Uncommon Sense

politics and society are, unfortunately, much the same thing

What happens when no one asks whether insurance is really a good way to deal with health care costs?

original article: How Obamacare Hurts Millions Of Americans By Robbing Peter To Pay For Paul
May 10, 2017 by Scott Ehrlich

In my prior article, I tried to outline the pre-existing condition issue. I concluded the amount of people potentially affected by this issue ranged somewhere between 500,000 and 1.9 million and, due to political reasons, it is much likelier to be on the lower end of that spectrum.

So for this article, I will use 1 million people as my number. Based on this data from Avalere, it’s a pretty sensible estimate, if you only count states that are solely Republican-run and therefore likely to seek a waiver.

This 1 million people are adults covered by the individual market, at the moment largely through the federal exchanges. People on group insurance are not affected by pre-existing conditions laws, as those plans do not do individual underwriting. People in government insurance such as Medicaid, Medicare, and Tri-Care are guaranteed issue upon meeting certain conditions. Children under 19 who aren’t covered by Medicaid are covered by the Children’s Health Insurance Program, which has no pre-existing condition exclusions. Futher, people in Maine, Massachusetts, New Jersey, New York, Vermont, and Washington have state laws that mandate guaranteed issue.

So our at-risk people are made up of the remaining 7 million or so people in the other 45 states who choose to self-insure, have pre-existing conditions that stop them from getting insurance, have states granted waivers under the American Health Care Act (AHCA, if it passes Congress in its current form), and have failed to keep continuous coverage.

Assuming your eyes glazed over a quarter of a way through that sentence, that shows just how many safety nets one has to fall through to be at risk of being denied coverage at the market rate, or any rate, for pre-existing conditions. Recall that just because someone has a pre-existing condition or is denied by an insurance company for one, doesn’t mean he will be denied by all. So that is why my numbers are lower than many others being reported.

Let’s Pin Down How Much These Folks’ Health Care Costs

So let’s go with that 1 million number, which is still a lot of people needing help. What can we do with them? That is the challenge. When enrolling a random assortment of 1 million Americans in a pool, theoretically about 27 percent could have some sort of ailment requiring immediate treatment. Depending on the mix of other people, it’s possible to make that pool actuarily sound.

But high-risk pools don’t work that way. In that pool, 100 percent of enrollees have pre-existing conditions. Therefore, it’s impossible to provide them insurance and keep a stable pool. You can’t insure someone for a condition he already has any more than you can insure a house that is already on fire or a car that has already crashed. There is no ability to pool risk.

So this group of people is very expensive to cover, as they are already sick and use a lot of health care. Average costs in the PCIP federal high-risk pool, the one the Affordable Care Act set up as a bridge to the exchanges, averaged more than $32,000 per enrollee per year. Based on those numbers, at 1 million enrollees, we’d be looking at more than $32 billion annually in costs for high-risk people. That $8 billion that got Rep. Fred Upton to vote yes on House Republicans’ Obamacare tweaks? That would cover only three months of expenses at full enrollment.

If the entire amount appropriated in AHCA were applied to pre-existing conditions, a whopping $123 billion, we’d only have enough to make it through four years if that cost were accurate.

Luckily, That Cost Is Likely Overstated

Reading deeper into the report, you find that, fortunately, it may not be. Not all people with pre-existing conditions are created equally: “4.4 percent of PCIP enrollees accounted for over 50 percent of claims paid, while approximately two-thirds of enrollees experienced $5,000 or less in claims paid over the same period.” So while Avalere used the $32,000 figure, it probably vastly overstates the cost of a program like this. That’s because the people most likely to have been enrolled in PCIP would be the sickest, who need the most care immediately.

Someone with early-stage diabetes with no side effects, like myself, who may currently be tough to insure may ignore a high-risk pool like this since it costs more than I spend on treatment, while someone with advanced cancer requiring frequent doctor visits, expensive medication, and consistent chemotherapy would seek something like this out. Therefore, if the pool of 115,000 enrollees in PCIP were expanded to the 1 million people who have pre-existing conditions but couldn’t be insured, we’d likely see many more costing about $5,000 per year than the ones costing $100,000 and up.

Therefore, I prefer the number $12,000 as the cost per additional enrollee. This uses the average benefit used by a person enrolled in Medicare based on the total benefits paid divided by the total people covered. Since these people are older, sicker, or disabled and have high health utilization, I think it makes a good proxy for the sort of person likely to seek a high-risk pool who would not have jumped at the opportunity to sign up for PCIP.

Adding 900,000 people at that cost to the 100,000 people at $32,000 in PCIP gives us a total annual cost of $14 billion. That means if people in these pools were to cover about 10 percent of their own health-care expenses, the money AHCA appropriates could cover the entire affected population of the high-risk pools for the entire 10-year budget window.

This Is Still a Lot of Money

So now we’ve seen the numbers. About a million people may need help. Pooling them with the healthy has real costs to a lot of people to help a few. But we have decided as a society that we can’t just let those few suffer. Yet helping pay for their care will be staggeringly expensive. Even in my example, with this smaller pool and smaller assumed costs, we would burn through the entire pool of $123 billion in a decade. These people will still need help at the end of that decade. How do we take care of our sick population into the 2030s without busting our budget?

That is why people argue we should keep the Affordable Care Act provisions regarding pre-existing conditions, which are community rating and guaranteed issue. The benefits are obvious, as they have been blasted all over the media. People getting operations they might not otherwise have had, seeing doctors they couldn’t otherwise see, getting care they wouldn’t have otherwise received. Who would be so heartless as to take that away?

This is a classic example of concentrated and observable risk and diffuse and hard to see benefits. Remember what has happened to premiums since ACA was implemented. All these people were not covered without a cost. That cost comes out of the pockets of everyone else in the exchanges. While much harder to see, and much less heart-wrenching in a soundbite or a video or a tweet, those costs did make a difference.

Adding a few hundred dollars a month to health premiums can mean the difference between eating terrible food and eating healthy, not working out and a gym membership, scrimping and stressing over every dollar and rationing essentials which adds mental and physical health costs, or a budget that more comfortably covers your fixed expenses.

More severely, higher premiums for lower-quality policies may mean that some people who may have formerly been able to afford some form of insurance now are going without, causing exactly the sort of problem ACA was supposed to fix. To act like the days, weeks, months, and years taken off the lives of some people due to the costs ACA imposes to help others is without consequence is sadly mistaken.

When Compassion Is Cruel

Those realities aren’t purely speculative, either. Rates are rising year over year. Even with rising subsidies, the plans get more expensive to both buyers and the taxpayers. And there is no sign these rising rates will abate, as more people for whom insurance has a marginal value will choose to go without, leaving a sicker pool, causing not only rates to rise but insurance companies to lose more and more money on these policies.

That leads to insurers dropping out of markets entirely. This is why doing it the “compassionate” way has not only costs for people whose rates will rise, but also costs for those this is supposed to help, as this adverse selection will result in many of them also having no insurance options. Guaranteed issue and community rating do very little good if no one is willing to sell policies because the cost risk is too high.

That is why, whichever way you lean politically, both the ACA and AHCA seem to be just a band-aid. Neither are sustainable, needing significant federal money pumped into them to survive. ACA will need it to subsidize the cost of policies to get healthy people to sign up while also subsidizing the losses insurance companies suffer in an effort to keep them on the exchanges when they don’t.

AHCA will need massive continued subsidies to fund high-risk pools, all as health-care gets more individualized and potentially more expensive. This is in addition to the increasing burden Medicare will put on state and federal budgets as baby boomers retire and live to a ripe old age, while higher birth rates among poorer Americans, in addition to ACA expansion, should cause a massive increase in Medicaid spending.

This is why any comprehensive health insurance reform is doomed to fail. Americans want great quality care at cheap prices that is abundantly available. At best, we can get two of those three. At worst, we get very expensive plans that provide very little real health care for the most vulnerable while making things worse for everyone else. That is why our efforts should focus on ways to provide better health care for everyone, increasing the size of the pie of good-quality, available health care rather than locking in the worst parts of our current system and merely fighting about who should pay for them.

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No, GOP’s Obamacare Update Doesn’t Make Rape A Pre-Existing Condition

original article: No, GOP’s Obamacare Update Doesn’t Make Rape A Pre-Existing Condition
May 8, 2017 by Robert Tracinski

The American Left is finishing its sixth straight month of losing it. They have been pegged at “total freakout” for so long now that it is impossible to tell when anything they say is valid or wildly exaggerated.

Take the headline you undoubtedly saw, or had forwarded to you on social media if you interact much with people on the Left, which proclaimed that the American Health Care Act—House Republicans’ Obamacare tweaks—makes sexual assault a pre-existing condition.

AHCA_preexisting

What’s actually going on here? The House bill, which mostly just tinkers with Obamacare instead of actually repealing it, still contains a requirement that insurers have to cover people with pre-existing conditions. But a late addition, the MacArthur Amendment, gives states the ability to ask the federal government for a waiver that would allow insurers to charge people with pre-existing conditions higher rates.

The amendment itself—and I had to search around for a while to find its actual text rather than somebody’s short-stroke summary of it—makes no mention of sexual assault or rape.

Ah, but somebody realized that rape victims sometimes suffer medical problems as a consequences of the assault and that these problems would count as “pre-existing conditions” under the law. They would count as such because they have always counted as pre-existing conditions. But so would any number of other conditions resulting from other tragic and unfortunate events. In other words, this headline is so misleading that even PolitiFact rates it as “Mostly False.”

The new law does not “make” sexual assault a pre-existing condition. The medical consequences of rape have always been considered a pre-existing condition, because that’s what the phrase “pre-existing condition” means. It refers to a condition that existed previously.

“Pre-existing condition” is not a value judgment. It does not imply that the pre-existing condition is the patient’s fault, or that this person is somehow unworthy of receiving medical treatment. It is a merely factual description, but one that has special relevance when talking about insurance. When you require insurance coverage for a pre-existing condition, it’s no longer insurance. Insurance is a financial mechanism for hedging against an unknown future risk, not a way of seeking compensation for damage that has already occurred.

If that seems like a nitpicking distinction, it’s one with very big real-world consequences. Telling insurance companies that they have to cover pre-existing conditions and can’t charge more for that coverage breaks the actuarial calculation behind insurance and contributes to the “death spiral” of escalating premiums, which we could already see under Obamacare. So you can understand why there’s a rational argument for not requiring pre-existing conditions of any kind to be covered under the heading of “insurance.”

So are Democrats making this claim about sexual assault because they want to lobby for free medical treatment for victims of sexual assault—a worthy cause they just discovered five minutes ago? No, they’re doing it because evoking sexual assault victims, as opposed to sufferers of any other kind of pre-existing condition, packs a special emotional wallop. Then when somebody responds by carefully and rationally explaining what’s really going on and why pre-existing conditions can’t be covered if health insurance is going to function properly—as I just did above—that person suddenly looks like a callous heel. How can he approach the issue with such cool logic? How can he be so insensitive to the victims?

In short, it’s a raw appeal to emotion, specifically designed to make rational analysis of the issues look not just inappropriate, but positively immoral.

The Appeal to Emotion is a fallacy that’s thousands of years old, but what makes this particular case a microcosm of today’s style of argument is one extra twist. If the purpose of the Appeal to Emotion is to make logical analysis seem insensitive, the purpose here is to make the user of logic seem insensitive specifically to women. This fits right in with the target audience’s prejudices. Of course those evil people on the Right, those old white men reveling in their patriarchal privilege, would be callously indifferent to the suffering of women. Of course they want women to bear the blame for their own sexual assaults. It’s just like “The Handmaid’s Tale.” We knew it all along!

That’s what makes the headline “too good to check” and ensures its entry into the natural life cycle of a “fake news” story: blaring viral headlines, followed by low-key, surreptitious corrections in the more reputable outlets, followed by the cementing of the headline as an established fact that will never be dislodged from the minds of its target audience. We’ll still be hearing about it 30 years from now.

This fits into a larger problem with how the Left tends to interact with everyone else while they’re in Perpetual Rage Mode. As someone who attempts to interact with the other side pretty regularly on social media—and not always just to score rhetorical points—I’ve begun to notice a distinct pattern. People on the Left will interact with someone on the Right just long enough to be able to find some sign, some slip of the tongue, some violation of accepted speech codes (like not being a prig about Cinco de Mayo) that allows them to dismiss that person as racist, sexist, homophobic, or just insensitive—which provides an excuse to ignore anything he has to say. The conclusion is always the same: all arguments from the Right can be dismissed without consideration because they come from bigots.

They need to stop doing this, and not for our sake—if you’re on the Right, you’re probably used to coping with an omnipresent background radiation of political hostility—but for their own sake. It is a spectacularly unconvincing method of argument that drives people back into their own social media “filter bubbles.” It doesn’t convince anyone. It just convinces them not to talk to you any more. Then you end up on an evening in November, stunned at the fact that so many people voted for a candidate whose sole political function is to stick a finger in your eye.

The Left is already paying the price for making “race, class, and gender” into a substitute for argument and persuasion. They might want to consider not digging that hole any deeper.

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The NEA has failed us and doesn’t deserve tax payer funding

original article: Where Are the NEA-Sponsored Classical Masterpieces?
March 27, 2017 by STEPHEN LIMBAUGH

Be it the misuse of funds, waste, or deleterious governing philosophy, the National Endowment for the Arts has proven to be a recidivistic cultural butcher.

The NEA’s process for cultivating art is informed by standards set by universities and critical theorists. Those standards of what qualify as “acceptable” contemporary art seem to be any phenomena that offends an individual’s inherent aesthetic disposition. Preferential treatment is given to those works that 1) are able to evoke the most unpleasant reaction and 2) are created with the least amount of discernible purpose. This destructive artistic praxis is thoroughly documented, and there are few examples of NEA-backed art that does not adhere to it.

In the art world, $150 million in annual funding is a lot of money. With that kind of money comes real power to shape the culture. That concentration of power has had a chilling effect on the production of new works by artists who do not abide by the NEA’s ideology. Artists either yield to these requirements or are driven to creatively limited commercial endeavors in order to survive.

That effect has contributed to the decline of quality of art in America for the last half century, and the art world would be in an undisputed crisis were it not for private philanthropic organizations. Even private philanthropists, rather than donating in response to artistic brilliance, too often acquiesce to NEA fundraising schemes and budget crises.

Another aspect of this decline is that the NEA has been largely unsuccessful in fostering new interest in existing masterpieces. One example of this is evidenced by a 1977 survey showing that in the top ten metropolitan areas, more people attended the opera than football games. Think about that for a second. Of course these days you could combine opera attendance with symphony and publicly financed modern-art museum attendance all together and it would barely register against football. That decline is the result of misguided policies by a select few cultural elites at universities, in the press, and of course at the NEA.

Apologists will have you believe that cuts to the NEA will force orchestras out of business, or require them to do without a full contingent of musicians, such as the underappreciated contra bassoonist. This is categorically false. The NEA accounts for a tiny fraction of a percent of major symphony orchestra budgets. For example, the Chicago Symphony, which truly is a national treasure, received a measly $80,000 in concert funding in 2015. I suspect that the Chicago Symphony will be able to survive without 0.112 percent of its funding. Good news for contra bassoonists everywhere, and for maestros who can still program Strauss’s Tod und Verklärung.

This is the reality for nearly all classical ensembles, jazz ensembles, and theater companies.

For years, modern composers have engaged in NEA-sponsored outreach to the young and old in order to normalize their atonal noise music. The result is a classical musical dark age—especially compared with the prior era during the Belle Époch (1865–1914)—that has caused audiences to flee to rock bands, film composers, and Broadway musicals. Case in point: where are the NEA-sponsored classical masterpieces?

Proponents of the NEA also claim that the organization is critical to bringing culture to underprivileged areas. This is classic virtue signaling built on faulty premises. Are these areas without culture? Revitalizing urban communities does not begin with elementary-school students painting murals that look like bad cubism on abandoned buildings. Revitalizing urban communities begins with jobs and security, not wasting money on some loft-lurking Brooklynite’s self-indulgent performance art.

As expected, famous politically progressive artists are coming to the defense of the NEA. Ironically, those like Julie Andrews are defending the organization as “fundamental” even though it had nothing to do with their successful roles and subsequent cultural importance. Instead the NEA awards grants to groups like Music in the American Wild. Made up of a small ensemble of musicians and composers from the prestigious Eastman School of Music, the group travels around to national parks performing new music. Admittedly this seems like a nice idea—until you hear the music and see what they garner in terms of audience. The pieces are so grating that the only conceivable use that warrants taxpayer funding would be as an interrogation technique on Gitmo detainees. At the time this article was written, this video had fewer than 40 views; it features a live audience of about nine people. The NEA is not helping these students learn how to have a career as a musician by setting them up for this kind of failure. This is not the path to become a cultural treasure like Julie Andrews.

The solution for these students and those in other artistic disciplines is the free market and good ol’ fashion patronage that gave us the masterpieces we all love and enjoy. The NEA has failed the country in this regard, and our culture must develop new conduits between money and creators. Under this new paradigm, America will unleash a flourishing of the arts that will endure for centuries to come.

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Government worship and deferred compassion

original article: Meals On Wheels Desperately Needs To Get Cut, And We Shouldn’t Stop There
March 23, 2017 by Robert Tracinski

Hey, everybody, the Trump budget guts everything!

Except, of course, that it doesn’t. It cuts about $54 billion from next year’s budget out of a total of $4 trillion in spending—a reduction of a little over 1 percent. It’s kind of a drop in the bucket.

But as part of their program to grow all spending for everything all the time, Democrats have had to find something that makes Trump’s budget cuts look totally radical and draconian, so they have seized on Meals on Wheels, a program that uses volunteers to deliver food to the elderly.

Not only is this factually wrong, but the really radical and dangerous position is the idea that programs like Meals on Wheels have to be part of the federal budget and must never be cut in any way.

First, the facts. Meals on Wheels is supported by volunteers and overwhelmingly funded by private charity. The national organization Meals on Wheels America gets only 3.3 percent of its budget, less than $250,000, from government grants.

Moreover, the money that is supposedly going to be cut doesn’t even come directly from the federal budget, and Trump’s budget doesn’t even mention Meals on Wheels. Instead, it eliminates Community Development Block Grants, some tiny fraction of which—nobody can say for sure exactly how much—is used by state and local governments to support local Meals on Wheels organizations. Apparently, nothing else done with these block grants is particularly defensible, so Democrats have focused all of their attention on Meals on Wheels.

In the meantime, all of the press attention has led to a surge of donations and volunteers. Did you know citizens could do that—take what they think is a worthy program and support it with their own time and money? Apparently, this is a surprise to everyone on the Left.

So the whole “Trump wants to cut Meals on Wheels” story line smacks of—what’s the phrase I’m looking for here?—oh yes, “fake news.”

Yet here’s why it’s important. The outrage over cutting Meals on Wheels from the federal budget implies that it ought to be part of the federal budget and that it ought to be getting more money. That’s the really radical idea here, and it explains why this country is in the deadly budget predicament we are.

Notice that the supposedly devastating Trump budget proposal says nothing about the largest and fastest-growing part of the budget, the big middle-class entitlements like Medicare and Social Security. If we have to fund Meals on Wheels, we definitely can’t make even the slightest changes to any of those programs. In fact, by this reasoning—if a small fraction of indirect support for a charitable venture is sacrosanct—then the assumption here is that anything good has to be funded by the federal government.

By that reasoning, we aren’t just forced to keep spending money for things the government already does. We will have to keep increasing our spending indefinitely, bring into the federal fold more and more programs and ventures. Anything that benefits anybody has to get government money. Not to support it would be monstrous.

If we can’t even say to any program, “You know that last 3 percent of your budget? We think you’ll be okay on that without the federal government,” then the result is going to be exactly what we have seen: vast, ever-increasing, unsustainable increases in government spending and government debt.

Do you know what happens if we carry this all the way to the end of the road? Take a look at Venezuela, which specifically focused its socialist programs on food banks for the poor, with government taking on an increasingly dominant role in the nation’s food supply. The result? People are starving and reduced to rummaging through trash bins to survive. But no matter how cruel that system ends up being in practice, nobody could ever advocate rolling it back, because that would make you reactionary and cruel and heartless and prove that you hate the poor.

The idea that the government must fund everything, that nothing can happen without it, that it must be the source and impetus behind every initiative, and that it must always expand relentlessly—that is the truly radical notion being pushed in this Meals on Wheels hysteria.

That’s why we have to take an axe to federal funds for Meals on Wheels. We have to do it just to establish that there is some limit, any limit to the scope and fiscal appetite of the federal government—before it yawns its throat open and swallows us whole.

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Billion$ spent to fix failing schools; fail

original article: Obama administration spent billions to fix failing schools, and it didn’t work
January 19, 2017 by Emma Brown

One of the Obama administration’s signature efforts in education, which pumped billions of federal dollars into overhauling the nation’s worst schools, failed to produce meaningful results, according to a federal analysis.

Test scores, graduation rates and college enrollment were no different in schools that received money through the School Improvement Grants program — the largest federal investment ever targeted to failing schools — than in schools that did not.

The Education Department published the findings on the website of its research division on Wednesday, hours before President Obama’s political appointees walked out the door.

“We’re talking about millions of kids who are assigned to these failing schools, and we just spent several billion dollars promising them things were going to get better,” said Andy Smarick, a resident fellow at the American Enterprise Institute who has long been skeptical that the Obama administration’s strategy would work. “Think of what all that money could have been spent on instead.”

The School Improvement Grants program has been around since the administration of President George W. Bush, but it received an enormous boost under Obama. The administration funneled $7 billion into the program between 2010 and 2015 — far exceeding the $4 billion it spent on Race to the Top grants.

The money went to states to distribute to their poorest-performing schools — those with exceedingly low graduation rates, or poor math and reading test scores, or both. Individual schools could receive up to $2 million per year for three years, on the condition that they adopt one of the Obama administration’s four preferred measures: replacing the principal and at least half the teachers, converting into a charter school, closing altogether, or undergoing a “transformation,” including hiring a new principal and adopting new instructional strategies, new teacher evaluations and a longer school day.

The Education Department did not track how the money was spent, other than to note which of the four strategies schools chose.

Arne Duncan, Obama’s education secretary from 2009 to 2016, said his aim was to turn around 1,000 schools every year for five years. “We could really move the needle, lift the bottom and change the lives of tens of millions of underserved children,” Duncan said in 2009.

Duncan often said that the administration’s school-improvement efforts did not get the attention they deserved, overshadowed by more-controversial efforts to encourage states to adopt new standards and teacher evaluations tied to tests.

The school turnaround effort, he told The Washington Post days before he left office in 2016, was arguably the administration’s “biggest bet.”

He and other administration officials sought to highlight individual schools that made dramatic improvements after receiving the money. But the new study released this week shows that, as a large-scale effort, School Improvement Grants failed.

Just a tiny fraction of schools chose the most dramatic measures, according to the new study. Three percent became charter schools, and 1 percent closed. Half the schools chose transformation, arguably the least intrusive option available to them.

“This outcome reminds us that turning around our lowest-performing schools is some of the hardest, most complex work in education and that we don’t yet have solid evidence on effective, replicable, comprehensive school improvement strategies,” said Dorie Nolt, an Education Department spokeswoman.

Nolt emphasized that the study focused on schools that received School Improvement Grants money between 2010 and 2013. The administration awarded a total of $3.5 billion to those schools, most of it stimulus funds from the American Recovery and Reinvestment Act of 2009. “Since then,” she said, “the program has evolved toward greater flexibility in the selection of school improvement models and the use of evidence-based interventions.”

“Here in Massachusetts, it actually took several years to see real improvement in some areas,” Duncan said at the time. “Scores were flat or even down in some subjects and grades for a while. Many people questioned whether the state should hit the brakes on change. But you had the courage to stick with it, and the results are clear to all.”

Smarick said he had never seen such a huge investment produce zero results.

That could end up being a gift, he said, from Duncan to Betsy DeVos, President-elect Donald Trump’s nominee for education secretary and is a prominent proponent of taxpayer-supported vouchers for private and religious schools.

Results from the School Improvement Grants have shored up previous research showing that pouring money into dysfunctional schools and systems does not work, Smarick said: “I can imagine Betsy DeVos and Donald Trump saying this is exactly why kids need school choice.”

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Republican lawmakers slam ‘diversion’ of ObamaCare funds from Treasury

original article: Republican lawmakers slam ‘diversion’ of ObamaCare funds from Treasury
March 11, 2016 by FoxNews

Republican critics say an ObamaCare program is breaking the law by shorting the U.S. Treasury — and therefore U.S. taxpayers– billions of dollars collected from the insurance industry.

Rep. Joe Pitts, R-Pa., chairman of the health subcommittee of the Energy and Commerce Committee, called it “an illegal wealth transfer from hard-working taxpayers to (insurers).”

He recently joined Republican colleagues in grilling Health and Human Services Secretary Sylvia Burwell about the shortfall of money  supposed to be flowing into Treasury coffers – as mandated in the Affordable Care Act of 2010.

They followed up that hearing by sending a letter this week seeking clarification from the administration, according to The Hill.

Under the law, money is collected each year from insurers for the ACA’s reinsurance program, which helps plans taking on higher costs associated with sicker enrollees.

While $10 billion was supposed to go back to the market to pay those costs in 2014, the first year, an additional $2 billion was supposed to go to the U.S. Treasury under the law. It never arrived.

That was because not enough money was brought in to cover both, so the administration prioritized. Then HHS published a new rule saying payments would be made to insurers first in the event of a shortfall.

The rule, set in 2014, was published publicly for comment and received no reaction at the time, Burwell told a Senate Appropriations Committee hearing when the matter was raised again by lawmakers last week.

According to health care law expert Tim Jost, a professor at Washington & Lee University School of Law, the reinsurance program is not permanent and was instituted as a way to shoulder some of the burden for the new costs connected with new, at-risk enrollees who weren’t able to get adequate coverage before ObamaCare.

The reinsurance program was to collect $10 billion from insurance companies in 2014, $6 billion in 2015, and $4 billion in 2016. The Treasury would get $2 billion in 2014 and 2015 and $1 billion in 2016.

In 2014, according to reports, only $9.7 billion was collected from the industry , and 2015 totals were expected to be short, as well.

Critics say the law is clear: the Treasury gets the money and it cannot be transferred elsewhere, even if that “elsewhere” is to the insurance companies for the reinsurance program.

According to The Hill, presidential candidate Sen. Marco Rubio, R-Fla., teamed up with Sen. Orrin Hatch, R- Utah, to write a letter decrying the administration’s moves.

“The statute in question is unambiguous, and the HHS regulation and recent practice violates its clear directive,” the letter read.

Jost is not so sure. He says it all depends on how the mandate is interpreted. “(The administration’s) reading of the statute is, that the reason for adopting this program was to establish a reinsurance program, and therefore if there was a shortfall the money collected should first go to reinsurance,” and if more is collected, “only then would it go to the Treasury,” Jost told Foxnews.com. “(Republicans) say that reading is wrong.”

“It’s a disagreement on how to read the statute,” he added, “but I don’t think there is anything illegal, unconstitutional or immoral in respect to what the administration is doing.”

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ACLU fights against school choice; is it because of anti-religious bias?

original article: ACLU Files Lawsuit to Block School Choice for Nevada Children
August 27, 2015 by Lindsey Burke

The American Civil Liberties Union (ACLU) has just filed a lawsuit intended to block students from participating in Nevada’s groundbreaking near-universal education savings account (ESA) option. The ESA option was signed into law this spring by Gov. Brian Sandoval, R-Nev., and began accepting applications a few weeks ago.

More than 2,200 parents have already applied to participate in the ESA option, which provides students with a portion (roughly $5,100 annually) of the funds that would have been spent on them in their public school in an ESA account that they can then use to pay for a variety of education-related services, products, and providers.

They can use their ESA to pay for private school tuition, online learning, special education services and therapies, textbooks, curricula, and a host of other education-related expenditures. As the name implies, parents can also save unused funds, rolling dollars over from year-to-year to pay for future education costs.

The ACLU’s lawsuit alleges that the ESA program “violates the Nevada Constitution’s prohibition against the use of public money for sectarian (religious) purposes.” Yet ESA funds go directly to parents, who can then choose from any education option that is right for their child.

The Foundation for Excellence in Education explains that the Arizona Court of Appeals noted in a similar case in 2013,

“The ESA does not result in an appropriation of public money to encourage the preference of one religion over another, or religion per se over no religion. Any aid to religious schools would be a result of the genuine and independent private choices of the parents. The parents are given numerous ways in which they can educate their children suited to the needs of each child with no preference given to religious or nonreligious schools or programs.”

The Institute for Justice, which will be defending the ESA option, is confident it does not violate the state’s constitution.

Tim Keller, a senior attorney with the Institute for Justice, declared that,

“Nevada’s Education Savings Account (ESA) Program was enacted to help parents and children whose needs are not being met in their current public schools, and we will work with them to intervene in this lawsuit and defeat it.”

“The United States Supreme Court, as well as numerous state supreme courts, have already held that educational choice programs, like Nevada’s ESA Program, are constitutional. We expect the same from Nevada courts.”

Education director for the Goldwater Institute, Jonathan Butcher, had this to say,

“Every child deserves the chance at a great education and the opportunity to pursue the American Dream. Lawsuits such as this challenge parents’ ability to help their children succeed,”

“Nevada has a unique law that makes flexible learning options available to every child attending a public school and a treasurer that has committed his team to listening to public comments and designing a successful education savings account program. Opponents should give students the chance to succeed with these accounts.”

Education savings accounts are one of the most promising paths forward on choice in education. They enable families to direct every single dollar of their child’s state per-pupil funding that is deposited into their account to a wide variety of education options. Arizona became the first state, in 2011, to enact the ESA model.

Today, five states, including Arizona, Mississippi, Tennessee, Florida, and Nevada have ESAs in place, with Nevada’s being notable because it will be available to every single child currently enrolled in a public school. It is the first program universally available to all public school students. Arizona, which has the longest-running ESA option, has had great success for participating families.

As Marc Ashton, father to Max Ashton who is legally blind and used the ESA prior to finishing high school explained,

“A blind student in Arizona gets about $21,000 a year. That $21,000 represents what Arizona spends to educate a student such as Max in the public-school system.”

“We took our 90 percent of that, paid for Max to get the best education in Arizona, plus all of his Braille, all of his technology, and then there was still money left over to put toward his college education,” Marc explains. “So he is going to be able to go on to Loyola Marymount University, because we were able to save money, even while sending him to the best school in Arizona, out of what the state would normally pay for him.”

That type of customization and innovation is what the ACLU is threatening now in Nevada. It’s a shame that special interest groups continue to threaten choice in education, when choice is what is needed so badly, for so many.

Do we need a separation between school and state?

anti-religion, bias, bigotry, bureaucracy, children, civil rights, discrimination, education, freedom, funding, government, ideology, innovation, intolerance, left wing, liberalism, litigation, nanny state, oppression, philosophy, political correctness, progressive, public policy, reform, relativism, spending, tragedy

Filed under: anti-religion, bias, bigotry, bureaucracy, children, civil rights, discrimination, education, freedom, funding, government, ideology, innovation, intolerance, left wing, liberalism, litigation, nanny state, oppression, philosophy, political correctness, progressive, public policy, reform, relativism, spending, tragedy

Federal watchdogs accused of stealing lunch money from needy kids

Federal watchdogs accused of stealing lunch money from needy kids
August 12, 2015 by Fox News

Five employees who work at a federal watchdog agency tasked with rooting out fraud and abuse were indicted Tuesday after investigators say they concocted a plan that stole lunch money from needy children.

Prosecutors say the employees, all working with the Government Accountability Office, as well as the spouse of a separate GAO worker, tried to illegally obtain reduced-price school lunches for their children. They did so by falsely reporting their incomes in order to qualify for the discounted government meals.

“There is no excuse for stealing funds intended to go to children whose parents cannot afford the school lunches,” Maryland’s Prince George’s County State’s Attorney Angela Alsobrooks said in a written statement announcing the news. “Their actions are made even worse by the fact that some of them claimed to have not just low income, but no income at all, even though they were working full-time jobs at the GAO.”

One of the accused is Lynette Mundey, a Prince George’s County school board member. Mundey, along with Barbara Rowley, Jamilah Reid, Tracy Williams, Charlene Savoy and James Pinkney, the spouse of a GAO employee, were charged with filing false applications, fraud and theft.

Federal officials say the group bilked the program designed to benefit needy children out of $13,000 over the course of five years. They did so by either under-reporting their income or in some cases, reporting that they had no income even though their actual salaries ranged from $55,000 to $78,000.

Children who are legally eligible for the reduced-cost lunch program must come from households with incomes at or below 130 percent of the poverty level – or about $30,615 for a family of four.

A reduced-price lunch costs an elementary child 40 cents compared to $2.75 for a full-price meal, according to the Prince George’s County Public Schools Food and Nutrition Services.

“This is a program for people who can’t afford it, but these are people who can,” John Erzen, a spokesman for the Prince George’s County State’s Attorney’s Office told The Washington Post in a statement.

Calls to Mundey as well as the Prince George’s County Board of Education were not immediately returned.

abuse, bureaucracy, children, corruption, criminal, ethics, fraud, funding, government, greed, nanny state, poverty, scandal, spending

Filed under: abuse, bureaucracy, children, corruption, criminal, ethics, fraud, funding, government, greed, nanny state, poverty, scandal, spending

Are we being double-taxed? Why ObamaCare may render Planned Parenthood obsolete

original article: Are we being double-taxed? Why ObamaCare may render Planned Parenthood obsolete
July 22, 2015 by Dr. Manny Alvarez

With the inception of the Affordable Care Act (ACA) in 2014, President Obama created a new system of health care that aimed to allow all Americans to carry health insurance, and in many cases, that insurance is subsidized by the federal government with our tax dollars.

His sales pitch to America was that by expanding access to health insurance, he would help create better patient-doctor relationships that would be effective in prineventing several of the chronic health conditions and concerns that affect the U.S. population— many of which affect women.

Now, no matter your stance on universal health care, a concern that every tax-paying American, man or woman, should take issue with centers on waste. This is especially true given the recent events surrounding the claims that Planned Parenthood seems to be in the business of selling aborted fetal body parts.

Now, if my tax dollars are being used to subsidize our national health care program, then why are my tax dollars also being allocated for Planned Parenthood? This isn’t a matter of ethics, but rather, of practicality.

Many of the clinical services Planned Parenthood offers— including Pap smears, breast exams, tests for sexually transmitted infections (STIs) and sexually transmitted diseases (STDs), and abortions— can be performed by gynecologists, family practitioners and pediatricians. The ACA guarantees coverage for the vast majority of women’s reproductive needs.

According to Planned Parenthood’s 2013-2014 annual report, the latest data available, the organization received nearly $1.15 billion in revenue— $528.4 million of which came from the federal government.

During that period, it spent about $769 million on medical services, $45 million on sexuality education, $34 million on public policy and $12 million to engage communities. In all, the organization spent over $859 million in the fiscal year of 2014.

Planned Parenthood heralds its efforts to promote education among young women and expectant mothers, and certainly it should be applauded for those campaigns. But according to the U.S. Department of Health and Human Services, under the ACA, women are now covered for annual counseling in STIs, HIV, contraceptive methods, breastfeeding support and interpersonal and domestic violence.

All things considered, if American tax dollars are being allocated for the ACA and Planned Parenthood, it seems like we are getting double-taxed. And I don’t want my tax dollars involved in promoting all the other programs that Planned Parenthood peddles outside the scope of medical care. In 2014, they spent $34 million in public policy. The average American does not control the political agenda of Planned Parenthood, and yet we are all paying for it.

Planned Parenthood accepts patients under Medicaid, private insurance and all state plans subsidized by Obama’s health care law. And again, this is the similar coverage that is offered by many other types of clinics. The only difference is they don’t receive added federal dollars.

Of course, for uninsured patients, Planned Parenthood services may prove cheaper than services offered at a regular doctor’s office. According to the organization’s website, many of its fees are based on a sliding fee scale, which depends on the patient’s income. Services like family planning, birth control, gynecological exams, pregnancy testing, STI testing and other reproductive health care services are on that sliding scale. But all of that should be irrelevant if the ACA, plus expanded Medicaid, is meant to guarantee health coverage for all.

The bottom line is this: There was a time in our country when Planned Parenthood played a role in providing women with medical services that otherwise were not available to people who had no insurance. However, to have, at present, an organization that continues to be subsidized by the taxpayer is not necessary. We now have the same services covered by ObamaCare, and millions of taxpayer dollars are helping to keep that system in check. And that system includes community hospitals, physician practices and community clinics that don’t receive any extra support from the federal government and only rely on the fees they receive from patient care.

abortion, bureaucracy, economy, entitlements, funding, government, health care, nanny state, public policy, spending, taxes, unintended consequences

Filed under: abortion, bureaucracy, economy, entitlements, funding, government, health care, nanny state, public policy, spending, taxes, unintended consequences

Planned Parenthood and Unfettered Congressional Spending

original article: Planned Parenthood and Unfettered Congressional Spending
July 22, 2015 by Zack Pruitt

The U.S. Constitution permits congressional spending for two purposes only — to pay debts and to provide for the common defense and general welfare of the country (Article 1, Section 8).  Experts have debated ad nauseam over the proper interpretation of the terms “common defense” and “general welfare” but it is difficult to deny that modern spending has far surpassed the intent of the Founders and, in some cases, reached the point of absurdity.  With entire websites devoted to exposing the excesses of government spending that has virtually no limits, it is inevitable that taxpayers will be forced to subsidize things that they view as morally questionable.

Planned Parenthood receives over $500 million each year from American taxpayers, which comprises over 40 percent of its budget.  It was recently shown on video ostensibly seeking to profit from the sale of aborted baby parts (as opposed to being reimbursed for tissue donation), perhaps in violation of federal law.  Make no mistake, the big picture story here is not congressional overspending; it is the Senior Director of Medical Services at Planned Parenthood graphically describing her efforts to “not crush” vital organs when performing abortions in an effort to preserve them and recoup “between $30 and $100 per specimen.”  In another video, the President of Planned Parenthood’s Medical Directors Council indicates a profit-motive for aborted parts by negotiating for higher prices and haggling over the cost of “intact tissue.”  When a system allows for unfettered spending, taxpayers can wind up paying not only for unnecessary services, but ones that straddle the line between genocide and the commercialization of human body parts.

Without government assistance it is unlikely Planned Parenthood could survive as currently structured.  A system without proper checks and restraints allows for congressional funding of a multitude of programs that are unnecessary, and some, like Planned Parenthood, that blur ethical and moral lines.  Numerous calls for investigation and defunding have followed the release of this video, but under the current setup it will be difficult to fully strip federal grants because congressional Democrats and the President support the continued funding of Planned Parenthood despite the recent revelations.  In 2013, President Obama said, “You’ve also got a president who is going to be right there with you, fighting every step of the way… Thank you Planned Parenthood, God bless you.”

It should come as no surprise that when the government sanctions a morally questionable procedure such as abortion, that other morally suspect actions will stem from that tree, even ones that shock the conscience.  Historically, polls have shown this nation to be nearly 50-50 when it comes to general abortion rights, but the same polls move sharply against abortion in the 2ndand 3rd trimesters.  Partial-birth abortion is illegal but the methods described by Dr. Deborah Nucatola in the video closely resemble techniques in the partial-birth procedure.  She said that “[Planned Parenthood doctors are] very good at getting heart, lung, and liver…so I’m not going to crush that part, I’m going to crush below, I’m going to crush above, I’m going to see if I can get it all intact.”  Dr. Nucatola implies that specific steps are taken to preserve body parts, deviating from legal abortion standards.  In response to this aspect of the video evidence, Bill Murphy, co-Director of the Stem Cell and Regenerative Medicine Center at the University of Wisconsin, told the Washington Post “The general consensus is that’s unethical and unsafe… you can’t modify a life-saving procedure for a patient in order to harvest organs.”

Control of the nation’s money with few limitations on expenditures encourages legislators to provide funding for projects they personally deem necessary for society and equality.  The results are runaway spending and massive budget deficits.  Politicians routinely use the public coffers to strengthen their reelection efforts by securing the support of special interest groups.  Irresponsible fiscal policy combined with substantial political support for abortion rights have led to taxpayer funding for an organization that harvests and sells baby body parts for research.  It strains credibility to reason that this is what the Founders had in mind when they authorized spending only for debt, defense, and general welfare.

Public money is used for a multitude of things that many Americans find objectionable.  When standards for congressional spending become virtually obsolete, the financial door swings wide-open for potential abuse.  Likewise, it is not a stretch that a society that permits abortion and the use of fetal parts for research would give rise to groups looking to profit from it.  As Dr. Nucatola explained in the video, “I think for [Planned Parenthood] affiliates, at the end of the day, they’re a non-profit… if they can do a little better than break even, and do so in a way that seems reasonable, they’re happy to do that.”

What has resulted is a perfect storm of economic entropy and blurred bioethical lines, in which congressional spending is rubber-stamped and prices can be placed on human body parts.  This lethal downward trajectory of fiscal and moral standards tugs at the fabric of society in ways that is harmful to both the economy and to the culture.  It is one thing for evil to exist but it is another for that evil to be sanctioned by the government and paid for by the people.  Without dramatic financial reforms and near-unanimous condemnation of immoral actions, we can expect an exponential increase of morally objectionable activity subsidized by the taxpayers.

Ending the trafficking of aborted baby parts will not be easy, but a return to the original plan for congressional spending would be a good start.

abortion, babies, bureaucracy, congress, constitution, corruption, ethics, extremism, funding, government, greed, ideology, political correctness, politics, public policy, reform, relativism, scandal, spending, taxes

Filed under: abortion, babies, bureaucracy, congress, constitution, corruption, ethics, extremism, funding, government, greed, ideology, political correctness, politics, public policy, reform, relativism, scandal, spending, taxes

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