Archive for the ‘Healthcare’ Category
Scott Pruitt, Oklahoma’s attorney general, distinguished himself in writing this op-ed in the Wall Street Journal. This paragraph is especially inspirational to this federalist:
Declining to establish a state exchange allowed Oklahoma to voice its strong political opposition to the Affordable Care Act as a whole, as well as to make a statement that it wanted neither the large-employer mandate nor the individual mandate to have effect within its borders. That was the trade-off. Oklahoma declined the premium tax credits, but freed itself of those mandates, and that was a choice the state was happy to make.
The states aren’t imbeciles that need the federal government’s protection from themselves. They’re co-equal sovereign governments quite capable of making decisions for themselves. In the early 1990s, the federal welfare programs were out of control. States like Arkansas, Massachusetts, Michigan and Wisconsin started experimenting on welfare. First, they got waivers from HHS giving them the authority to experiment.
Thanks to their experimentation, they improved millions of people’s lives.
Another point worth making is that the ACA, aka Obamacare, is an experiment in anti-federalism. Rather than letting states experiment, President Obama pushed a one-size-fits-all plan down our throats. Scott Pruitt and Oklahoma asserted their rights to make their own decision as allowed by the ACA. It might be that Oklahoma made the wrong decision but it’s their decision to make. The fact that they made an informed choice is proof that they weren’t coerced.
In the original Obamacare lawsuit NFIB vs. Sebelius, the Supreme Court ruled that Medicaid expansion was unconstitutional because the ACA didn’t give the states of opting out of Medicaid expansion. The fact that Oklahoma said no, according to Pruitt, made their decision based on the trade-off of not getting IRS subsidies in exchange for not dealing with the individual and employer mandates. That’s a rational choice, something that wasn’t there with Medicaid expansion.
Third, this sort of federal program isn’t antithetical to federalism, it is federalism. As we explained in our amicus brief to the court, this carrot-and-stick approach is found in dozens of federal programs sprinkled throughout the United States Code. The states are not children that the federal government must paternalistically “protect” from the consequences of their choices by rewriting statutes. In our constitutional system, states are free to make decisions and bear the political consequences, good or bad, of those choices.
Frankly, I’d rather trust decisions made at the state level than decisions made by a DC politician or bureaucrat. In fact, it wouldn’t take more than a nanosecond or 2 to make that decision for me.
Technorati: Scott Pruitt, Oklahoma, Attorney General, Federalism, Medicaid Expansion, Individual Mandate, Employer Mandate, IRS Subsidies, King v. Burwell, NFIB v. Sebelius, Anthony Kennedy, SCOTUS, Affordable Care Act, Obamacare
Brian Beutler’s article is a testimony to how warped hardline progressives’ thinking is. Check this out:
At every step, we were told our goals were misguided or too ambitious; that we would crush jobs and explode deficits. Instead, we’ve seen the fastest economic growth in over a decade, our deficits cut by two-thirds, a stock market that has doubled, and health care inflation at its lowest rate in fifty years. So the verdict is clear. Middle-class economics works.
As a theme, this riff should have struck a chord with the conservative movement’s myriad Reaganologists.
This, supposedly, is Beutler’s attempt to prove that Barack Obama is the next Reagan. Let’s check that comparison. The ‘Obama Recovery’ is still the slowest recovery in history. It’s created few full-time jobs. Most of the jobs it’s created are part-time jobs. Economic growth has stagnated because a) regulation has skyrocketed and b) Obamacare became the law of the land.
Most of the full-time jobs that’ve been created were created in spite of Obama’s policies. Think Texas, which is pretty much putting anti-Obama policies in place, and North Dakota, where the Bakken Boom is happening because they didn’t have to deal with Obama’s oppressive, stifling regulations.
Any comparison with Reagan is foolish. In September, 1983, the economy created 1,100,000 jobs. For 6 straight quarters, GDP topped 5%. Thus far, the economy hasn’t grown by 4% two quarters in a row. It hasn’t had back-to-back quarters topping 3.5%.
Comparing Obamanomics with Reaganomics is like comparing a small plate of tofu with a thick, juicy steak with a side of hash browns. They’re both food but that’s where the similarity ends.
The economy’s rapid growth in recent quarters has scrambled these assumptions, and now the White House is pitching the Reagan comparison to political reporters in Washington.
What rapid growth? Seriously? Economists will slap down Beutler’s claims in a New York minute.
“All historical analogies are imperfect,” Obama’s senior adviser Dan Pfeiffer told me recently, but “people connected the economic success of the ’80s to Reagan’s policies and Democrats also became convinced that the only way to win was to move to the middle. … We want to make sure people understand the policies we put in place, how they work, how they’ve improved their situation, so when Republicans get back into it we’ll have shifted the four corners of the political debate to the left.”
First, there’s no question that President Obama’s policies are definitely to the left of where people are at. Further, there’s no question that it’ll take time to fix the myriad of messes President Obama has created.
Finally, here are the biggest ways to show Obama isn’t like Reagan:
- Economic growth was robust during the last 6 years of Reagan’s time in office.
- Economic growth during President Obama’s time in office has been pathetic.
- Reagan’s national security policies brought the Soviet empire to its knees.
- President Obama’s policies of appeasement has helped terrorism expand its control while threatening most of the civilized world.
Other than that, Obama’s accomplishments are virtually identical with Reagan’s.
Based on Heather Carlson’s reporting, MNsure isn’t sustainable without substantial taxpayer bailouts:
Lackluster enrollment in private plans and drying-up federal funds may force Minnesota to pick up more of the tab for its health insurance exchange. MNsure would get another $11.7 million of state money under Gov. Mark Dayton’s proposed budget for technological improvements, a necessary change because public-plan signups have far outpaced private-plan enrollments.
The governor is also recommending the state assume costs the federal government covered until this year, such as $1.3 million over the next two years for staff to review rate submissions from insurance companies and another $558,000 to investigate complaints. Most federal funding has expired as Washington’s aim is to make state-run health exchanges self-sufficient.
Together, those changes would bring the state’s running costs for the exchange to at least $23.5 million since it was set up in 2013.
The only way the ACA is sustainable financially is if a large number of young healthies buy qualified health plans, aka QHPs. According to Ms. Carlson’s reporting, that isn’t happening:
Lawmakers set up MNsure mostly with federal funds, aiming to sign up Minnesota residents in both private plans and public programs for lower-income families like MinnesotaCare and Medical Assistance. State officials initially estimated about two-thirds of enrollments would be in those programs, with the remaining third in private plans. Instead, 91 percent of applicants have been placed in public programs, forcing the state to pitch in more money.
That’s unsustainable. Perhaps it’s unsustainable for the short term. That’s even questionable. There’s no doubt that it isn’t sustainable for the long term.
MNsure officials say they’ve altered their budget to put the exchange on a steady financial course, upping its fee on premiums from 1.5 percent to 3.5 percent and scaling back costs. But their three-year budget plan hinges on continually adding more new members in private plans than enrolled the year prior.
Anything that can’t be sustained won’t be. Inevitably, MNsure will be unaffordable. When (not if) that happens, the DFL will have egg on their faces. Republicans will criticize the DFL for implementing something that was expensive to the taxpayers and eventually, unsustainable financially.
Dylan Scott’s article about what might happen if the Supreme Court invalidates health insurance subsidies being paid to people who bought insurance through HealthCare.gov is fascinating. For instance:
What leeway does the ACA itself give the administration? It seems self-evident that the states currently using the federal exchange would be required to do something, to “establish” their own exchanges, and the Health and Human Services Department therefore couldn’t just decree that all exchanges are state-based. States also probably need to do more than, say, sign a piece of paper declaring their exchange state-based.
“Now you could perhaps define the word ‘established’ down. HHS might be tempted to do so,” Bagley said. “But at the minimum, that kind of move from the administration would be sure to provoke a prompt legal response.”
There’s an additional problem not cited in the article. Specifically, state-established exchanges are part of Section 1311:
(1) In general
An Exchange shall be a governmental agency or nonprofit entity that is established by a State.
Changing that language requires legislation, which Mitch McConnell might agree to in exchange for other concessions:
That also extends to Congress, which as Bagley and Jones both noted, could correct the problem with ease by amending the law to allow tax credits on the federal exchanges. “Congress could fix this with a stroke of the pen,” Bagley said. “I could write the statute in a single sentence.”
But nobody is really expecting that. Incoming Senate Majority Leader Mitch McConnell said earlier this month that SCOTUS could “take down” Obamacare in the King case and that would open up the opportunity for “a major do-over.”
“If that were to be the case, I would assume that you could have a mulligan here, a major do-over of the whole thing,” he said, in comments flagged by the Washington Post’s Greg Sargent.
While the administration might be willing to do a lot to save the law, an emboldened Republican Congress seems unlikely to settle for anything less than major concessions, as McConnell suggests. So a fix in Washington doesn’t appear in the cards.
It’s interesting that Democrats fear a Washington fix because that would require them making major concessions in exchange for those subsidies. In other words, DC Democrats are most afraid of actually improving the ACA.
That’s insane on a multitude of fronts, starting with the fact that the ACA is a weighty millstone around their political necks. Democrats got crushed in 2010 and 2014 because of the ACA. Despite experiencing those historical thumpings, Democrats don’t want to change the ACA. It’s their right to commit political suicide.
After watching this video, it’s clear that Jeb Bush doesn’t have a clue about conservatism:
This post shows that Paige Lavender, a reporter/commentator for Huffington Post, is utterly clueless. Before we get into Jeb Bush’s statements, here’s what Ms. Lavender said:
PAIGE LAVENDER: We’ve seen in the last 2 election cycles that the Republican primary tends to favor the more conservative candidate.
In 2008, there weren’t any conservatives in the race. Of the liberals, John McCain was the most liberal. He got the nomination. In 2012, the GOP candidates were marginally more conservative. Mitt Romney wasn’t as liberal as McCain but he wasn’t a conservative, either. He was simply the least liberal of the liberals running.
The good news is that Republicans will have a handful of conservatives to pick from in 2016, starting with Scott Walker, then adding John Kasich and possibly Mike Pence. GOP activists won’t have to hold their noses when supporting one of these candidates. Conservatives will be able to enthusiastically support one of these three candidates.
The last 20 seconds of this video will hurt Gov. Bush:
Here’s what Gov. Bush said:
GOV. BUSH: I kinda know how a Republican can win, whether it’s me or somebody else and it has to be much more uplifting, much more positive, much more willing to, you know, to be practical now in the Washington world, to be willing to lose the primary to win the general without violating your principles.
Jeb Bush, like Mike Huckabee before him, doesn’t have a clue about conservatism. True conservatism has a healthy libertarian streak to it, mixed with a healthy skepticism of Washington, DC-run programs. We prefer smallish programs administered at the local level because that’s the best way to ensure accountability. Gov. Bush enthusiastically supports Common Core, which is federalizing education curriculum and standardizing tests nationwide. It’s even telling school boards which text books fit with Common Core’s curriculum.
Conservatism is about giving people lots of positive options, whether we’re talking about families’ health care decisions or telling parents that they can send their children to schools that aren’t failing students.
For the last 6-8 years, Republicans had to play defense because Democrats controlled the agenda. The next Republican president will work with GOP majorities in the House and Senate. That means they’ll be setting the agenda. Their first assignment must be to fix the messes created by President Obama, Sen. Reid and Nancy Pelosi. That means finally getting the fed to shut off the QE2 spigot. That’ll require the GOP to starting over with health care reform. This time, it’s imperative to get it right. Getting America’s economy requires siding with construction unions while ignoring environmental activists on pipeline projects.
There’s no shortage of things that need fixing. When a Republican governor is elected to become the 45th president of the United States, he’ll have lots of things to fix or to get started on. Hopefully, the 45th president won’t be Jeb Bush.
Sen. Klobuchar’s op-ed in the St. Cloud Times would be easier to take seriously if she wasn’t MIA on other issues surrounding the military.
With grateful hearts, Minnesotans this month gathered on Veterans Day to honor the brave Americans who have served in uniform to protect our freedom. This day should be about more than just saluting our veterans. It also serves as an opportunity to renew our commitment to serve those who have served us.
After all, that is our responsibility, to do right by those who have stood tall on the front lines so that we can live free. This is especially true for soldiers returning from battle permanently injured and suffering life-altering disabilities.
It’s a bit hollow sounding, not because wounded vets don’t deserve the medical treatment, but because Sen. Klobuchar didn’t speak out when the military started sending out pink slips to officers still fighting in Afghanistan:
In a stunning display of callousness, the Defense Department has announced that thousands of soldiers, many serving as commanding officers in Afghanistan, will be notified in the coming weeks that their service to the country is no longer needed. Last week, more than 1,100 Army captains, the men and women who know best how to fight this enemy because they have experienced multiple deployments, were told they’ll be retired from the Army.
The overall news is not unexpected. The Army has ended its major operations in Iraq and is winding down in Afghanistan. Budget cuts are projected to shrink the Army from its current 520,000 troops to 440,000, the smallest size since before World War II. What is astonishing is that the Defense Department thought it would be appropriate to notify deployed soldiers, men and women risking their lives daily in combat zones, that they’ll be laid off after their current deployment.
Why was St. Amy of Hennepin County silent about this? Shouldn’t the Obama administration treat the men and women still risking their lives on the battlefield deserve better treatment than this?
As one Army wife posted on MilitaryFamily.org, “On some level I knew the drawdowns were inevitable, but I guess I never expected to be simultaneously worried about a deployment to Afghanistan and a pink slip because my husband’s service is no longer needed.”
The thing is that these troops are needed more than ever:
The nation should worry about the increased national-security risk of separating such a large pool of combat-experienced leaders. The separated soldiers are those who carry the deepest knowledge base of counterinsurgency operations. A senior Defense Department official warned: “If the force is smaller, there’s less margin for error. Let’s face it — things are pretty uncertain out there.”
Then again, that’s never worried Sen. Klobuchar. Since her first campaign in 2006, Sen. Klobuchar consistently talked about “ending the war responsibly.” Winning wasn’t important to her.
That’s why her op-ed rings hollow. This isn’t just about health care for wounded vets. It’s about giving them the resources they need to accomplish their mission. That mission is to defeat and destroy the terrorists before they attack again.
Tuesday evening, Senate Democrats voted to reject Mary Landrieu’s bill that would’ve forced the federal government into issuing the permits to build the Keystone XL Pipeline. The All Star Panel discussed it on this video:
My favorite part of the segment is the final part of the discussion. Here’s that transcript:
BRET BAIER: George, do you expect a lot of stories on the civil war within the Democratic Party?
(Laughter from George Will and Steve Hayes)
GEORGE WILL: I don’t think so. It is interesting to note that maybe they couldn’t have saved Mary Landrieu but they could’ve at least tried. And they didn’t even try.
The experts knew on Election Night that Mary Landrieu was history. That isn’t surprising to people who’ve followed that race. The Democrats’ circular firing squad hasn’t officially convened in public but it’s certainly started outside the public’s eye. I can’t picture it stopping until there’s political blood on the floor and the Democratic Party is damaged going into 2016.
While this was Sen. Landrieu’s last stand, we’ll have to wait until 2016 for Hillary’s last stand. Behind every ebb and flow in presidential polling is a steady current just beneath the surface. Right now, that current is running against the Democratic Party. They’re no longer the party of hope and change. They’re the party of Washington, DC. They’re the party of obstruction. They’re the party that’s stopped listening to the American people.
Hillary is the poster child for people who stayed too long in DC. Just like Mary Landrieu’s magic has evaporated, so has Hillary’s. Hillary first set foot in DC 24 years ago. She hasn’t left since. While Bill finished his time in office, she established a residence in New York, then immediately ran for Pat Moynihan’s seat. After winning re-election, she launched her first presidential campaign. After getting beaten by Barack Obama, she got picked to be his first Secretary of State.
Just like Sen. Landrieu tried getting her Washington friends to help her win a fourth term, Hillary is counting on her Washington friends to help her win her presidential election. It’s a schtick that Louisiana voters didn’t buy with Sen. Landrieu. It’s a schtick that Americans aren’t likely to buy in 2016.
As for Sen. Landrieu and the Democrats, 2014 was a difficult year, mostly because they ran a bunch of retreads that cast their votes for Obamacare. Isn’t it ironic that the ACA is sinking as fast as Sen. Landrieu’s political career is sinking? Isn’t it ironic that the Democratic Party’s favorability ratings are dropping as fast as the ACA’s favorability ratings are dropping? It couldn’t happen to a more deserving bunch.
Talking Points Memo’s article shows that they’re either hallucinating or they’re thinking words don’t have meanings. They’re talking about possibilities about how to skirt the Supreme Court’s ruling should they rule against the administration:
The specter of the Supreme Court gutting Obamacare and putting health coverage for millions of people at risk is back in a very real way, with the justices taking up the lawsuit that would prohibit tax subsidies from being given to people in the 36 states that use the federal health exchange, HealthCare.gov.
But while the White House has been publicly mum about how it would address that worst-case scenario, policy experts have told TPM that there could be ways for the Obama administration to get around such a ruling.
The specifics would need to be worked out, but the crux is this: States could continue to use HealthCare.gov as their technical backdrop, but they would be considered state-based exchanges. That would allow the law’s tax subsidies to keep flowing, even if the Supreme Court were to invalidate them on the federal exchange, as the lawsuit’s plaintiffs argue it should.
That might work with the Nevada and Oregon exchanges but it won’t fly with the 36 states that refuse to create a state-run exchange. Apparently, that didn’t dawn on these geniuses until later in the article:
“One such scenario would be for HHS to effectively deem all of the exchanges to be state-based, but continue operating them through HealthCare.gov,” Caroline Pearson, vice president at Avalere Health, an independent consulting firm, told TPM earlier this year. On Thursday, she added that the legal grounds for such a move would be “uncertain,” however.
Every bill that’s signed into law, especially lengthy, complex statutes like the ACA, contain a list of definitions specific to that legislation. Section 1311 of the ACA establishes how state-run exchanges are created. This part is vital:
SEC. 1311. AFFORDABLE CHOICES OF HEALTH BENEFIT PLANS.
(a) ASSISTANCE TO STATES TO ESTABLISH AMERICAN HEALTH BENEFIT EXCHANGES.—
(1) PLANNING AND ESTABLISHMENT GRANTS.—There shall be appropriated to the Secretary, out of any moneys in the Treasury not otherwise appropriated, an amount necessary to enable the Secretary to make awards, not later than 1 year after the date of enactment of this Act, to States in the amount specified in paragraph (2) for the uses described in paragraph (3).
(2) AMOUNT SPECIFIED.—For each fiscal year, the Secretary shall determine the total amount that the Secretary will make available to each State for grants under this subsection.
(3) USE OF FUNDS.—A State shall use amounts awarded under this subsection for activities (including planning activities) related to establishing an American Health Benefit Exchange, as described in subsection (b).
This is vital in the context of HHS “effectively deem[ing] all of the exchanges to be state-based.” Section 1311, paragraph (3) specifically talks about the grants from HHS to each of the states. The states must use that money to create their exchanges. Since 36 states didn’t accept grants from HHS under Section 1311, paragraph (3), that means the exchange is federally run.
Technically, Oregon and Nevada took HHS grant money. Therefore, they’re technically classified as state-run exchanges. Wyoming and Wisconsin, by contrast, didn’t accept 1311 grants from HHS. Therefore, those states’ exchanges aren’t state-run exchanges.
Simply put, that means any attempt by the Democrats to change the clearly-written definitions in the ACA will likely be quickly rejected by the Supreme Court. It’s further proof that Democrats put their ideology ahead of doing what’s right for the nation.
When Ed Henry questioned WH Press Secretary Josh Earnest about Jonathan Gruber’s statements, Earnest’s reply was stunningly dishonest:
ED HENRY: While you’ve been here, the President has been here, there’s videotape from Jonathan Gruber, who was one of the architects when the law came out. Among the things he said was that the bill was originally written in a “very tortured way,” in his words, to kind of mislead people about the taxes in the law and other parts of the law. He went on to say, “A lack of transparency was a huge political advantage for the President…” in terms of selling it to the American people.
I thought it was just the opposite. Didn’t the President promise unprecedented transparency? Why would one of the architects of the law suggest that you were misleading people?
MR. EARNEST: Well, I’m not sure, frankly, Ed. The fact of the matter is the process associated with writing and passing and implementing the Affordable Care Act has been extraordinarily transparent. We all sat through many town hall meetings and discussions where this piece of legislation was vigorously debated by people on both sides. There was even a meeting that the President convened at Blair House with Republicans to discuss this policy proposal. It was, as you know, broadcast by C-SPAN.
There was a steadfast commitment by this administration to make sure that people had good insight into the benefits of the law. The fact is we spent a lot of time talking about one of those benefits. And that is the fact that individuals could receive tax credits from the federal government to make their health care costs more affordable. The fact is, I think it’s actually Republicans who haven’t been particularly transparent or even honest about the true impact of those.
That’s a breathtakingly dishonest statement, especially in light of John Fund’s article for the WSJ at the time:
For Their Next Trick . . .
By John Fund
Updated Dec. 23, 2009 12:48 p.m. ET
Look for House Speaker Nancy Pelosi and Senate Majority Leader Harry Reid to try to circumvent the traditional conference committee process by which the different versions of health care reform passed by each house will be reconciled. If so, it will be the latest example of violating principles of transparency and accountability in the single-minded pursuit of legislative victory.
When Harry Reid and Nancy Pelosi rewrote the ACA from what it looked like after multiple committee hearings, they did so exclusively in their offices and without a Republican in sight. If that’s Mr. Earnest’s definition of being “extraordinarily transparent”, then he needs a dictionary. Here’s the definition of transparent:
Capable of transmitting light so that objects or images can be seen as if there were no intervening material.
Here’s the definition of extraordinary:
Highly exceptional; remarkable.
One of the 2 chief architects said that a lack of transparency was essential to passing the bill. That directly and emphatically contradicts Josh Earnest’s statements that the process was remarkably visible for all to see. But that isn’t enough. Then there’s this doubling down:
I do think that the question that you raised is about the commitment to transparency that was embodied in the process of writing and passing the Affordable Care Act. And again, I think the President is proud of the transparent process that was undertaken to pass that bill into law.
The Obama administration hasn’t had a press secretary. They’ve had willing liars delivering the daily White House briefings. Words don’t mean things to Mr. Earnest. He knows key buzzwords and he knows he should repeat them as often as possible, especially when they aren’t true.
Throughout this campaign, Gov. Dayton hasn’t told Minnesotans the truth about MNsure. In his final debate with Jeff Johnson Friday night, Gov. Dayton insisted that MNsure was getting better all the time. Gov. Dayton said that despite this information:
Counties will have to start next month processing thousands of paper applications for health insurance for MNsure, the state’s online health exchange.
Local officials say the unexpected shift will result in a significant increase in workload for counties, which already are dealing with additional duties related to the Affordable Care Act. “We will have to gear up for it, there’s no doubt about that,” said Mary Jo Cobb, Sherburne County health and human services director.
Apparently, Democrats think spending $155,000,000 on a website that didn’t work last year and that isn’t working this year is proof that MNsure’s getting better all the time. People living in the real world, however, think that’s a gigantic waste of their hard-earned money.
Politicians, for the most part, don’t think about whether money spent improves people’s lives. Businessmen, on the other hand, are constantly monitoring whether the money they’ve spent is producing positive results because it’s either their money or their job depends on spending their investors’ money wisely.
The Twin Cities legislators that voted to create MNsure will likely win with 75% of the vote. For them, consequences don’t exist. As long as they do what the DFL machine tells them to do, they won’t have a thing to worry about.
This information is frightening:
Since the MNsure exchange launched a year ago, it’s been plagued with technical problems. That’s caused more people than expected to resort to submitting paper applications, said Janet Goligowski, gateway services director in Stearns County’s human services department.
“Presumably, the concept is that the online system will be so easy and so intuitive and user friendly that no one would really think to go to paper applications, which are very hefty and very long,” Goligowski said. However, since the exchange has been unable to process many applications promptly, “people just really naturally gravitated toward the paper applications,” she said.
That’s frightening. Apparently, the Dayton administration thought that the website would work beautifully so they didn’t need a tested manual system. The Dayton administration’s actions and assumptions wouldn’t be tolerated in the private sector. The thought of not being prepared for multiple eventualities is disgusting.
Why Gov. Dayton’s administration didn’t prepare for this is beyond incomprehensible. Apparently, Gov. Dayton thinks that his job is to sign bills. He hasn’t shown an interest in making sure the nuts and bolts operations are operating properly.
That’s why MNsure is an ongoing disaster. That’s why his administration is an ongoing disaster.