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Kathleen Sibelius, who as Secretary of Health and Human Services will be in charge of developing much of our new healthcare system, had an intriguing piece in Roll Call this morning. If you peruse the secretary’s article, you get the impression that the new healthcare system is already improving the lives of many Americans.
However, if you read Sibelius’ piece carefully, you might be more inclined to come away thinking that it is more rhetoric than reality. “In general,” said Cato Institute healthcare expert Michael Cannon, “the piece paints a picture of what they hope will be accomplished by the healthcare legislation as opposed to what it will actually accomplish.”
Let’s look at some highlights of the Roll Call piece.
Sibelius: Small businesses, which have increasingly been forced to drop health care coverage over the past decade, are also getting some relief: In addition to new tax credits available this year, small businesses will be able to band together in new Small Business Health Options Programs to negotiate better deals for health insurance beginning in 2014. And large employers have gotten help, too, in the form of an early retiree reinsurance program, which will help ease the burden of soaring legacy health costs.
In reality, the heralded tax credits for small businesses are so small as to be insignificant, more window dressing than anything else, say critics. A calculator chart by the National Federation of Independent Business estimates that the small business credit for a typical employee making around $36,000 a year will be something in the neighborhood of $308. The NFIB cautions that these figures are tentative since the provisions of the legislation are just now unfolding. But I think we can all agree that $300 isn’t going to make much difference to any business.
Some critics of healthcare reform have gone so far as to claim that the credits are so small as to be utterly meaningless.
Sibelius: Meanwhile, all Americans are beginning to see the impact of strengthened consumer protections, which are being implemented ahead of schedule through our partnerships with insurance companies. Private insurers have promised to end the practice of rescinding coverage from people when they get sick because of paperwork errors, and 65 of our largest insurance companies have agreed to allow young adults under age 26 to stay on their parents’ coverage.
In reality, you’d have to have an inaccurate picture of what health insurance companies can do now to buy this claim. “There’s nothing new here,” said Marie Grace Turner of the Galen Institute, which focuses on health and tax policy, “it’s just rhetoric. Companies legally now can’t rescind insurance coverage when people get sick—they can only rescind coverage when people commit fraud.”
Turner admits that allowing young people to remain on their parents’ policies is having an impact: it is causing premiums to rise. You simply can’t have new services without somebody picking up the tab.
Sibelius: Over the past year, President Barack Obama has made it clear that these people should be able to keep their plans. To make sure that happens, we recently issued a new regulation on “grandfathered” plans that gives important new protections and benefits to Americans while ensuring that insurers have the flexibility to keep offering preferred plans.
Where to begin? The problem is that, yes, you can keep a plan that is grandfathered into the new system, but the plan will likely have so many mandated, new features, none of which are free, that it’s really not your old plan at all. The National Federation of Independent Businesses has figured out what the allegedly grandfathered policies will really be:
“Unfortunately, the restrictiveness of these regulations removes the already limited choices small businesses have to try to keep up with the ever-increasing cost of plans. The Administration is essentially making it harder for small firms to continue offering healthcare, much less keep what they’ve got,” notes in a report on its website.
Sibelius: The Affordable Care Act takes aggressive steps to eliminate waste, fraud and abuse in our health care system — especially in Medicare, where billions of dollars a year are lost and seniors pay the price.
Well, good luck! Who’s not in favor of eliminating fraud, waste, and abuse? But if it were that easy, we’d have done it long ago.
Sibelius’s piece is just one more effort to convince people by rhetoric of things that their lying eyes (and checkbooks) will perceive otherwise. All the happy talk in the world isn’t going to change public perception of the emerging, new healthcare system.
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POLITICO
By: Alex Isanstadt
In an unprecedented expansion of their scope and profile, conservative women’s groups are plowing cash into the campaigns of female candidates across the map.
At least three separate groups are actively engaged in efforts to elect conservative women to Congress, providing a counterpoint to influential Democratic-oriented women’s groups, such as EMILY’s List, which have long played an outsize role in funneling resources into electing women to office.
The Susan B. Anthony List, an organization that backs female candidates who oppose abortion, is on track to raise and spend as much as $12 million this election cycle — $4 million more than the group spent in 2008 and more than twice as much as it spent in 2004. As recently as three weeks ago, the SBA List announced it was launching a $215,000 independent expenditure campaign in support of California GOP Senate candidate Carly Fiorina, who won the nomination June 8. The group also spent $200,000 in neighboring Nevada, where it backed former state GOP Chairwoman Sue Lowden, who finished second in that state’s June 8 Senate primary.
“The stakes are high for women and unborn children this election,” said SBA List President Marjorie Dannenfelser, whose group claims 280,000 members. “Our membership is energized like never before, and we are committed to making gains at the ballot box in November.”
The groups’ leaders say they’ve been spurred to action by a confluence of political events — the inspirational value of Sarah Palin’s vice presidential nomination, an abundance of credentialed female conservative candidates and a landscape that is rife with opportunities for Republicans.
“We are definitely ramping up,” said Concerned Women for America Political Action Committee Executive Director Mike Mears. “We are seeing a lot going on out there.”
The Concerned Women for America PAC, another group that opposes abortion rights, plans to bundle $10,000-$15,000 for candidates in more than 40 targeted races this cycle and, for the first time in the organization’s history, will launch an independent expenditure campaign.
The 50,000-member organization has already endorsed 38 House and Senate candidates — more than double the number of contenders it backed in 2006 and 2008. In January, the PAC brought in Penny Nance, an outspoken and visible social conservative activist, to serve as its chief executive officer.
Independent Women’s Voice is another group that is suddenly flexing its muscles. IWV has invested more than a half-million dollars in key 2010 races — not enough to leave a big footprint in races but a significant amount for an organization that had never previously spent money on elections.
Already, IWV’s presence has been felt: In May, the group was the only outside organization on the airwaves in Hawaii’s House special election, spending about $250,000.
Heather Higgins, the organization’s president and chief executive officer and a longtime conservative activist, says the group is planning an independent expenditure campaign in the fall.
The increased involvement is in no small part the result of the increased number of viable GOP female candidates seeking office this year. According to the Center for American Women and Politics at Rutgers University, 17 Republican women have sought Senate seats this cycle, compared with six in 2008. And 113 Republican women have sought House seats in 2010, compared with just 65 in 2008.
“There has been a big shift. We are seeing Republican women running and really stepping up,” said SBA’s Dannenfelser. “It’s qualitatively different this year than last.”
“We are seeing women come of age in politics,” added Concerned Women for America’s Nance. “It’s a coming of age in conservatism to have women embracing becoming our leaders.”
The more expansive conservative female presence is also a reflection of the rise and prominence of outspoken, high-profile female pols such as Palin and Rep. Michele Bachmann (R-Minn.), both of whom are frequently credited with advancing an activist mind-set in conservative women’s circles.
Dannenfelser, whose organization played host to Palin at a May breakfast fundraiser in Washington, noted that the former Alaska governor played an important role in conservative politics — a world that is dominated by men.
Palin’s model “has absolutely produced a template to step up in a way we haven’t seen before,” said Dannenfelser. “You have a traditional woman doing a nontraditional thing. Before those doors opened, they were largely closed to Republican women.”
The issue agenda, once the primary focus for many of the groups, is another reason the groups have stepped up their efforts.
As the debate over federal funding for abortion took center stage in the health care push, the SBA List launched a “Votes Have Consequences” campaign aimed at contacting hundreds of thousands of anti-abortion voters across the country. Concerned Women for America PAC, for its part, is set to announce a similar campaign, targeting Democrats who voted for the “don’t ask, don’t tell” repeal.
“When you’ve got a Congress that just passed don’t ask, don’t tell, when you’ve got an administration that is the most pro-abortion administration in years, I think that’s a factor,” said Mears. “I think groups are saying the stakes are pretty high.”
Social issues, however, aren’t the groups’ sole focus. IWV is centering its campaign on the nation’s ailing economy, running an ad in the Hawaii special election that hammered former Democratic Rep. Ed Case as a “tax-raising liberal.”
“For the last year, we think [Troubled Asset Relief Program], the stimulus and the health care bill have really brought economic issues to the fore,” said Higgins.
And while social issues like abortion and gay marriage have for years dominated the agenda for conservative women, Kellyanne Conway, a GOP pollster who works with all three women’s groups, said homing in on the economy was key to appealing to those voters in 2010.
“I think, for years, women were concerned about the abortion issue. I think women’s issues in 2010 begin with the economy,” said Conway. “You can’t say abortion is a women’s issue and leave it at that. This year, the predominant concerns are jobs, the economy and health care.”
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The Washington Examiner
By: Sally C. Pipes
Devotees of big government, like Archimedes, believe that if they have a long lever and a place to stand, they can move the world.
In 2006, a bipartisan band of such politicians in Massachusetts immersed themselves in wishful thinking, ignored both hard facts and proven theory, and used their political muscle to build bureaucracy, increase taxes, and aggregated power to remake health care in the Bay State.
President Obama, House Speaker Nancy Pelosi and Senate Majority Leader Harry Reid took the act nationwide with the passage in March 2010 of the Patient Protection and Affordable Care Act. Like the canary in a mineshaft, Massachusetts provides a strong indication of our fate.
By now, Bay Staters should be celebrating reform. It promised to benefit all. The bureaucrats would design and broker affordable health plans, doctors and hospitals would get a bump in Medicaid rates, and the uninsured would no longer be a burden.
The system was cracked from the beginning, its promises undelivered even as it picked the pockets of business owners and taxpayers. The crack turned into a chasm this spring, when the state’s private carriers filed for double-digit rate increases for individual and small group plans.
This incensed Democratic Gov. Duval Patrick and the bureaucrats who simply said no. A court upheld their authority, and carriers were forced to continue at 2009 prices, booking loses daily.
They are still fighting in court, and another ruling is expected on the applications for rate increases on plans this summer.
In early June, two large carriers came back with more double-digit increases for plans renewing in July. They expect them to be declined. They are simply positioning themselves for a two-front war: One with the regulators and one with the providers they pay.
The system is inherently unstable and primed for a series of nasty fights. Like dry season at an Everglades watering hole, all the players confined in a tight space, hungry, and all eyeing the same receding resources. Like this tight ecosystem, the players will start to feed on each other, as survival of the politically-fittest takes hold.
This is the case in Massachusetts now. The state’s four largest carriers are hemorrhaging $150 million a month. Roughly a third of contracts are up for negotiation and they are pushing for givebacks.
Providers are crying poor. Reform actually hurt their numbers, as most of the newly-insured enrolled in government-run and subsidized plans under Commonwealth Care that pay less than the actual cost for care.
When you lose money on every unit, you can’t make it up on volume. Traditionally, the cost has been shifted to those with private insurance, but those days are over.
Hospitals and clinic operators maintain that two-thirds of the monies they collect are simply passed on to doctors, nurses, and other essential staff. Cuts here are akin to cuts in wages. Wage cuts will be resisted. The unionized will strike. Those who aren’t will slow down on the job. Doctors will reduce their level of service and some will take early retirement.
The political and bureaucratic response is naturally to clamp down with more control. Massachusetts’ political leaders and activists are making a strong push for a structure of mandatory global payments, which is merely a state-dominated HMO or single payer system. This, they claim, is the next logical step of health care reform.
Meanwhile, a bill in the state senate would force doctors to accept cut-rate reimbursements for Medicaid patients as a condition to practice medicine in the state. When voluntary exchange doesn’t work for politicians, they move to conscription.
In Massachusetts, it took four years to get to this point, and it’s certainly a downhill slide from here. Nationally, Obama’s bureaucrats are just getting started. The administration has yet to comply with the law’s requirement that it detail the myriad of powers it’s been granted, yet it has put the bureaucrats in place to get the job started.
While Obama did not get his Health Insurance Rate Authority into the final bill, the newly-created Office of Consumer Information and Insurance Oversight within HHS will perform the same function.
The new authority has been staffed at the top by four individuals known to be tough on private insurers and more comfortable with the views of Ralph Nader than Adam Smith.
Former Missouri Insurance Commissioner Jay Angoff is the head watchdog. We can expect this team to pick up where Obama and Democrats in Congress left off beating up the insurance carriers including writing regulations to define when premium increases are reasonable.
At the end of the day, the carriers are merely pass-through entities that are necessary to administer the system. They will probably survive but, like regulated public utilities, will be guaranteed after their Medical Loss Ratios (the percentage that an insurer must pay out in claims) and administrative costs are controlled by government, a modest surplus for their efforts. The ultimate payers will be consumers and taxpayers, who will either pay more for less or more for nothing at all. What happens in Mass won’t be staying in Mass.
Sally C. Pipes is president and CEO of the Pacific Research Institute, and author of The Top Ten Myths of American Health Care.
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Carrie Lukas joins the Martha Zoller Show to discuss feminism issues.
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The Wall Street Journal
The Primaries are producing some welcome new talent.
American democracy is nothing if not responsive, and on the evidence of the current primary season the frustrated American voter is demanding a transfusion of new political blood. The results have been volatile, and sometimes bewildering, but overall the elections are throwing up more candidates who are refreshingly unconventional.
Meg Whitman, left, winner of the Republican nomination for governor of California, and Carly Fiorina, the GOP nominee for the U.S. Senate from California, celebrate at a post-primary election celebration in Anaheim, Calif.
Take California, where the Republican Party—the party of primogeniture and middle-aged white males—has nominated a pair of female former Silicon Valley CEOs to run for Governor and the Senate. Neither has run for office before, and both are running as pragmatic but unapologetic conservatives seeking to reform runaway governments in Sacramento and Washington. Both face difficult autumn races in that Democratic-leaning state, but this is the kind of tumultuous year when they might win.
If Carly Fiorina can defeat liberal Barbara Boxer, she would represent the largest ideological shift in one Senate seat in many years. Ms. Boxer is so doctrinaire, and so unpersuasive to her peers, that Democrats have stripped her of Senate leadership on climate legislation. But she is also a brutal and well-funded campaigner who will portray Ms. Fiorina, the former Hewlett-Packard boss, as a cross between BP and Goldman Sachs who also favors back-alley abortions.
Ms. Fiorina’s message can be distilled into two themes: Grow the economy and cut spending. If that prevails on the Left Coast, we really do have a lovely revolution on our hands.
As for former eBay CEO Meg Whitman, she has the task of convincing voters that a rookie Republican can tame the special-interest mobs that run Sacramento. Arnold Schwarzenegger was elected on a similar promise but was broken by the unions and his own desire to be liked. Ms. Whitman will have to convince voters she won’t be rolled in the same way. Her support for a one-year moratorium on the state’s self-destructive climate-change rule AB32 is a tepid start, but she’ll need both tax- and spending-limit proposals if she’s going to win a mandate to overcome the gerrymandered far-left legislature.
Her Democratic opponent, former two-term Governor Jerry Brown, is a career politician but one who has been quirky enough in the past to make us wonder if he might take on Sacramento’s Greek chorus. On the other hand, he may now be so beholden to the unions to help him defeat Ms. Whitman that he won’t be able to challenge them on spending and pensions. This is the kind of big reform debate that California voters deserve.
Tea party candidates also showed their mettle on Tuesday, though in ways that make their staying power in November unpredictable. The rise and triumph of Republican state legislator Sharron Angle in Nevada’s Senate primary against two better known candidates happened so fast that we wonder how many Nevadans really know her generally conservative voting record.
She’d better know how to defend those votes, because Senate Majority Leader Harry Reid is preparing to run ads portraying her as a radical even as you read this. “Further and Further Right” is the headline on a Democratic fund-raising pitch we recently saw describing several GOP Senate candidates, and with President Obama and his agenda down in the polls, going negative and ad hominem will be the party’s Alamo strategy.
Perhaps nowhere was the voter rebellion greater than in conservative South Carolina. Incumbent Republican Congressman Bob Inglis was crushed after his dalliance with cap and tax and his vote for TARP. Tea party favorite Nikki Haley prevailed over no fewer than three pillars of the GOP establishment, including the current Lieutenant Governor, state Attorney General, and a Member of Congress—and the state’s media establishment. The articulate conservative and daughter of Sikh immigrants barely missed avoiding the need for a runoff with 49% of the vote and is the favorite to win that on June 22.
Perhaps most revolutionary was the strong showing by black Republican Tim Scott in his Congressional primary against scions of two legendary South Carolina political families. Mr. Scott, a state legislator from the Charleston area where the Civil War began, ran well ahead of former Senator Strom Thurmond’s grandson and the son of former Republican Governor Carroll Campbell.
He faces a runoff against Paul Thurmond in the heavily GOP district, but his showing to date demonstrates how far the South has come on race matters. He would be the first black Republican in Congress from the Old Confederacy since Reconstruction.
The Obama Democrats lit the match for this voter tumult with their radical expansion of government. The voters are responding with a healthy fervor, with Republicans in particular looking for standard-bearers who will fight more than accommodate the status quo. While some of these new faces will falter before November, others look to be the kind of determined reformers that our political class naturally fears. So much the better
