Given all the headaches, a number of states are considering offloading responsibility for their exchanges to the federal government. But that exit path may not be as appealing if the Supreme Court rules this summer that subsidies for the purchase of insurance are only available through state-operated exchanges in King v. Burwell.
States could have to choose between absorbing millions of dollars in losses running their own exchanges -- or depriving their residents of subsidies by sending them into the federal exchange.
They can't afford the former -- and the latter may prompt open public revolt. Perhaps that will be enough to convince Congress to repeal Obamacare altogether and replace it with market-based reforms that empower patients. Those would actually make sense.
Watched a nice bit of escapism the other night, "World War Z" (I'll give 2.5 stars for decent tension) where a UN "investigator" takes time away from being a soccer Dad to save the world from the undead, with the help of smart, determined people in a shiny WHO building (and the occasional SEAL, Ranger, female Israeli soldier and MOSSAD operative).
Now, cut to headlines where the real-world WHO was found to be "compromising rather than aiding" the Ebola response.
And the greedy, seedy capitalist world manages to make a safe haven for 8000 families right in the middle of hell, by using good common sense, tools at hand "based on the US model" and what must have been a fair degree of grit.
IRS Scandal: Now, officially, "Worse than Watergate"
We've seen lies. We've seen violations of the Constitution. We've seen every sort of despicable behavior on the part of government officials in President Obama's "most transparent administration in history" up to and including cover ups of despicable behavior. But now, in the IRS scandal, we have evidence of a cover up - in the form of "missing" evidence.
Paul Bedard summarizes, links to a Daniel Henninger WSJ editorial making the "official" judgment, and throws in this hilarious MSNBC segment where the morning hosts joke about the story that "I've never told a lie" Jay Carney parroted out to all of us.
I'll excerpt: "I'm an idiot... Even I know that if you have a hard drive and you can't find an email you can get a little nerd to come in and they can find them for you." (...) "Instead of 'We trashed the evidence and tore it up and buried it... no, we were earth friendly." [On the claim that the hard drive was "recycled."]
Daniel Henninger opens his "worse than Watergate" editorial by saying, "With 2 and a half years left in the Obama presidency, it is at least an open question what will be left of it by December 2016. Or us." Indeed.
"I will happily pay you today, for a free lunch I don't eat before tomorrow"
In an apparent attempt to deflect attention away from the federal exchange portion of O-care, just as we are learning that the entire functionality of the system is not even built, much less tested, numerous democrats have cheered that the state-run exchanges are working well.
More than 55,000 people in Washington state enrolled in health coverage in October - most in Medicaid - and around 40,000 more applied for coverage, making the Evergreen State one of the brightest success stories in the rocky national rollout of the federal health law. Here in the home of online shopping giant Amazon.com, officials credit the exchange’s success in part to the Pacific Northwest's high-tech bent.
Colorado enrolled just more than 37,500 in the period. New York state - with a population nearly three times the size of Washington's - had enrolled just over 48,000 in health plans as of Tuesday, state officials announced. Kentucky enrolled more than 32,000 in its first month.
All are among the states that embraced Obamacare and crafted their own insurance exchanges rather than rely on the federal site, which has been riddled with breakdowns.
Wawazat? "most in medicaid?" Yup.
Mansfield and Rodriguez huddled together over a shiny new laptop in the busy trailer, setting up the older woman’s account. Rodriguez led Mansfield through a series of questions, typing in the necessary information about citizenship, tax filing status, family makeup.
Mansfield pulled out a letter from the Social Security Administration to prove how much money she makes each month. Rodriguez tapped a few more keys, then looked up, smiling.
"You qualify for Washington Apple Health," she told the uninsured woman, referring to the state’s expanded Medicaid program. And then she shared the best part: "At no cost."
"That’s it?" Mansfield asked, relieved and incredulous that the process was so fast and easy, and the result so comforting. "Wonderful."
And Colorado's metrics are very similar, with most enrollees being in Medicaid - 47,306 versus 6,001 in "private health insurance" through the first six weeks.
I don't know about you but I sure am relieved that, under O-care, no insurance company can interrogate me about my medical history. Now I only have to answer questions about "citizenship, tax filing status, family makeup" and "prove how much money [I make] each month."
But the LA Times story says nothing about website security on the state exchanges, which is what I was researching when I found that Connect for Health Colorado was so forward thinking on the issue that they sought a third party security review for the 2011 startup's flagship, nay, only ship, website way way back in ... June. The proposals were due in less than 3 weeks after the date of RFP and would be reviewed for a full week before awarding a contract, possibly not to the lowest bidder, or at all, before work could begin on July 22, leaving ten weeks and a day for the third party to "Provide additional inputs to the C4HCO team for risk management activities as the system Go Live date of 1 October 2013 approaches."
What could go wrong? No matter, since the result is so comforting. Wonderful! At least, until you try to see your, or any, doctor.
"Common-sense" is one of those adjectives politicians use to describe legislation they're afraid will get them fired either way: if they support it or if they don't. It means, "If you don't agree with this you are senseless" and it has to be employed because if they didn't cover it with that fig leaf, there's little other reason for voters to agree with it.
Vulnerable Senate democrats are running away from Obamacare as fast as they can. That includes Colorado's Mark Udall but since "he’s not viewed as being nearly as vulnerable as [Sen. Landrieu, D-Louisana] or Sen. Mark Pryor, D-Arkansas" he isn't running as far. Fox31:
"I share the concern that some health insurance companies are choosing to cancel thousands of Coloradans' plans. That’s why my common-sense bill will allow Coloradans the option to keep their current coverage if they want or to purchase new plans through the Connect for Health Colorado marketplace that may better meet their health care needs."
What a swell guy - he wants to "allow" Coloradans options! We shouldn't be surprised. After all, he is well known as a pro-choice politician.
But don't let that power of choice go to your heads, fellow Centennial-staters.
With support building for a plan introduced by Sen. Mary Landrieu, D-Louisiana, that would allow people mislead by the president's promise to keep their plans to actually do so indefinitely, Udall has come up with a scaled down version that would allow policyholders to keep their current plans, being cancelled under the new law, for two years.
"We're protecting the stability of the insurance market in the exchange while allowing people to hold on to their current plans a little bit longer," Joe Britton, Udall's deputy chief of staff, told FOX31.
So now we know that "common-sense" has an expiration date: 2 years.
I have a better idea. How about, instead, we "allow" the stability of the insurance market while "protecting" people to hold on to their current plans? But you shouldn't be surprised. After all, I am a well-known "extremist, hostage taking" TEA Partier.
Though it might have been a big risk several months ago, with the growing dissatisfaction over Obamacare emerging just in time for the CMA Awards, Brad Paisley and Carrie Underwood hit it out of the park with this year’s funny skit.
I really enjoyed reading this Investor's editorial and leaned toward posting. Then I saw who wrote it and couldn't get to the login page too quickly.
The mainstream media have in large part turned against ObamaCare, and all these factoids are going to be reported. So that raises the question regarding 2014: Do Republicans really want to bail out Obama by handing him a year's delay? If all the flaws in ObamaCare do pan out, they may well overshadow the shutdown negatives suffered by the GOP.
I think I am lining up on Chris Ruddy's side. There's an old political adage: If your opponent is determined to hang himself, for heaven's sake, don't take away the rope.
So supposedly the new health care law eliminates pre-existing condition restrictions. And you can stay on your parents' plan until you are 26 or some such. But there's still an "open-enrollment" period, which of course means that there's a closed enrollment period.
March 31, 2014
Open enrollment for 2014 health insurance coverage closes on March 31, 2014. Be sure to visit the Marketplace and enroll in a plan before this date.
After March 31, 2014, you can get new private health insurance for 2014 only through a special enrollment period if you have a qualifying life event like a job loss, birth, or divorce.
Government - Making life better since 1930.
UPDATE: Are we worried yet? What could possibly go wrong?
"You are allowing Connect for Health Colorado and the Department to use Social Security numbers and other information from your application to request and receive information or records to confirm the information in your application. You release Connect for Health Colorado and the Department of Health Care Policy and Financing from all liability for sharing this information with other agencies for this purpose. For example, Connect for Health Colorado and the Department may get and share your information with any of the following agencies: Social Security Administration; Internal Revenue Service; United States Customs and Immigration Services; Department of Homeland Security; Centers for Medicare and Medicaid Services; Colorado Department of Labor and Employment; Financial institutions (banks, savings and loans, credit unions, insurance companies, etc.); child support enforcement agencies; employers; courts; and other federal or state agencies. We need this information to check your eligibility for health insurance or help paying for health insurance, if you choose to apply, and give you the best service possible."
"Are you F'ing kidding me????" she wrote on the government's Obamacare Facebook page. "Where the HELL am I supposed to get $3,000 more a year to pay for this 'bronze' health insurance plan!?!??? And I DO NOT EVEN WANT INSURANCE to begin with!! This is frightening," -"Single mother of two" commenting on Healthcare.gov Facebook page
This chart from another federalist.com article - 8 Charts That Explain the Explosive Growth of U.S. Health Care Costs, shows how government medical spending, originally promised to help Americans afford care, has had the opposite effect.
Gosh, maybe we really do need another huge new federal health care program like Obamacare to "fix things."
I trust I will not be accused of defending NSA privacy abuses if I admit to a hope that most of those empowered to snoop have undergone some kind of background check.
Hey, stop laughing in the back! My point is that the IT guys, insurance form handlers, and Community Organizer "Facilitators" that will have access to the health care information of an ObamaCare® exchange customer will be subject to far less rigor and will have access to even more private data.
The NSA has released some details of 12 incidents in which analysts used their access to America's high-tech surveillance infrastructure to spy on girlfriends, boyfriends, and random people they met in social settings. It's a fascinating look at what happens when the impulse that drives average netizens to look up long-ago ex-lovers on Facebook is mated with the power to fire up a wiretap with a few keystrokes.
One such analyst working on foreign soil started surveillance on nine phone numbers belonging to women over five years, from 1998 to 2003. He "listened to collected phone conversations," according to a letter from the NSA's Inspector General to Senator Charles Grassley released today. The unnamed spy conducted "call chaining" on one of the numbers -- to determine who had called, or been called from, the phone -- and then started surveillance on two of those numbers as well.
Innovation is not dead. Got this on my work account:
Rewriting marketing history...how the GSA could have saved their jobs
We all speculate about those moments when history might have taken a different path. If Washington hadn't chopped down that cherry tree. If Columbus had headed in the opposite direction. If Charlie Sheen hadn't discovered twitter...
Now here's a new one for you. Imagine if the GSA had heard about the Creative Services Exchange before they blew their budget in Vegas. They would have been able to find great creatives to deliver everything from cool designs for commemorative coins to the most happening event -- but they wouldn't have wasted $800K. So instead of Congress holding hearings and questioning how the GSA could do that with our hard earned tax dollars, we'd be congratulating them on knowing how to spend wisely.
That's because when anyone wants any sort of marketing, from an experiential event, to a promotional campaign, supporting collateral and brand buzz and excitement, the Creative Services Exchange does it without a fuss. It does it without padding and overheads. It's why those brands which have engaged their brains come to us to save up to 50% on the old way of doing things.
We can't save the jobs of the GSA now, but we can ensure that your head doesn't roll because of bad marketing decisions and overspending. Submit a brief at the Creative Services Exchange and you'll save yourself time, money and gain plaudits, not problems.
PS What happens in the Exchange, stays in the Exchange (just like Vegas).
Like myself, Boulder's [Democrat] District Attorney Stan Garnett doesn't understand why the Obama Justice Department is so tough on the medical marijuana business. After all, aren't Democrats and weed activists fellow travelers? And, perhaps because I had dinner with the man 12 days ago (well, actually, different tables in the same Boulder burger joint) I agree verbatim with General Garnett on this sentence from his letter to United States Attorney John Walsh:
"The people of Boulder County do not need Washington, D.C., or the federal government dictating ..." WAIT! Stop right there.
But he continued, "how far dispensaries should be from schools or other fine points of local land use law," Garnett wrote.
I don't think Garnett helped his effort by suggesting what the US Attorney's priorities should be, but that probably won't be what makes or breaks the G-Men's "prosecutorial discretion."
In the "things that make you say, hmmm" department: The article also says that Boulder has an estimated 12 dispensaries within 1000 feet of a school.
...to pass my jobs bill!" That's the campaign strategy of President Obama in the face of the wascally wepubwicans who refuse to sign on to another government spending "stimulus" escapade. While implying that what we "can't wait" for is the jobs supposedly to be created, what he really can't wait for is the chance to take credit for jobs already growing in the private sector.
Since Republicans took control of the House in January and secured enough votes in the Senate to block big spending bills, the economy has created 1.5 million private-sector jobs, according to the Friday report from the Bureau of Labor Statistics.
That's well above the 1.2 million created in all of 2010, when Democrats ran everything in Washington, and when stimulus money was still pouring into the economy. In fact, if you compare private job growth with stimulus spending, they practically move in opposite directions.
This might be uncomfortable news for big-spending Keynesians like Obama and liberal economist pals who remain convinced growth depends on never-ending stimulus. But it's an indication that when it comes to job creation, government spending is the problem, not the solution.
Somehow, inexplicably, nobody has called to ask that their connection to coal fired power plants NOT be restored.
DENVER -- The October snowstorm is being blamed for numerous power outages.
More than 40,000 people from Fort Collins to Littleton were without power as of 5:30 a.m. By 9 a.m. that number had increased to more than 90,000 without power, according to Xcel's website.
Power outages forced the closure of the University of Northern Colorado in Greeley and the Boulder County Criminal Justice Center in Boulder.
In the Boulder area, Xcel is handling 157 outages affecting more than 13,000 people.
Boulder officials are treating the fast moving storm as a civil preparedness exercise, in the event that the Utility Municipalization ballot measure passes and city council takes over management of the power company. "The wind doesn't always blow and the sun doesn't always shine," said Boulder's Mayor.*
How much longer do we have to endure government economic estimates based on static analysis of tax rate changes?
In November the mail-in ballot votes will be tallied to decide whether Colorado will lose 7,400 to 11,600 private sector jobs [you know, the ones that pay their own way and don't require a new tax every year to keep them going?] The culprit is Colorado's Proposition 103, a five-year plan to hike three different state taxes on individuals and businesses, conceived and placed on the ballot almost single handedly by Senator Rollie Heath (D-Boulder) and his personal fortune.
Voters will decide between the projected outcome voiced by one Senator Mary Hodge (D-Brighton) who said "she’s optimistic that state finances will not take a turn for the worse," or that of Barry W. Poulson, Senior Fellow in Fiscal Policy and Professor of Economics (retired), University of Colorado, Boulder and John D. Merrifield, Professor of Economics, University of Texas whose analysis resulted in the job loss estimate in the lede. To understand the magnitude of the job loss you can read the paper or just watch this video from a Jon Caldera press conference that, somehow, I haven't seen reported by Denver's Fox 31.
By the way, there weren't enough dominoes to have one for every job lost. Each domino represents TWO jobs.
John Goodman at Health Affairs Blog (his picture does not look like the beloved comedic actor who plays Walter in "The Big Lebowski") has some bad news and some bad news about the epidemic of drug shortages.
First the bad news:
Doctors at the Johns Hopkins cancer center are rationing cytarabine, a drug used to treat leukemia and lymphoma. They are literally deciding who will live and who will die.
About 90 percent of all the anesthesiologists in the country report they are experiencing a shortage of at least one anesthetic
Currently, there are about 246 drugs that are in short supply and as the chart shows, the number has been growing for some time.
Hospitals are scrambling to make up the shortfall, in some cases rationing medications, postponing surgeries and using alternative drugs.
What's the problem? Supply-chain? We can fix that. Shortages in transportation or labor? That can be fixed. The FDA? Oh crap. And that's the bad news:
The Federal Food and Drug Administration (FDA) has been stepping up its quality enforcement efforts -- levying fines and forcing manufacturers to retool their facilities both here and abroad. Not only has this more rigorous regulatory oversight slowed down production, the FDA's "zero tolerance" regime is forcing manufacturers to abide by rules that are rigid, inflexible and unforgiving. For example, a drug manufacturer must get approval for how much of a drug it plans to produce, as well as the timeframe. If a shortage develops (because, say, the FDA shuts down a competitor's plant), a drug manufacturer cannot increase its output of that drug without another round of approvals. Nor can it alter its timetable production (producing a shortage drug earlier than planned) without FDA approval.
Emphasis added, which I rarely do, but the emphasized statement is utterly gobsmacking.
Why doesn't the Administration simply outlaw shortages?
EPA: "Employee salary is our highest budget priority"
On his radio show today Mike Rosen read a copy [2:00 to 4:55] of an internal memo from EPA Regional Administrator James Martin to all Region 8 EPA employees. Subject: Fiscal Year 2011 Budget Decisions.
I want to update you on the status of Region eight's budget. The most important thing to tell you is that we continue to protect salary for our on-board EPA employees. It is our highest budget priority and that has not and will not change.
Our OCFO has been able to provide us with some relief for our payroll shortfall. This will allow us to maintain our support services at the current levels as we work to meet our agency's mission. We are continuing to work with headquarters for additional relief. In the meantime, to meet the remaining payroll needs we'll be reducing our programmatic funds by 30 percent, as well as some regional support funds.
A distinct difference, to be sure, from EPA's stated policy on private sector jobs.
A front-page article in today's Denver Post declares, "Colorado Not Cashing in on Census." According to the article, Colorado is the third-lowest state in terms of federal reimbursement. The culprit seems to be Medicaid reimbursements that lag because of Colorado's relatively high per-capita income and relatively low child poverty rate. We also set the bar for Medicaid eligibility at the poverty line, whereas states like Vermont set the bar at 3X the poverty line. And that's a bad thing? It is if your a liberal who rates success based on how many tax dollars you can vacuum up.
Kathy White, program director for the Colorado Fiscal Policy Institute, said the state generally provides basic Medicaid benefits without the options other states provide for adults and children.
"We kind of keep it scaled back to the minimum requirements," White said.
Gov. Bill Ritter's office agreed.
"One of the primary reasons Colorado is toward the bottom of this list is that we have very lean safety-net programs," said Ritter's spokesman, Evan Dreyer.
However, that will change with legislation passed last year that increases benefits, said Adela Flores-Brennan, health care attorney for the Colorado Center on Law and Policy.
"Colorado is expanding its program," she said.
In addition to the galling situation in Vermont, Alaska is even worse. Alaska ranks among the highest-reimibursed states, garning more than $2000 per citizen compared to Colorado's $890. This, despite the fact that Alaskans have a negative state income tax (i.e., residents pay no state income tax but get an annual rebate from oil tax revenues). So, Alaska pays for all of its state social benefits funded by tax payers in other states - and rather generously at that. Question: what happens when every states is a net tax receiver? Answer: Unending deficit spending.
But they'll rock at heathcare... wait a minute... they already do...
DAMNING reports on the state of the National Health Service, suppressed by the government, reveal how patients’ needs have been neglected.
They diagnose a blind pursuit of political and managerial targets as the root cause of a string of hospital scandals that have cost thousands of lives.
The harsh verdict on the state of the NHS, after a spending splurge under Labour between 2000 and 2008, raises worrying questions about the future quality of the health service as budgets are squeezed.
Lord Darzi, the former health minister, commissioned the three reports from international consultancies to assess the progress of the NHS as it approached its 60th anniversary in 2008. They have come to light after a freedom of information request.
The first report, by the Massachusetts-based Institute for Healthcare Improvements (IHI), identified the neglect of patients as a serious obstacle to improving the NHS. “The lack of a prominent focus on patients’ interests and needs ... represents a significant barrier to shifting the trajectory of quality improvement in the NHS.”
One heading in the report says: “The patient doesn’t seem to be in the picture.” It adds: “We were struck by the virtual absence of mention of patients and families ... whether we were discussing aims and ambition for improvement, measurement of progress or any other topic relevant to quality.
“Most targets and standards appear to be defined in professional, organisational and political terms, not in terms of patients’ experience of care.”
250,000 White House Staffers, Visitors Affected by National Archives Data Breach
A data breach at the National Archives and Records Administration is more serious than previously believed. It involved sensitive personal information of 250,000 Clinton administration staff members, job applicants and White House visitors, as well as the Social Security number of at least one daughter of former Vice President Al Gore.
Of course, your private medical information will be fine.
I really resent TaxProf Blog's blatant spin on this issue. I would have entitled it "IRS Gets 30% Right!"
TIGTA reviewed a sample of ITIN applications and found that almost 70% contained significant errors and/or raised concerns that should have prevented the issuance of an ITIN. The IRS estimates that it has issued more than 14 million ITINs as of December 2008.
ITINs are intended to provide tax identification numbers to resident and nonresident alien individuals who may have U.S. tax reporting or filing obligations but do not qualify for Social Security Numbers, which generally are only issued to U.S. citizens and individuals legally admitted to the U.S.
Third call today from the Nebraska Correctional Facilities Victims Notification Unit. Notifying me of an upcoming parole hearing for some guy I never heard of. (I got a new landline installed for work, the previous owner of this number gets a lot of calls from debt collectors.)
To stop the calls, all I have to do is enter the four-digit PIN number I registered with. Of course, I did not register and do not have a PIN. I have learned that they are serious about calling back.
They do leave a number to call but nobody answers.
UPDATE: It gets better. I have now called five numbers and finally found the right office. They can't turn it off because I don't have the PIN. They have to be certain that I am not the criminal turning it off to keep bad testimony from my parole hearing. I told young Justin that I'm certain it is easier to get out of jail than to stop these calls.
For some reason, John Stossel questions government’s ability to run health care:
Now I hear about another absurd green energy subsidy: government subsidizes wind farmers so much that, in Western Texas, they run the turbines even when nobody wants electricity. because the grid there has a limited capacity, wind farms literally have to pay companies to take the extra energy: This April, the price of electricity in Western Texas was negative 23% of the time.
This follows up on his post on free golf carts (costing less than the tax break). I have seriously considered a golf cart. I live on a course and it would rock for trash runs and trips to the strip mall 3/4 mile across the course. Hey, free stuff from the gub'mint! Go Obama!!
Not me, Cap'n Ed, worried about felon census workers:
If the properly processed criminal record checks are any indication, the Bureau may have let a large number of violent criminals slip through the cracks. Of the prints that were properly checked, about one percent, or 1,800 workers, had criminal records that name checks failed to identify.
Of these 1,800 workers with criminal records, about 750 had their employment terminated or further reviewed due to criminal records that included crimes like rape, manslaughter and child abuse. Projecting these numbers to the employees with spoilt prints, the GAO came up with the figure of 200 census workers that may have had serious criminal records.
Unfortunately, we don’t have the luxury of turning Census Bureau workers away from our doors as we do with partisan community organizers. In their rush to hire, probably brought on in an attempt to alleviate the unemployment numbers (the money this year came from the stimulus package), the Census Bureau botched a process that private-sector employers routinely employ, and hired hundreds of felons to demand our personal information on our doorsteps.
Imagine how the Obama administration will handle hiring in the public-option health-insurance agencies …
Remember when the 111th Congress stepped up to protect us little guys from the mean old credit card companies? They were going to dictate terms that are fair. Scrivener notes "Politicians shocked! Price controls produce the same result as always."
After passing the new law by an overwhelming vote, it hailed its achievement as a great bipartisan act of consumer protection.*
But now Reps. Barney Frank and Carolyn Maloney, the prime political movers behind the new restrictions, are shocked and appalled to find that credit card issuers are raising interest rates before the effective date of the new law, as per their press release ...
Pew Charitable Trust reports that interest rates have spiked by an average of 20% on credit cards representing more than 91% of the $864 billion in outstanding credit card balances. It’s clear that credit card companies are taking advantage of this period between the signing of my bill and the current effective date,” Rep. Maloney said. “The breadth and depth of the rate hikes happening now point to the need for faster consumer protections. Americans need relief now.”
I just hope that there are no unintended consequences of their dictating terms to health insurers. Nah -- certainly, they've figured all that out...
I created a new category for this. I like to oppose ObamaCare on first principles, but the craptastick reputation of other government services can be very effective. Some people would not know an enumerated power if it bit them in the ass (I think that's in Article III) but the DMV and Post Office are universal.
TaxProf Blog reports that the IRS is going to get serious about protecting your data, now (after) 500 laptops are missing.
The Treasury Inspector General for Tax Administration released a report yesterday noting that after the loss of nearly 500 laptop computers, the IRS has improved its procedures for protecting confidential taxpayer data and guarding against the unauthorized disclosure of sensitive information if laptops are lost or stolen in the future. Significant Improvements Have Been Made to Protect Sensitive Data on Laptop Computers and Other Portable Electronic Media Devices (No. 2009-20-120).