Topic: insurance plans

Government by Whim

Jennifer Rubin 10.07.2010 - 3:43 PM

The Department of Health and Human Services announced yesterday that 30 corporations (including McDonald’s, Jack in the Box, and a New York teachers’ union) would receive exemptions from a rule that would have required them to raise the minimum annual benefit in their employee insurance plans.

The exemptions themselves are good news, since the rule would have forced these companies to drop their employee coverage, leaving almost a million workers without the insurance they had before Obamacare. But it means that these companies now need permission from the administration to offer their employees a benefit they have offered for years. And of course, many other companies—those without the lobbying operation of a company the size of McDonald’s, or without the access to liberal policymakers that a NY teachers’ union has—can’t get the same permission, and so can’t compete on a level playing field, or offer coverage that might entice the best qualified people to work for them. This kind of government by whim, and not by law, is the essence of the regulatory state.

This is one more example of the pattern we have seen since the closing weeks of the Bush administration. As the bailouts and mind-numbingly complex legislation multiplies, the private sector becomes rife with rent-seekers, looking to spin the dials and eke out some preferential treatment from the heavy hand of government. CEOs are chosen for their political and PR skills, not their prowess as wealth creators. Business judgment is clouded and distorted as businessmen must look over their shoulders to avoid the wrath of bureaucrats and elected officials.

The fact that these judgments are unmoored to any fixed rules and depend on the whim of government officials makes it all the worse. If the rules are unclear and the name of the game is about access, the opportunities for corruption multiply. In fact, it’s hard to tell what corruption is.

This is all a recipe for a creepy sort of corporate statism, where big business and big government are joined at the hip. It is the natural and inevitable result of Obama’s agenda. Unless of course a new set of lawmakers decide they’ve had enough and it’s time to constrain government, keep the private and public realms distinct, and support rather than undermine the rule of law.

There Is No Santa Claus for Health Care

Jennifer Rubin 05.26.2010 - 8:52 AM

A sharp reader points me to this:

The official projections for health-care reform, which show it greatly reducing the number of uninsured and also reducing the budget deficit, are simply not credible. There are three basic issues. The cost and revenue projections rely on unrealistic assumptions and accounting tricks. If you make some adjustments for these, the cost of the plan is much higher. The so-called “individual mandate” isn’t really a mandate at all. Under the new system, many young and healthy people will still have a strong incentive to go uninsured. Once the reforms are up and running, some employers will have a big incentive to end their group coverage plans and dump their employees onto the taxpayer-subsidized individual plans, greatly adding to their cost.

James Capretta? Yuval Levin? Rep. Paul Ryan? No — John Cassidy of the New Yorker. It does of course raise the question as to why these warning flares didn’t go up from liberal publications before ObamaCare passed, but it’s nice to know there is broad opposition to it now across the ideological spectrum.

Cassidy’s entire piece is well worth a read, but his takedown of the cost numbers is especially helpful and echoes what conservative critics have been saying for months:

Does Santa Claus live after all? According to the C.B.O., between now and 2019 the net cost of insuring new enrollees in Medicaid and private insurance plans will be $788 billion, but other provisions in the legislation will generate revenues and cost savings of $933 billion. Subtract the first figure from the second and—voila!—you get $143 billion in deficit reduction. …

The first objection to these figures is that the great bulk of the cost savings—more than $450 billion—comes from cuts in Medicare payments to doctors and other health-care providers. If you are vaguely familiar with Washington politics and the letters A.A.R.P. you might suspect that at least some of these cuts will fail to materialize. … The second problem is accounting gimmickry.

Cassidy, who favors “Romney-ObamaCare” instead, may not have the right solution. (Massachusetts is not exactly a smashing success.) But his analysis is dead-on and may show up in more than a few political ads this season.

Is It Historic if It Never Happens?

Jennifer Rubin 03.25.2010 - 8:29 AM

As many Republicans are advocating, Karl Rove argues for a repeal-and-replace strategy for ObamaCare. He writes that the content of ObamaCare and the timing of its implementation make Republicans’ job easier:

Democratic hopes that passing health-care reform will help them politically will be unfulfilled because ObamaCare only benefits a small number of people in the short run. Until the massive subsidies to insurance companies fully ramp up in 2017, this bill will be more pain than gain for most Americans.

For example, changes in insurance regulations in 2011 and two new mandates in 2014 that force everyone to buy insurance and require everyone to be charged a similar price regardless of age or health will cause insurance premiums to rise more than they would have otherwise. The 10 million people who have a health savings account will also be hurt starting in 2011. With each passing year after that, they will be able to put less away tax free for medical expenses.

ObamaCare cuts $1.8 billion in support for Medicare Advantage this October, another $5.8 billion in October 2011, and an additional $9.2 billion right before the 2012 presidential election. This will increase premiums and reduce benefits for the 4.5 million people in the program.

Moreover, some of the immediate benefits that Obama promised – such as forcing insurance carriers to keep children on their parents’ insurance plans — seem, well, not to be real. And then there is the impact on the deficit, which will become all the more apparent once the Doc Fix is passed this year. In sum, the public’s strong aversion to the bill is not likely to be diminished by anything they see or learn about it between now and November.

Rove argues: “As voters start to feel the pain of this new program, Republicans will be in a stronger position if they stay in the fight, make a principled case, and lay out a competing vision.” If the Democrats do suffer heavy losses this year, we’ll see just how precarious the “historic” victory is. The great transformation of American society that Obama and his party have attempted to foist on an unwilling public may in fact end before it begins.

Obama’s Credibility Deficit

Jennifer Rubin 03.05.2010 - 8:35 AM

Obama faces not simply a shortage of votes for his health-care plan but also a diminishing reservoir of credibility. The longer he talks, the less believable his arguments have become. After a year, dozens of speeches, hundreds of interviews, and a health-care summit, who believes of ObamaCare that: 1) you will get to keep your health-care plan; 2) it won’t add to the deficit; 3) it will cut costs; 4) it won’t adversely affect Medicare patients; and 5) it won’t affect the status quo on abortion funding? The endless discussions and Obama’s obvious discomfort in hearing informed arguments from Republicans at his summit (e.g. John Boehner on abortion and Paul Ryan on the rest) have served to undermine the president’s credibility on these points with all but the most devoted spinners.

The abortion issue is particularly revealing. Whether or not one thinks the government should subsidize abortion, Obama’s claim that his favored bill (essentially the Senate bill) doesn’t subsidize abortions simply doesn’t stand up to scrutiny. Charmaine Yoest of Americans United for Life explains:

The president’s latest proposal mirrors legislation that has passed the Senate, which doesn’t include a Hyde Amendment [prohibiting taxpayer funding of abortions], and would inevitably establish abortion as a fundamental health-care service for the following reasons:

• It would change existing law by allowing federally subsidized health-care plans to pay for abortions and could require private health-insurance plans to cover abortion.

• It would impose a first-ever abortion tax—a separate premium payment that will be used to pay for elective abortions—on enrollees in insurance plans that covers abortions through newly created government health-care exchanges.

• And it would fail to protect the rights of health-care providers to refuse to participate in abortions.

The president’s plan goes further than the Senate bill on abortion by calling for spending $11 billion over five years on “community health centers,” which include Planned Parenthood clinics that provide abortions.

The president insists that his bill maintains the status quo on abortion funding, but those most concerned and whose votes are at stake, namely pro-life House Democrats, know better. So when Obama and Nancy Pelosi repeat their assertion that the bill contains no federal funding of abortion, they are being less than truthful.

The president’s repeated misstatements have rendered him less and less effective as a salesman for his plan, both with the public and key lawmakers. Just as his claim of the stimulus plan’s job-creating success now engenders eye-rolling and groans, his health-care talking points have also become the objects of derision. The impact may extend well beyond the health-care debate.

After all, in matters large and small, on both foreign and domestic policy, the president must be taken seriously and his word respected by the public and lawmakers if he is to sustain support for his initiatives. Obama, among his many errors, has frittered away not only a year on hugely unpopular legislation but his own credibility as well. The year is gone for good; his credibility may likewise be impossible to recover. Obama, if he were prone to self-reflection, may come to regret having been so cavalier with the truth.

LIVE BLOG: Obama Says We Need to Do Something About Costs

Jennifer Rubin 02.25.2010 - 11:01 AM

Well, yes, we do. He touts the benefits of health-care-purchasing exchanges. But here’s the thing: he’s taxing health-care plans and he’s setting expensive new mandates on insurance plans. That pushes up the cost of plans people will be purchasing. Alexander says the CBO says Obama’s plan will increase costs. Obama says Alexander doesn’t have his facts straight, but he does. Obama argues that in the future the insurance will be better than the “bad” insurance they have now, so of course it may cost more. Got that? This, of course, is Alexander’s point: Obama is setting a new standard for health-care insurance, which will make the plans businesses are forced to offer and the plans individuals must buy more expensive.

The Latest Same ObamaCare Bill

Jennifer Rubin 02.22.2010 - 3:59 PM

Obama has put forth another version of ObamaCare, but it’s not even sufficient to be scored by the CBO. The CBO website explains:

This morning the Obama Administration released a description of its health care proposal, and CBO has already received several requests to provide a cost estimate for that proposal. We had not previously received the proposal, and we have just begun the process of reviewing it—a process that will take some time, given the complexity of the issues involved. Although the proposal reflects many elements that were included in the health care bills passed by the House and the Senate last year, it modifies many of those elements and also includes new ones. Moreover, preparing a cost estimate requires very detailed specifications of numerous provisions, and the materials that were released this morning do not provide sufficient detail on all of the provisions. Therefore, CBO cannot provide a cost estimate for the proposal without additional detail, and, even if such detail were provided, analyzing the proposal would be a time-consuming process that could not be completed this week.

We do have some idea what’s in it, however. Matt Continetti explains: “Obama’s new, improved plan is more expensive than the Senate bill, does not address the concerns of pro-life House Democrats over the Senate’s abortion language, maintains the tax exemption for the Democrats’ union friends, and will effectively turn insurance companies into heavily regulated public utilities.”

What we do know is that under ObamaCare’s latest incarnation, you really don’t get to keep your existing health-care plan. And we know that it seeks to federalize the regulation of the health-insurance industry. (“The big new idea in the president’s plan is to federalize regulation of health insurance, creating a Health Insurance Rate Authority to conduct ‘reviews of unreasonable rate increases and other unfair practices of insurance plans.’ This reflects the overall strategy to give more and more control over the health sector to Washington.”) And it seems that there are $136B worth of new taxes to be imposed on the people Obama said he’d never tax, namely those families making less than $250,000.

What we don’t know is why anyone who opposed the last version(s) of ObamaCare would accept this one. It is still a mammoth tax-and-spend bill and still seeks to federalize health care. If Nancy Pelosi has 218 votes for this, I’d be surprised. If Senate Democrats want to walk the plank for a retread of the bill that voters in Massachusetts sent Scott Brown to the Senate to oppose, I’d be surprised. But I suppose we’ll find out.

Flotsam and Jetsam

Jennifer Rubin 01.14.2010 - 7:00 AM

Noemie Emery says the elite pundits blew it in hawking Obama’s candidacy: “Could it be that The One has misjudged both the times and the country?; that he made a strategic mistake in pushing for health care (and a tactical one in trusting the Congress)?; that he created a nightmare for most in his party, who face epic losses this year? … To acknowledge this is to indict their own judgment, to face the fact they themselves may be less than insightful, that ‘talking like us’ means next to nothing, and that writing for magazines doesn’t equip one for greatness, or leadership. In fact, it only equips one to write for more magazines.”

Rep. Bart Stupak is holding firm for now. He isn’t buying the Reid–Ben Nelson abortion compromise language, “arguing that the Senate bill would effectively allow millions to buy insurance plans covering abortion because of federal subsidies and break the long-standing Hyde rule preventing federal funding of abortions — even if the federal government isn’t signing the checks directly, as it would have with the now-dead public insurance option.” The Democrats claim they have enough votes even without Stupak and pro-life Democrats. Really? We’ll find out.

Talking Points Memo or American Spectator? “Most campaign-type Democrats think Coakley will pull out a victory Tuesday despite a lackluster campaign and independents and undecideds rapidly slipping from their column, but some openly warn that a close race in the Bay State is a real warning sign for November’s mid-term elections.”

Barack Obama or Newt Gingrich? “That’s what’s been lost this year … that whole sense of changing how Washington works.”

A former Justice Department official doesn’t think much of the Obama team’s flurry of excuses for not responding to discovery requests in the New Black Panther Party case: “They are relying on privileges that the Office of Legal Counsel says do not exist. … There is no privilege, for instance, saying that the Justice Department will not identify personnel working on the case. … Generally, a number of these privileges [are ones] I’ve literally never heard of.” Well, who ever heard of executive privilege for a social secretary?

New Hampshire once looked like a potential lost seat for the GOP. Not anymore. The Republican front-runner, Kelly Ayotte, leads Paul Hodes by 9 points in the latest poll.

Good for him: “The top Senate Democrat in charge of military affairs on Wednesday ended a three-day trip to Afghanistan with a message of optimism that the U.S. mission can still succeed. Sen. Carl Levin (D-Mich.), chairman of the Armed Services Committee, said he sees a higher confidence among U.S. military leaders and Afghan leaders that the war against insurgents can be successful.” And a lesson for Obama: if he leads on national security, his base will follow.

Politico has a forum on: “Massachusetts: Does the closer-than-anyone-expected race jeopardize the Democratic agenda?” If you have to ask, the answer is yes.

All that groveling for nothing: “Although a State Department China hand described constructive U.S.-China cooperation on Iran in Hill testimony today, there are more signs that China is trying to put the breaks on moving forward with new Iran sanctions at this time. … But a diplomatic source tells POLITICO that China is saying its political director may not necessarily be able to come to a meeting of the P5+1 — the five permanent members of the UN Security Council plus Germany — that is scheduled for next weekend in New York.”

Lies, Big Lies and Nancy Pelosi Press Conferences

Jennifer Rubin 01.06.2010 - 9:22 AM

Nancy Pelosi has had a her run of memorable moments — promising to drain the swamp of corruption (no, not anytime soon), warning that we were losing 500 million jobs a month and accusing the CIA of lying to her about the use of enhanced interrogation techniques. Then yesterday she comes up with a doozy in responding to a letter by C-SPAN that sought to televise the conference committee (which isn’t going to happen because it’s all to be done in secret cloakroom deals): “There has never been a more open process for any legislation.”

Well, we can’t say this sort of thing is out of character, can we? She seems not to recall that the Senate hid the bill until Sen. Bill Nelson’s vote had been bought and then rushed a bill to a 1:00 a.m. vote right before Christmas. She seems not to recall that the House staged a Saturday vote and broke her pledge to post the bill online 72 hours before the vote.

Mark Hemingway asks, “It’s no secret that Pelosi and Democratic leaders are desperate to pass health care reform, but do they really think delusional lies are the best way to win over the public?” Well, yes, I think they do. That’s why they keep saying things such as “we must pass it or go bankrupt.” That’s why they deny that there will be health-care rationing while they cut $500B out of Medicare. That’s why they refuse to call taxes “taxes.” That’s why they insist we are going to keep our insurance as the Mayo Clinic gets out of the Medicare business. That is why they boast that they are cutting spending on health-care when, as the Heritage Foundation points out, “total U.S. health care spending would increase by 0.7%, or $234 billion through 2019. . . and that’s after taking into account what little savings would be achieved by cutting Medicare benefits and encouraging employer to cut health benefits by taxing private insurance plans that are ‘too generous.’”

In short, the Democrats are reduced to making up stuff, both on substance and on process, because what is in the bill is unpalatable to a majority of voters. And they certainly don’t want to discuss the details or put any of the final back-room bribery . . . er . . . legislative compromising . . . on C-SPAN.

This Is “Reform”?

Jennifer Rubin 12.16.2009 - 8:47 AM

Sen. Dick Durbin says Democrats will have 60 votes for health-care legislation by next week. This is revealing in two respects. First, they don’t have the votes now. And second, they don’t have the exact bill on which they are voting. Sen. Evan Bayh said plaintively, “We’re all being urged to vote for something and we don’t know the details of what’s in it.” He seems to have a problem with that.

We are, in general terms (we think — since there is no bill yet and no CBO scoring), going to raise huge amounts of taxes from some Americans (including those promised by candidate Obama that they’d see no tax hike), give it to others, force individuals and businesses to buy really expensive insurance plans, and then take a chunk of money out of Medicare, which will squeeze doctors and hospitals, not to mention patients. This legislation has little to recommend it.

Liberals are angry, fearing that the bill will be shoveling massive subsidies to private insurers. As Politico put it, “More than anything else in Barack Obama’s presidency so far, health reform has exposed a get-a-deal-at-any-cost side of Obama that infuriates his party’s progressives.” So Howard Dean wants to kill it. Conservative James Capretta sees their point: “The Democratic party is on the verge of enacting a requirement, enforced with federal tax penalties, which would effectively require hard-working Americans to hand over even more of their wages to profit-hungry, private insurance companies.”

Conservatives point to the hundreds of billions in new taxes, the mandates, the fines, and the heavy hand of government — in short, a huge, fiscally reckless entitlement:

Sen. Mitch McConnell, the party’s leader, said the legislation includes “a half a trillion dollars in cuts in Medicare, $400 billion in higher taxes and higher premiums for everyone else.”

We’re about to spend a trillion dollars we don’t have to force many people to buy insurance they don’t want. So there are 60 votes for this monstrosity? Not yet. But next week, we’re told, there will be. Because, as the president says, we’re on the “precipice” of something really big. Well, we can all agree on that.

From COMMENTARY: Health Care in Three Acts

Sam Munson 01.22.2007 - 4:31 PM

As President Bush prepares to address the issue of health care in his State of the Union address, COMMENTARY is fortunate to have a trenchant analysis of the wider problem, “Health Care in Three Acts,” by Eric Cohen and Yuval Levin, coming out in the February issue. Here is an advance look.

Americans say they are very worried about health care: on generic lists of voter concerns, health issues regularly rank just behind terrorism and the Iraq war. And politicians are eager to do something about it. To empower consumers, the White House has advanced the idea of Health Savings Accounts; to help the uninsured, it has explored using Medicaid more creatively. Senator Edward Kennedy of Massachusetts, the Democrats’ leader on this issue, has backed “Medicare for all.” The American Medical Association has called for tax credits to put private coverage within reach of more Americans. A number of recent books have proposed solutions to our health-care problems ranging from socialized medicine on the Left to laissez-faire schemes of cost containment on the Right. In Washington and in the state capitals, pressure is building for serious reforms.

But what exactly are Americans worried about? Untangling that question is harder than it looks. In a 2006 poll, the Kaiser Family Foundation found that while a majority proclaimed themselves dissatisfied with both the quality and the cost of health care in general, fully 89 percent said they were satisfied with the quality of care they themselves receive. Eighty-eight percent of those with health insurance rated their coverage good or excellent—the highest approval rating since the survey began 15 years ago. A modest majority, 57 percent, were satisfied even with its cost.

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