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Report: Obamacare Exchanges Fraud Costs Taxpayers Millions

It seems an incredible waste to put tens of millions, if not hundreds of millions, of taxpayer dollars at risk through fraud on federal exchanges.

Christopher Jacobs reports: What do Obamacare and Haley Joel Osment have in common? They both see dead people.

On Tuesday, the Government Accountability Office (GAO) released another report into eligibility verification checks on the federally run Obamacare insurance exchange used by more than three dozen states. As with prior studies, GAO concluded that regulators still need to improve integrity efforts to ensure the federal government spends taxpayer funds wisely.

[Read the full story here, at thefederalist.com]

Among the report’s most noteworthy conclusions: A total of 17,000 federally subsidized insurance policies studied during the 2015 plan year—the most recent for which GAO had complete data at the time of its investigation—began or continued after the applicant’s reported date of death. In 1,000 of those cases, coverage began after the applicant’s reported date of death. In a further 2,000, the application was submitted after the applicant’s reported date of death—in most cases because the exchange automatically re-enrolled applicants without checking to determine that they remained alive.

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GAO previously recommended that the federal exchange verify eligibility periodically, checking changes in circumstances that would affect the status of federal subsidies, such as death. However, to the best of auditors’ knowledge, the Centers for Medicare and Medicaid Services (CMS) has not implemented this recommendation, one of 18 relating to exchange integrity that remain open (i.e., not completed) from two prior GAO reports. Read the rest of this entry »

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Why Didn’t ObamaCare Make Us Healthier? 

Bernie Sanders inadvertently raises a critical question as Republicans pursue reform.

writes: Vermont Socialist Sen. Bernie Sanders deplored the actions of his former campaign volunteer James T. Hodgkinson, who was killed after opening fire on participants at a congressional baseball practice for Republicans on June 14. More recently, Mr. Sanders has been accusing his Republican colleagues of hatching a plan that will result in thousands of deaths.

The anti-Trump ”resistance,” still smarting from its recent loss in a Georgia House race, has apparently decided that it needs someone more radical than Rep. Nancy Pelosi (D., Calif.) to lead the opposition to GOP health care reforms. So the organization MoveOn.org has been staging a multi-state tour with Mr. Sanders as the headliner.

The basic Sanders argument, which he has been articulating in various fora in recent days, is that fewer people on government insurance plans will mean more people dying. It seems likely that any health reform plan that makes it to the President’s desk will no longer force people to buy ObamaCare plans, and will give states at least some flexibility in choosing not to provide insurance to people who aren’t sick, aren’t poor and don’t have children.

But will fewer people on government-mandated insurance plans automatically make them less healthy? Mr. Sanders appears to be convinced. He tweeted on Friday: “Let us be clear and this is not trying to be overly dramatic: Thousands of people will die if the Republican health care bill becomes law.” Asked to defend such remarks on NBC’s “Meet the Press” on Sunday, Mr. Sanders said:

I wish I didn’t have to say it. This is not me. This is study after study making this point. It is common sense. If you have cancer and your insurance is taken away from you, there is a likelihood you will die and certainly a likelihood that you will become much sicker than you are today. That’s the fact. Unpleasant, but it’s true.

Speaking of studies, all of America has been participating in an experiment since 2010 to see if a federal effort to extend government-mandated insurance coverage to millions more people can improve our lives. Read the rest of this entry »


Peggy Noonan: High Anxiety Over Health-Care Reform 

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People need simplicity and clarity. They deserve it. They’ll pay for it as best they can, a lot if they have to. But they need not to be jerked around anymore. And that is what Congress doesn’t know.

Peggy Noonan writes: What politicians, those hardy folk, don’t understand about health care is how anxious it makes their constituents. Not suspicious, not obstinate, but anxious. Because unlike such policy questions as tax reform, health care can be an immediate life-or-death issue for you. It has to do with whether, when, and where you can get the chemo if you’re sick, and how long they’ll let you stay in the hospital when you have nobody, or nobody reliable and nearby, to care for you. To make it worse, the issue is all hopelessly complicated and complex and pits you as an individual against huge institutions—the insurance company that doesn’t answer the phone, the hospital that says “I’m afraid that’s not covered”—and you have to make the right decisions.

It’s all on you.

Politicians don’t understand all this, in part because they and their families are well-covered on a government insurance policy, and they have staff to put in the claim and argue with the insurance company, which, when it’s a congressman calling, answers the phone in one quick hurry. They don’t know it’s not easy for everyone else. Or rather they know on some abstract level but forget in the day-to-day, as one does with abstractions.

But I want to speak of how it’s all on you: You don’t want to be seen—by others, by yourself—as someone who couldn’t make the right decisions for yourself and your family. “She didn’t know she needed Part B.” “She got the supplement that says she can’t be treated in Jersey.” You don’t want to be humiliated. “What a dope.” “What fatal lack of sophistication.”

“Seven years ago it’s Democrats: “Wow, we’re so supercompetent, we’ll make it better!” And suddenly you lose your doctor or your coverage, or your premiums spike, and it’s a mess. They can’t even make the website work. And you’re anxious, and you have to renavigate an entire opaque empire of rules and passive-aggressive clerks. It’s a shadow on your life.”

And then these jokers in Congress come along. Seven years ago it’s Democrats: “Wow, we’re so supercompetent, we’ll make it better!” And suddenly you lose your doctor or your coverage, or your premiums spike, and it’s a mess. They can’t even make the website work. And you’re anxious, and you have to renavigate an entire opaque empire of rules and passive-aggressive clerks. It’s a shadow on your life.

[Read the full story here, at WSJ]

And then it settles down, as things do after seven years. You hate the system, but it is what it is and you’re used to it. And now these new jokers come along and say, “We’ll make it nice, trust us!” And it’s all big and complicated—so complicated the president negotiating it appears to have no idea what he’s saying yes or no to. But the effects and implications of his decisions will all be left on you. And you watch from the corner of your eye as you pass the TV, and suddenly your blood pressure’s spiking again. For you it’s all more anxiety and dishevelment and confusion, but in a new package, this time delivered by Republicans.

When all you want is the card in the wallet so when you’re strapped to the gurney in the emergency room, they’ll see it and they’ll say the word you want to hear: “Covered.” Then you can happily pass out.

People need simplicity and clarity. They deserve it. They’ll pay for it as best they can, a lot if they have to. But they need not to be jerked around anymore.

And that is what Congress doesn’t know.

We go now to the failure of the ObamaCare repeal-and-replace bill.

Politically it’s all obvious. For the new administration it is a loss and a significant one. It has damaged the new president’s prestige. Every president until he fails has the aura of unused power. Boy, when I use it, you’re gonna see muscle. He used it. No muscle. Fatal? No. Damaging and diminishing? Yes. It is an embarrassment too for Speaker Paul Ryan. Together they could not get a win on the board after they threw everything they have into it. This does not speak well for everything they have. Read the rest of this entry »


Obama’s Parting Gift: Trillion-Dollar Deficits As Far As The Eye Can See

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Legacy:  Barack Obama came into the White House in 2009 promising a “new era of responsibility.” What he’s left President Trump is a government careening toward fiscal ruin.That’s what the latest report from the Congressional Budget Office shows.

The CBO report looks at what federal spending and revenues will look like over the next decade if the government is left on autopilot. The picture is grim.

(AP Photo/Craig Ruttle)

Deficits this year are expected to be $559 billion. By 2023, the government will once again be running trillion-dollar annual deficits that will quickly climb in the following years.

Left unchanged, the national debt will worsen by an additional $10 trillion in a decade, equaling almost 90% of the economy.

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And that’s despite the fact that, thanks to Obama’s multiple tax increases, revenues are on track to consume more than 18% of the nation’s economy, which is a full percentage point above the average since 1967.

Spending, however, is completely out of control. It’s set to climb from 20.5% of GDP next year to 23.4% by 2027. The post-1967 average was 20%.

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ObamaCare subsidies alone will, according to the CBO, climb 22% this year and 20% the next — thanks to the massive increase in premiums. This cost explosion is in addition to the vast increase in Medicaid spending ObamaCare already generated. And it’s all on top of fast-growing Social Security and Medicare, both of which are rapidly headed toward insolvency.

Perhaps the biggest driver of future deficits, however, is the incredibly sluggish economy the CBO expects current economic policies to produce. Read the rest of this entry »


Did Obamacare Really Insure 20 Million?

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Jared Hatch and Alyene Senger report: One of the most frequently heard claims from the Obama administration is that Obamacare is responsible for insuring 20 million adults who were previously uninsured. But Heritage Foundation research shows the administration’s figure is off by a few million.

The Department of Health and Human Services claims that 20 million people have gained health coverage since the enactment of Obamacare in 2010 through early 2016.

Of those people, 2.3 million are said to be young adults (ages 19 to 25) that gained coverage between 2010 and 2013 as a result of the Obamacare provision allowing them to stay on their parents’ plan until age 26.

The remaining 17.7 million people gained health insurance from Obamacare’s first open enrollment period between October 2013 and early 2016.

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However, it is important to note that the administration’s coverage estimates are based on survey data rather than calculating the actual change in coverage in different markets. Though surveys can provide useful information, they are not as precise as using enrollment data taken directly from insurance companies.

[Read the full story here, at dailydignal.com]

A recent analysis by The Heritage Foundation’s Edmund Haislmaier and Drew Gonshorowski uses the more accurate method, taking actual enrollment data from Medicaid and private insurance companies to assess the impact Obamacare has had on coverage. Read the rest of this entry »


The Great Recession Enabled ObamaCare. Now the Law’s Failure Makes Reform Possible

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The Four Legs of a New Health-Care System

James C. Carpetta and Scott Gottlieb write: Donald Trump announced this week that he had chosen Rep. Tom Price (R., Ga.), a leader in the efforts to replace ObamaCare, to be his secretary of Health and Human Services. This is a consequential choice. Mr. Trump’s election, and the political realignment it represents, offers a generational opportunity to pursue a new direction for American health care. Mr. Price will now be leading the charge.

The new system should be fully consumer driven, empowering individuals to be the surveyors and purchasers of their care. Past reforms in this direction became stilted and ultimately incomplete, but the current moment offers a chance to truly rebuild from the ground up. If Messrs. Trump and Price want to make the most of this short window, they should keep four central reforms in mind.

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1. Provide a path to catastrophic health insurance for all Americans. There’s ample evidence that enrollment in insurance doesn’t always lead to improvements in health—but access to health insurance is important nonetheless. A 2012 study from the National Bureau of Economic Research found higher insurance enrollment from reforms in Massachusetts led to better results in several measures of physical and mental health.

[Read the full text here, at WSJ]

Health insurance is also important for financial security. The ObamaCare replacement should make it possible for all people to get health insurance that provides coverage for basic prevention, like vaccines, and expensive medical care that exceeds, perhaps, $5,000 for individuals.

Those Americans who don’t get health insurance through employers, or Medicare and Medicaid, should be eligible for a refundable tax credit that can be used to enroll in a health-insurance plan. The credit would be set at a level comparable to the tax benefits available to individuals with employer-sponsored insurance plans. The subsidy would be enough to make a basic level of catastrophic coverage easily affordable for all Americans.

2. Accommodate people with pre-existing health conditions. The price of insurance naturally reflects added risk. That’s why beach houses cost more to insure than a typical suburban home. Yet there is a reasonable social consensus that people should not be penalized financially for health problems that are largely outside of their control.

So as long as someone remains insured, he should be allowed to move from employer coverage to the individual market without facing exclusions or higher premiums based on his health status. If someone chooses voluntarily not to get coverage, state regulation could allow for an assessment of the risk when the person returns to the market. Read the rest of this entry »


Why Government Doubles Down on Policy Mistakes

Lawmakers, press and the public need to understand the strength of this “doubling down” phenomenon of and guard against it when adopting policy positions.

In simplified form, the dynamic runs as follows:

1)  Government, in response to a perceived need, takes action to meet that need in a manner that distorts economic behavior and produces predictable adverse effects.

2)  The public consequently experiences problems and expresses concern.

3)  The problems themselves become justification for additional government actions that worsen the distortions and the resultant problems.

4)  As problems worsen, the public more urgently demands corrective actions.

5)  Steps #3 and #4 are repeated ad infinitum.

We have seen and continue to see this dynamic operate in many areas of economic policy. To cite but a few:

Worker Health Benefits

With the best of intentions the federal government has long exempted worker compensation in the form of health benefits from income taxation. Lawmakers aren’t scaling back the flawed policy that fuels these problems.There is wide consensus among economists that the results of this policy have been highly deleterious. As I have written previously, this tax exclusion “depresses wages, it drives up health spending, it’s regressive, and it makes it harder for people with enduring health conditions to change jobs or enter the individual insurance market.” Lawmakers have reacted not by scaling back the flawed policy that fuels these problems, but rather by trying to shield Americans from the resulting health care cost increases. This has been done through the enactment of additional health programs and policies that further distort health markets and which themselves drive personal and government health spending still higher.

Federal Health Programs

The federal government has enacted programs such as Medicare and Medicaid to protect vulnerable seniors and poor Americans from ruinous health care costs.
The positive benefits of these programs co-exist with well-documented adverse effects. For example, it is firmly established that creating these programs pushed up national health spending, driving health costs higher for Americans as a whole. Consumer displeasure over these health cost increases subsequently became a rationale for still more government health spending, rather than reducing government’s contribution to the problem. Examples of this doubling down include the health exchange subsidies established under the Affordable Care Act (ACA), as well as its further expansion of Medicaid. As the problem of high health care costs remains, proposals have proliferated to expand government’s role still further; for example, some have proposed making Medicare available to the entire US population. Though intended to provide relief, such legislation inevitably adds to national health spending growth. Read the rest of this entry »


THE PANTSUIT REPORT: Clinton Calls Skyrocketing ObamaCare Premiums ‘Glitches’

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[See the VIDEO here]

RADDATZ: What’s broken in Obamacare that needs to be fixed right now, and what would you do to fix it?

CLINTON: Well, I would certainly build on the successes of the Affordable Care Act and work to fix some of the glitches that you just referenced. Number one, we do have more people who have access to health care. We have ended the terrible situation that people with pre-existing conditions were faced with where they couldn’t find at any
1208_angry-doctor_400x400-300x300affordable price health care. Women are not charged more than men any longer for our health insurance. And we keep young people on our policies until they turn 26. Those are all really positive developments. But, out-of-pocket costs have gone up too much and prescription drug costs have gone through the roof. And so what I have proposed, number one, is a $5,000 tax credit to help people who have very large out-of-pocket costs be able to afford those. Number two, I want Medicare to be able to negotiate for lower drug prices just like they negotiate with other countries’ health systems. We end up paying the highest prices in the world. And I want us to be absolutely clear about making sure the insurance companies in the private employer policy arena as well as in the affordable care exchanges are properly regulated so that we are not being gamed. And I think that’s an important point to make because I’m going through and analyzing the points you were making, Martha. We don’t have enough competition and we don’t have enough oversight of what the insurance companies are charging everybody right now.PANTSUIT-REPORT

RADDATZ: But you did say those were glitches.

CLINTON: Yes.

RADDATZ: Just glitches?

CLINTON: — Well, they’re glitches because —

RADDATZ: –Twenty-seven percent in the last five years, deductibles up 67 percent?–

CLINTON: It is. Because part of this is the startup challenges that this system is facing. We have fought as Democrats for decades to get a health care plan. I know. I’ve got the scars to show from the effort back in the early ‘90s. We want to build on it and fix it. And I’m confident we can do that. And it will have effects in the private market. And one of the reasons in some states why the percentage cost has gone up so much is because governors there would not extend Medicaid. And so people are still going to get health care, thankfully, in emergency rooms, in hospitals. Those costs are then added to the overall cost, which does increase the insurance premiums.

(read more)

Source: National Review Online

 


ObamaCare’s death Spiral, Stage One: Denial 

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Enrollment is falling short. The Obama administration projects that it will have roughly 10 million people on the state and federal exchanges by the end of next year, a staggering climb-down from prior expectations.

lowryRich Lowry writes: For the press, the debate over ObamaCare is over. There may be a few proverbial Japanese soldiers wandering on isolated islands yammering on about the failure of ObamaCare, but word will eventually filter down to them, too. This assumption is so deeply embedded that it is impervious to new evidence that ObamaCare is an unwieldy contraption that is sputtering badly.

“ObamaCare is a monopoly. It gives money to people to buy its product and through the individual mandate punishes those who don’t. And yet it’s still having trouble making the sale.”

Yes, ObamaCare has covered more people and has especially benefited those with pre-existing conditions (to be credible, Republican replacement plans have to do these things, as well), but the program is so poorly designed that, surely, even a new Democratic president will want to revisit it to try to make it more workable.

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“Premiums are rising. Not everywhere, but steeply in some states. Indiana is down 12 percent, but Minnesota is up 50 percent.”

Enrollment is falling short. The Obama administration projects that it will have roughly 10 million people on the state and federal exchanges by the end of next year, a staggering climb-down from prior expectations. The Congressional Budget Office had predicted that there would be roughly 20 million enrollees.

[Also see – Giving Voters Exactly What They Deserve: Health Insurance Premium to Spike Again]

[More – Broke U.S. Government Needs Millions of New Obamacare Enrollees to Prevent Program Collapse]

If the administration is to be believed, enrollment will only increase about another million next year from its current 9 million and only sign up about a quarter of the eligible uninsured.

[Read the full story here, at the New York Post]

Premiums are rising. Not everywhere, but steeply in some states. Indiana is down 12 percent, but Minnesota is up 50 percent. Health care expert Robert Laszewski points out that it’s the insurers with the highest enrollment and therefore the best information about actual enrollees that have tended to request the biggest increases — a sign that they don’t like what they’re seeing in their data. Read the rest of this entry »


Richard A. Epstein: Is Obamacare Sustainable? 

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The marketplace’s uncertain response to the ACA suggests the program could unravel.

Richard A. Epstein It has been over five years since the Patient Protection and Affordable Care Act (ACA) was passed into law on March 23, 2010. Today, the major legal challenges are over. In 2012, the Supreme Court sustained the power of Congress to enact the law in NFIB v. Sebelius. Three years later, it held that the ACA allowed for the payment of subsidies for all applicants who enrolled through either the state or federal exchanges. Chief Justice Roberts wrote both decisions. They will not be overturned.

” The issue here is simple enough. Can the plan, which has weathered the legal challenges, survive in today’s highly dynamic economic market? The prospects are uncertain to say the least. Some clear signposts indicate the answer is no.”

But if the legal battle over Obamacare is over, the economic battle over Obamacare has just begun. The issue here is simple enough. Can the plan, which has weathered the legal challenges, survive in today’s highly dynamic economic market? The prospects are uncertain to say the least. Some clear signposts indicate the answer is no. The ACA cannot succeed simply by securing first-time enrollments in its exchanges. Insurance policies are subject to annual renewals. The first year of operations will give information about how the second year will go.

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“Market rate insurance will always contain differentials that reflect these risk differences.  Liberals may decry the supposed inequity, but in so doing they overlook the decisive advantage of market rate plans.  They are stable in ways that Obamacare is not, because customers will not leave plans from which they derive a net benefit unless they can get a better alternative.”

On the insurer side, it has proved unclear whether the premiums collected have been sufficient to cover the incurred losses. No one yet knows how the various new types of coverage required by the ACA will be priced going forward.  For plans now running a deficit, belts have to be tightened.

On the insured’s side, a year’s experience could lead many customers to think that they pay too much for benefits they would rather not have. The point is especially true of people who are both healthy and young, from whom Obamacare exacts a heavy cross-subsidy that they won’t pay year after year. Market rate insurance will always contain differentials that reflect these risk differences.  Liberals may decry the supposed inequity, but in so doing they overlook the decisive advantage of market rate plans.  They are stable in ways that Obamacare is not, because customers will not leave plans from which they derive a net benefit unless they can get a better alternative.

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 “The government takes it as an article of faith that private plans are inefficient. But that unfortunate mindset leads to additional government oversight. The upshot is reduced business flexibility coupled with an additional layer of administrative costs.”

These forces are now exerting tectonic pressures in many, but not all states.  Across the country, many insurance companies are increasing their rates between 25 and 35 percent as they adjust to the “shock waves set off by the Affordable Care Act” in the marketplace. But the full story is necessarily far more complicated because a lot more goes into providing an insurance policy than setting the annual premium. Equally critical are the rules on coverage, how high the deductibles and copays are, where the plan facilities are located, and what the options are in the choice of physicians. And, of course, there is the tantalizing question of whether the current round of increases are one-shot adjustments, or whether they represent the onset of a consistent trend that will replicate itself in future years?

Without detailed information, it is not possible to access the peculiarities of the individual plans. But it is possible to predict that the slow death of Obamacare has become more likely. Most obviously, any premium increases within the exchanges can lead potential and current enrollees to direct their healthcare dollars elsewhere, perhaps by doing without any insurance at obamacare-horror-approvedall or by signing up for Medicaid. Ironically, it will be hard to win these defectors back with advertisement or improvements in plan coverage, because these options are tightly constrained by Obamacare, which by design limits competition only to the choice of various care levels. Ordinary markets allow for innovation on all dimensions of service, and thus have a resilience that is all too lacking in Obamacare.

Here are some instructive results. As of early June, some 1.5 million people dropped out of the exchanges by failing to pay premiums, reducing the number covered from a February 2014 high of 11.7 million enrollees to 10.2 million four months later. That figure was still a substantial increase over the 6.3 million people insured at the end of 2014. But in the next three months, the downward trend continued so that by September 2015, the number of enrollees tumbled to 9.9 million, which was still above the administration’s goal of having 9 million on the rolls by the end of this year. But the current negative trend line is all the more striking given that some 8.3 million subscribers receive a subsidy of about $270 per month, which works out to a program wide subsidy of about $224 billion per year.

At this point, most of the gain in coverage, about 71 percent of the total, has come through the expansion of Medicaid, which in general offers inferior care to that provided by private insurance carriers. The decline in enrollees on the exchanges represents a displacement of ordinary people from insurance plans that they chose for those which come with a government stamp of approval. Read the rest of this entry »


Concealed Carry Permit Holder Shoots Armed Robbers After Being Mugged

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DETROIT – Another robbery victim fights back after he’s targeted at a Detroit bus stop. The 23-year-old had officially become a Concealed Pistol License holder a couple of weeks ago and after what happened Sunday night – it was just in time.

Tremain, who doesn’t want to be identified because his family fears retaliation, says his brother had just finished work and was waiting for the bus at Schaefer and West Outer Drive on the west side when three teens confronted him.

One pulled out a gun and demanded his money.

“They threatened him and told him if he moved they were going to blow him which is a term for I’m going to kill or shoot you if you move,” Tremaine said. “And that’s what ended up happening.”

One of the suspects reached into the victim’s pocket and  stole $220. The trio became excited about the money they just nabbed and became distracted – at that moment the CPL holder pulled out his gun and fired.

He hit the16-year-old in the chest and the 17-year-old in the leg. The 19-year-old took off running. Read the rest of this entry »


Celebrating 50 Years of Medicaid & Medicare

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 writes: This week marks the fiftieth anniversary of Medicare and Medicaid, the healthcare entitlement programs that together cover 125 million Americans and last year cost nearly a trillion dollars.

When these programs were created back in 1965, no one ever thought they would get this big or cost this much. Congressional budgeters at the time thought Medicare, the healthcare program for the elderly, would cost about $12 billion by 1990. The actual cost that year was $90 billion.

We should have seen it coming. After all, it didn’t take decades for actual Medicare and Medicaid costs to overrun projections. That pretty much happened right away. In 1965, the House Ways and Means Committee estimated that Medicaid, the jointly funded federal-state program originally meant to cover the poor, would cost $238 million in its first year. It actually cost more than $1 billion. By 1971, Medicaid spending had reached about $6.5 billion, blowing away all previous estimates….(read more)

TheFederalist.com


Scalia: ‘Words No Longer Have Meaning if an Exchange That is Not Established by a State is ‘Established by the State’

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Did the chief justice mean what he said? 

James Taranto writes: “It is not our job to protect the people from the consequences of their political choices,” Chief Justice John Roberts observed three years ago in National Federation of Independent Business v. Sebelius, the case that is usually described—with a good deal of imprecision—as having “upheld” ObamaCare.

Did the chief justice mean what he said? Today the court delivered another ObamaCare ruling, this time entirely in the administration’s favor and by a vote of 6-3. Unlike in NFIB, the majority in King v. Burwell spoke with a single voice, Roberts’s. So did the dissenters, that of Justice Antonin Scalia.

As Scalia sums it up: “The Court holds that when the Patient Protection and Affordable Care Act says ‘Exchange established by the State’ it means ‘Exchange established by the State or the Federal Government.’ That is of course quite absurd.” The practical consequence is that despite the limiting language, tax subsidies will continue to flow to people who buy medical-insurance policies in the majority of states, which have not established exchanges.

ALERT-GOP

BONUS: GOP Already Fundraising on SCOTUS Defeat

The justices went further in the administration’s favor than the Fourth U.S. Circuit Court of Appeals, whose judgment they upheld. As Roberts explains (citations omitted here and in subsequent quotes): “The Fourth Circuit viewed the Act as ‘ambiguous and subject to at least two different interpretations.’ The [circuit] court therefore deferred to the IRS’s interpretation”—a doctrine known as Chevron deference.

[Read the full text here, at WSJ]

In a similar case called Halbig v. Burwell, the U.S. Circuit Court of Appeals for the District of Columbia had ruled that the statute was not ambiguous—that the provision limiting subsidies to policies purchased through “an Exchange established by the State” did in fact limit subsidies to policies purchased through “an Exchange established by the State.” As Scalia observes:

You would think the answer would be obvious—so obvious there would hardly be a need for the Supreme Court to hear a case about it. . . . Words no longer have meaning if an Exchange that is not established by a State is “established by the State.” Read the rest of this entry »


‘Home Confinement’? Houston Couple Sentenced For $9M Health Care Scam

Just-cut stacks of $100 bills make their way down the production line at the Bureau of Engraving and Printing's Western Currency Facility in Fort Worth, Texas, on Tuesday, Sept. 24, 2013. (AP Photo/LM Otero)

HOUSTON (AP) — A Houston businessman has been sentenced to five years in prison and his nurse wife faces home confinement in a $9 million health care billing scam.

William Owuama was sentenced Monday. The 56-year-old owner of Wilmar Healthcare Systems in February pleaded guilty to conspiracy to commit health care fraud and violation of kickback laws.

His 47-year-old wife, Marla Owuama, received a year of home confinement probation. She pleaded guilty to misprision of a felony for helping conceal the scheme…(read more)

CBS Houston


Giving Voters Exactly What They Deserve: Health Insurance Premium to Spike Again

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Stephen Dinan reports: Obamacare exchange customers could see a significant spike in their premiums over the next few years as insurers face pressures from both the government and the marketplace, the Congressional Budget Office said Monday in a new analysis finding Obamacare is both cheaper and less comprehensive than predicted.

Kevin Lamarque/Reuters

The CBO said the exchanges and other new medical coverage under the Affordable Care Act will cost the government slightly more than half a trillion dollars over the next five years…(read more)

Washington Times


John Davidson: King v. Burwell Reveals The Threat Of The Administrative State

(Photo: Karen Bleier, AFP Getty Images)

What happens to the subsidies should not be the court’s concern. The only question that matters in King is whether the administration used the IRS to rewrite a law Congress passed

John Davidson writes: The U.S. Supreme Court will hear oral arguments today in what is probably one of the most straightforward questions of statutory interpretation ever to come before the court.

“Over and over, the law says premium subsidies are only to be disbursed ‘through an Exchange established by the State.’ It says this nine times.”

At the heart of King v. Burwell is whether the text of the Affordable Care Act (ACA) means what it says. Specifically, the case hinges on what the word “state” means. Does it mean one of the fifty states, or does it mean the states and the federal government?

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At issue are the tax credits (subsidies) the law doles out to help Americans pay for health insurance premiums sold through the exchanges. Over and over, the law says premium subsidies are only to be disbursed “through an Exchange established by the State.” It says this nine times.

“Their assumption was that states would set up the exchanges and federal subsidies would flow through them, as described in the law. When 37 states opted instead to let the federal government set up exchanges, it exposed the weakness of the law’s reliance on cooperative federalism.”

If Obamacare is to be faithfully executed, say the challengers in King, then federal subsidies for health insurance are not allowed in the 37 states that failed or refused to set up a state-based exchange and obamacare-design-250instead have federal “default” exchanges. Two different sections of the law authorize exchanges and distinguish in statute between an exchange a state has established (section 1311) and an exchange the Secretary of Health and Human Services has established in states that fail to create one (1321). Subsidies are available only to those who purchase coverage on a state-based—section 1311—exchange.

Cooperative Versus Competitive Federalism

Suffice to say that Obamacare’s exchanges are built on the idea of cooperative federalism: the federal government, unable to simply commandeer state agencies, invites states to implement federal policies in return for federal funding or favorable regulatory treatment.

States carry out a great many federal policies and programs using cooperative federalism, like Medicaid, Common Core, and a host of environmental regulations.

“It comes down to a question about the rule of law and whether, in an advanced administrative state, laws can have a fixed meaning.”

States carry out a great many federal policies and programs using this scheme, like Medicaid, Common Core, and a host of environmental regulations. Because Obamacare meddles so much with health insurance markets, which states traditionally regulated, it relies on the practice of cooperative federalism to an astonishing degree. Congress had hoped to induce states to cooperate by making subsidies contingent on states setting up their own exchanges—a policy proposition that, like Medicaid expansion, could bring millions or even billions of federal dollars into a state. At least, that’s what the Kingchallengers contend.

obamacare-hindenburg

That’s where Obamacare’s legislative history comes into play. When Senate Democrats passed the ACA in December 2010, they hadn’t a vote to spare. When Republican Scott Brown won a special election the very next month to fill the seat vacated by Sen. Edward Kennedy’s death, Senate Republicans gained enough votes to filibuster a conference report on the House and Senate bills. Congressional Democrats therefore had to resort to the budget reconciliation process to pass the final version of the law: they opted for an imperfect bill, one that didn’t go as far as many Democrats had originally wanted, instead of no bill at all.

Read the rest of this entry »


Federal Programs: Too Big Not To Fail?

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Reason via Twitter

 

 


David Harsanyi: No, The GOP Doesn’t Have To Replace Obamacare. Just Get Rid Of It

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Republicans have every incentive to come up with an appealing menu of health care policy alternatives to sell voters. But the notion that they need to assemble these ideas into a single obamacare-design-250Washington-centric reform plan that can be plugged into the void left by Obamacare’s demise is a puzzling one.

“They don’t need a breakthrough. The fact is, Republicans have offered a number of plans with varying levels of free-market reforms, but Americans aren’t in the mood for another wide-ranging effort from Washington.”

According to Mike Allen, in the new insider account of ObamaCare, America’s Bitter Pill: Money, Politics, Backroom Deals, and the Fight to Fix Our Broken Healthcare System, Steve Brill writes: “Nearly five years later, President Obama would tell me … ‘In hindsight, … there should have been one central person in charge, a CEO of the Marketplace.’”

“The president’s comment reflects his inability to grasp what a marketplace actually is, but it’s also a reminder that one of the most distasteful aspects of ACA is its centralized structure—which, for most liberals, was the point of the project.”

What does a contrived “marketplace” built on cronyism, coercion, and rent seeking, paid for by tax subsidies and governed by a regulatory structure that makes any genuine competitive pricing impossible need to be successful? More top-down bureaucratic management, of course.

torture-obamacare-popularity-contest

The president’s comment reflects his inability to grasp what a marketplace actually is, but it’s also a reminder that one of the most distasteful aspects of ACA is its centralized structure—which, for most liberals, was the point of the project. Even voters who aren’t directly hurt by ObamaCare tend to dislike the idea of DC dictating what their coverage looks like. For many voters, ObamaCare represents every problem with health care in the United States. Gallup’s recent polling found that Americans now say that the “biggest problem” in America is “the government.” And they’re talking about federal government. Read the rest of this entry »


Scott Gottlieb: ObamaCare’s Threat to Private Practice

WSJ-Ocare-reform

A true legislative alternative to ObamaCare would support physician ownership of independent medical practices, and preserve local competition between doctors and choice for patients.

Scott Gottlieb writes: Here’s a dirty little secret about recent attempts to fix ObamaCare. The “reforms,” approved by Senate and House leaders this summer and set to advance in the next Congress, adopt many of the Medicare payment reforms already in the Affordable Care Act. Both favor the consolidation of previously independent doctors into salaried roles inside larger institutions, usually tied to a central hospital, in effect ending independent medical practices.

“ObamaCare has accelerated many of the detrimental trends doctors see in their profession, and introduced new ones.”

Republicans must embrace a different vision to this forced reorganization of how medicine is practiced in America if they want to offer an alternative to ObamaCare. The law’s defenders view this consolidation as a necessary step to enable payment provisions that shift the financial risk of delivering medical care onto providers and away from government programs like Medicare. The law’s architects believe that doctors, to better bear financial risk, need to be part of larger, and presumably better-capitalized institutions. Indeed, the law has already gone a long way in achieving that outcome.

“Reformers in Washington need to do a better job of explaining how market-based alternatives to ObamaCare are a better outcome for the structure and delivery of health care. And how they intend to preserve the entrepreneurship, autonomy and physician ownership that have long been the hallmark of American medicine.”

A recent Physicians Foundation survey of some 20,000 U.S. doctors found that 35% described themselves as independent, down from 49% in 2012 and 62% in 2008. Once independent doctors become the exception rather than the rule, the continued advance of the ObamaCare agenda will become virtually unstoppable. Read the rest of this entry »


Transparency: Three Lies About Obamacare Jonathan Gruber Accidentally Revealed

Gruberology

1. The Individual Mandate ‘Is Absolutely Not a Tax Increase’

2. Congress Meant for Subsidies to Flow Through State-based and Federal Exchanges

3. Obamacare Will Make Health Insurance More Affordable

read it here…

The Federalist


Reality Check: MORE Patients Flocking to Emergency Rooms Under Obamacare, Not Less

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Norton Hospital emergency room technician Christy Coviello adjusts an ice pack on Richard Roberts. Roberts received health care coverage via Coventry Care a few months ago. (Photo: Alton Strupp/The Courier-Journal)

It wasn’t supposed to work this way (actually, yes it was — Ed.) but since the Affordable Care Act took effect in January, Norton Hospital has seen its packed emergency room become even more crowded, with about 100 more patients a month.

“It’s a perfect storm here. We’ve given people an ATM card in a town with no ATMs.”

— Dr. Ryan Stanton of Lexington

That 12 percent spike in the number of patients — many of whom aren’t actually facing true emergencies — is spurring the hospital to convert a waiting room into more exam rooms.

By the numbers

12% – The per-month increase in ER visits at Norton Hospital since the ACA went into effect

9% – The increase of Ky. Medicaid patients seen in ERs in March, compared with last March

3,790 – The number of doctors needed in Ky. to meet pre-ACA demand, as of last year

284 – The projected number of new primary-care doctors needed in Ky. by 2017

Sources: Norton Hospital, Kentucky Cabinet for Health and Family Services, Deloitte Consulting

“We’re seeing patients who probably should be seen at our (immediate-care centers),” said Lewis Perkins, the hospital’s vice president of patient care and chief nursing officer. “And we’re seeing this across the system.”

That’s just the opposite of what many people expected under Obamacare, particularly because one of the goals of health reform was to reduce pressure on emergency rooms by expanding Medicaid and giving poor people better access to primary care. Read the rest of this entry »


Daniel F. Craviotto: A Doctor’s Declaration of Independence

It’s time to defy health-care mandates issued by bureaucrats not in the healing profession.

daniel-f-craviotto-jr-md-pro-phDaniel F. Craviotto Jr. writes: In my 23 years as a practicing physician, I’ve learned that the only thing that matters is the doctor-patient relationship. How we interact and treat our patientsis the practice of medicine. I acknowledge that there is a problem with the rising cost of health care, but there is also a problem when the individual physician in the trenches does not have a voice in the debate and is being told what to do and how to do it.

As a group, the nearly 880,000 licensed physicians in the U.S. are, for the most part, well-intentioned. We strive to do our best even while we sometimes contend with unrealistic expectations. The demands are great, and many of our families pay a huge price for our not being around. We do the things we do because it is right and our patients expect us to.

So when do we say damn the mandates and requirements from bureaucrats who are not in the healing profession? When do we stand up and say we are not going to take it any more?

The Centers for Medicare and Medicaid Services dictates that we must use an electronic health record (EHR) or be penalized with lower reimbursements in the future. There are “meaningful use” criteria whereby the Centers for Medicare and Medicaid Services tells us as physicians what we need to include in the electronic health record or we will not be subsidized the cost of converting to the electronic system and we will be penalized by lower reimbursements. Across the country, doctors waste precious time filling in unnecessary electronic-record fields just to satisfy a regulatory measure. I personally spend two hours a day dictating and documenting electronic health records just so I can be paid and not face a government audit. Is that the best use of time for a highly trained surgical specialist? Read the rest of this entry »


The Obamacare Lock-Out Effect

How the president’s health reform will harm the working poor

0000072500001497298482For City Journal,Joel Zinbberg writes:  The nonpartisan Congressional Budget Office (CBO) recently projected that the Affordable Care Act (ACA)—better known as Obamacare—will lead Americans to reduce the hours they work by 2 percent. This will reduce the overall labor supply by the equivalent of 2.5 million full-time workers over the next decade. The decrease in labor supply will occur because the ACA mandates that everyone buy health insurance and provides large subsidies to low-income individuals and families to buy insurance on the new exchanges. As CBO director Douglas Elmendorf recently testified, “By providing heavily subsidized health insurance to people with very low income, and then withdrawing those subsidies as income rises, the act creates a disincentive for lockoutpeople to work.” Thanks to this implicit tax on extra work, spending a few more hours on the job will, at the margins, result in minimal or even negative income for those qualifying for the ACA’s subsidies. The CBO reports that some will choose to work fewer hours in order to qualify for a subsidy. Others will choose not to work at all.

Normally, when the well-respected CBO finds that a law will significantly decrease the labor supply and harm economic growth, it becomes a great embarrassment to the law’s authors. But the White House insists that critics have misconstrued the CBO report. It’s not a bad thing if people work less, they say. On the contrary, the law will give workers the flexibility to leave jobs that they’re currently “locked” into because of their health-insurance benefits. According to Jason Furman, Chairman of the Council of Economic Advisors, the law will alleviate such “job lock,” giving workers the freedom to work less, enjoy more family time, or start a new business.

Read the rest of this entry »


The Hammer: Health-Care Myths We Live By

TheHammerCharles Krauthammer  writes:  Swedish researchers report that antioxidants make cancers worse in mice. It’s already known that the antioxidant beta-carotene exacerbates lung cancers in humans. Not exactly what you’d expect given the extravagant — and incessant — claims you hear made about the miraculous effects of antioxidants.

John Shinkle/POLITICO

John Shinkle/POLITICO

In fact, they are either useless or harmful, conclude the editors of the prestigious Annals of Internal Medicine: “Beta-carotene, vitamin E and possibly high doses of vitamin A supplements are harmful.” Moreover, “other antioxidants, folic acid and B vitamins, and multivitamin and mineral supplements are ineffective for preventing mortality or morbidity due to major chronic diseases.” So useless are the supplements, write the editors, that we should stop wasting time even studying them: “Further large prevention trials are no longer justified.”

[Charles’ bestselling book: Things That Matter: Three Decades of Passions, Pastimes and Politics at Amazon]

Such revisionism is a constant in medicine. When I was a child, tonsillectomieswere routine. We now know that, except for certain indications, this is grossly unnecessary surgery. Not quite as harmful as that once-venerable staple, bloodletting (which probably killed George Washington), but equally mindless. Read the rest of this entry »


Progressivism Kills

detroit-kills

Detroit is not healthy for children and other living things

Kevin D. Williamson writes:  There are many horrific stories to be told about the implosion of Detroit, once the nation’s most prosperous city, today its poorest. There is the story of its corrupt public institutions, its feckless leaders, its poisonous racial politics, its practically nonexistent economy, the riots that have led to its thrice being occupied by federal troops. The most horrific story may be that of the death of its children.

“Detroit represents nothing less than progressivism in its final stage of decadence”

Detroit has the highest child-mortality rate of any American city, exceeding that of many parts of what we used to call the Third World. The rate of death before the age of 18 in Detroit is nearly three times New York City’s, and it’s infant-mortality rate exceeds that of Botswana. The main cause of premature death among the children of Detroit is premature birth — the second is murder. While the city’s murder rate among adults is nothing to be proud of, more horrifying is the fact that between 30 and 40 children are murdered in Detroit in a typical year. Some of those children are nine-month-olds killed by rifle fire in their beds; some are budding criminals in their late teens — and each of those situations offers its own unique horrors.

Read the rest of this entry »


As Rich And Poor Take Their Slices, Who Will Stand Up For The Middle Class?

Hanson_VictorDavis_BIg.jpg.cmsVictor Davis Hanson writes:  On almost every left-right issue that divides Democrats and Republicans — as well as Republicans themselves — there is a neglected populist constituency.

The result is that populist politics are largely caricatured as Tea Party extremism — and a voice for the middle class is largely absent.

The problem with ObamaCare is that its well-connected and influential supporters — pet businesses, unions and congressional insiders — have already won exemption from it.

The rich will always have their concierge doctors and Cadillac health plans. The poor can usually find low-cost care through Medicaid, federal clinics and emergency rooms.

In contrast, those who have lost their preferred individual plans, or will pay higher premiums and deductibles, are largely members of the self-employed middle class. They are too poor to have their own exclusive health care coverage but too wealthy for most government subsidies. So far, ObamaCare is falling hardest on the middle class.

Consider the trillion-dollar student loan mess. Millions of young people do not qualify for grants predicated on either income levels, ancestry or both. Nor are their parents wealthy enough to pay their tuition or room-and-board costs. The result is that the middle class — parents and students alike — has accrued a staggering level of student loan debt.

Read the rest of this entry »


As Predicted, ObamaCare Plunges Into ‘Utter Chaos’

Cato senior fellow Jagadeesh Gokhale predicts ObamaCare’s rollout will cause “utter chaos” at a Kansas Policy Institute forum in February 2013. Photo credit: Kansas Policy Institute.

Cato senior fellow Jagadeesh Gokhale predicts ObamaCare’s rollout will cause “utter chaos” at a Kansas Policy Institute forum in February 2013. Photo credit: Kansas Policy Institute.

Michael F. Cannon writes:

 “HHS maintains they’ll have these [Exchanges] up and running by October 2013. I don’t know anyone who is confident about that and I’m ready to predict that they will not.” — Michael F. Cannon, December 2012

“In my opinion, what’s going to happen is utter chaos.”Cato Institute senior fellow Jagadeesh Gokhale, February 2013

“With no clarity as to when people should sign up and who they should pay and when, it’s a virtual certainty that many consumers will find themselves uncovered for a period of time through no fault of their own.” — Senator Orrin Hatch (R-UT), December 2013

My December 2012 prediction that ObamaCare’s health insurance “exchanges” would not be ready on time proved true by July 2013, when President Obama unilaterally delayed the law’s employer mandate for a year. It proved painfully, obviously true when the Exchanges crashed upon takeoff on October 1, just as ObamaCare was throwing millions out of their current health plans.

My colleague Jagadeesh Gokhale‘s February 2013 prediction of “utter chaos” (audio here, at 48: 25) arguably proved true in October, and is now evident in President Obama’s decision to exempt from the individual mandate those millions whose plans Obama himself cancelled.

This categorical exemption is a bigger deal than it seems. With it, President Obama has admitted ObamaCare will strip many people of their health insurance and leave them with gaps in coverage, or no affordable coverage options at all. It is an implicit admission that ObamaCare has created economic peril for millions of Americans and political peril for Democrats.

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[VIDEO] Krauthammer: Just wait, Insurance Companies Ruined By ObamaCare Will Need A Bailout Next Year

Syndicated columnist Charles Krauthammer made a dire prediction. Appearing on Fox News Sunday, Krauthammer said that all the exemptions the President has given to ObamaCare will ruin insurance companies thereby necessitating the White House to ask for a huge government bailout of these companies next year that Republicans in Congress should prevent.

But it seems far likelier that the overwhelming majority of ObamaCare enrollees are for Medicaid. The early numbers show upwards of 80 percent of applicants are qualifying for such assistance. As a result, the burden will initially be on the federal government, but will be transferred to the states with the passage of time.

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Reality Check: Five Things the Media Aren’t Reporting About Today’s ObamaCare Numbers

UPINoBamaCareJohn Nolte writes:  Only our media would report as “progress” the fact that thus far ObamaCare has resulted in only 364,000 sign-ups after cancelling 5.2 million policies. The White House and some in media are also incorrectly using the word “enrollee.” You have to pay for your first premium in order to  enroll, and according to some insurers, payment rates languish in the 5-15% arena.

Using words like “progress,” “soars,”  and “enrollee,” the White  House and media are spreading so much disinformation, it is hard to know where to begin.

Here are five things the media aren’t telling you about today’s ObamaCare numbers

1. ObamaCare Is at Less Than 30% of Its Stated Goal:

Let’s start with the number of enrollees the White House predicted they have by now: 1.2 million. Even using the Administration’s juiced number of 364,000 enrollees, that is only 30% of a goal that was low-balled to begin with.

The real enrollee number is is probably half that (see #4).

2. ObamaCare Has Likely Increased the Number of Uninsured:

ObamaCare has resulted in 5.2 million Americans having their insurance policies cancelled. While some of those ObamaCare victims likely re-enrolled directly with their insurance company, who knows how many were forced into the exchanges. It is therefore a safe guess that as of right now ObamaCare has resulted in a net increase in the number of uninsured in America (even if you include the 800,000 new Medicaid enrollees).

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Tuesday News Dump

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Ben K – Ace of Spades HQ


Thursday News Dump

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via Ace of Spades HQ

 


Why We Have Federal Deficits

6a00d8341c3e3953ef0167661243ea970b-320wiCharles Blahous writes: Today the Mercatus Center is releasing a study I completed earlier this year that comprehensively analyzes the policy decisions underlying federal deficits.  Too often partisan advocates focus on a limited time period to purposely throw blame on a targeted political figure.  Instead I dissected the entire budget, identifying deficit-driving policies regardless of when they were enacted.  The study was a mammoth undertaking; it required the digestion of practically every Congressional Budget Office (CBO) and Office of Management and Budget (OMB) budget report published over the past forty years.

The striking finding is that more than three-quarters of our long-term fiscal problem derives from a set of policy decisions made over a period of just seven years, 1965 to 1972.  1965 saw the establishment of Medicare and Medicaid, advocated for and signed by President Lyndon B. Johnson.  Both of these programs were later expanded in 1972 during the Nixon administration, as was Social Security.  Nothing done by any recent President or Congress carries long-term fiscal consequences as daunting as those arising from these 1965-72 decisions. Read the rest of this entry »


Obamacare Proves the Virtues of Federalism

"We told you so"

“We told you so”

 writes:  No issue in recent years has polarized Americans as much as Obamacare. It produced a party-line vote in Congress, a near-fatal court battle, a revolt by states that refused to run exchanges or expand Medicaid, dozens of House votes to repeal it and, now, a bungled launch that could be its undoing. It’s a barroom brawl that never ends.

Barack Obama’s health care plan hit nerves that are still radiating pain among many people. But being a federal program, it couldn’t accommodate the many Americans who want a different approach. It’s a zero-sum game. One side has to win, and the other has to lose. Read the rest of this entry »


Gut Check: Greg Answers Questions While Drinking Lots of Wine

Hell comes in small steps. And before you know it you're there.

“Hell comes in small steps. And before you know it you’re there.”

Breitbart NewsWhat do conservatives have to do to resonate with young people?

GG: They have to explain, succinctly, why their stuff works. And you have to do it with humor, minus jargon, minus anger. Freedom is fun. It’s not shrill.

Read the rest of this entry »


What’s Next For Health Care Policy?

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Ben Domenech writes:  Over the past few days we’ve seen an ever-increasing number of voices on the Left, most of whom laughed at the prospects of Obamacare as a train wreck a few months ago, gradually opening up about their concerns on the future of the law.  They aren’t saying it’s going to fail now, mind you – but they are gaming out a future where things just don’t work out as they had intended, where the combination of implementation failures and unfixable policy come together to make a real mess of things. It raises the possibility of the post-Obamacare era, with policy writers on the left finally recognizing that there will be another round of health care reform in the near future.

What might post-Obamacare health care policy look like?

Read the rest of this entry »


‘Death Spiral’ Preview

Twitter / NorahODonnell: .@janCBS: @CBSNews 


System Failure

The president can blame software developers and vendors all he likes, but this is his mess, and if he can’t clean it up — and he can’t — then it is up to Congress to do it for him.

Failure to execute: the president can blame software developers and vendors all he likes, but this is his mess, and if he can’t clean it up — and he can’t — then it is up to Congress to do it for him. 

Now, more than ever, repeal, not replace

The rolling fiasco that is the launch of the health-insurance “exchanges” — the government-run online marketplaces at the heart of the Affordable Care Act — is something the Obama administration is attempting to explain away as a “glitch,” but it now threatens to throw an entire AutoZone worth of wrenches into the Rube Goldberg machine that is Obamacare. Health and Human Services managers close to the project privately say that hitting early enrollment goals will be all but impossible. The White House has called the situation “unacceptable” (yet it isaccepted); insurance companies attempting to use the system are in a state of panic; only a handful of states have their own working exchanges; and the federal exchange is snarled up in Washington’s usual managerial incompetence. Nobody knows how long it will take to fix the problems, or whether they even can be fixed. The president has said that there is “no excuse” for this mess, but there is no one taking responsibility either, nor any credible timetable for getting it sorted out. Read the rest of this entry »


It’s Official: Obamacare is Coughing Up Blood

Ten Things to Expect from Obamacare

Obama's Promise Fulfilled: A Great Leap Forward to the Best of Modern Health Care

Obama’s Promise Fulfilled: A Great Leap Forward to the Best of Modern Health Care

By Elizabeth Lee Vliet, M.D.

1. The expansion of Medicaid, with increased cost burden for taxpayers.

Medicaid is a combined state-federal program initially designed to help the neediest among us. But it has burgeoned to cover medical costs for about one in every five people. Today, Medicaid pays for two of every five babies born in the United States, and three of every five people in long-term care facilities in the US.

Obamacare will add another 20 million new Medicaid dependents. According to the Kasier Family Foundation, that Medicaid expansion will add an average of 13% to state budgets in costs for 2014 alone.

Even though Medicaid was designed to help the poor, studies have consistently shown that Medicaid recipients receive worse medical care than people withoutany health insurance at all! Medicaid patients have longer waits to see a doctor, fewer specialists to choose from, and poorer medical outcomes overall. A particularly morbid piece of evidence is that on average, Medicaid patients die sooner after surgery than people who have no medical insurance.

Essentially, Obamacare is forcing 20 million more Americans into second-class medical care with Medicaid.

2. “Sticker shock” as the reality of higher health insurance premiums hits home.

The majority of Americans, especially those who are young and healthy and therefore have paid low premiums in the past, are seeing their health insurance premiums rise between 50% and 150%. Further, employers are cutting full-time workers back to part-time by reducing employees’ hours per week from 40 to 29 or less, to avoid having to provide those employees with expensive, Obamacare-compliant coverage.

The “Affordable Care Act” has become anything but affordable for most people.

Read the rest of this entry »


Trial Balloon: White House Implies Individual Mandate Could Be Delayed

jayjayOn Monday, White House press secretary Jay Carney implied that the Obama administration could delay the implementation of the individual mandate thanks to the massive technological glitches attendant on the launch of the Obamacare exchanges. Carney explained that anybody “without access to affordable care due to a state not expanding Medicaid or other factors” wouldn’t be penalized, and then avoided answering whether the website failures could be an excuse for non-compliance with Obamacare. “We are focusing on implementing the law,” Carney said, “and ensuring that people have the information they need.” He added, “The law is clear that if you do not have access to affordable health insurance, then you will not be asked to pay a penalty because you haven’t purchased affordable health insurance.” Read the rest of this entry »

Goodbye to Health Care Jobs

Nurse-with-Patient

The medical industry’s employment growth disappears. 

Kevin D. Williamson writes: In another bit of grim news for the long-term prosperity of these United States, hospitals, medical practices, and related businesses are shedding jobs: 8,000 of them since April, more than in any other sector. For the year, there have been more than 41,000 layoffs at health-care firms. As Paul Davidson and Barbara Hansen of USA Today report, those are mostly hospital staffing reductions in response to reduced reimbursement rates for Medicare patients under the sequester and cuts for some providers under the Affordable Care Act. Private insurers, who are starting to experience a burning sensation after having gone to bed with the devil on Obamacare, are reducing payments, too.

The sequester, unfortunately, is likely to be repealed at some point, but the Independent Payments Advisory Board (IPAB) is required by the ACA to reduce the growth of Medicare spending. The American Medical Association sees the writing on the wall and assumes that the bulk of any savings will come in the form of reduced payments to providers — which it more or less has to, since the ACA forbids IPAB from raising Medicare premiums or rationing care. (We are going to ration care regardless of what the law says.) The more serious long-term problem is that the aging of our population means that more and more health care will be paid at Medicare rates in the coming years, putting more financial strain on hospitals.

So hospitals are cutting back.

Read the rest of this entry »