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The official blog of the National Center for Public Policy Research, covering news, current events and public policy from a conservative, free-market and pro-Constitution perspective.

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Tuesday
Apr222014

Project 21 Members Discuss Supreme Court’s Race Ruling on American Urban Radio

Members of the Project 21 black leadership network discussed the U.S. Supreme Court ruling in the case of Schuette v. Coalition to Defend Affirmative Action on American Urban Radio Network on 4/22/14.

In the decision, the Court upheld a Michigan state constitutional amendment banning race preferences in state matters such as government contracting and hiring as well as state school admissions.  It overturns a lower court ruling, noting that Michigan’s state constitutional amendment does not violate the U.S. Constitution’s “equal protection” clause.

Both Project 21 co-chairman Horace Cooper and member Shelby Emmett pointed out that race preferences are a tool of the past that is no longer appropriate and that the focus of reformers today should be on fixing the poorly-performing government-run schools that leave kids unprepared for higher education.

Tuesday
Apr222014

ObamaCare Whac-A-Mole!

The “skinny networks” of physicians and hospitals in many ObamaCare exchange plans are really beginning to rankle patients, so much so that the political class feels increasingly compelled to do something.

In Washington State, Insurance Commissioner Mike Kreidler said “companies need to justify those narrow networks.”  He is proposing new rules that “would make it harder for insurers to thin out their networks. He says consumers should have some basic safeguards: You shouldn’t have to drive too far or wait too long for care, and you should be able to find the specialists you need.”

By limiting insurers ability to offer fewer benefits and forbidding them to offer lifetime or annual limits on policies, insurers tried to keep premiums down by reducing the networks in exchange plans.  Now Washington wants to “fix” that problem, and it surely won’t be the last if stories from California are any indication.

Unfortunately this becomes like a game of “Whac-A-Mole,” where a new problem pops up in response to politicians and bureaucrats try to tamp down on an older one.  Kriedler is already getting an earful about the new mole:

But Kreidler quickly found himself under a minor siege from board members like Bill Hinkle.  

“This is called the Affordable Care Act, not the Accessible Care Act,” said Hinkle, a former state lawmaker.

Board member Bill Baldwin lobbed a string of adjectives at Kreidler’s proposal: “burdensome,” “bureaucratic,” “complicated,” “excessive,” “countercompetitive,” “counterproductive” and “kind of Big Brother.”

Sydney Smith Zvara of the Association of Washington Healthcare Plans says the new rules would require stacks of paperwork, including thousands of maps.

“The sheer weight and volume of the administrative and reporting requirements that come along with that have the effect of just smothering the ability to provide more innovative networks,” Zcara said.

Extra paperwork won’t be the only added cost.  Expanding a network means paying physicians and hospitals more to entice them to join.  That, of course, will be reflected in higher premium costs.  Apparently, one of the requirements for being elected Insurance Commissioner of Washington State is an unshakable belief that government can do magic:

Kreidler says he doesn’t believe prices will increase. He sees himself as walking a fine line, but with his compass oriented decidedly toward the consumer.

The best way to protect the consumer is to remove the barriers to market competition.  But bureaucrats seldom think that way.

Final thought:  If back in 2009 an ObamaCare supporter had said this “is called the Affordable Care Act, not the Accessible Care Act,” what do you think the chances are it would have ever become law?

Tuesday
Apr222014

Video: Supreme Court Upholds Michigan's Ban on Race Preferences; Video Explains the Issues Before the Court

The U.S. Supreme Court today, in the case of Schuette v. Coalition to Defend Affirmative Action, upheld the state of Michigan's decision, made by referendum in 2006, prohibiting preferential treatment in public employment, education and contracting based on "race, sex, color, ethnicity or national origin."

Last October 16, the day after the U.S. Supreme Court heard oral arguments in the case decided today, the Project 21 black leadership network held a policy luncheon featuring Jennifer Gratz, the executive director of the Michigan Civil Rights Initiative. Gratz was the plaintiff in the 2003 case of Gratz v. Bollinger that found the University of Michigan's race conscious admissions policy violated the Constitution's Equal Protection Clause.

This is an excellent video to view for a quick education on the issues and events surrounding the case decided today.

Project 21 also issued a press release on the Schuette decision this morning after it was handed down, featuring the comments of Project 21's two co-chairmen, Cherylyn Harley LeBon and Horace Cooper. LeBon and Cooper also moderated the discussion in the video:

Supreme Court on Path to Ending Race Preferences

Ruling in Schuette Case Paves Way for More Equal, Less Divided America

Black Activists in Favor of Ending Quotas Available for Comment

For Release: April 22, 2014

Contact: David Almasi at (202) 543-4110 x11 or (703) 568-4727 (text-enabled) or dalmasi@nationalcenter.org or Judy Kent at (703) 759-7476 or jkent@nationalcenter.org

WASHINGTON, DC - Attorneys and activists with the Project 21 black leadership network are pleased about today's U.S. Supreme Court decision on race preferences, and hope the Court's latest ruling on race-conscious school admissions policies will become decisive in finally ending government-enforced rules creating arbitrary demographic quotas.

"Today, the Supreme Court moved us closer to the colorblind principle that Martin Luther King advocated and that is embedded in the 14th Amendment," said Project 21 Co-Chairman Horace Cooper, a former constitutional law professor. "I'm pleased that the principle of treating all Americans the same under the law can go forward in Michigan."

ALT TAGThe Court ruled 6-2, with Justice Kagan not voting.

In the case of Schuette v. Coalition to Defend Affirmative Action, which was argued before the U.S. Supreme Court last October, the justices considered whether the 6th Circuit Court of Appeals correctly voided an amendment to the Michigan state constitution, passed by voters in 2006, prohibiting preferential treatment in public employment, education and contracting based on "race, sex, color, ethnicity or national origin." The Michigan Civil Rights Initiative, which became Section 26 of the state's constitution after its enactment, was supported by 58 percent of Michigan voters. It was struck down, however, by the 6th Circuit in 2012.

Project 21 submitted an amicus brief to the Supreme Court in the Schuette case written and joined by the Pacific Legal Foundation, noting that "[t]he clear effect of Section 26 is to prohibit the State and its political subdivisions from adopting race- and sex-based preference programs." The brief also presented factual data about how the prohibition of race-based preferences in California increased diversity and minority retention rates. Similar to Michigan, California voters outlawed race preferences in public college and university admissions in 1996.

Project 21 held a meeting of experts to discuss the case featuring Jennifer Gratz, the executive director of the Michigan Civil Rights Initiative after the Court's oral arguments. Gratz was the plaintiff in the 2003 case of Gratz v. Bollinger that found the University of Michigan's race conscious admissions policy violated the Constitution's Equal Protection Clause. Her talk and the discussion following can be viewed online here.

"It remains to be seen as to whether this is the definitive ruling which will eliminate racial preference policies," said Project 21 Co-Chairman Cherylyn Harley LeBon, a former senior counsel for the U.S. Senate Judiciary Committee. "But I am encouraged that we are moving towards creating an equal playing field where the government does not choose the winners and inadvertent losers."

The rest of the press release is available here.

Monday
Apr212014

ObamaCare Protects Widows and...Whoops!

Over two dozen widows of Madison County, Alabama employees received health insurance via their deceased husbands’ policies.  Then along came ObamaCare’s grandfather regulations.  Here’s WHNT with the rest of the story:

A few widows—wonder why they couldn’t get an exemption to ObamaCare’s rules?  Here’s a wild guess:  They don’t have anywhere near the political clout that labor unions do.  

In other news, enrollment in exchange policies in Georgia isn’t looking so good:

Georgia insurers received more than 220,000 applications for health coverage in the Affordable Care Act’s exchange as of the official federal deadline of March 31, state officials said Wednesday. - See more at: 

Insurance Commissioner Ralph Hudgens, though, said premiums have been received for only 107,581 of those policies, which cover 149,465 people.

“Many Georgians completed the application process by the deadline, but have yet to pay for the coverage,” Hudgens said in a statement Wednesday.

Some of that discrepancy is likely due to the late surge in enrollments which is undoubtedly inflating the number of people who haven’t paid their premium.  But with such a high number, chances are good that the number of enrollees in Georgia who don’t pay their premiums will be higher than much-touted 20 percent.  

As goes Georgia, so goes the nation? Well, no.  The rate of non-payment could be much lower in other parts of the country.  We’ll just have to wait and see if Georgia is an aberration or a warning sign.

Finally, Politico has a good run down on the Obamacare numbers, although it repeats the RAND numbers uncritically.  (For more problems with the RAND survey, go here.)  Despite that, it’s worth reading.

Sunday
Apr202014

Black Activists Lament Later Tax Freedom Day

April 21 is “Tax Freedom Day.”  It commemorates the day when all taxpaying Americans have collectively earned enough to settled up the tab for what Uncle Sam demands from them in tribute.

From here on out, the American people can reasonably consider it possible to now begin to work to pay their own rents and mortgages, buy food, settle their auto and tuition loans and maybe save for a vacation or their retirement — among other things.

It is estimated that American taxpayers will have been forced to render around $3 trillion to the federal government in taxes in 2014.  This does not count the additional $1.5 trillion in taxes required to be paid to state governments (which could alter individuals’ actual date of tax freedom).

The total tax bill paid by the American people this year is estimated to amount to over 30 percent of earnings — more than is expected to be spend on food, shelter and clothing over the course of the year in total.

Tax Freedom Day is three days later than last year and eight days later than in 2012.  According to the Tax Foundation, this year’s late date is because of “the country’s continued slow economic recovery.”  And, if the calculations were to also include the costs of federal borrowing, Tax Freedom Day would be an even later May 6!

Members of the National Center’s Project 21 black leadership network — a hard-working, tax-paying group of individuals — is outraged at being in debt to the government for such a growing number of days each year.

For example, Project 21 member Hughey Newsome, a financial expert with a Harvard MBA, noted:

More and more, Americans are seeing their paychecks go to fund growing government activity.

While Tax Freedom Day is getting later and later (this year, it’s April 21), what Americans actually get from government does not seem to grow.

Today, we debate over whether or not private businesses should be forced to pay a higher minimum wage, yet government is not holding itself accountable for the shortage of people that come out of public schools prepared for 21st century jobs.  Today, we debate over extending unemployment benefits for longer periods, yet government is not holding itself accountable for hundreds of billions of dollars of stimulus that never worked as intended.  Today, we prepare to pay even more taxes in coming years to pay for a massive health care law, yet nobody seems to be able to say that health care costs will shrink for most Americans because of it.

It is unfortunate that Tax Freedom Day gets later and later, yet blame must be shared because there are not enough people speaking out for the taxpayer to make sure those who claim these extra funds are held accountable.

Another Project 21 member demanding accountability is Derryck Green, who writes a monthly blog post on the state of the economic recovery for this blog called “About Those Jobs Numbers…”  Derryck said:

This year’s Tax Freedom Day is three days later than last year’s, which was five days later than the previous year’s Tax Freedom Day.  Depending on which state you live in, you still may have several more days before you can declare your “freedom.”

Think about that.  We’re past the midway point of April, and we’re just now settling the nation’s tax bill — which is above $3 trillion.

Since this economic recovery isn’t what it was promised — the country still has more than 11 million people unemployed and tens of millions more who’ve given up the hope of finding work, full-time or otherwise — Tax Freedom Day will likely be at a later date next year than it is this year.

This means that next year, just like right now, fewer people will probably be working longer to settle our continually rising tax obligations.

This is economic oppression, and it sounds more like slavery than freedom.

Also weighing in is new Project 21 member M.J. Koskinen, a former nonprofit executive.  Maia said:

America, can you hear the sucking sound of food being taken out of the mouths of children whose misfortune in life is having been born to parents who work?

Happy Tax Freedom Day!

But, before pulling out the red, white and blue streamers and the “I love America” bumper stickers, please keep in mind that this day is only meaningful insofar as one can accept its premise: that the tax burden legitimately represents the actual cost of governance.

The fact is, it does not.  A significant portion of this tax burden represents the cost of maintaining the ambitions of a progressive government whose political survival depends upon the maintenance of the flow of wealth from productive Americans to others.  It is a kind of “economic osmosis” where the Obama Administration not only gets to regulate how much comes out of our pockets but how much of it flows into their own and those Americans of their choosing.

That being said, Tax Freedom Day — whether calculated on a national level or for each individual state — should be recognized as a tool highlighting the crisis created by the agenda of punitive liberalism, underscoring the fact that the three-fifths of Americans who pay its taxes must labor one-third of the year to discharge that burden.  And that’s the 111 days leading up to April 21st. 

Trust me, if progressives had their way, Tax Freedom Day would likely extend to July 4th.  Actually if they really had their way, I imagine it would be as late as Thanksgiving or even later — like Christmas.  Considering this belief, I would want to make a snarky comment about coal being found in taxpayers’ holiday stockings.  But the Obama Administration is against coal!

Friday
Apr182014

Obama's Enrollment Triumph A Pyrrhic Victory

Today I have an article in The Federalist titled “Why Obamacare’s Enrollment Triumph Will Prove Fleeting.”  In it a look at many of the same issues I did in yesterday’s blog post on Obama’s phony numbers.  But I expand it to include a look at the 8 million enrollment figure.  For example:

The U.C. Berkeley Center for Labor Research and Education recently estimated that just under one-fifth of enrollees on Covered California would leave the exchange for Medicaid. Combined with people who left because they gained employer-based coverage, the Center found that Covered California would retain about 57.5 percent of current enrollees.

If that occurs across all exchanges,then the final enrollment number will be closer to 4.6 million.  Of course, not every state is California (thank goodness), so the amount of churn due to Medicaid and employer-based coverage will vary across the nation.  Yet those factors will cause the eight million figure to be revised downward as the year goes on.

As a result the enrollment number will be revised downward over the coming months:

Each time that happens in the coming months, the media will hark back to the President’s victory dance.  For a public that doesn’t much trust Obama on health care, each revision will likely erode that trust a little further.  They will also provide his political opponents with more opportunities to claim Obamacare isn’t working as well as the President claimed.

Read it all here.

Thursday
Apr172014

Obama Administration Uses Bogus Insurance Coverage Figures

Well, put on your shocked faces my friends.  The Obama Administration sent out an email about an hour ago touting all of the accomplishments of ObamaCare and—are you sitting down for this?—the email contained phony statistics!

You can see the email here.  Here is the second bullet point:

3 million young adults gained coverage thanks to the Affordable Care Act by being able to stay on their parents plan.

Regular readers of this blog know that about two weeks ago NCPPR released a study showing that the 3 million number was bogus.  It used both private and public sources of coverage and had not been updated since June 2012.  Correcting the numbers show that not more that 2.64 million young adults have gained coverage via their parents plan.  

Additionally, using Census Bureau data (the Administration used a survey from the Centers for Disease Control), showed that not more than 258,000 young adults had gained coverage under their parents plan.  I concluded that “we have no clue how many young adults have gotten coverage this way, and the numbers flying around are too unreliable for the president or anyone else to be using.”  Guess the President didn’t get the message.

(Avik Roy has more on the problems with the “3 million” figure.)

Near the end of the email the Administration uses this whopper:

Up to 129 million Americans with pre-existing conditions – including up to 17 million children – no longer have to worry about being denied health coverage or charged higher premiums because of their health status.

That was based on a study by the Dept. of Health and Human Services that included “pre-existing conditions” like arthritis, asthma and high cholesterol to boost up the number of people who could be denied insurance to absurd heights.

That fact is that research on the pre-existing conditions shows that barely one percent of the population is ever denied insurance for a pre-existing condition.

Further evidence that the 129 million number is rubbish was supplied by ObamaCare’s own high risk pool, set up for people with pre-existing conditions prior to the exchange.  Known as the Pre-Exising Condition Insurance Plan, it never enrolled much more than 107,000 people.  That’s about .04 percent of the under 65 population.

The HHS study was even too much for Factcheck.org and PolitiFact.  Factcheck.org said the number wasn’t true “because number who would be truly at risk of losing health insurance or paying more money is much smaller.”  Of those 129 million, supposed 17 million were children.  When President Obama used the 17 million figure, Politifact called it “mostly false.”

This Administration has shown itself to be utterly shameless in hawking bogus statistics, but sometimes they get caught when the press holds it to account, as it did with the pay gap nonsense.  It’s time for the media to start questioning the Administration’s statistics on ObamaCare.

Thursday
Apr172014

More Medicaid Melarky

Sally Kohn of the Daily Beast points to some new state polls showing that majority in those states favor Medicaid expansion.  From this she concludes: “A core part of Obamacare is popular in states from Kansas to Georgia where Republicans are blocking it. They’ll pay come November.”

Uh, yeah.  No doubt Democrats will want to hit Republicans over the head for not going ahead with the ObamaCare Medicaid expansion thereby reminding voters that they, the Democrats, support Obamacare.  Good luck with that!

On a more serious note, the polls, conducted by Public Policy Polling do find majorities in Florida, Georgia, Kansas, Kentucky, Maine, Pennsylvania and a plurality in Virginia are in favor of Medicaid expansion:

 

But here is how PPP asks the question (the same for all states): “Kansas is eligible to receive new federal funding to pay for health care through the Medicaid program. Do you think the Kansas state government should accept this federal funding to expand Medicaid coverage, or not?”  That comes pretty close to suggesting that it is free money.  Of course, there is no such thing.  What if the question mentioned that within a few years the state would have to kick in 10 percent of the cost and there is no guarantee that it won’t be more in future years?  Or perhaps PPP could have mentioned that expanding Medicaid means paying higher federal taxes and/or more federal debt?  Mentioning trade-offs in poll questions usually produce different results, sometimes dramatically. And, of course, there are always trade-offs.

Thursday
Apr172014

Not Even a Clinton Compromise Can Persuade Strident Voter ID Critics

Does Bill Clinton really want to suppress the black vote?

And why, for that matter, is civil rights hero Andrew Young apparently willing to discourage minority, elderly and student from going to the polls?

At least that’s what would be said of these guys were conservative.

But both of these popular liberal icons are effectively putting their political legacies on the line by endorsing a plan that seeks to work with existing voter ID laws.

Clinton calls the idea, which calls for adding photos to Social Security cards in order to meet certain states’ requirements for a valid ID as well as bringing people without valid proof of identity into the 21st century, “a way forward that eliminates error” that helps end controversy threatening to “paralyze and divide a country with significant challenges.”

This very simple plan — adding photos to cards that every American citizen is required to sign up for — was promoted by the group WhyTuesday? and endorsed by Clinton and Young (who chairs that group) during events last week at LBJ presidential library marking the 50th anniversary of the passage of the Civil Rights Act of 1964.

Easy peasy, right?!

Even former president Jimmy Carter is said to support the proposal.  But there was one very prominent liberal who wasn’t interested in talking about this voter protection proffer coming from the left: President Barack Obama.  When a reporter asked for the President’s reaction to this potential political breakthrough, White House spokesman Jay Carney had no comment — begging off a response because they needed “to review all the implications.”

Obama’s really been no help at all.

While Clinton and Young are earnestly seeking a suitable compromise that will promote clean elections and provide dignity for those lacking the full representation that can come with having valid identification, Obama’s most recent contribution to the voting rights debate (also last week) was to take the stage at Al Sharpton’s National Action Network convention and stir up fears that conservatives were actually suppressing peoples’ votes by demanding that ballots not be left open to fraud.  Obama complained that lawmakers promoting polling place protections to help secure the votes of law-abiding Americans from fraud are actually “pass[ing] laws to make it harder, not easier, to vote.”

The notion of putting photos on Social Security cards certainly isn’t the most foolproof plan, nor does it meet with complete conservative acceptance.  Senator Rand Paul (R-KY), for example, fears it would create a national ID card.  Having a card with ones’ valuable Social Security number featured so prominently may also increase privacy concerns.  And, in California, Michael Hiltzik of the Los Angeles Times pointed out that there are more Department of Motor Vehicle offices in California — where people can get traditional state-issued identification — than Social Security Administration offices.

Clearly, current laws may already be the best laws.

There’s also the not so insignificant factor that all of these existing laws — all enacted at the state level — would need to be changed to include the newly-designed Social Security card.  It’s a fair bet, however, that legislators would be amenable to this additional form of identification considering that some current laws allow the use of hunting licenses.

But Hiltzik, in his criticism, seemed more concerned that Clinton and Young coming to the table to try to work out a solution is “effectively a capitulation to the Republicans’ hopelessly dishonest and deceitful voter ID laws.”

So forget giving Americans the basic tool to get over the voter ID hurdle, as critics would suggest exists with this simple and commonsense request for proof of identity.  Forget about the notion that this new federally-issued photo ID could help people vote as well as help them travel, bank and more easily engage in day-to-day activities in a world that is more security-conscious.  No — it’s giving an inch to conservative lawmakers who have enacted (or still seek to enact) a method for people who want to vote to prove they are who they say they are.

While not endorsing the plan advocated by Bill Clinton and Andrew Young, members of the National Center’s Project 21 black leadership network do see the merit in both coming to the table and seeking out a solution to the divide between those who want safe voting and those who would allow ballots to remain susceptible to fraud.  From Obama, they see an unwillingness to compromise and a zealousness to exploit the issue for political expediency.

Project 21 member Hughey Newsome, who recently wrote on the voter ID issue for the Daily Caller, said:

President Obama and the White House are accused of politicizing voter ID laws and using charges of voter suppression for their own partisan gains.

It’s actually hard to reach any other conclusion about it when one considers the proposal backed by former president Bill Clinton and former Atlanta mayor Andrew Young and the lack of White House enthusiasm.

Putting photos on Social Security cards would help address any lack of state-issued IDs in minority communities and provide a means that could be used to verify voter authenticity and help with daily business needing ID nowadays.

The White House’s silence on this proposal seems to show that politics, not solutions, is the goal.

Project 21 co-chairman Horace Cooper, a former congressional leadership staff member and constitutional law professor who also met with United Nations officials on the topic of voter ID in 2012, added:

More and more Americans now recognize the importance of ensuring that measures are undertaken to guarantee that only lawful, eligible voters participate in the electoral process.

The actions by Mayor Young and President Clinton demonstrate how bipartisan and commonsense these efforts are.

Opposition to this new proposed form of voter ID seems to be based on one of two theories — that it is politically effective to pretend that minorities are facing limits on voting or letting phony voters participate on Election Day assures left-wing political victories.

Project 21 member Kevin Martin, a Navy veteran and former state employee in Maryland, said:

Without fail, progressives talk about how elections should be fair and equitable for all.  But when lawmakers make an effort — such as with voter ID laws — the same progressives almost always level unfounded charges of racism.

Progressives will argue that an ID requirement for voting amounts to a poll tax and is unfair for the poor, minorities and the elderly.  They’ll also claim that voter fraud and identity theft doesn’t readily exist despite examples that prove otherwise.

Pia Farrenkopf’s mummified remains were recently found in Michigan.  Experts estimate that she died in 2008, but records indicate that she voted in 2010.  Melowese Richardson actually admitted and served time in jail in Ohio for, in part, voting for President Obama more than once and for more than herself in 2012 (and in past elections).  Despite this admission, Al Sharpton — instead of denouncing Richardson for her crimes — embraced her at a recent rally that condemned voter protection laws.

This isn’t right.

Progressives have not given logical reasoning to oppose voter ID laws — especially now that Bill Clinton and Andrew Young are willing to come to the table and offer their own ways to work with current ballot protection laws.

It is long past time for progressives to distance themselves from the lies and disinformation and embrace the facts.  The fair and equitable elections they claim to support are best safeguarded when a person shows up to vote with a photo ID that proves their identity.

top photo credit: iStockPhoto

Wednesday
Apr162014

Myth: America Had A Free-Market Health Care System Prior To ObamaCare

It appears that the second greatest trick the Devil ever pulled was convincing lots of Americans that they had a free-market health care system prior to ObamaCare.  That became evident after I received this tweet the other day:

That fact is even prior to ObamaCare the U.S. did not have anything close to a free-market in health care. To see this, it’s best to examine the government interventions in health care and then ask to what extent other markets have that level of interference.  

1. Tax Exclusion For Employer-Provided Insurance.  The tax exclusion was the result of wage controls during World War II—employers couldn’t attract employees by raising wages, so they attracted them by offering tax-free health insurance—and was formalized into law in the 1950s.  It’s long been known the tax exclusion encourages employees to purchase more insurance than they otherwise would, since every extra dollar put into insurance is tax free while every extra dollar of income is taxed at the marginal rate.  More generous coverage leads to overuse of health care.  It also creates other inefficiencies, such as letting the employer choose insurance for the employee, instead of the employee finding the insurance that best suits him.  Number of other markets where you get a tax break for buying a product but only if you buy it through your employer? Zero.

2. ERISA.  The abbreviation for the Employee Retirement Income Security Act, it permits companies that self-insure to avoid having to conform their insurance to state regulations.  Since usually only large firms—100 employees or more—are capable of self-insuring, it gives large firms an advantage over other firms.  (For more on ERISA, go here.) ERISA, combined with the tax exclusion, also results in a three-tiered system of health insurance: 1. Larger firms that can self-insure avoid state regulations and make use of the tax exclusion; 2. Small firms that can still make use of the tax exclusion but must buy insurance that conforms to state regulations since they seldom can self-insure; and 3. The individual market in which individuals get no tax break for insurance and must follow state regulations.  Number of other markets that have a three-tiered system for a service or product? Zero.

3. McCarran-Ferguson.  This law dates back to 1945 and it has the effect of allowing states to prohibit the sale of insurance across state lines.  This protects states from having to engage in regulatory competition—i.e., which state can come up with the lightest regulations that make the cost of selling insurance cheaper—and protects big insurers in those states from having to face out-of-state competition.  The loser in all this is the consumer who must buy more costly insurance.  Number of other markets where you cannot buy a product or service out of state? Zero. 

4. STARK  The STARK laws, named after former-Congressman Pete Stark, prohibit physicians from receiving Medicare or Medicaid payments for any medical facility they have an ownership stake in.  Obviously, this makes it very difficult for physicians to own medical facilities.  Stark first targeted physicians who owned or were partial owners of their own labs.  It reached its culmination under ObamaCare which forbids Medicare and Medicaid payments going to hospitals owned by physicians.  The supposed justification for this was physicians would encourage patients to overuse health care, thereby putting more strain of government budgets.  The evidence for this has always been shaky.  The likely reason is that big lab companies and big hospitals wanted to stamp out competition.  Yet physicians are often best-suited to own medical facilities because they spend so much time working in them.  This gives physicians the experience to know how a hospital can improve its service for patients.  Ownership enables them to to put that knowledge into practice.  Unfortunately, the STARK laws largely end that sort of innovation.  Think of it this way: It would be the same as having laws that say attorneys can’t own law firms, auto mechanics can’t own car repair shops, bankers can’t own a bank, and so on.  Think that would improve or hinder those markets?  Number of other markets in which practitioners can’t own their facilities? Zero.

5. Medicare, Medicaid and Other Government Programs.  In 2012 the U.S. spent $2.793 trillion on health care.  Medicare, Medicaid, S-CHIP, Veterans Affairs and other government programs accounted for almost $1.098 trillion of that.  So, just under 40 percent of our health care expenditures go through government where politicians and bureaucrats decide how they are spent instead of physicians and patients making such decisions exclusively.  Number of other markets where government controls at least 40 percent of the resouces: I can think of a few, such as education and defense.  In most other markets consumers control most of the resources.

That is an incomplete list. There are plenty of other federal laws that apply to health care and health insurance such as CLIA, COBRA, HIPAA, the HMO Act and the Mental Health Parity Act. (Am I forgetting a few?  Probably). Then there are laws on the state level like benefit mandates, certifcate of need, and, in some states, guaranteed issue and community rating.

Few other markets have anywhere near the government interference and meddling that health care does.  And, remember, all of this came into being well before ObamaCare.  

The best way to describe the health care market in the pre-Obamacare days was a government mis-managed market.  The best way to describe health care under Obamacare is a government mis-managed market on steroids. But no one can accurately describe the market prior to Obamacare as “free.”  It doesnt’ square with the facts.

For more on this see Greg Scandlen’s “100 Years Of Market Distortions.”

UPDATE: For even more on this, see Rituparna Basu’s “The Broken State of American Health Insurance Prior to the Affordable Care Act.”

Tuesday
Apr152014

Why do the Left's Stories about the Death of Charlene Dill Leave Out So Much Information?

Coreg by GSKCoreg, one of many drugs prescribed for heart conditions, is made by GlaxoSmithKline, which has a program to help low-income people receive its medicines free or nearly free, for those who qualify for help.

David Hogberg wrote a blog post this morning on Medicaid and the deaths of Charlene Dill and Deamonte Driver. I have a few thoughts to add.

David pointed out to stubborn leftists exploiting this poor woman's death that Medicaid is no panacea. Even had Charlene Dill had Medicaid coverage, she may not have been able to see a doctor. He notes that in Florida, only 60% of doctors* will see new Medicaid patients. He also notes the semi-famous case of Deamonte Driver, a Maryland boy who died of an infection related to an abscessed tooth. The left has exploited Deamonte's death in a call for government-run health care, ignoring both the fact that Deamonte's family had Medicaid coverage, and also that countries with single-payer health care, such as Britain, have notoriously poor dental care (see my 2009 book with Ryan Balis, PDF version available free here, for stories of desperate Britons pulling out their own teeth because that country's National Health Service never gets around to treating them).

David, however, kindly accepted the left's version of the Charlene Dill story, but it has gaps bigger than the alleged one they decry about Medicaid. Maybe all those gaps, if filled, would make the case the leftists want to make stronger -- but if so, why isn't the left filling them?

Here's what Think Progress -- which probably did more than any other outlet to promote the Charlene Dill story after it initially was brought out by a press conference by SEIU Local 1991 (which has been campaigning for Medicaid expansion) -- wrote about it:

Charlene Dill, a 32-year-old mother of three, collapsed and died on a stranger’s floor at the end of March. She was at an appointment to try to sell a vacuum cleaner, one of the three part-time jobs that she worked to try to make ends meet for her family. Her death was a result of a documented heart condition — and it could have been prevented. Dill was uninsured, and she went years without the care she needed to address her chronic conditions because she couldn’t afford it.

Under the health reform law, which seeks to expand coverage to millions of low-income Americans, Dill wasn’t supposed to lack insurance. She was supposed to have access to a public health plan through the law’s expansion of the Medicaid program. But Dill, a Florida resident, is one of the millions of Americans living in a state that has refused to accept Obamacare’s Medicaid expansion...

...Dill made about $9,000 annually by babysitting, cleaning houses, and selling vacuum cleaners...

Here are a few of the questions none of the left-wing articles and diatribes I saw addressed:

  • Dill, described as a single mother in most articles, actually was married (in fact, Dill was not her married name, but I'm sticking with "Dill" for this story for the sake of the family's privacy). Was Dill's reported $9,000 annual income (some stories said $11K) the family income, or hers alone? The stories imply it was hers alone.

  • If Medicaid had been expanded in Florida, would Dill have qualified, given that any income her husband earns would have been taken into consideration?

  • What was Dill's actual, legal cause of death and why do none of the stories report it?

  • What are the unnamed medications Dill allegedly would have been taking had she had Medicaid coverage? What is the certainty that these medications would have prevented her death? Would Medicaid have covered them? What did they cost?

  • Why do many, if not all, of the stories fail to mention that the state of Florida has a program to help people who are ill and uninsured, but whose income falls above Medicaid's eligibility levels? If Dill had a life-threatening condition that could have been fixed with medication, and could not afford to pay for the drug or drugs herself, did she apply for help from this program?

  • Pharmaceutical companies have programs to help low-income people receive medications they otherwise cannot afford. Did Dill apply for help from this source, from charities, from other family members or elsewhere?

Charlene Dill's close friend, Kathleen Voss Woolrich, the person responsible for circulating her story to the left, blames Florida Governor Rick Scott (R) for Dill's death. She also complains of being uninsured herself, and has said in social media, "I'm uninsured. Too much for medicaid, too little for a subsidy. I cannot get infusions I need to stay well. I could die of respiratory failure." An interesting coincidence -- though entirely possible, I concede -- that two close friends, both young adults, need Medicaid for ongoing conditions to survive.

Woolrich is an SEIU organizer. The SEIU claims to be very pro-health insurance. Why isn't the SEIU providing health insurance to Kathleen Voss Woolrich?

pliersOur book Shattered Lives describes people in government-run health care systems pulling out their own teeth with pliers. These people have health insurance, but inadequate health care.

Many leftists yearn for health systems like those in Britain and Canada, where everyone is promised health insurance, but health care, not so much. We think these leftists would be wise to heed the admonition: Be careful what you wish for.

Which brings us to Deamonte Driver, the boy used by the left to argue for government-run health care who had Medicaid coverage but who died because he did not get medical attention in a timely manner. I agree with David Hogberg's comments on this, although I do think two things are worth noting: 1) the temporary "lapse" in the Driver family's Medicaid coverage reportedly occurred not because of taxpayer parsimony but because the Driver family didn't turn in a necessary address change to Medicaid (and the lapse was rectified when the family did so); and 2) David's reference to Deamonte's mother's parenting skills. I concur in his assessment overall, but remind him that no stories mention Deamonte Driver being a virgin birth -- though, admittedly, I've never seen a story that mentions a father. It takes two to create babies, and unless Deamonte's father was dead or genuinely incapacitated, he shares equal responsibility for what happened. The news media gives us entirely too many sob stories about single parents without explaining either that the missing parent is dead or why children are being raised by a only one of the two people who brought them into this world.

*This post was edited to reflect the fact that the correct number is 60%, as I originally wrote 40% in error, and to add the information that the SEIU originally brought the Charlene Dill story to the news media.

Tuesday
Apr152014

ObamaCare Medicaid Expansion: The Cruelty Of False Hope

I was on the Thom Hartmann show last night discussing Medicaid.  I wasn’t as sharp as I wanted to be, so I hope you’ll let me make up for that here.

Hartmann pointed to the example of Charlene Dill.  Here’s lefty William Hamby on that tragic case:

…in Florida, Charlene Dill has paid the ultimate price for this political screwing over of the poor. Anything but “lazy,” she worked three jobs as a single mother. She had a documented heart condition that was treatable, but could not afford to go to the doctor. 

….The Republican stonewalling of the ACA is hard to see as anything other than willful evil. It goes much deeper than one dead woman in Florida. We’re talking about millions of people who are suffering, right now, today, with conditions that are treatable. Some will die, and others will live in pain that could be prevented. People will lose their jobs over their illnesses. Some will lose their houses. Families will be torn apart. This is real world suffering that is directly caused by Republicans.

Dill may not have been able to go to the doctor even if she’d had Medicaid.  Over 30 percent of doctors are refusing to see Medicaid patients.  If she lived in Wyoming, she’d be in luck.  Close to 99 percent of doctors their take new Medicaid patients.  But she lived in Florida, where just over 40 percent refuse to do so.  So, had Florida expanded Medicaid, Dill very well could have died anyway.

That happened to Deamonte Driver.  For a refresher on Driver, go here.  Driver died from complications related to an absessed tooth.  He had Medicaid, but his mother, Alyce, could not find a dentist willing to take Medicaid.  Interestingly, Deamonte’s brother, DeShawn, was also having problems with his teeth.  It was hard not to read between the lines of this story and realize that it was not only a failure of Medicaid, but also possibly of a mother who probably should not have been a parent also society’s fault.

Furthermore, the best data we have, the Oregon Medicaid experiment, found almost no improvement in health outcomes from expanding Medicaid.  In short, expanding Medicaid means expanding a costly program whose benefits are questionable at best.

Hamby argues that not expanding Medicaid is evil but, I wonder, which is more evil? Not expanding a costly yet ineffective program, or expanding that program and giving the Charlene Dills and Deamonte Drivers of the world false hope?

Monday
Apr142014

Government Wants You To Have Choices--As Long As You Make The 'Right' Choice

Hat tip to Walter Russell Mead who points to this article in the New York Times about physicians in Texas who have switched to “all-cash” (that is, they don’t take insurance) practices:

For 12 hours a day, the waiting room at Dr. Gustavo Villarreal’s family practice is packed with patients who pay a flat $50 fee for the convenience — or necessity — of a walk-in, quick-turn doctor’s visit….

“It had always been affordable and possible to maintain a practice with what insurance and patients paid, but about 10 or 15 years ago, you started seeing a decline” in revenue, said Dr. Villarreal, who switched his traditional family practice to its current business model in 2012.

But, as Mead warns, “now that Obamacare is swelling the ranks of the comprehensively insured, doctors who don’t take insurance are increasing the pressure on the system. There’s a hint in the NYT piece that other doctors think it’s irresponsible for their colleagues to stop taking insurance just as the Obamacare rollout promises to strain practices and hospitals past capacity.”  I’ll include the “hint” at the end of the post.

Restricting the choice of patients to use direct pay physicians—something that won’t happen soon, but is a very real threat the longer Obamacare remains in place—is not limited to Obamacare.  A while back NCPPR published a study I did on physicians in Medicare.  In it, I recounted the story of Dr. Juliette Madrigal-Dersch who runs a cash-only practice near Austin, Texas.  When she initially began her practice, she took Medicare but not other forms of insurance.  Eventually she decided to drop Medicare.  Here are the hoops she has to go through to stay out of Medicare:

To leave Medicare, you actually have to do quite a bit of paperwork,” [Dr. Madrigal] said. She turned to the Association of American Physicians and Surgeons (AAPS), an interest group that in recent years has helped physicians exit Medicare. The AAPS recommends that the physician first tell her Medicare patients that she is leaving Medicare. Second, the physician must file an affidavit stating that while she is opting out of Medicare she “will provide services to Medicare beneficiaries only through private contracts,” and “will not submit a claim to Medicare for any service furnished to a Medicare beneficiary during the opt out period.” The affidavit must be sent to all of the private companies that handle Medicare claims in the physician’s state.

The physician must then fill out a separate contract with each of her Medicare patients stating that the patient understands that the physician has opted out of Medicare. It states that the patient must accept “full responsibility for payment of the physician’s charge for all services furnished by the physician.” The patient must also understand “that Medicare payment will not be made for any items or services furnished by the physician that would have otherwise been covered by Medicare if there was no private contract and a proper Medicare claim had been submitted.” The patient must sign this contract in order to continue to be treated by the physician.

Even though she dropped out of Medicare, Dr. Madrigal’s hassles with the government haven’t ended. The “opt-out” period only lasts for two years, so Dr. Madrigal must re-file up-to-date affidavits biennially. She must make sure that her Medicare patients sign new contracts every two years as well.

That is the nature not just of Medicare or Obamacare, but of government in general.  It may let consumers and providers have choices, but they must be the correct choices as defined by the politicians and bureaucrats.  Making choices outside the government system, even when it is legal, is frowned upon, and so politicians and bureaucrats make getting out as cumbersome as possible.  

Doing something like forcing physicians to accept exchange policies won’t happen in the current policial environment.  Any politician suggesting that would likely get hammered this November, if not November 2016.  But political environments change, and when health care is no longer the salient issue it is today, politicians will try to slip regulations into large bills that begin us on the path of forcing physicians to take exchange policies.  

It’s another reason why repealing Obamacare is so important.

Here’s the part of the Times article that hints at trouble for physicians with all-cash practices:

Some health care specialists worry that if too many practitioners choose this path, the state could be left struggling to find doctors to accommodate patients with insurance as the federal health care overhaul is making such coverage mandatory for most Texans. So far, efforts to enroll Texans in the federal insurance marketplace — crucial to the success of the Affordable Care Act — have made a small dent in the state’s uninsured population, which has reached 6 million, according to United States Census Bureau data. The federal Department of Health and Human Services reported that 295,000 Texans had signed up for insurance coverage in the federal marketplace as of March 1.

“We have to find ways of stretching the current number of primary care doctors to meet that demand,” said Dr. Clare Hawkins, president of the Texas Academy of Family Physicians. “Direct primary care goes in the other direction.”

Saturday
Apr122014

Why is the American Geophysical Union Prioritizing Climate Alarmism Over Scientific Inquiry?

IStock Man ZipperWjpg

I had a comment rejected by a blog of the American Geophysical Union (AGU) last night because I included within it a link to a blog post by a climate scientist, Dr. Roger Pielke, Sr., who has over 370 peer-reviewed articles in scientific journals to his name.

Any aspersions this casts on the AGU's objectivity and spirit of scientific inquiry are entirely earned.

Climate alarmists -- those who believe humankind is dramatically affecting the climate in a very harmful way -- have often censored contrary views (e.g., routinely deleted comments at the uber-alarmist blog Real Climate; the revelation in Climategate that alarmist scientists were prepared to "redefine what the peer-review literature is" or shut down academic journals if they published skeptics' papers; the decision by various publications and websites including Popular Science, the Los Angeles Times and Reddit to block comment postings by skeptics; among others).

Despite this, I did not expect my rather casual comment to the AGU blog to be censored. In it, I provided a link to a paper praised by the blog's author, Dan Satterfield. The blog post itself had encouraged people to read the paper, but a linking error prevented full access to the paper itself at a spot where such a link was advertised. I supplied one.

But in a move that proved fatal to my comment, I also included a link to comments by Dr. Pielke, Sr. questioning the methodology of the paper recommended by the AGU post.

I know this because Mr. Satterfield sent me an email highlighting the following from his blog's comment policy: "I do not publish links to junk science papers/sites. This is not a platform for you to publicize junk science."

Let us examine what constitutes "junk science" to the AGU and/or its representative.

Mr. Satterfield was promoting a 2010 paper, Anderegg et. al., 2010, "Expert Credibility in Climate Change," whose lead author was a graduate student, which attempted to claim scientists who are alarmist on global warming are more prominent than those who are not by counting the number of journal papers with the word "climate" in them, per scientist, that pop up in Google.

Dr. Pielke, Sr., who is not, as it happens, a skeptic of the theory that humans are having a strong impact on global climate (though he does believe the IPCC underestimates the impact on climate of humans' use of aerosols and land, which irritates some anti-CO2 activists), believed the Anderegg paper had weaknesses. He commented on this in a 2010 blog post and provided links to comments by other experts unconvinced of the strength of the Anderegg paper.

One of those, Science magazine reporter Eli Kintisch, writing on the American Association for Advancement of Science website, explained three criticisms of the paper's methodology:

  • The study allowed for no nuance in the views of scientists. All scientists were lumped into one of two groups.

  • The study limited its analysis to scientists who had signed public statements on climate science or participated in IPCC proceedings.

  • The study conflated frequency of appearance in peer-reviewed publications with prominence.

The AGU blog didn't want its readers to know of these and other criticisms.

Why?

And it's not as if the AGU blog post itself was high-minded and limited only to discussions of peer-reviewed science.

  • Its opening paragraph criticized anticipated commenters for linking to websites with unflattering pictures of Al Gore before they could even have read the post, let alone commented.

  • It bizarrely claimed the fact that an NBC correspondent interviewed a non-skeptic political scientist instead of, presumably, a skeptic climate scientist to "balance" alarmists in a story was evidence for the catastrophic global warming theory.

  • It said that interviewing anyone [emphasis added] about climate science who has not been published in a peer-reviewed journal is "lousy journalism, and the equivalent of doing a story about the Apollo Moon missions, and then giving the chem-trail believer down the street equal time to say the Moon landing was fake, and pro-wrestling is real!" Really? Anyone?

  • And most significantly, it rudely and one-sidedly attacked a University of Colorado at Boulder professor (who is not a skeptic), Dr. Roger Pielke, Jr. (coincidentally, the son of the scientist I linked to about the Anderegg study, but the two debates are unrelated otherwise and separated by about four years) for telling the Senate last year that extreme weather events have not increased in recent decades, a view that happens to be consistent with that of the IPCC, but also politically inconvenient for the White House, which attacked him. (For background on that not supplied by the AGU, go here for his story in the New Republic; go here for a review of the matter in the New York Times by Andrew Revkin (also not a skeptic).)
My blog comment was nothing special, nor was the blog post upon which I commented. But it is important to note how little it takes for an AGU blog to censor an opposing view, even about a study as unremarkable as one that counts the number of papers scientists publish (aka, a study not even about hard science!).

The American Geophysical Union stands with a small clique of "approved" alarmists on global warming, and it wants to make sure you do, too.

Friday
Apr112014

A Bad Week for Lois Lerner, But a Good Week for Finding the Truth

This was a bad week for Lois Lerner, but nothing that she apparently couldn’t have prevented.  It’s her mess.

The former head of the Internal Revenue Service’s division that oversees tax-exempt organizations incurred the wrath of two different congressional committees this week for her part in the alleged malicious targeting of conservative organizations seeking nonprofit status.

Lerner previously professed her innocence in the matter in a statement before the House Oversight and Government Reform Committee, but then immediately invoked her 5th Amendment protection against testifying before the committee.  This conflicted episode in particular, as well as the mounting evidence that only conservative applicants were hounded and delayed by the IRS during their application processes, has drawn the ire of lawmakers who are seeking answers.

So, on Wednesday, the House Ways and Means Committee voted to formally request that the U.S. Department of Justice consider a criminal prosecution of Lerner for the unfair treatment of conservative applicants, misleading congressional investigators and illegally releasing private information from taxpayer records.  An official statement from the Committee stated that “Lerner used her position to improperly influence agency action against only conservative organizations, denying these groups due process and equal protection rights under the law.”

Then, on Thursday, the Committee on House Oversight and Government Reform voted to hold Lerner in contempt for her refusal to testify before the Committee.

Project 21 co-chairman Horace Cooper, a former staff member of the House leadership, said that Lerner has only herself to blame and that the American people are owed answers to the lingering questions about the probably political targeting of certain Americans for the political beliefs.  Horace said:

This past week, both the Committee on Ways and Means and the Committee on Oversight and Government Reform of the U.S. House of Representatives signaled that the Internal Revenue Service is not the law unto itself and that every federal employee — including Lois Lerner — must be accountable to the American people.

The charges involved here are serious.  Every American is subject to the dictates of the IRS, and they expect that those interactions will be neutral and dispassionate.  Unfortunately the evidence indicates that Lerner’s actions were anything but neutral.

It is axiomatic that the IRS shouldn’t target Americans because of their beliefs or their political activities.

Our nation was founded on the principle that citizens are free to criticize or support the government without reprisal.  By threatening this principle, it appears that Lerner violated the law.

Now, it is important for Lerner to face the consequences of her alleged actions and to tell the American people about the other parties potentially involved in such crimes.

photo credit: iStockPhoto

Friday
Apr112014

Medicaid Expansion: Good News And Bad News

Will Obamacare’s Medicaid expansion make it more difficult for Medicaid beneficiaries to find care?  It’s already well known that finding a physician who takes Medicaid is difficult.  Some critics of Obamacare have suggested that by expanding Medicaid enrollment without also expanding the supply of providers to treat the new enrollees will result in a shortage of health care for Medicaid beneficiaries.

Well, some recent research in JAMA Internal Medicine suggests that might not happen.  This article looked at Medicaid expansions prior to Obamacare and found little difference in access for Medicaid beneficiaries in states that expanded Medicaid versus states that did not.   In short, Medicaid enrollees may have trouble accessing care, but it doesn’t appear that those difficulties get any worse with an expansion.

That’s the good news.  On the other hand, some of these expansions were limited to a few states and some were relatively small expansions.  That is, they were not on the magnitude of the Obamacare expansion.  Will the greater magnitude of this expansion create access problems?  We’ll, have to wait and see on that.

The bad news comes from an article in the International Journal of Health Care Finance and Economics.  It examined the the effect that Medicare prices had on Medicaid prices, and while it found that while Medicare prices affect Medicaid prices for physicians, they didn’t find any impact on hospital prices.  The article states:

This suggests that the Medicaid program does not compete with Medicare by adjusting reimbursement prices for patient access to basic hospital care.  In this case, lack of competition is consistent with providers having enough capacity to serve all Medicare and Medicaid patients at relatively lower market prices.

The take away from that is Medicaid is likely to remain a program where enrollees are likely to get a lot of their care in an emergency room, and not from physicians, even under the expansion.

Wednesday
Apr092014

Health Care Odds & Ends: Why The ObamaCare Numbers Matter

1. Costs Versus Benefits.  If you’ve read this blog in the last week or so, you’ve seen a lot of numbers about how many uninsured have gained coverage on the ObamaCare exchanges.  Are there 3.1 million young adults who’ve gained coverage via their parents plan or only 258,000?  Has ObamaCare really reduced the number of uninsured by 5.4 million or is the real number closer to 3 million? And so on.

This matters because the benefits of this law—reducing the number of uninsured—have to be weighed against the costs.  If the number of uninsured has declined precipitously, then the costs are easier to justify.  Thus far, the benefits are falling far short of what the Obama Administration has promised.  The Administration touted the number from the Congressional Budget Office (CBO) that ObamaCare would reduce the number of uninsured by 13 million in 2014—6 million on the exchanges, 7 million on Medicaid.  It is highly unlikely that goal will be reached.

The costs, however, have been quite steep: loss of freedom; higher taxes, even for some in the middle class; at least 5 million people with insurance on the individual market who received cancellation notices; many of those people losing their insurance and now paying higher premiums for new insurance; patients having difficulty finding exchange plans that cover their doctors; and, of course, the “horror stories.”

Then there are the costs yet to come.  We don’t yet know how many people have lost their small-group plans, although we do know it is happening.  The effect of the employer mandate is as of yet unknown since it doesn’t take effect until January 2015.  But Jed Graham of Investor’s Business Daily counts at least 401 employers who are looking at reducing worker hours in response to the mandate.  He’s also found that some lower-wage workers may already be seeing a reduction on their hours.  Finally, there is the CBO analysis that the incentives in ObamaCare will encourage employees to work fewer hours which would equal 2.5 million jobs by 2014.

Ultimately, we are enduring a great deal of costs for relatively small benefits.  If this trend continues, at some point one has to admit that ObamaCare has not been worth it.

2. More Bad Numbers For The Exchanges.  The New York Times reports a study from Express Scripts that compares pharmaceutical use in the first two months on the exchanges to such use in employer-based plans.  The article notes that while exchanges enrollees appear to be filling prescriptions at about the same rate as those with employer-based plans, the pharmaceuticals exchange enrollees purchase tend to be more expensive:

People who signed up early for insurance through the new marketplaces were more likely to be prescribed drugs to treat pain, depression and H.I.V. and were less likely to need contraceptives, according to a new study that provides a much-anticipated look at the population that signed up for coverage under the new health care law.

The health of those who enrolled in new coverage is being closely watched because many observers have questioned whether the new marketplaces would attract a large share of sick people, which could lead to higher premiums and ultimately doom the new law.

The study, to be released Wednesday by the major pharmacy-benefits manager Express Scripts, suggests that early enrollees face more serious health problems and are older than those covered by their employers. The study also showed a higher use of specialty drugs, which are often used to treat diseases like cancer and rheumatoid arthritis; the use of such drugs could hint at more costly medical problems.

This appears to be bad news for the ObamaCare exchanges.  If enrollees are much sicker than what is optimal for a risk pool, then insurance prices will rise and its off to races on the death spiral.  Nevertheless, a piece on the same subject by the Kaiser Family Foundation and the Daily Beast notes:

Experts caution that the findings are limited to two months’ data and don’t reflect the surge in enrollment which occurred in March and April….

“We all expected that the people who signed up by January and February would be a lot sicker than anyone else,” said Robert Lazsewski, a consultant to the insurance industry. 

The consensus among insurers, he said, is that “it will be a year before we know what we’ve got.”

Thus, this is only the first hint that the exchanges are in trouble.  We’ll need a lot more data before any definitive conclusions on the health of the exchange risk pools can be drawn.

3. About That RAND Study.  Recall that RAND study that said close to 9 million people have recently gained coverage?  Well, we are finally getting a look at it, and it turns out the increase doesn’t come primarily from the exchanges or Medicaid, but from an over 8 million increase in the number of people who get employer-based insurance.  In fact, when you compare the gains from the exchanges and Medicaid with the losses in the individual market and the military and federal employee market, the net increase in the insurance is only about 1.1 million:

For more, see Avik Roy.

Wednesday
Apr092014

Project 21's Cooper on Hank Aaron's Race Remarks

Legendary baseball star Hank Aaron fouled out when he tried to play politics — essentially spoiling the 40th anniversary of his record-breaking 715th home run for many fans.

During an interview with USA Today, when Aaron unfortunately steered the conversation into politics, the 80-year-old retired right fielder said about Barack Obama and his performance as president:

Sure, this country has a black president, but when you look at a black president, President Obama is left with his foot stuck in the mud from all of the Republicans with the way he’s treated.

We have moved in the right direction, and there have been improvements, but we still have a long ways to go in the country.

The bigger difference is that back then they had hoods.  Now they have neckties and starched shirts.

After an otherwise dignified anniversary and a stirring speech by Aaron at the Atlanta Braves game on April 8, Project 21 co-chairman Horace Cooper found Aaron’s comments to USA Today to be wholly misleading and inappropriate:

Hank Aaron’s remarks are as disappointing as they are inaccurate.

Suggesting that political differences are the moral equivalent to the odious philosophy of racial superiority is sickening.  To make matters worse, they minimize the truly wicked past policies of institutional racial segregation.

Across the board, President Obama’s policies are failing the American people — black and white.   Pretending that they aren’t just because he’s the country’s first black President serves no one’s interest and ignores the progress we’ve made.

As an individual who had to actually live by his talents and character when it mattered most, Hank Aaron should — of all people — know the difference between naked bigotry and genuine political differences.

Tuesday
Apr082014

Medicare Advantage, Insurance Premiums and Chutzpah

“Great kid!  Don’t get cocky!”  Han Solo’s timeless warning about how to handle success (don’t let it go to your head and stay on your toes) applies as much today as it did back in 1977.  However, Paul Krugman always ignores it.  Here’s Krugman after the announcement that 7.1 million people had signed up on the Obamacare exchanges:

The biggest risk to reform has always been that the scheme would founder on its complexity. And now we know that this won’t happen….The nightmare is over. It has long been clear, to anyone willing to study the issue, that the overall structure of Obamacare made sense given the political constraints. Now we know that the technical details can be managed, too. This thing is going to work. And, yes, it’s also a big political victory for Democrats. 

The general pattern of ObamaCare has been that when it appears something about it is working, something else soon follows to show that it’s not:

The Obama administration announced Monday that planned cuts to Medicare Advantage would not go through as anticipated….

Under cuts planned by the administration, insurers offering the plans were to see their federal payments reduced by 1.9 percent, which likely would have necessitated cuts for customers.

Instead, the administration said the federal payments to insurers will increase next year by .40 percent.

Medicare Advantage was supposed to be cut to the tune of $200 billion over ten years to, in part, help pay for Obamacare.  But, now suddenly, that doesn’t seem necessary: 

The Centers for Medicaid and Medicare Services (CMS) on Monday said changes in the healthcare market meant it did not need to make those cuts to Medicare Advantage this year.

It cited an increase in healthy beneficiaries under Medicare, which it said has lowered projected costs for that program.

Uh huh.  Here’s the real reason:

The announcement comes after insurers spent millions on a public relations blitz seeking to head off the cuts, and after dozens of Democrats joined Republicans in calling on the administration to keep MA rates flat to avoid cutting benefits for seniors. (Bold added.)

Guess the Democrats don’t want to have to explain both why people lost their insurance and why seniors saw cuts in the Medicare Advantage plans.

Here’s betting they won’t want to explain this either:

Americans have recently been hit with some of the largest premium increases in years, according to a Morgan Stanley survey of insurance brokers.

The investment bank’s April survey of 148 brokers found that this quarter, the average premium increase for customers renewing an insurance plan is 12 percent in the small group market and 11 percent in the individual market, according to Forbes’ Scott Gottlieb.

What was that about a political victory for Democrats?

Monday
Apr072014

180,000 Women Lost Jobs in February While Obama’s Promotes Gender Warfare

It’s probably a pretty safe bet that President Obama won’t be talking about last month’s unemployment numbers when he officiates at “Equal Pay Day” at the White House on Tuesday, April 8.

Last Friday, the federal Bureau of Labor Statistics announced that the overall unemployment rate for the American workforce as a whole was unchanged at 6.7 percent.  To break that down among some key Obama demographics, Hispanic unemployment went down slightly to still-high 7.9 percent while black overall unemployment rose by twice as much as Hispanics fell to post at an extremely high 12.4 percent.

And the unemployment rate for all women who are 20 years old or older rose by two-tenths of a percent.  It’s back to the same rate — 6.2 percent — as last November.  Not good news.

There are approximately 180,000 more women in the American workforce who joined the ranks of the unemployed last month.  Black women 20 years and older, in particular, saw their unemployment rate skyrocket by 1.1 percent to 11.0 percent.  While not seasonally adjusted, the Hispanic unemployment rate for women is reported to have fallen four-tenths of a percent to 8.4 percent.

Also, according to CNSNews, approximately 36,000 women chose to join the over 54.6 million other American women who are now considered to not be participating in the workforce at all.  Overall, the American labor participation rate is near a modern low of 63.2 percent.

Yet, as Obama prepares to stoke the partisan fires of an alleged “war on women” on Tuesday by using his much-heralded pen and phone to sign two executive orders he will undoubtedly claim will help equalize the genders in the workplace, the fact that 180,000 more women than in February are no longer drawing amy regular salary should hang over the event like a dark cloud of foreboding.

These very stark facts about womens’ employment will likely go unmentioned as they don’t fit the liberal narrative that the economy is recovering splendidly and that problems right now are borne more out of race, class, gender and power dynamics than an environment toxic to job creation and fiscal growth.

The expected Obama orders, to mandate that federal contractors (the apparent extent of Obama’s pen power) provide federal regulators with salary data broken down by factors of employees’ gender and race and to protect contractors from retaliation for publicly complaining about their wages, are considered dubious in effectiveness and considered by critics to only add more of a regulatory burden on employers that will instead depress wages for all affected workers.

This latest skirmish in the liberal war on women meme fronted by the White House and its supporters is being rebutted by members of the National Center’s Project 21 black leadership network.  These black conservatives find there is more to worry about in the workforce that the specter of gender discrimination.

For instance, Project 21 member Derryck Green, who writes a regular monthly commentary for the National Center’s blog that analyzes the unemployment numbers and the state of the Obama economic recovery, said:

For all the talk about this so-called conservative “war on women,” it seems like an actual two-stage war is being waged on women by the actions of the Obama White House and as a result of his economic “recovery.”

Under Obama’s recovery, for example, women saw their share of the nation’s unemployed increase by 180,000 from February to March.  Since Obama has been in office, the representative percentage of employed women in the civilian federal workforce has also declined.  In 2013, roughly 44 percent of the civilian federal workforce was women — a 16-year low.

Also, during Obama’s tenure, for example, women are reportedly earning less on average than their male counterparts.  Not only are there fewer women working in the White House than men, they are also making $9,000 less per year.

So much for gender equality!  It’s just another example of the apparent unspoken motto of the Obama presidency: “Do as I say, ignore what I do.”

Americans should keep this in mind the next time the Obama Administration and their sympathizers campaign against the “war on women.”

Project 21 member Lisa Fritsch, a Tea Party activist who ran for governor of Texas earlier this year, added:

The way liberals are addressing this alleged recent “War on Women” is equivalent to their “War on Poverty” initiative of the last five decades.  It has only made things worse for both minorities and women.

The unfortunate truth is that women are finding fewer professional jobs that they depend on to support their families.  A real reason is the Affordable Care Act and the unpredictability of its implications and taxes.

top photo credit: iStockPhoto

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