismiss much of the drop because of the bad weather, the level of home construction continues to be depressed.”  There are also still 1.4 million fewer construction jobs than in 2006.

In addition to problems in the construction industry, there is a potential problem for auto sales as well.  It appears the expected drop in sales of new cars has arrived, with automakers such as Ford and Nissan reporting March sales were down by three percent.  Honda sales were down by five percent.  Volkswagen fared even worse with an 18 percent decline.  General Motors also lost two percent.

Some people want to blame a snowier March, but it is still generally supposed to be a good month for car sales.  Alec Gutierrez of Kelly Blue Book told the Associated Press that “we’re at a point where sales are going to grow at a much slower pace.”

What are government officials thinking?  Over at the Agriculture Department, while many families are planting their own vegetable gardens this spring, it would appear bureaucrats are instead trying to find better ways for Uncle Sam to deliver fruits and vegetables to those on public assistance.  They are apparently less focused on helping people in need do things themselves, and would prefer spending more on enhanced benefits.

SNAP/food stamp participation more than doubled since the start of the Great Recession.  It is expected to cost an estimated $80 billion in 2015.  At least $31 million of that is allegedly to be spent on encouraging “incentive strategies to help SNAP participants better afford fruits and vegetables.”

It would appear as if there is more emphasis on using welfare dollars to meet the desires of bureaucrats than in encouraging recipients to not need them at all.  It’s like there is no expectation of an end of attempts to slow the economic malaise that has gripped the nation throughout the Obama Administration.

Seven winters have come and gone while Barack Obama has lived in the White House.  The economy has remained in a rut throughout these winters and the following springs, summers and falls.

Even the New York Times article on these latest unemployment numbers can’t find much of merit: “This latest jobs report underscores what has been a persistent theme: that in the recovery, many working Americans have received only scant benefits from the upswing.”

It’s not the rain or the snow probably as much as the drip at 1600 Pennsylvania Avenue at fault!


Celebrity Chef Tom Colicchio Divides Us Between Red Plates and Blue Plates 

Vegetable sandwich LW

In a National Review piece just out today, food writer Julie Kelly and I review the divisive activism of celebrity chef and MSNBC food correspondent Tom Colicchio.

We write that,

If you’re looking for practical dinner advice, look elsewhere.  

I’m confident that National Center for Public Policy Center Research readers are erudite enough to already know that an MSNBC food correspondent isn’t the guy you should look to for recipes. 

Recall, for instance, when I told The Washington Post not to give mainstream credence to the 2013 National Food Policy Scorecard sponsored by Mr. Colicchio’s group, Food Policy Action. 

Jeff Stier, senior fellow at the conservative National Center for Public Policy Research, said there’s a good reason for Republican lawmakers’ performance on the scorecard. “It does not, as FPA claims, ‘reflect the consensus of top food policy experts,’ ” he said. “Rather, it represents the narrow views of a select group of some of the nation’s most ideologically divisive activists.”

Stier called the scorecard a “sham,” saying it has all the validity of an “NRA scorecard on gun ownership. But they’re playing it off as otherwise, which I think is misleading.”

Well, not much has changed since 2013. 

Celebrity chef Tom Colicchio probably doesn’t cook much these days. Having built his reputation preparing expensive entrées for his well-heeled customers at Craft Restaurants, Colicchio is now cooking up liberal food policy to expand the government’s ever-encroaching role in how we eat, and what.

 His self-promotion schedule and branding pursuits could put Kim Kardashian to shame. He’s the star and producer of two reality shows on Bravo, Top Chef and Best New Restaurant. Colicchio owns several pricy restaurants and “ethical sandwich” joints on both coasts. He lends his name to a collection of expensive artisanal kitchenware, including a coffee mug for only $46.

 But apparently television and restaurant fame don’t hold enough gravitas for this wannabe political star. Over the last few years, Chef Colicchio has emerged as the face of the food movement, culinary elitists who insist that every bite of food is a political statement (think climate-change folks going after your shopping cart instead of your SUV). 

Testifying before Congress a few years ago about the school-lunch program whet his appetite for politics. Since then, Colicchio has visited Capitol Hill several times to promote mandatory labeling of genetically modified foods, and as the guest of organic farmer Representative Chellie Pingree (D., Maine) he even attended the State of the Union address in January. No doubt the chef will want a seat at the table to spin the now controversial update to the Dietary Guidelines for Americans, due for approval later this year.

Read the full piece here.


Repealing the SGR Without Adding (Too Much) to the Deficit

Today the House passed the “Medicare Access and CHIP Reauthorization Act of 2015” which will repeal the dreaded Sustainable Growth Rate.

Unfortunately, the bill is not without its problems, not the least of which is it will cost $141 billion over ten years.  

Thanks to the folks at the Heritage Foundation for pointing out to me that there is at least $57.6 billion worth of Medicare changes in President Obama’s budget that could be used to defray some of the cost.  They include:

-$62.5 billion by increasing income‐related premiums under Medicare Parts B and D.

-$6.6 billion by increasing the Part B deductible for new beneficiaries.

-$0.8 billion by introducing home health co‐payments for new beneficiaries.

-$17.7 billion by encouraging  the use of generic drugs by low‐income beneficiaries.

-$5 billion by introducing a Part B premium surcharge for new beneficiaries who purchase near first‐dollar Medigap coverage.

That adds up to about $92.6 billion. The House bill already incorporates about $35 billion of it, meaning that there is another $57.6 billion that the Obama Administration is willing to go along with.  Include the rest and the cost drops to $83.4 billion.  

I’d still like to see that final $83.4 billion paid for, but if that was the only thing standing in the way of SGR repeal, it might be worth it.



I walked to the corner coffee shop this morning (not Starbucks) and ordered a mocha. I then asked the clerk if she could write #RaceTogether on it.

She replied that she didn’t know what I was talking about.  I smiled and said, “You know, Starbucks?”  The barista overheard me and said, “Yeah, I heard about that.  I don’t get what they were trying to do with that.”

I couldn’t help myself: “I think the goal was to lose customers.”

My encounter this morning renews my faith that there are normal people in the world who have better things to do with their time than pay attention to silly social justice campaigns.  



ObamaCare At Five: Lipstick on a Pig

The Los Angeles Times editorialists today acknowledged some unpleasant reality about ObamaCare: “…surveys show little love for [ObamaCare]— a view that hasn’t shifted much over time.”

But the Times can’t acknowledge that the law is unpopular without prefacing it with a distortion: “The general public isn’t as eager to do away with the law, widely known as Obamacare…”  Really?  The last poll conducted on the question of repeal showed 58 percent favor repeal.  The poll, commission by FoxNews last December, found that was up 53 percent from a year earlier.

You might think that the persistent unpopularity of ObamaCare would encourage some reconsideration the value of the law.  But then you realize this is the Times editorial page.  Naturally, they quickly get on with the lipstick application:

Despite the relentless attacks, however, the act has been a notable success on one front: It has helped millions of Americans obtain insurance coverage that would otherwise be out of their reach. By March, more than 21 million people had enrolled through new state insurance exchanges or Medicaid, including more than 16 million who’d previously been uninsured, and the number of Americans without coverage has dropped to a little over 12%, according to Gallup

Yes, but that 21 million include about 10 to 11 million more on Medicaid, the worst health care program in the U.S., not exactly something to cheer about.  It also includes some of the 4 to 6 million people who lost their insurance thanks to ObamaCare, rendering President Obama’s promise that if you like your health plan, you can keep you health plan” quite possibly the lie of the decade.  Funny, but the editorial doesn’t mention that.

At the end of that paragraph, they pull a fast one: “There’s much more to be done to make healthcare affordable and sustainable, but lawmakers should build on the foundation laid by Obamacare instead of continuing to battle over whether to demolish it.”  Health insurance and health care are two different things. Making health insurance more “affordable” by heavily subsidizing it does not necessarily make health care more affordable. (Indeed, it might make health care more expensive).

The editorial next claims that “One result [of ObamaCare], according to PricewaterhouseCoopers’ Health Research Institute, has been a surge of new businesses into healthcare as entrepreneurs offer their own approaches to less costly, ‘consumer-oriented’ care.”  According to the Congressional Budget Office, ObamaCare will also reduce the number of hours worked by the equivalent of 2.5 million job by 2017.  Sure hope that surge of new businesses is enough to compensate for that.

Finally, it’s hard to know what to make of this passage: “A key part of the effort to rein in healthcare costs is covering more people with insurance plans that promote wellness and prevention. [ObamaCare] has done much of that work, so the rational thing for lawmakers to do now would be to build on that progress.” Either the editorialists are lying or they are ignorant.  Let’s give them the benefit of the doubt and assume the latter.   Sorry, but wellness programs do not save money and, of the most part, don’t improve health.  And while preventive care can improve health, it generally does not save money.  Maybe the Times’ editorialists should start getting their information on such subjects from sources other than the propaganda of former HHS Secretary Kathleen Sebelius.

Of course, propaganda is very useful when trying to make ObamaCare out to be a good law.


Upset with Ringling Bros. for Taking Elephants out of the Circus? Blame PETA Instead

In an op-ed for USA Today, I remind readers that radical animal rights activists are to blame for the loss of elephants in the Ringling Bros. circus.

For all the families who have yet to take their children to a Ringling Bros. and Barnum & Bailey Circus — hurry. The company announced recently that its storied elephant act will no longer appear in the traveling circus as of 2018.

This decision has been met with disappointment by people like myself who value the wholesome entertainment that the circus provides, and bristle at hysterical attacks by animal rights extremists. Groups like People for the Ethical Treatment of Animals (PETA), on the other hand, have cheered the decision and claimed victory in the long fight against elephants in the circus. This, in their view, is a major victory in their broader war against any human ownership of animals.

But those, like me, whose initial reaction was anger at Ringling Bros. and its parent company, Feld Entertainment, for “capitulating” to animal rights activists should consider placing the blame on the activists themselves. By engaging Feld in a perpetual stream of litigation and proposed bans, activists were able to distract the company from its core competency — family entertainment — until those distractions became too onerous.

What’s particularly obnoxious about the litigation brought on by radical animal rights groups, including the Humane Society and the American Society for the Prevention of Cruelty to Animals (ASPCA), is that it was summarily dismissed in court. In fact, these plaintiffs ended up paying Feld for bringing such outrageous claims. Just last year, the Humane Society and other animal rights groups paid a $15.75 million settlement to Feld after their lawsuit alleging elephant abuse was found without merit.

Two years earlier, the ASPCA was ordered to pay Feld $9.3 million after making false claims against the company in court. These groups aren’t just having their claims thrown out; they’re so egregious that they are compensating Feld and Ringling Bros. for their misdeeds.

So the claims by these animal rights extremists against Ringling Bros. have been shown in court to be a total fraud, and claims that the “Greatest Show on Earth” is harmful to animals have been debunked repeatedly in court, as well as in the court of public opinion.

But the threats of further litigation didn’t stop. Activists publicly admit that it doesn’t really matter if you’re successful in court — the act of suing is a useful irritant that costs your adversary time, money and focus, and gets them to give in, even if the underlying litigation is without merit. . In fact, here, Feld conceded that the non-stop litigation and costs of opposing regulatory threats in localities around the country were integral to the Feld family’s decision to retire the 13 currently performing Asian elephants from the traveling circus.

The suit against Ringling Bros. is just one of a long and colorful list. I will mention just a few other animal rights zealot’s efforts here. PETA condemned the Pokémon media franchise because the video game “paints a rosy picture of what amounts to thinly veiled animal abuse,” PETA filed suit in federal court in Southern California seeking to declare that SeaWorld’s whales are being held in slavery in violation of the 13th Amendment. The failed litigation sought a court-ordered release of the whales “from bondage.” CNN reported that the suit sought “a permanent order against holding them in slavery, as well as appointment of a legal guardian to carry out the transfer of the whales to a suitable habitat.” The Animal Legal Defense Fund is planning to sue a Napa restaurant for serving foie gras during a now-overturned ban on foie gras.

The irony here is that Ringling Bros. has done far more to preserve Asian elephants’ on planet earth than the flailing animal rights groups. They, instead, are popping corks that children can’t see elephants in the circus anymore, and I’m certain will continue their tried and true pattern of focusing their time, energy and resources ginning up lawsuits or other bogus attacks on human interaction with animals — impacting the ability of companies and governments who come under their scrutiny from focusing on their missions. Sadly, I guess that’s the point.





Loretta Lynch Race Card Tactics Rebuffed by Black Conservatives

With Senate liberals refusing to allow a vote on legislation that would combat human trafficking because there are long-established protections against taxpayer funding of abortion included in it, Senate Majority Leader Mitch McConnell (R-KY) said political shenanigans will come at a price.  Until the filibuster of that human trafficking bill comes to an end, it will also effectively block any confirmation vote for Loretta Lynch to become the next attorney general.

Naturally, rather than lifting the filibuster or seeking a compromise, Senate liberals instead went on the attack.  Their weapon of choice?  The race card, of course!

Senator Dick Durbin (D-IL) chose to take the fact that Lynch is a black woman to claim that the procedural delay was akin to Rosa Parks in Montgomery, Alabama in 1955, and that McConnell was making Lynch “sit in the back of the bus.”

Over in the U.S. House of Representatives, which has no bearing on confirmation matters other than to bluster, Representative Sheila Jackson Lee (D-TX) suggested in a MSNBC interview that Lynch’s race and sex are “a factor” in why a vote is not scheduled.

Members of the National Center’s Project 21 black leadership network take exception to these liberal bullying tactics.  They see Lynch as just another nominee, not someone who deserves special treatment because of her skin color or her gender.

Speaking about the liberals’ race card strategy to push her confirmation and silence dissent, Project 21 Co-Chairman Horace Cooper, a former constitutional law professor at George Mason University and former leadership staffer in the U.S. House of Representatives, said:

This is truly shameful.

Instead of letting Loretta Lynch’s nomination rise or fall on the merits, Washington liberals in the House and Senate are trying to use her race and gender as a tool to prevent any examination of her record or agenda.

When these same so-called progressives opposed women and minorities who were conservative, such as Janice Rogers Brown for a federal judgeship, no one claimed they were bigots.   Liberals should abide by this same standard when they nominate one of their own.

Furthermore, instead of clouding the issue with racist charges, Loretta Lynch should be encouraged to be forthcoming on her positions on gun control, executive amnesty and perpetuating a politicized Justice Department. 

Project 21 member Shelby Emmett, an attorney and former Capitol Hill staffer, said:

As a black woman and an attorney, I am so sick and tired of race always being the liberals’ default talking point.

Ms. Lynch went through four years of college, three years of law school and has decades of experience to put her where she is today.  She is just as qualified as any other candidate, and thus all the scrutiny, questions, procedures and games should be fair game just like with any other nominee during the confirmation process.

God forbid that Senator Dick Durbin should see an attorney instead of a black woman who apparently isn’t on the same level as her white male peers and thus worthy of a defense based on her resume instead of her pigmentation.

True racial harmony is holding this woman’s feet to the fire — just like we would with any white, male candidate.  She can handle it. 


Hey Amy & David, You Should Adopt This Policy for NCPPR!

Now this is an awesome employee incentive program!

For a little more than four years, Eric Puryear with Puryear Law in Davenport, Iowa, has given his employees an extra $50 a month if they get their permits and carry a gun.

“Well, I really like gun rights. I think they’re a basic human right. I think so many bad things wouldn’t happen to people if they were armed for self-defense,” said Puryear.

You know, I’d be okay with even $25 a month!

More here:


Health Care Odds & Ends: Government Incompetence Edition

1. Fixing The Doc Fix Is Tricky.  Congress is finally getting around to eliminating Medicare’s Sustainable Growth Rate (SGR), something it should have done a long time ago.  The SGR is a system for cutting Medicare’s physician fees that has proven unworkable.  Congress routinely suspends the cuts imposed by the SGR and replaces them with a small increase, a process known as the “Doc Fix.”

I’ve argued that Congress should get rid of the SGR (for a somewhat longer treatment go here and scroll down to “Sustainable Headache”.)

Yet some conservative groups are opposing the current SGR fix, and they raise two legitimate points.  First is that Congress has usually found “offsets”—i.e., cuts in the budget—to help pay for the various Doc Fixes. Without those offsets, the national debt would have been $165 billion higher since 2003.  Second, the current reform costs $200 billion over ten years, while only $70 billion of that is offset.  For more on conservative objections, go here.

The opposing view is that the Congress doesn’t need to fully offset it since it won’t be paying for Doc Fixes anymore.  Congress has spent about $170 billion on Doc Fixes over the last 12 years.  “I think what’s happening is that both Republicans and Democrats have come to the conclusion that, first they were paying for patches [Doc Fixes] with mostly gimmicks anyway, and second, that the new payment system has a good chance of saving money in the long run,” said Robert Laszewski, founder and president of Health Policy and Strategy Associates. 

For more on this, see Peter Suderman at Reason.

2. Most ObamaCare Policies In New York Have Restrictive Provider Networks.  “…there’s one popular feature that most New Yorkers can’t find in any of the health plans offered on their state exchange: out-of-network coverage,” writes Michelle Andrews at Kaiser Health News. Most plans, including all in the New York City area, “are health maintenance organization-style plans that cover care provided only by doctors and hospitals in the plan’s network.”

This is what happens when the government forces insurance plans to cover ten “essential” benefits, and conform to guaranteed issue, community rating and medical-loss-ratio regulations.  One of the few ways left for insurers to keep costs down is to scrimp on the quality of provider networks.  

3. Guess What Canada’s Oh-So-Wonderful Single-Payer System Doesn’t Cover?  Canadian Alheli Picazo is a writer and former elite gymnast who has suffered from a severe digestive tract problem. Her condition caused her to suffer “from severe acid reflux. This wore down the enamel of her teeth and caused the equivalent of osteoporosis in her oral cavity. The 30-year-old needs urgent oral surgeries, including bone and tissue grafts, to remove and replace what she described painfully as ‘the increasingly diseased bone.’”  Unfortunately, “Picazo has to wait until she can amass the $100,000 needed to pay for the procedures” because Canada’s system does not cover dental care.  

The article, which appeared in Vox, noted that “This is similar to a gap in Obamacare: health plans on the exchange aren’t required to offer dental coverage.”  Guess what? There is another plan in the U.S. that doesn’t cover dental care.  Here’s a hint: it’s the program that activists point to when they want to promote single-payer here in America.


Conservative and Libertarian Alternatives to ObamaCare

I was on the “Up Front” radio program on KTLF out of Minnesota this morning, and as I promised, here is a link to the spreadsheet showing all the health care reform plans offered by the political right.

At issue is the Supreme Court case King v. Burwell, a case that has the potential to unravel ObamaCare.  The Court heard the case about two weeks ago and will likely render its decision in June.  If the plaintiffs win, then about 6 million people in federal exchanges would lose their premium subsidies.  That would give Congress an opportunity to re-open ObamaCare entirely.

While the mantra among the political left is that conservatives, libertarians and Republican don’t have alternatives to—i.e., plans that are better than—ObamaCare, the spreadsheet gives the lie to that mantra.

There are terms in the spreadsheet that are rather “wonky” such as refundable, tax exclusion and HIPPA.  A glossary is provided in the National Policy Analysis that accompanies that spreadsheet.  The NPA is entitled, “If Plaintiffs Prevail in King v. Burwell, Conservatives and Libertarians Have Many Health Care Reform Options Ready to Help People who Lose ObamaCare Subsidies.” 


Many Changed Their ObamaCare Plans Because It Was Too Expensive Not To

According to the headline over at National Journal, “Obamacare Enrollees Are Surprisingly Smart Shoppers”. What makes them so smart?  Well, about 1.2 million exchange enrollees “ended up switching plans.”  

Or perhaps they just aren’t inordinately stupid.  After all, if keeping the plan you chose last year could result in premium hikes of hundreds if not thousands of dollars more this year thanks the ObamaCare’s goofy subsidy mechanism, shopping around is the pretty obvious thing to do.

The National Journal’s Sam Baker, to his credit, makes note of this: 

Before the 2015 open-enrollment period, which ended last month, it was an open question whether consumers who signed up in 2014 would come back to the exchanges and shop around for a better deal.

If they didn’t, they were at risk for particularly large premium increases, because of quirks in the way the law’s insurance subsidies are calculated. The Health and Human Services Department strongly encouraged returning consumers to shop around this year. 

Unfortunately, the article then reports the Obama Administration’s spin without reporting any dissenting voice:

Kevin Griffis, HHS’s acting assistant secretary for public affairs, said the rate of plan-switching was better than HHS had expected and higher than the rates for Medicare Part D.

Consumers’ engagement will also send a message to insurance companies, he said, that “it’s critical to compete on price” on the law’s insurance exchanges.

More likely it is sending the Obama Administration a message that it has constructed a messed up system.  But don’t count on that message getting through.


Fixing Veterans Health Care

About two weeks ago Concerned Veterans for America released a report on how to reform veterans health care.

The title of the report doesn’t exactly inspire confidence: “Fixing Veterans Health Care: A Bipartisan Policy Taskforce.”  Bipartisan is too often a euphemism for liberal.

The members of the taskforce include Dr. William Frist, Rep. Jim Marshall, Dr. Michael Kussman, Darin Selnick, Pete Hegseth and Avik Roy.  Roy appears to be the only free-market oriented member of the group.

However, some of the report’s recommendations are quite good.  For example, one of the Principles for Veterans’ Health Care Reform is: “The veteran must come first, not the VA. The institutional priorities of the VHA weigh too heavily in current planning, funding and care delivery decisions. We believe the interests of veterans should be paramount.”  Another is: “Veterans should be able to choose where to get their health care. Based on eligibility, veterans should have the option to take their earned health care funds and use them to access care at the VA or in the voluntary (civilian) health care system. Because private health care is somewhat costlier than VHA [Veterans Health Administration]-based care, most veterans who choose this option will be expected to share in some of the costs of such care, through co-pays and deductibles.”

So, Veterans can take the money they get from the VHA and use it to buy private health insurance.  That’s a very good start.

But here is where it begins to get worrisome: “Those veterans who choose to use VHA facilities should receive timely and quality care. In order to achieve this goal, the VHA should be restructured—as an independent, efficient, and modern organization—that can compete with private providers.” (Italics added.)

In the VHA’s new, independent role, the Veterans Health Insurance Program would administer the insurance and premium supports.  The Veterans Accountable Care Organization (VACO) would actually provide the care and would be the one competing with the private sector.  But if it competes, will VACO be allowed to go out of business should it fail just like other competitors in the private sector would?  If not, then the playing field is titled at a 45 degree angle, with the VACO’ endzone at the top and everyone else’s at the bottom.

I’ve emailed Avik Roy about this.  Will let you know when he gets back to me.


The VA Scandal May Be Much Worse

From USA Today:

The Department of Veterans Affairs’ [Office of Inspector General] has not publicly released the findings of 140 health care investigations since 2006, potentially leaving dangerous problems to fester without proper oversight, a USA TODAY analysis of VA documents found.

The Inspector General has declined to comment on what is in the reports.  That said,

It is impossible to know how many of the investigations uncovered serious problems without seeing the reports, but all concerned VA medical care provided to veterans or complaints of clinical misconduct.

Thus, it is possible that nothing damaging is in the reports, which means that this is a “nothing burger.”  However, 140 reports would be a very big nothing burger.

For those who need a refresher on the VA scandal, here is my summary from 2014:

Employees at the VA were manipulating data on wait times for care so that the VA appeared better than it was at meeting its standard of a maximum 14-day wait for treatment. Many whistleblowers at the VA were harassed and, in a few cases, even fired. The result was that over 57,000 veterans waited at least three months for a doctor’s appointment while nearly 64,000 veterans were never added to any waiting list. We may never know exactly how many of these veterans suffered in pain or saw their conditions worsen while they waited for treatment. We do know the deaths of at least 23 veterans are attributable to delays. 

From 2000 to 2011, there were at least 26 reports—six from the Government Accountability Office (GAO) and 20 from the VA Office of Inspector General (OIG)—that examined wait times within the VA system.  That should have been a warning sign that something was seriously wrong, but, as I explained in my policy analysis, the reports were ignored because intellectuals had convinced policymakers that the VA was a wonderful health care system.

Wait times are far from the only problem with the VA that has been made public, as even a cursory look at the Veterans Affairs OIG websites shows. But to now learn that there may be many more problems that have not been made public is a bitter pill to swallow.


Gender-Bending Gym Rule Goes Too Far in Catering to LGBT Agenda

Yvette Cormier walked into the women’s locker room of a Planet Fitness location in Midland, Michigan and claimed she saw a man changing in there.  She alerted the front desk of the gym.

It was then that Cormier discovered Planet Fitness has a “no-judgment” policy that allows those who consider themselves to be transgendered to use the locker room of their choice.  While no one was apparently confronted that day, a local man who considers himself a woman told the media that he was a guest at the gym that day and used the women’s locker room.

When Cormier later complained to the Planet Fitness corporate office and told other female members of the Midland location about the locker room policy and what happened to her, her membership was cancelled.

A Planet Fitness spokesman told CNN that Cormier’s actions were “inappropriate and disruptive.”  In rebuttal, Cormier said: “I didn’t go out to specifically bash a transgender person that day.  I was taken aback by the situation.  This is about me and how I felt unsafe.”

But it’s not about her, as her concerns about safety and privacy are apparently second to a Planet Fitness policy embracing the LGBT agenda.  People can use locker rooms based on the gender they think they are at that moment.  A unisex changing area is not a compromise at least one local transgender activist is willing to accept.  Charin Davenport told “I don’t think anyone should require me to use [a unisex locker room].  I use the facility that I am comfortable with.”

Planet Fitness seems to feel the same way.  And Cormier will have to find herself a new gym.

Project 21 member Bishop Council Nedd II, the rector of St. Alban’s Anglican Church in central Pennsylvania and the archbishop of Abu Dhabi, says people shouldn’t have to be confronted with such gender-bending surprises when they go to work out.  Those who are offended by Planet Fitness’s embrace of the LGBT agenda over the rest of society, he suggests, should show the gym chain how they feel by taking their business elsewhere:

Planet Fitness claims to offer a “non-intimidating, welcoming environment” for its members.  But when a female member said she was uncomfortable with a transgendered male using the same locker room as her, and warned other women about whom they might encounter in that locker room, it was the woman who lost her gym membership.

This woman, who is now forced to find another gym, had a simple request: “I should feel safe in there.”  The Planet Fitness policy reportedly allows people to choose locker rooms “based on their sincere self-reported gender identity.”  How does Planet Fitness measure and prove sincerity?  This is obviously something that can be abused at the expense of those who paid Planet Fitness to use their facilities with fair expectations of safety.

The policies and practices of Planet Fitness are capricious and arbitrary.  A company claiming to follow a “no judgment” policy harshly judged a woman complaining about a perceived safety issue.  Her compromise for allowing transsexuals in the locker rooms is “post it, tell me or put a unisex bathroom in.”  Yet this is apparently “inappropriate” and politically incorrect.

This woman’s membership should absolutely be reinstated, and Planet Fitness should revise its policies.  Until then, those who believe one’s gender organs should determine which locker room they undress in and those with moral objections or a desire for a family-friendly facility should consider boycotting Planet Fitness gyms wherever they are found.

A reasonable person should not be penalized for expecting a gender-specific gym locker room be free of people of the opposite gender.


Project 21's LeBon Defends Voter ID, Decries Big Government Abuses on MSNBC

Appearing last week on MSNBC, Project 21 Co-Chairman Cherylyn Harley LeBon boldly spoke out in favor of laws that are protecting the integrity of the American voter from potential fraud, saying: “I’m a black leader.  I’m in favor of voter ID.  I don’t really care what the other black leaders are saying.”

A guest of uber-liberal host Chris Matthews on the 3/6/15 edition of “Hardball,” Cherylyn defended the need for common sense procedures such as voter ID that safeguard the identity of legal voters.  Beating back the tired racial rhetoric of Matthews and his other guests, Cherylyn explained:

Voter ID laws, in fact, have been proven to increase black voter participation — as they did in the state of Georgia… In the state of Georgia, black voter participation increased after they passed the state voter ID law… People do have photo IDs.  How do you think you can get any form of government assistance?  How are people flying on planes?

Later, while discussing the newly-released U.S. Department of Justice report alleging racial discrimination in the Ferguson Police Department, Cherylyn pointed out that the system of preying upon local residents with pernicious fines and harsh punishment for not paying those fines is the sign of an overbearing government obsessed with finding new sources of spending money.  And this is a problem not just isolated to the suburbs of St. Louis.

Cherylyn said:

This is not just happening in Ferguson.  This is happening in a number of communities across the country where there are black leaders… These cities want revenue… Why can’t these mayors come up with other ways of increasing revenue?


Risk Analysis Division's Comments to Consumer Product Safety Commission on Proposed Chemical Ban

Below are the comments submitted by RAD to the Consumer Product Safety Commission in response to a proposed rule to ban children’s toys and child care articles containing specified phthalates.

I am writing on behalf of the Risk Analysis Division (RAD) of the National Center for Public Policy Research. RAD is concerned with the proliferation of regulations that impinge on consumers’ access to safe and affordable products.

We have been concerned about the process that led up to the proposed rule known as “Prohibition of Children’s Toys and Child Care Articles Containing Specified Phthalates.”
Docket ID: CPSC-2014-0033

The Chronic Hazard Advisory Panel (CHAP) on Phthalates was fraught with precautionary approaches that made a recommendation of extending a ban on phthalates in certain applications nearly a foregone conclusion. From the CHAP report’s controversial use of cumulative risk assessment to the use of no-longer relevant exposure data, to the unorthodox failure to open up the study to public peer review consistent with OMB Information Quality Bulletin for Peer Review, the CHAP report is a flawed basis for developing what should be science-based regulations.

One especially ill-conceived aspect of the proposed rule illustrates why the failures in process lead to failures in policy-making.

The proposed rule would extend the ban on DINP from a temporary ban on mouthable children’s toys and child care articles containing DINP, to a permanent ban on even non-mouthable children’s products.

The justification cited by the Consumer Product Safety Commission to support this heavy-handed rule was that non-mouthable products are touched- and that can also cause exposure, thus adding to the cumulative exposure from other phthalates, such as DEHP.

But DINP is among the least potent phthalates. And exposure from toys and child care articles, even mouthable ones, is a very minor source of DINP exposure in the first place, and an even more minor concern in terms of cumulative phthalate risk, given DINP’s low potency.

Cumulative exposure from DINP in children’s products may have conceivably been a concern when overall phthalate exposure was much higher prior to the legislative ban on certain phthalates, but with overall exposure much lower now, DINP exposure from touching should barely even be considered de minimis.

Yet the CHAP report failed to take today’s lower exposure levels into account, instead relying on data that was not only old, but no longer relevant given the bans of more potent phthalates. A cumulative assessment based on exposure levels we know to be no-longer accurate renders the CHAP report irrelevant when considering cumulative exposures.

What’s worse, even though CPSC was aware of this fatal flaw in the CHAP report, it relied on this aspect of the report, ignoring these concerns that would have surely been raised had the CHAP report been subject to open peer review.

The supposed logic of the extension of the DINP ban is that all exposure, no matter how remote, is a problem.

The CHAP report didn’t even justify an expansion in a direct manner, rather leaving CPSC to conjecture as to a basis for the ban.

In fact, the CPSC wrote,

“The Commission notes that the CHAP assessed the risks of DINP both in isolation and in combination with other phthalates. Considered in isolation, staff concluded that DINP would not present a hazard to consumers because the MoE (830 to 15,000) is well in excess of 100. (CHAP, 2014, p. 99). This is consistent with previous work. (CHAP, 2001; CPSC, 2002). “

Instead, the CPSC relies on the cumulative risk theory:

“the Commission agrees with the CHAP that DINP is antiandrogenic and contributes to the cumulative risk. Specifically, the CHAP found that 10 percent of pregnant women and up to 5 percent of infants have a HI greater than one. Therefore, as discussed previously, the Commission concludes that the cumulative risk of male developmental reproductive effects should be considered ‘to ensure a reasonable certainty of no harm to children, pregnant women, or other susceptible individuals with an adequate margin of safety.’”

This, all despite outdated data. Yet nonetheless, CPSC writes,

“The Commission believes that the expansion in scope is appropriate because exposure occurs from handling children’s toys, as well as from mouthing. (CHAP, 2014, Appendix E1). The additional exposure from handling toys would add to the cumulative risk. Therefore, the Commission concludes that expanding the scope of the DINP prohibition to include all children’s toys is necessary to ensure a reasonable certainty of no harm to children with an adequate margin of safety.”

It should be noted that not even the precautionary European Commission (EC) goes this far.

In fact, the EC submitted a comment to this docket addressing this point. (see:!documentDetail;D=CPSC-2014-0033-0032 )
To justify going beyond even the EC, the proposed rule states:

“As discussed in the CHAP report, there are multiple studies related to the male developmental reproductive effects of DINP, many of which were published after 2005, the date of the EC directive. Thus, the Commission concludes that because the CHAP report addresses uncertainties regarding the potential hazard associated with DINP, an expansion of the prohibition on DINP to all children’s toys is appropriate.”

Yet at the same time, the CPSC ignores the most relevant change related to phthalates between then and today: that is, a range of other, more potent phthalates have been banned and thus the cumulative risk has fallen precipitously. To suggest that the EC directive is too lenient on DINP because it relies on old science is an insult to the intelligence of even the most casual observer who is aware that the CHAP report’s assessment of cumulative risk is based on data that we know, because of the recent ban, to be out of date and no longer relevant, especially when attempting to gauge cumulative risk.

Even more troubling to a policy analyst, is that the proposed CPSC rule comes close to acknowledging the scientific weakness of the case to extend the ban on DINP to non-mouthable products, by arguing that the effect of the ban would be minimal. “Additionally, we expect that expanding the scope to all children’s toys would have a minimal effect on manufacturers because few products would need to be reformulated to comply with the broader scope. (See Tab A of the staff’s briefing package.) In practice, children’s toys and toys that can be placed in a child’s mouth all require testing for phthalates. The testing costs are the same in either case. The only change caused by expanding the scope to all children’s toys is that toys too large to be mouthed could not be made with DINP.”

First, CPSC doesn’t bother to consider any effect on consumers or the potential that in the future, smaller manufacturers would be burdened by this regulation, which offers no demonstrated public health benefits in exchange for even “minimal” costs.

Second, the CPSC fails to take into account the potential for future uses of DINP in non-mouthable children’s products.

Third, the notion that the effect on manufacturers is supposedly minimal is a weak basis for keeping a safe and useful chemical out of the hands (but not mouths) of consumers, even children.

When Congress passed the Consumer Product Safety Improvement Act in 2008, it did not give the CPSC power to remove safe products from the marketplace if the effect of such a ban would be minimal. It simply didn’t give CPSC power to remove products that were safe, or that could only be shown to present a risk based on old exposure data we know to be no-longer accurate.


A Lefty Admits That ObamaCare Has Made Us More Dependent on Government

If you are a conservative or libertarian and are in a particularly generous mood, send a thank you note to Bloomberg’s Joshua Green.  He recent piece entitled “Is Washington Ready for the Death of Obamacare?” gives us a preview of the strategy the political left will use should the plaintiff’s prevail in King v. Burwell and the subsidies to federal exchanges be shut off.

But it does more than that.  For a while now, many on the political right have warned that ObamaCare is making us more dependent on government.  Green inadvertently confirms it.

Here are Green’s warnings:

-If the plaintiffs prevail, millions of people in 34 states who bought insurance on federal exchanges would suddenly lose the subsidies that make it affordable. Consequently, most would lose their coverage. A Rand study pegged the number at 9.6 million people, with premiums soaring 47 percent for those still able to afford them. 

-The result would not just leave millions uncovered but also risk destroying the individual health-care markets in states that don’t act. According to a brief filed by a consortium of hospital trade groups, “A market without subsidies will trigger a premium ‘death spiral’ in those states: With subsidies gone and premiums pushed higher, younger and healthier patients will likely drop coverage. Those that remain, paying the higher rates, are likely to be sicker and use more health-care resources. That, in turn, will push rates for everyone in those states even higher, which will cause more to drop coverage, and so on.”

-On the business front, the effects would be no less significant…Entire segments of the health system redesigned their business models to take advantage of the ACA’s incentives. Hospitals, for instance, were given a trade-off: They stopped receiving government payments to offset the cost of treating the uninsured, cuts that amount to $269 billion over a decade. In return, they were promised millions of new patients insured through federal subsidies. 

-The ACA also opened up a flood of investments in digital health ventures. A recent study by StartUp Health, a New York incubator, found that $14.5 billion has been invested since the law was signed, including $6.5 billion last year. “If Congress is unwilling to take action, it would clearly make it less attractive to invest in things related to the coverage expansion,” says Bob Kocher, a partner specializing in health-care IT at the venture capital firm Venrock. “It slows the rate of change in the health-care ecosystem in a way that’s bad for everybody and hurts companies going after these new patients, who are going to suffer.”

Ed Haislmaier at Heritage disputes most of these claims, but the larger point is that, based on Green’s article, conservatives and libertarians were absolutely right. Policyholders, insurers, hospitals and investors in digital health care are now dependent on government, much more so than they were prior to ObamaCare.

Of course, that may be what the left wanted all along.  After all,the more people who are dependent on the government spigot, the harder it is to ever turn it off.  Of course, few of them will ever admit that.  Heck, they only barely acknowledge the government dependence has grown under ObamaCare.


Hard Truths Overshadow Happiness about Unemployment Figures — “About Those Jobs Numbers” for February 2015

There’s no denying that the American economy is in a state of flux.  Where is President Barack Obama going to take our economy?  It doesn’t seem to be in the right direction by any stretch of the imagination.

Employers are obviously nervous.  Hiring is a not the simple process it once was.  People who want and need jobs are despondent and actually giving up looking for employment.  Plans are delayed and hopes are dashed as the Obama era grinds along.

There are plenty of things to be nervous about.

For one, the U.S. Supreme Court this week heard arguments in the case of King v. Burwell — a challenge to ObamaCare that could halt the federal subsidies propping up the state health care exchanges.  Justice Sonia Sotomayor suggested her fellow jurists could send ObamaCare, the policy Americans couldn’t examine in detail until it was enacted, into a “death spiral” if it turns out that ObamaCare was as poorly-crafted as the plaintiffs allege.  And the Obama Administration allegedly has no Plan B in the event the justice do rule against them.  Not smart.

Furthermore, White House Press Secretary Josh Earnest said Obama is “very interested” in taking an executive action that would raise taxes on businesses.  This could be hard on businesses already feeling a pinch in the Obama economy.

And then there is the capitulation in Congress that will allow President Obama’s executive action on immigration to become further established and harder to dismantle.  Millions of new applicants for legal work status could join the estimated 7.4 million foreigners — almost a million of them are thought to have come to America illegally – receiving work permits from the government since 2009.  They are now competing with a large contingent of unemployed American citizens for the few available jobs.

Jobless numbers just released by the government offer little encouragement when one looks at the big picture.

As he does every first Friday of the month when the federal Bureau of Labor Statistics issues its newest data on American unemployment, Project 21 member Derryck Green provides an in-depth analysis of the nation’s employment situation and the general state of the economy under Barack Obama’s stewardship.

This month, with the official jobless rate falling to 5.5 percent (but the overall figure being twice that percentage!), Derryck is once again feeling pessimistic:

There’s been a revision to the gross domestic product (GDP).

The federal Bureau of Economic Advisors (BEA) just released a second revised estimate of the fourth-quarter GDP for 2014.  According to their report, the nation’s GDP was revised downward from 2.6 percent to 2.2 percent.

America’s economic growth was redefined downward.  What was once a source of great pride for President Obama and his supporters is diminished.  This fact, by the way, received to no real media attention.

Chances are that this number will be revised further downward when the BEA releases a third estimate at the end of this month, when they will also announce the overall rate for which the economy grew in 2014.

Private sector estimates regarding job creation coming from payroll processor ADP doesn’t create optimism.  Their report, released before the federal government’s estimates, noted job creation was once again below expectations in February.  Last month, ADP predicted that 212,000 private sector jobs were created, well below the 220,000 that were expected.

According to the latest federal Bureau of Labor Statistics (BLS) jobs report, only 295,000 jobs were created last month — an increase of 38,000 from last month. 

The BLS announced the national unemployment rate fell in February to 5.5 percent.  The alternative U-6 number — a more accurate accounting of the nation’s unemployment rate because it includes the unemployed, underemployed and discouraged job seekers — was twice that at 11 percent.

Despite the drop in the official unemployment rate, the workforce participation rate fell again.  It was at 62.8 percent in February, and that rate has been stuck between 62.7 percent and 62.9 percent since April 2014.  That alone should offset any cheering over the official unemployment rate dropping.

Additionally, the unemployment rate for blacks increased slightly to 10.4 percent.  For black teens, their unemployment rate increased into the 30s again to 30 percent.  The unemployment rate for women and Latinos was 4.9 percent and 6.6 percent, respectively.

Despite these disappointing numbers, it’s likely that the mainstream media will try to put a happy face on things.  Expect breathless reports of these modest gains and assurances from pundits that the economy is getting stronger.

But the coverage of this relatively good-sounding jobless report will likely ignore some hard truths.

Among those hard truths:

  • Staples and Office Depot have agreed to merge, potentially costing thousands of employees their jobs;
  • RadioShack filed for bankruptcy protection and plans to liquidate its stores.  Part of the plan is to close its headquarters and potentially lay off more than a thousand workers;
  • Target plans to lay off several thousand workers as part of a $2 billion cost-cutting plan;
  • Obama vetoed the Keystone XL pipeline authorization passed by Congress and effectively killed the jobs that go along with it;
  • According to Challenger, Gray and Christmas, a private company reporting on economic matters, U.S.-based employers announced plans to cut 50,579 jobs last month.  That’s five percent fewer than the 53,041 in January, but still up 21 percent from a year ago.  They also report job layoffs in the first two months of this year were up almost 20 percent from the same time last year;
  • The number of people filing for jobless benefits rose last week to 320,000 — above the 295,000 filers projected and the highest since May 2014.  ZeroHedge reported that, “non-seasonally-adjusted claims surged 29,361 to 310,000 making 2015 the worst start to the year for claims since 2009;
  • U.S. factory orders were down for the sixth straight month, something not seen since the recession of 2008;
  • The U.S. student loan program could need a $500 billion bailout because of the sharp increase in borrowing.  This is no surprise when one considers the poor economy is forcing the more than 30 percent of Millennials who cannot find a job are still living with their parents.  Of course, since the bad economy forces people to live with their family or other roommates rather than living on their own, we understand why the U.S. homeownership rate is at a 20-year low.

To read a really unnerving assessment of the actual conditions of the economy, there’s a particularly scary analysis of the economy posted on Zero Hedge that really puts one on edge.

But worry ye not.  Obama has just the plan to put us on the road to prosperity.  According to his Press Secretary Josh Earnest, Obama is “very interested” in raising taxes through executive action.

Of course this would probably be unconstitutional — but when has that prevented him before?


King v. Burwell--Will Kennedy Swing Left?

After yesterday’s hearing of King v. Burwell, it appears that Justice Anthony Kennedy is the swing vote.  Kennedy worried that if the plaintiffs are correct, that subsidies can only flow to exchanges established by a state, then it puts states in the position of being coerced by the federal government:

Let me say that from the standpoint of the dynamics of Federalism, it does seem to me that there is something very powerful to the point that if your [the plaintiffs’] argument is accepted, the States are being told either create your own Exchange, or we’ll send your insurance market into a death spiral. We’ll have people pay mandated taxes which will not get any credit on on the subsidies…It seems to me that under your argument, perhaps you will prevail in the plain words of the statute, there’s a serious constitutional problem if we adopt your argument.

Kennedy later said, “It may well be that you’re correct as to these words, and there’s nothing we can do.”  In other words, the plaintiffs are right that ObamaCare says subsidies can only flow to state-based exchanges, but the Court won’t do anything about it since agreeing with that interpretation creates a situation where the federal government is coercing the states.

Two points on that, one light-hearted, the other serious.

First, Phil Kerpen of American Commitment referred me to his tweet from 2014 in which he predicted this (at the time, the case was still called Halbig):

After seeing that, I asked Phil if I give him $1,000 in late January of next year, would he pick the Super Bowl winner for me?

On a serious note, Kennedy’s argument doesn’t hold much water since the federal government is already sending state insurance markets on a march toward the death spiral.  The subsidies have not been attractive enough to entice sufficient young people to sign up for coverage on the exchanges, something that I predicted back in 2013.  Thus far, insurance premiums haven’t sky-rocketed, but that’s largely due to the “risk corridors” which cover most of the losses insurers incur on the exchanges (few losses, no reason to raise premiums much.)  However, Republicans Congress stopped the first year of the risk corridors in the recent Cromnibus bill.  Now that insurers won’t be receiving risk corridor payments for the first year of the exchanges, expect to see some double-digit premium increases for 2016. Then the death spiral begins.

Avik Roy examines Kennedy’s death spiral argument in some more detail and also argues that Kennedy is not likely to swing to the left in this case.  Well worth the read.

Here’s another reason why Kennedy might not side with the left.  If a phrase in a law is vague as is, arguably, the part of ObamaCare that says subsidies may only go to the states, then the Court often defers to the regulatory agency’s interpretation of the phrase, something known as “Chevron Deference.”  Here’s what Kennedy said about that:

Well, if it’s if it’s ambiguous, then we think about Chevron. But it seems to me a drastic step for us to say that the Department of Internal Revenue and its director can make this call one way or the other when there are, what, billions of dollars of subsidies involved here? Hundreds of millions?

….And it…seems to me our cases say that if the Internal Revenue Service is going to allow deductions using these, that it has to be very, very clear.

Kennedy appears to be saying that the phrase needs to be very clear before the I.R.S. can hand out billions of tax dollars.

Last point: Predicting which way the Court will go in a close case like this is fraught with peril.  At the hearing for NFIB v. Sebelius, the Court seemed very likely to strike down the individual mandate.  And we know how that turned out.