Taking Advantage Of Those Who Can Least Afford It

The Daily Signal posted an article today about another battle in the war on the involuntary taking of union dues.

The article reports:

Sally Coomer of Seattle, who cares for her disabled adult daughter at home, doesn’t like the fact that union dues are deducted from the Medicaid payment she gets for her services under a Washington state policy.

“The money that is taken out in union dues, if it was not siphoned off, could be used to provide for more care,” Coomer told The Daily Signal about the Medicaid stipend given to home care providers.

“A lot of family members forgo careers to take care of family members and are working in situations where they are really financially struggling,” she said.

Washington is one of 11 states where the state governments work with public-sector unions to automatically deduct a portion of the Medicaid stipend and divert it to unions representing state employee unions.

The other states are California, Connecticut, Illinois, Maryland, Massachusetts, Minnesota, Missouri, New Jersey, Oregon, and Vermont, according to the State Policy Network, a conservative think tank that focuses on state issues.

Nine states take money from Medicaid home child care workers: Connecticut, Illinois, Maryland, Massachusetts, New Jersey, New York, Oregon, Rhode Island, and Washington.

Taking care of your child at home should not result in having union dues taken out of money you receive for the care of that child.

The Trump administration agrees:

However, the states face pushback from the Trump administration and, potentially, the courts in light of a recent Supreme Court ruling striking down mandatory payments to public employee unions by employees who don’t belong to the union.

The rule proposed by the Centers for Medicare & Medicaid Services would eliminate states’ ability to divert part of Medicaid payments from providers to a third party.

The article continues:

Caregivers may pay up to $1,000 per year in union dues, according to the State Policy Network, which says state governments are “dues-skimming” an estimated $200 million per year from home health providers and $50 million from child day care providers to give to unions.

Coomer’s daughter Becky, almost 28, has cerebral palsy and a disorder that causes seizures. She is blind and developmentally disabled.

Coomer, who has become an advocate for other families who don’t want to be forced to pay union dues, said many home care providers are not aware they have a choice in joining a union.

To qualify in Washington state, family members are required to go to an orientation run by the Service Employees International Union, which represents state government employees.

“At the orientation, they would tell people they are required to sign up,” Coomer said. “I don’t know what benefit we get from the dues. The only time I hear from the union is when they inundate me with a political agenda.”

The proposed new Medicaid regulation, announced July 10, is open for public comment.

Let’s hope that the practice of taking union dues from people caring for family members is ended quickly.

 

Not Really A Surprise

The American Spectator posted an article today that tells us everything we already knew about ObamaCare. The Centers for Disease Control (CDC) has just released a report about uninsured Americans.

The article reports:

Anyone with the intestinal fortitude to subject themselves to the legacy media will have seen countless “news” stories about the devastation wrought by President Trump’s “sabotage” of Obamacare. A typical headline appeared a couple of weeks ago in the Washington Post: “Americans are starting to suffer from Trump’s health-care sabotage.” This work of fiction claimed that the number of working-ageAmericans without health insurance had risen to 15.5 percent, a 3 point increase since 2016. But a report just released by the Centers for Disease Control (CDC), says the real number is 12.8 percent — exactly what it was in 2015.

…NBC recently reported that the total number of uninsured Americans rose by a preposterous 3.2 million in 2017. According to the CDC, however, “There was no significant change from the 2016 uninsured rate.” The percentage is, like the working age statistic, precisely what it was in 2015. NBC, parroting the Post, based its uninsured propaganda on an unreliable source.

There are a few things to keep in mind when evaluating ObamaCare. The first is that is was never about health insurance–it was about giving government control of a major sector of the American economy and a major sector of people’s lives. We have seeen how well socialized medicine works in Britain when a child isn’t even given a chance to leave the country to receive alternative medical care that could possibly save his life. ObamaCare was a planned failure that would lead to socialized medicine in America during the presidency of Hillary Clinton. We have dodged that bullet (at least temporarily).

The major change that occurred to ObamaCare this year was the end of government subsidies to insurance companies and changing rules for insurance pools to make it easier for people to get health insurance in various groups. The real answer to health insurance is the free market–let companies compete without being over-regulated and let people know how much they are actually paying for healthcare services. It would also help to end ObamaCare completely. In order to end ObamaCare completely, the Republicans would have to learn how to get their message out over the din of the mainstream media. They would also have to develop a spine.

The article concludes:

A multi-year study dubbed the “Oregon Health Experiment,” whose results were published in the New England Journal of Medicine in May of 2014, has demonstrated that health outcomes for Medicaid patients are no better than those enjoyed by the uninsured. Scott Gottlieb, the current Commissioner of the Food and Drug Administration, summarized various Medicaid studies in the Wall Street Journal and also concluded that being covered by Medicaid is demonstrably worse for your health than having no coverage at all.

The CDC report doesn’t weigh in on this issue, of course. It just attempts to show us where the uninsured rate was and where it is now. But that is damning enough. It not only shows that the projections originally touted for Obamacare were wildly off the mark — it was supposed to have brought the non-elderly uninsured rate down to 7.6 percent by 2016 — it demonstrates that the Democrats and their media co-conspirators have been lying about what the real uninsured numbers are as well as President Trump’s role in their mythical increase. Not that this is new. The Democrats and the media have been lying about Obamacare from day one.

As more Americans realize that the media has been lying to them from the beginning, we may have a chance to get rid of ObamaCare. Until then, we are stuck with it.

Policies Have Consequences

On Friday, Investor’s Business Daily posted an article about the impact of some of the changes President Trump is making to federal handouts.

The article first cites changes in welfare:

Earlier this month, the government reported that enrollment in food stamps plunged by nearly 600,000 in one month. Is this part of a broader trend toward greater self-reliance?

…In the months since President Trump has been in office, the number of people collecting food stamps plunged by nearly 2 million.

The same is true for welfare. Enrollment in the Temporary Assistance for Needy Families program dropped 12% last year, to reach 2.3 million.

Better still, the number of workers on Social Security Disability Insurance was down to 8.6 million in March — a decline of more than 100,000 since January 2017, and the lowest level since February 2012.

So far this year, disability applications have averaged 179,000 a month, compared with more than 193,000 a month in 2016. And the number of people dropping off disability rolls is up.

The next area cited is Medicaid:

Even enrollment in Medicaid and CHIP — the health care program for the poor and children — dropped by almost a million in 2017, to 74 million. In contrast, enrollment surged by more than 2 million in 2016. (Medicaid’s rolls could climb gain if additional states decide to expand the program under ObamaCare.)

In other words, millions of people are now free from at least some of their dependence on federal benefit programs.

The article notes that some people judge the success of these programs by how many people take advantage of them–thus a drop in enrollment is seen as a drop in the level of success. Actually, it would be nice if those running the programs actually wanted people to be successful enough not to need the programs. However, if the level of participation in these programs dropped greatly, there would no longer be a need for the giant federal bureaucracy that administers them. It is unrealistic to expect people to do something that in the long run might make their job obsolete.

The article also cites changes in Work Benefits:

ObamaCare, for example, allowed able-bodied childless adults — with incomes above the poverty line — to enroll in Medicaid in expansion states. Because these states are now picking up a bigger share of the expansion costs, many are looking to impose work requirements to stay on the program. There’s also a push to add work requirements for food stamps.

That may seem heartless. But keep in mind that most of these programs have the word “temporary” right in their titles. They were never envisioned as permanent means of support, but a way to cover over rough patches.

The article reminds us that a poverty program is truly successful when there is no one who has the need to enroll in it!

To understand more about poverty in America and exactly what qualifies as poverty, I strongly recommend reading The Heritage Foundation‘s report Poverty and the Social Welfare State in the United States and Other Nations.

 

Should Your Family Caregiver Have To Join A Union?

Many families face the challenge of having to take care of elderly parents or disabled children. In certain states these family members are classified as public employees and required to have union dues taken out of the Medicaid funds that help pay for this care. If we are not careful, mom is going to be classified as a public employee so that unions can collect dues from her!

The Independent Journal Review  (IJR) posted an article today stating the following:

House Republican Conference Chairwoman Cathy McMorris Rodgers (R-Wash.) will introduce a bill by the end of February “that would prohibit states from allowing unions to automatically deduct dues and fees from Medicaid funds that are intended to help family caregivers,” according to McMorris Rodgers’ aides.

The bill, which according to aides has at least some support in the Senate, will clearly state that withdrawing labor organization dues from a Medicaid payment to a family caregiver is an “improper use of Medicaid funds.”

A civil monetary penalty will be handed out for any violations of the proposed bill, according to the chairwoman’s office. “Due-skimming is robbing our nation’s most vulnerable who need Medicaid the most,” an aide told IJR.

The article concludes:

Caregivers took to Capitol Hill on Tuesday, calling on Congress to stop states — including California, Minnesota and Illinois — from classifying family caregivers as public employees. House GOP officials say ending the practice could save Medicaid and other programs as much as $200 million a year.

“What bothers me the most is, I know a lot of parents, because I’m in this community,” said Miranda Thorpe, a registered nurse who also cares for her 21-year-old daughter, according to Fox News.

“And none of them really understand that this is happening to them. They have no idea. I don’t think the state should be the factor that colludes with unions to take out this money without people’s knowledge,” Thorpe added.

“If they really wanted people to have a choice, then they should let them know what their options are. … I think it’s very unfair since this is a very vulnerable population.”

I don’t have a problem with unions, but they have become as corrupt as politicians (and sometimes the two work together very closely). Union dues should be collected from people who choose to join a union. Union fat cats live as well as the corporate fat cats they condemn (at least the corporate fat cats generally produce either a product or a service). It is time for the practice of penalizing family members who provide care for a family member to end.

 

Teaching Responsibility To Those Who Have Somehow Avoided The Lesson

Yesterday Fox News posted a story about Kentucky‘s plan to follow President Trump’s suggestion to add a work requirement for receiving Medicaid.

The article reports:

Under the new rule, adults age 19 to 64 must complete 80 hours of “community engagement” per month to keep their care. That includes working a job, going to school, taking a job-training course or volunteering.

“There is dignity associated with earning the value of something that you receive,” Kentucky Gov. Matt Bevin said. “The vast majority of men and women, able-bodied men and women … they want the dignity associated with being able to earn and have engagement.”

One of the comments under this article on the site where I saw it posted commented that benefits were not for the benefit of the recipients, but to make sure how the recipients voted. Unfortunately we have created a group of people in America who would rather receive free things that the rest of us pay for than earn those things himself. I realize that some people need these benefits and have valid reasons for wanting them, and we need to help these people. However, we need to end the free ride for those who are taking advantage of the situation.

Note that the requirement is 80 hours a month. That is not a lot. That is approximately 20 hours a week. That is not an unreasonable requirement.

Losing Health Insurance Because You Want To

Yesterday National Review posted an article about the claims the Congressional Budget Office (CBO) is making regarding the number of people who would lose their health insurance if ObamaCare were repealed.

The article states:

Do you want to repeal every word of Obamacare and replace it with nothing? CBO says 22 million fewer people would have health insurance. Do you prefer replacing Obamacare with a system of flat tax credits, in which you get the same amount of assistance regardless of your financial need? CBO says 23 million fewer people would have health insurance. Do you prefer replacing Obamacare with means-tested tax credits, like the Senate bill does, in which the majority of the assistance is directed to those near or below the poverty line? CBO says 22 million fewer people would have health insurance.

22 million, 23 million, 22 million—these numbers are remarkably similar even though the three policies I describe above are significantly different. Why is that?

Thanks to information that was leaked to me by a congressional staffer, we now have the answer.

Nearly three-fourths of the difference in coverage between Obamacare and the various GOP plans derives from a single feature of the Republican bills: their repeal of Obamacare’s individual mandate. But the CBO has never published a year-by-year breakout of the impact of the individual mandate on its coverage estimates.

So actually, a large percentage of the people who would lose insurance coverage if ObamaCare is repealed would choose to lose coverage because they would no longer be penalized for not having insurance. Basically, the CBO report is spin! There is also the matter of ObamaCare requiring people to pay for coverage they don’t need. Generally speaking senior citizens do not need maternity coverage or pediatric dental coverage. They should not be asked to pay for it!

When The Numbers Just Don’t Add Up

This was posted by a friend on Facebook:

This seemed like a reasonable question, so I did some research. On December 2016, CNN Money posted the following:

Nearly 6.4 million Americans have selected Obamacare policies through the federal exchange for coverage starting Jan. 1, federal officials announced Wednesday. That’s 400,000 more than had selected policies a year ago.

Under the proposed repeal and replace ObamaCare bill, the rate of growth of Medicaid will be cut–Medicaid will still grow, but more slowly. The goal is to create a program that will create a rate structure that allows more Americans to pay for their own health insurance. I am not thrilled with the current bill in the Senate, but passing it may be a necessary evil if we are to avoid single-payer or socialized medicine (which would be the result of the total collapse of ObamaCare which is rapidly approaching).

The Truth About The Current Healthcare Bill

Yesterday the Independent Journal Review posted an article about some of the lies we are being told about the current healthcare bill. I don’t support the current bill, but I resent the fact that lies are being used in an attempt to discredit it.

The article explains how the numbers are being twisted:

The current repeal and replace bill is a bad bill. ObamaCare needs to be fully repealed and the government needs to get out of health insurance. Let the people who understand actuary tables run healthcare. The only provision the government needs to make is to insure that high-risk pools are set up (and made affordable) for the people that need them. Healthcare should be available across state lines, tort reform is needed, and tax credits given to lower-income families to help pay for insurance. Otherwise, the government needs to let the free market to work.

 

Fake News Abounds About The Repeal/Replace ObamaCare Bill

I have stated before that I do not support the current bill to repeal and replace ObamaCare. I believe that what we need is straight repeal. Then we need to teach Congress about the free market and let them apply those principles to healthcare and health insurance.

On Friday, Investor’s Business Daily posted an article about the current repeal-replacement bill on ObamaCare.

Here are some observations from the article:

Look at any story about the Senate health bill, and you’ll see words like those describe its supposed cuts to Medicaid. What if we told you there are no such cuts?

First, the Senate bill doesn’t change Medicaid at all for three years. That means spending on the program will continue to grow, just as it is slated to now — at an annual 5% clip — until 2021.

What does that mean in dollar terms? Under the Senate’s “shredding” reform, Medicaid’s budget in 2021 will be $85 billion bigger than it is this year, and $209 billion (or 79%) bigger than it was in 2013.

What about after that? Under the Senate plan, there’d be a three-year transition to a new way of financing Medicaid.

And then, starting in 2025 federal Medicaid spending would be capped each year, with the cap set to grow at the overall inflation rate.

If you plot annual spending out over the next 10 years, what you see is that spending is never actually cut — at least not in the sense that most people think of a spending cut. Instead, it would grow at a slightly slower rate.

Even under the more restrictive House bill, Medicaid’s budget would still climb 20% over the next decade. So growth will end up higher still under the more generous Senate version.

This is the usual game that Congress and the media play with budget issues–only in Washington could a 5% increase be considered a cut!

The article explains the problems with Medicaid:

As a result, Medicaid now consumes about 20% of state general fund spending — and it’s rising. Next year, the 32 states that expanded Medicaid under ObamaCare will see their costs climb by an additional $9 billion.

Meanwhile, a Government Accountability Office investigation found that improper payments accounted for more than 10% of all Medicaid spending last year.

And for all this, Medicaid grossly underpays doctors and provides lousy care to many of its enrollees. In California, for example, the Medicaid expansion resulted in a flood of patients into emergency rooms because they can’t find a doctor willing to treat them.

In short, Medicaid is in dire trouble, and the Senate and House bills offer smart, prudent — and relatively modest — fixes.

Clean up the fraud, and encourage people to actually get jobs that will help them obtain medical insurance. We need less people riding in the wagon and more people pulling the wagon.

A Good Idea Whose Time Has Come

On Friday, CNS News posted a story about one area of President Trump’s proposed budget–the area of food stamps.

Here are some numbers from The Gateway Pundit in 2015:

Under Obama the poverty rate has stood at greater than 15% for three consecutive years (2010-12), the first time that has happened since the mid-1960’s.  A record number of people have been on Medicaid (72 million or 1 out of 4 Americans) and Medicare (more than 47 million Americans) during Obama’s presidency.  When Obama entered office in 2009, 31.9 million individuals received food stamp benefits. As of January 2015, 46 million people received food stamps for a 44% increase in food stamp usage since Obama took over and record numbers.  Food stamp users had topped 46 million for 38 straight months as of January 2015.  (People don’t reach out for food stamps when good paying jobs are plentiful.) Due in part to the increase in food stamps, Welfare spending  (not counting social security) reached nearly $1 trillion in 2013.

Obviously change is needed. The article at CNS News details some of the suggested changes:

In reality, the president’s proposed policy is based on two principles: requiring able-bodied adult recipients to work or prepare for work in exchange for benefits, and restoring minimal fiscal responsibility to state governments for the welfare programs they operate.

The president’s budget reasserts the basic concept that welfare should not be a one-way handout. Welfare should, instead, be based on reciprocal obligations between recipients and taxpayers.

Government should definitely support those who need assistance, but should expect recipients to engage in constructive activity in exchange for that assistance.

Work Requirements

Under the Trump reform, recipients who cannot immediately find a job would be expected to engage in “work activation,” including supervised job searching, training, and community service.

This idea of a quid pro quo between welfare recipients and society has nearly universal support among the public.

Nearly 90 percent of the public agree that “able-bodied adults that receive cash, food, housing, and medical assistance should be required to work or prepare for work as a condition of receiving those government benefits.”

It is time for those sitting in the economic wagon being pulled by working people to get out of the wagon and help pull.

The article reminds us that when Maine placed a work requirement on food stamp recipients, the number of people collecting food stamps dropped sharply. I believe Americans are basically generous people who want to help the less fortunate, but I also believe that Americans do not like being taken advantage of.

The article reports what happened in Maine:

In December 2014, Maine imposed a work requirement on this category of recipients. Under the policy, no recipient had his benefits simply cut. Instead, recipients were required to undertake state-provided training or to work in community service six hours per week.

Nearly all affected recipients chose to leave the program rather than participate in training or community service. As a result, the Maine caseload of able-bodied adults without dependent children dropped 80 percent in just a few months.

We need to learn from Maine’s experience.

When Budget Cuts Are Actually Budget Increases

Yesterday Investor’s Business Daily posted an editorial about President Trump‘s budget proposal.

The article included the following graph:

As you can see, the federal budget does increase. However, it increases at a lower rate than it would if baseline budgeting were used. Baseline budgeting is a tactic used by people who want to grow the government to convince the rest of us that the sky is falling. It is very simple–if you got a 3% budget increase last year and you get a 2% increase this year, your budget has been cut (even though it grew by 2%).

The article further reports:

Trump’s proposed spending cuts for entitlement programs have been described as “massive,” “sweeping,” and on the surface, the $1.7 trillion spending cuts Trump proposes look massive.

But these reports always leave out one key fact. Spending on entitlement programs isn’t being cut. At least not in the traditional sense of spending less next year than you spend this year. Trump’s budget doesn’t touch Social Security or Medicare, and only slows the growth of the remaining “safety net” programs.

In fact, the projected 10-year spending for all entitlement programs under Trump’s budget would be trimmed by less than 8%. (See the accompanying chart.)

Some analysts say Trump’s budget would end up cutting $1.4 trillion from Medicaid over 10 years, because his proposed $610 billion in savings from reforming the program would come on top of the $800 billion proposed cuts contained in the House ObamaCare repeal-and-replace bill. (The budget doesn’t spell this out, but does contain a mysterious “allowance for ObamaCare repeal and replace” line item, with annual savings that match up to spending reductions in the House repeal bill.)

If true, that looks like a huge chunk, even from a program slated to spend $5.3 trillion. But keep in mind that states also contribute almost an equal share to Medicaid. In fact, when you combine federal and state spending, Medicaid is forecast to shell out more than $8 trillion over the next decade.

The article concludes:

Is Trump’s budget perfect? Hardly. We’d prefer that he tackle Social Security and Medicare reform in addition to Medicaid. The ObamaCare repeal savings are likely exaggerated. His $200 billion in infrastructure spending will only whet the appetite of lawmakers.

But on balance, this budget is far more realistic, and more responsible, than anything that ever came out of the Obama White House.

And as a statement of Trump’s governing principles — which is really all the presidents’ budgets ever amount to — Trump’s focus on spending restraint, entitlement reform, work incentives and on removing government impediments to growth is spot on.

In the world of Washington politics, power is measured by how much money you control. Bureaucrats love to spend our money. They will not give up that power easily. There will be a lot of people running around in the coming days yelling “the sky is falling.” They are misinformed. I wish this budget could pass Congress in its present form, but that is highly unlikely. However, I hope that the principles behind the budget will somehow survive and we will see a recognition of the fact that we are currently spending ourselves into destruction. The Washington establishment will not go down easily, but they seriously need to go down.

Changing the Wrapping Doesn’t Change The Package

Yesterday Paul Mirengoff posted an article at Power Line about the changes made to the ObamaCare replacement bill.

The article quotes Arkansas Senator Tom Cotton:

“Despite the proposed amendments, I still cannot support the House health-care bill, nor would it pass the Senate. The amendments improve the Medicaid reforms in the original bill, but do little to address the core problem of Obamacare: rising premiums and deductibles, which are making insurance unaffordable for too many Arkansans. The House should continue its work on this bill. It’s more important to finally get health-care reform right than to get it fast.”

The article at Power Line states the following:

If, under a Republican plan, premiums/deductibles continue to rise, people will believe that Obamacare’s replacement made things worse. They will blame Republicans and the GOP will pay a heavy price.

No Republican should support replacement legislation unless he or she is confident it will result in better outcomes with regard to premiums/deductibles. If Democrats won’t support legislation that’s likely to produce that result, Republicans should either push such legislation through without Democratic support (overruling the Senate parliamentarian) if necessary or let such legislation be voted down.

Republicans have no obligation to pass replacement legislation they don’t like in order to patch up Obamacare. The Democrats created the current mess. If they won’t cooperate with the GOP in fixing it properly, Republicans shouldn’t take the political hit that would come with pretending to fix it on their own.

I left the Republican Party because I felt that they had forgotten their commitment to smaller government and had become part of the problem rather than part of the solution. The current ObamaCare replacement bill is a perfect example of that. Republicans were told that if we gave them the House, ObamaCare would be gone. When it wasn’t gone, we were told that if we gave them the House and the Senate, ObamaCare would be gone. When it wasn’t gone, we were told that if we gave them the House, the Senate, and the Presidency, ObamaCare would be gone. If this bill passes, it won’t be gone. We will simply have ObamaCare Light, a bad bill that the Republicans would be totally responsible for–just as the Democrats were totally responsible for ObamaCare. That is not a step forward–it is a step backward! Please, Republicans, do not pass this bill. Simply repeal ObamaCare. Then you can fight over its replacement. Don’t break faith with the voters.

 

A Law We Can Understand And Support

Yesterday CSC Media Group, a conservative website, posted an article about S.222, a bill introduced in the U.S. Senate by Senator Rand Paul. The bill, called the ObamaCare Replacement Act, would repeal and replace ObamaCare. Currently the bill has been referred to the Committee on Finance. The bill is four pages long. The summary of the bill is not yet posted at Thomas.gov, but you can go to Thomas.gov and put in S.222 and read the entire bill. You can also follow the link to the website above and read the bill.

The following is the CSC Summary of the bill given in the article:

Legalizes Inexpensive Insurance Plans:

  • Ensures that Americans can purchase the health insurance coverage that best fits their needs.
  • Eliminates Obamacare’s essential health benefits requirement, along with other restrictive coverage and plan requirements, to once again make low-cost insurance options available to American consumers.

Protects Individuals with Pre-Existing Conditions:

  • Provides a two-year open-enrollment period under which individuals with pre-existing conditions can obtain coverage.
  • Restores HIPAA pre-existing conditions protections. Prior to Obamacare, HIPAA guaranteed that those in the group market could obtain continuous health coverage regardless of preexisting conditions.

Helps More People Save To Buy Health Insurance and Cover Medical Costs:

  • Incentivizes savings by authorizing a tax credit (up to $5,000 per taxpayer) for individuals and families that contribute to HSAs.
  • Removes the annual cap on HSAs so individuals can make unlimited contributions.
  • Allows HSA funds to be used to purchase insurance, cover premiums, and more easily afford a broader range of health-related expenses, including prescription and OTC drugs, dietary supplements, nutrition and physical exercise expenses, and direct primary care, among others. 

Guarantees Fair Tax Treatment of Health Insurance:

  • Equalizes the tax treatment of the purchase of health insurance for individuals and employers by allowing individuals to deduct the cost of their health insurance from their income and payroll taxes.
  • Frees more Americans to purchase and maintain insurance apart from their work status.
  • Does not interfere with employer-provided coverage for Americans who prefer those plans.

Helps Individuals Join Together to Purchase Insurance:

  • Expands Association Health Plans (AHPs) to allow small business owners and individuals to band together across state lines through their membership in a trade or professional association to purchase health coverage for their families and employees at a lower cost.
  • Also allows individuals to pool together through any organization to purchase insurance.
  • Widens access to the group market and spreads out the risk, enhancing the ability of individuals and small businesses to decrease costs, increase administrative efficiencies, and further protect those with pre-existing conditions.

Allows the Purchase of Insurance Across State Lines:

  • Creates an interstate market that allows insurers who are licensed to sell policies in one state to offer them to residents of any other state.

Increases State Medicaid Flexibility:

  • Enables states to fully exercise current flexibilities afforded to them through Medicaid waivers for creating innovative state plan designs.

Empowers Physicians:

  • Allows non-economically aligned physicians to negotiate for higher quality health care for their patients.
  • Amends the Internal Revenue Code to allow a physician a tax deduction equal to the amount such physician would otherwise charge for charity medical care or uncompensated care due to bad debt, limited to 10% of a physician’s gross income for the taxable year.

Rand Paul is a doctor who practiced medicine for more than ten years before becoming a Senator. I believe he understands the problems involved in health insurance better than most senators. Among other things, his plan allows doctors to treat patients who cannot pay and take a limited tax deduction for providing the services. I think that is a wonderful idea.

This is a healthcare plan I can support.

It Can Be Fixed, But It’s Not Right Yet

Yesterday The Heritage Foundation posted their evaluation of the bill to replace ObamaCare. Admittedly, The Heritage Foundation is a politically conservative group, so their solution to ObamaCare would be aimed at shrinking government, not just moving the chairs around.

The article lists some of the problems with the bill:

Basically, the bill focuses on protecting those who gained subsidized coverage through the law’s exchange subsidies and Medicaid expansion, while failing to correct Obamacare’s misguided insurance regulations that drove up premiums for Americans buying coverage without government subsidies.

That is both a policy problem and a political problem.

The article goes on to explain that the people who need relief from ObamaCare are the people whose premiums and deductibles rose dramatically. That is the group the does not get relief in the new bill. The new bill leaves costly regulations in place and attempts to offset those costs with subsidies. That is what most Americans want to get rid of.

The article explains:

In that regard, the draft bill’s new “Patient and State Stability Fund” is particularly problematic. That program would provide grants to states of up to a total of $100 billion over the nine years 2018-2026.

There are a several significant problems with this new program.

First, it substitutes new funding for old Obamacare funding without adequately addressing the misguided Obamacare insurance market rules and subsidy design that made the exchanges a magnet for high cost patients.

Those mistakes in Obamacare created an insupportable burden on the individual insurance market by concentrating expensive patients in only that small portion of the total market.

Second, like Obamacare, it doesn’t actually reduce premiums, but rather masks with subsidies the effects of Obamacare provisions that drove up premiums in the first place.

Third, it creates a new entitlement for states. Furthermore, without a resulting reduction in unsubsidized premium levels, future Congresses will likely face pressure from states and constituents to extend and expand the program.

That is exactly backwards from what is needed.

The new healthcare bill also fails to reign in Medicaid.

The article reports:

Under the Medicaid expansion, the federal government reimbursed states 100 percent of the cost of expanding Medicaid to able-bodied adults, with federal support eventually declining to 90 percent.

Yet, states continue to receive significantly less federal assistance (50 percent to 75 percent, depending on the state) for covering the more vulnerable populations (such as poor children and the disabled) that the program was intended for. That policy was both inequitable and unaffordable.

The draft bill does not correct that inequity, but rather reduces the enhanced match rate from 95 percent to 80 percent. The better approach would be to allow states to immediately cap expansion population enrollment, while also setting federal reimbursement for any new expansion enrollees at normal state match rates.

Please follow the link above to read the entire article. There are three things that need to happen with health insurance in America–the policy needs to be attached to the person–not their employer, policies need to be portable across state lines, and people with pre-existing conditions need to have a way to be insurance. Other than that, the government needs to get out of the healthcare business and let the free market rule. It will be bumpy for a short while, but if we don’t do it now, things will only get worse.

Repeal It Or Go The Way Of The Whigs

Yesterday Investor’s Business Daily posted an editorial about the repeal of ObamaCare. The editorial made some very important points. First of all, the writer reminded us that the demonstrations opposing the repeal of ObamaCare were planned by the Democrats shortly after the election. There are some people who want to keep ObamaCare, but despite what you see on the news, they are a minority.

The editorial reminds us:

Imagine that Democrats announced a health care reform plan that would force millions to cancel health plans and leave the doctors they like, drastically reduce choice and competition in the individual market, cause health insurance premiums to skyrocket, blow billions of taxpayer dollars creating faulty “exchanges” and failing co-ops, leave millions of middle-class families stuck with higher deductibles and higher premiums, cause massive industry losses, slow the economy, cost jobs, and increase the deficit.

Those are the results ObamaCare’s critics predicted and, without exaggeration, what it has produced. Does anyone honestly believe ObamaCare would have ever made it to Obama’s desk if its backers had been honest with the public?

Yes, the uninsured rate has come down, but as IBD noted, the “20 million gained insurance thanks to ObamaCare” claim is a wild exaggeration, and the gains that did occur are entirely due to the expansion of Medicaid — a terrible and financially troubled program — and other government insurance programs, not ObamaCare’s individual market “reforms.”

ObamaCare will implode on its own in a year or so, but the chaos it will leave will take years to undo. It makes much more sense to repeal it before it collapses.

There is another aspect of this mentioned in the editorial–the trust of the voters. First Republicans said, “Give us the House, and we will repeal ObamaCare.” Voters did that, and ObamaCare was not repealed. Then Republicans said, “Give us the House and the Senate, and we will repeal ObamaCare. Voters did that, and ObamaCare was not repealed. Then Republicans said, “Give us the Presidency, and we will repeal ObamaCare.” Well…

During the Obama Administration, Congress took numerous votes to repeal ObamaCare. It was a safe vote–Congressmen knew that President Obama would veto anything that actually got through the Senate, and nothing would happen. Now that a vote to repeal ObamaCare would actually mean something, Congress is stalling.

I have not given up on the repeal of ObamaCare. However, I have pretty much given up on the Republican party. If they choose not to repeal ObamaCare, how are they any different from the Democrats? How can their platform say that they support smaller government and their actions say something else? In plain English, it is time for the Republicans in Congress to put up or shut up.

Is Medicare Going Bankrupt?

Yesterday The New York Post posted an article about the financial condition of Medicare. It seems that Medicare is really doing rather well.

The article cites some interesting statistics:

As the new Congress convenes, budget cutters are eyeing Medicare, citing forecasts the program for seniors is running out of money. But federal bean counters have erroneously predicted Medicare’s bankruptcy for decades. One reason: They don’t consider medical breakthroughs.

Another problem is medical ethicists like Dr. Ezekiel Emanuel, who insist the elderly are a burden and that resources would be better spent on the young.

The facts prove otherwise. New medical findings give plenty of reason for optimism about the cost of caring for the elderly. According to data published in the journal JAMA Internal Medicine, Medicare spending on end-of-life care is dropping rapidly, down from 19 percent to 13 percent of the Medicare budget since 2000. Living to a ripe old age shouldn’t be treated like it’s a problem. It’s a bargain. Someone who lives to 97 consumes only about half as much end-of-life care as someone who dies at 68.

Dr. Emanuel has some unique ideas about aging, which are stated in the article:

Why would we emulate Zeke Emanuel, age 59, who swears that at 75, he will forego all medical care and let death come quickly? “Our older years are not of high quality,” he insists. He’ll skip them. In The Atlantic magazine, he dismissed compression of morbidity as “quintessentially American” wishful thinking, and mocked seniors for trying to “cheat death.”

Keep in mind that Dr. Emanuel was one of the people behind ObamaCare who espoused the idea of limiting medical care for older Americans. That is one of the reasons it was so surprising that the AARP supported Medicare. They betrayed their own members.

The article concludes:

Too often, Congress treats Medicare as a piggy bank — raiding it when money is needed elsewhere. In 2010, Democrats in Congress paid for over half of ObamaCare’s spending by cutting Medicare. This year, Republican lawmakers eager to control federal health spending should avoid that error and instead focus on fixing Medicaid, the money pit program for the poor, where spending per capita is growing twice as fast as for Medicare. (I added the italics to this quote.)

Medicaid spending now tops $8,000 per recipient. That’s thousands more than is spent on people in private plans. And for all that money, studies show Medicaid isn’t improving patients’ health.

By contrast, Medicare is a success story. It has transformed aging, enabling older Americans to lead longer, more independent lives than our grandparents did. The average man turning 65 today will live five years longer than in 1970. Not just more years. Quality years. What a gift.

Medicare is partially paid for by payroll deductions from both the employee and the employer totaling about 2.9 percent, so Medicare is at least partially paid for. Medicaid is a gaping hole in our pockets that does not guarantee quality care to anyone. Healthcare in America is a problem that ObamaCare has made worse. Hopefully Congress and President Trump can come up with something that provides care for everyone who needs it, but also allows free market competition to keep the costs down for everyone.

Your Tax Dollars At Work

Fox News reported yesterday that illegal immigrants and others whose citizenship status was unclear received up to $750 million in ObamaCare subsidies as of June 2015.

The article reports:

The report, produced by Republicans on the Senate Homeland Security and Governmental Affairs Committee, examined Affordable Care Act tax credits meant to defray the cost of insurance premiums. It found that as of June 2015, “the Administration awarded approximately $750 million in tax credits on behalf of individuals who were later determined to be ineligible because they failed to verify their citizenship, status as a national, or legal presence.”

The review found the credits went to more than 500,000 people – who are illegal immigrants or whose legal status was unclear due to insufficient records. 

The Centers for Medicare and Medicaid Services confirmed to FoxNews.com on Monday that 471,000 customers with 2015 coverage failed to produce proper documentation on their citizenship or immigration status on time – but stressed that this does not necessarily mean they’re ineligible.  

The people who make comments like “that does not necessarily mean they’re ineligible” have obviously never raised teenagers.

The Senate report states that it is doubtful that the IRS will be able to recoup the money as there is no concrete plan to locate the people who illegally took the subsidies.

The article concludes:

The Senate report says the IRS and HHS initially failed to coordinate on a plan for recouping funds, and claimed that a subsequent plan from the IRS to recoup the money is still “ineffective and insufficient.”

In a July letter to Johnson, IRS Commissioner John Koskinen assured that the agency is “committed to identifying and efficiently addressing” improper payments. He reiterated that anyone “not lawfully present” who enrolls for ObamaCare coverage “must repay” the advance premium credit payments, and would be breaking the law if they don’t.

And the government has suddenly become efficient????

The Current State Of ObamaCare

Today’s Wall Street Journal included an article about the current state of ObamaCare. The article mentioned that Health and Human Services Secretary Sylvia Burwell recently announced that by the end of next year she expects 10 million people to be enrolled in ObamaCare. She failed to mention that in March 2014 the Congressional Budget Office predicted that 21 million people would be enrolled in 2016. The Obama Administration explains the difference as the result of fewer companies dropping employee heath insurance than expected.

There are some facts left out of the statistics quoted by ObamaCare supporters. Supporters claim that ObamaCare helped 9 million Americans get health insurance coverage in 2014. The Heritage Foundation showed that nearly 9 million people were added to Medicaid. The 9 million were given free or nearly free health insurance. That’s really not much of a sales accomplishment.

The article reminds us:

In other words, ObamaCare expanded coverage in 2014 to the extent that it gave people free or nearly free insurance. That goal could have been accomplished without the Affordable Care Act. To justify its existence, ObamaCare must make affordable private insurance available to a broad cross-section of uninsured Americans who are ineligible for Medicaid.

But with fewer people buying insurance through the exchanges, the economics aren’t holding up. Ten of the 23 innovative health-insurance plans known as co-ops—established with $2.4 billion in ObamaCare loans—will be out of business by the end of 2015 because of weak balance sheets.

The article is written by Andy Puzder, Chief Executive Officer of CKE Restaurants. He observes that of his company’s 5,453 employees who were not eligible for company health insurance, only 420 enrolled in ObamaCare. The problem with ObamaCare is that it expects healthy young people to pay higher premiums to cover the cost of the older, less healthy, insured. Young people are not inclined to do that and are instead paying the penalty for not being insured. The problem with that is that the penalties are paid to the government and not to the insurance companies and do nothing to help with the imbalance on what is paid in and what is paid out. Insurance companies charge premiums based on actuary tables, and ObamaCare has chosen to ignore the basis of the business model of insurance companies. In essence, they have attempted to reinvent the wheel while leaving out the spokes and the hub. The private sector always does better than the government when it comes to business models.

The article concludes:

How have things changed under ObamaCare? Wealthy Americans continue to have health insurance, albeit at a higher price. But they can afford it. Many middle-class Americans are paying higher premiums they can hardly afford. And then millions more low-income Americans have heavily subsidized insurance or Medicaid coverage.

However, millions of other Americans who enjoyed good individual insurance before ObamaCare have found themselves forced out of affordable plans, with their new premiums rising rapidly. Other middle- and working-class Americans who were uninsured are still uninsured and paying the penalty or claiming an exemption. That isn’t affordable care. In many cases, it isn’t care at all.

Hopefully, we will elect a President next year who will rid us of this horrendous program.

Why The Government Needs To Get Out Of Healthcare

CBS Local in New York is reporting today that the New York State Health Exchange gave out  $325,000 in overpayments to the deceased throughout the 2013 fiscal year.

The article reports:

Auditors said flaws in the eligibility process also resulted in New York enrolling 21 dead people for Medicaid, while continuing government-funded health coverage for 333 others who died.

The state comptroller’s office says its auditors found overpayments of $3.4 million in total for the year starting Oct. 1, 2013.

The Health Department says it’s been awaiting a new federal system to verify deaths. It confirmed 321 people cited in the audit were dead, four are still alive and it’s checking the other 29.

This might be one way to cut the cost of Medicaid–make sure the people claiming to be covered under it are alive.

The article further reports:

The NY State Health Exchange launched in Oct. 2013, but many faced confusion and other issues like lost insurance coverage and high premiums though the initial enrollment process.

The exchange was established under the Affordable Care Act in an effort to extend coverage to uninsured New Yorkers.

Medicaid now covers about 6 million New Yorkers and costs $60 million annually.

The department notes state enforcement efforts in 2011-2012 recovered $1.73 billion.

It’s time to get the government out of healthcare!

The Republican Congress Did Actually Accomplish Something This Year

On Friday, The Daily Signal posted an article about the payments that were supposed to bail out insurance companies for their losses under ObamaCare. When the health insurance companies initially balked at the provisions of ObamaCare, President Obama sweetened the pot by demanding that everyone have insurance, providing subsidies to make insurance affordable and expanding Medicaid.

The article explains:

The law also created two back-end bailout programs designed specifically to benefit insurers selling Obamacare plans in the individual market. Goody No. 1 was a reinsurance program that reimburses Obamacare plans for most of the expenses run up by people with high annual claims. Funded by a tax on everyone with non-Obamacare coverage, the reinsurance program shoveled nearly $8 billion to Obamacare insurers last year.

The second bailout provision was a “risk corridor” program designed to collect payments from insurers who made excess profits—as determined by the federal government—and make payments to insurers with excess losses. If the government didn’t collect enough from profitable insurers to cover the compensatory payments, taxpayers would be stuck with covering the “shortfall.”

The design amounted to a double bailout, with taxpayers on the hook for subsidizing insurance company losses on the back end as well as for the front-end subsidies and mandates that benefited insurers.

Jeff Sessions, R-Ala, led the effort to block the subsidies to insurance companies.

The article further reports:

In January, Sessions’ committee and the House Energy and Commerce Committee had identified that the Department of Health and Human Services (HHS) lacked an appropriation for bailing out insurance companies through the risk corridors. They asked the Government Accountability Office to look into the matter. That September, the GAO issued its legal opinion: the administration would need an appropriation from Congress to make outgoing payments.

Congress decided that the taxpayers should not be responsible for bailing out the insurance companies, and the taxpayers saved $2.5 billion this year.

The Republican Congress can say that it accomplished at least one thing this year.

The Problem Is Not The Income

The Wall Street Journal posted an article yesterday about the amount of tax revenue the federal government collected for fiscal 2015. The good news is that the government collected a record amount of money–$3.249 trillion. That is an 8 percent increase in revenues for the year. The bad news is that the government still managed to spend more than it took in. The budget deficit was $435 billion–a decline of $48 billion. The article notes that although the decline is small, it is huge for the seventh year of what the government claims is an expansion. The article also notes that inflation is growing by less than 2 percent.

The article reports:

The reason for the small decline is that spending for the fiscal year climbed 5.2% to $3.685 trillion. That increase came even though defense spending fell $16 billion, or 2.7%, thanks to the drawdown in Afghanistan.

The spending burst included a 16.1%, or $49 billion, increase in Medicaid for the first full year of ObamaCare. Medicaid spending has climbed $85 billion to $350 billion in two years, and that’s with 19 states declining to join.

The Congressional Budget Office also cites a $30 billion, or 51%, spending increase for the Department of Education—“mostly because of an $18 billion upward revision in the estimated net subsidy costs of student loans and loan guarantees issued in past years.” Translation: Mr. Obama’s takeover of the student-loan business is costing far more money than advertised, probably due to growing defaults.

Let’s put these numbers together. Inflation is less than 2 percent. There was an 8 percent increase in revenues collected by the federal government. There was a $435 billion deficit. These numbers are unsustainable. They will assure the destruction of America. We need to elect people to Congress and the White House who will cut government spending. It is a national disgrace to have an 8 percent increase in revenues and still have a deficit. It is time for any rational members of Congress to demand a spending cut.

Is Death An Excuse For Missing Work?

Is death an excuse for missing work? I don’t mean a death in the family–I mean your own death. Well, not in New York City. The New York Post reported that that Medicaid-eligibility specialist Geoffrey Toliver was fired after not showing up for his hearing where he was to be accused of going AWOL because he had not shown up for his job since November 2013. Toliver died at age 65 on Dec. 8, 2014.

 

The article reports:

“How do you fire a man who is already dead? He deserves better. The agency itself should have known,” said Ted Willbright, who added that he considered Toliver as a brother.

“Some people he worked with were very supportive, so how did HRA the organization not know? He’s dead, and they’re saying he abandoned his job. He didn’t abandon his job, his job abandoned him. He was a good man. Truly, truly a good man.”

HRA officials said they sought to remove Toliver from his $38,000-a-year job after they couldn’t reach him for well over a year.

They marked the start of his absence as Nov. 12, 2013, and said calls and certified letters mailed to his home were never answered.

“We did everything we could to contact him and his family,” said HRA spokesman David Neustadt. “This employee was not paid when he wasn’t working, but we left his job open in case he recovered.”

He said that now that the agency knows of his “unfortunate death,” it would take no further action.

What would be the appropriate further action to take against a dead man?

Here’s One Place We Can Cut Government Spending

The Washington Examiner posted a story today about Medicaid fraud. Medicaid is the federal program that provides medical care to people who can’t afford it.

The article reports:

Healthcare providers banned from Medicaid may have been reimbursed $213 million in federal money, thanks to a state agency oversight, a government watchdog reported.

Valid identification numbers — identifiers that ensure providers are eligible for Medicaid reimbursements — were missing from 800,000 Colorado claims in 2011, the U.S. Department of Health and Human Services inspector general reported Wednesday.

The state reimbursed the providers $424.4 million for the claims, of which, $213 million was federal money.

Regardless of how you feel about government-provided healthcare and whether or not it is constitutional, a $213 million dollar savings in federal spending would be nice. If one state has that much Medicaid fraud, how much do the other states have?

The article goes on to explain that the computer system in Colorado was not able to alert officials to missing or incorrect identification numbers and that the problem would not be corrected until 2016. However, the agency is now denying claims with invalid or missing numbers. It sounds like Colorado is working with the same programmers that designed the ObamaCare website.

The Cost Of Immigration

America is a country that was built by immigrants. People came here from Europe and other places to celebrate freedom, escape religious persecution, or simply to begin again. The Catholics fled the potato famine, the Jews fled the pogroms, and others came to buy land to farm and support a family.

Well, not all of today’s immigrants have the same sort of ambition. National Review reported today that 42 percent of new Medicaid recipients are immigrants.

The article reports:

Federal law bans the admission of immigrants who are likely to be significant beneficiaries of welfare, technically a “public charge,” but that definition doesn’t consider in-kind welfare programs like Medicaid: U.S. Citizenship and Immigration Services defines being a public charge as “the receipt of public cash assistance for income maintenance or institutionalization for long-term care at government expense.” The USCIS union president has recently complained that President Obama is not enforcing public-charge laws.

Illegal immigrants are ineligible for Medicaid currently and are technically ineligible for the Medicaid expansion or any other direct Obamacare benefits, but fraud in the program is rarely investigated and recipient-level eligiblity is rarely investigated.

The article also reminds us that Medicaid has been expanded so that people with incomes up to 138 percent of the federal poverty line are eligible. This greatly increased the cost of the program.

I am not opposed to immigration, but I question the wisdom of an immigration policy that allows people to come here and be a burden on the federal government. Our federal deficit is out of control, why are we passing laws that make it worse?

Once The Camel’s Nose Is Under The Tent

On Monday, Byron York posted an article at the Washington Examiner about the problems involved in getting rid of ObamaCare as it becomes entrenched in American medicine.

The article reports:

What is different about Republican calls for repeal today — as opposed to calls for repeal from 2010 to the end of 2013 — is that Obamacare is now in place. It exists. Exchanges are running — many of them badly, but running. Subsidies are being paid. Insurance companies have changed the way they do business. Medicaid has been expanded. Special taxes are being collected.

Even though the system is new, millions of Americans have gone to a lot of trouble to adjust to it, and it would be disruptive to them to just stop cold. Halt subsidies? Undo Medicaid expansion? Just as last fall, when millions of Americans received coverage cancellation notices, millions more would face new burdens under the repeal of Obamacare.

This is not good news for the American healthcare system, but it is not unexpected news. Just as ObamaCare was extremely disruptive to the system in place, repealing ObamaCare is going to be disruptive to what has been put in place since the law was passed.

Meanwhile, in an effort to avoid a stunning defeat in the mid-term elections, the rules of ObamaCare have been changed again.

The Washington Post reported yesterday:

The Obama administration has decided to give extra time to Americans who say that they are unable to enroll in health plans through the federal insurance marketplace by the March 31 deadline.

Federal officials confirmed Tuesday evening that all consumers who have begun to apply for coverage on HealthCare.gov, but who do not finish by Monday, will have until about mid-April to ask for an extension.

Under the new rules, people will be able to qualify for an extension by checking a blue box on HealthCare.gov to indicate that they tried to enroll before the deadline. This method will rely on an honor system; the government will not try to determine whether the person is telling the truth.

The rules, which will apply to the federal exchanges operating in three dozen states, will essentially create a large loophole even as White House officials have repeatedly said that the March 31 deadline was firm. The extra time will not technically alter the deadline but will create a broad new category of people eligible for what’s known as a special enrollment period.

This is another example of the Obama Administration moving the goal posts when it is to their political advantage to do so. It would be nice if someone in Congress had the backbone to stand up for the Constitution.

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