Archive

Author Archive
September 30th, 2014 at 7:25 pm
HHS’ Burwell Caught Low-Balling Congress on Cost of Healthcare.gov

A new report by Bloomberg Government indicates that Sylvia Burwell, the Secretary of Health and Human Services (HHS), gave a potentially misleading answer when she told Congress that Healthcare.gov – the federal government’s ObamaCare portal – cost taxpayers $834 million to build.

Nicole Kaeding at the CATO Institute teases out some of the unstated, but related, costs that balloon the overall price tag to $2.14 billion, far north of Burwell’s testimony.

I’ve summarized them here as bullet points:

  • $300 million contract to process paper applications to serve as backups to electronic files
  • $387 million for real-time interfacing between the IRS and Healthcare.gov to verify income and family size for insurance subsidy calculations
  • $400 million in accounting tricks HHS used to pay for creating Healthcare.gov when 26 states refused to take federal start-up grants to build their own. Congress made no appropriations to build Healthcare.gov, so HHS shifted money from other units to fund the project.
  • $255 million in spending between February 2014 – the end of Burwell’s timeline – and August 20, 2014, the most recent information available. Bloomberg also included projected spending at current levels through September 30, 2014, the end of the fiscal year.

These are the kinds of expenses that Members of Congress would expect the HHS Secretary to include when testifying about full cost of a program. The fact that Burwell gave a low-ball estimate when these figures were easily accessible to her or her staff weakens her credibility as an honest broker of information. As her departing colleague Eric Holder knows, once Congress loses its ability to trust a Cabinet official, the gloves come off.

September 29th, 2014 at 5:07 pm
California’s ObamaCare Exchange Can’t Match Doctors to Plans

If you purchase an ObamaCare plan in California, good luck trying to find a directory that matches your insurance policy with a specific doctor.

“Altogether, the 10 insurers in Covered California have contracted with an estimated 75% of California’s licensed physicians, or nearly 90% of those considered active in the state,” reports the Los Angeles Times. “However, many of those doctors are available in just one or two health plans.”

That is, if you can find them.

“There’s no timetable for a state provider directory after the exchange scrapped an initial version that was riddled with errors. Instead, Covered California refers people to insurance company websites that vary in usefulness,” says the paper.

The resulting anger and confusion has spawned almost 300 complaints to state regulators and two consumer lawsuits against some of the biggest insurance companies in California.

Doctors are getting hosed too, according to the report. “Insurers say they can pass along savings by paying doctors less and rewarding that select group with higher patient volume. It’s also hoped those doctors will take on a bigger role coordinating patient care.”

To clarify, in return for getting paid less doctors that accept ObamaCare-compliant plans are getting more patients and more exposure to medical malpractice lawsuits.

No wonder there’s no directory matching providers to plans. The docs want to hide!

September 25th, 2014 at 3:00 pm
Eric Holder’s Legacy at DOJ: Not Enforcing the Law

Eric Holder, the controversial face of the Obama Justice Department, is stepping down as United States Attorney General.

The timing seems odd. If Democrats lose control of the U.S. Senate in this year’s midterm elections – a very likely prospect – it will be impossible for President Barack Obama to win confirmation for a replacement as polarizing as Holder.

That would be a good thing for the Republic.

Among the many blemishes on Holder’s tenure as AG – such as the Fast and Furious scandal, his unprecedented Contempt of Congress citation, his failed attempt to prosecute the 9/11 conspirators in a civil court instead of a military tribunal – it’s the so-called “legacy” actions Holder took that should give observers the most pause.

According to NPR, “Holder most wants to be remembered for his record on civil rights: refusing to defend a law that defined marriage as between one man and one woman; suing North Carolina and Texas over voting restrictions that disproportionately affect minorities and the elderly; launching 20 investigations of abuses by local police departments; and using his bully pulpit to lobby Congress to reduce prison sentences for nonviolent drug crimes. Many of those sentences disproportionately hurt minority communities.”

Notice what’s missing?

Only one achievement on the list actually enforces the law. (And even this area, prosecuting allegedly abusive local police departments, tells us a lot since it’s directed at cops and not, say, verified abuses by the New Black Panthers.)

Everything else – from refusing to defend a traditional marriage statute to playing a prison reform lobbyist – are actions designed to undermine the law as written.

Eric Holder shouldn’t worry. His legacy is clear. His will be remembered as the time when activism replaced lawyering and the rule of law suffered.

Hopefully, it’s not the start of a trend.

September 24th, 2014 at 3:05 pm
ObamaCare’s Coverage Gaps Will Kill Good Health Insurance

If you’ve tried to buy insurance on an ObamaCare exchange, you’re familiar with the four levels of coverage available: Bronze, Silver, Gold and Platinum. Each level covers a set percentage of costs should you incur health-related expenses.

For example, a Bronze plan covers 58-62 percent, a Silver plan 68-72 percent, Gold 78-82 percent and Platinum 88-92 percent.

Notice, however, that there are gaps between the coverage levels.

Recall as well that ObamaCare’s coverage requirements get tweaked from year-to-year, changing the actuarial value – i.e. the percentage of covered benefits the insurance company is expected to pay – each year.

Here’s the problem.

“Suppose you are in a Bronze plan with an actuarial value of 58 percent. Then, a year from now, because of price changes, technology changes, or some other kind of change, your plan suddenly covers 64 percent of expected expenses. That’s good for you, right? Wrong. Because your plan no longer fits into one of the metallic corridors, it’s no longer a valid plan – despite the fact that it has become a better plan,” explains John C. Goodman, a conservative health policy expert.

The same is true at the other end of the coverage spectrum.

“Now let’s suppose you have a really good plan – a plan that pays 98% of expected health care costs,” writes Goodman. “Given the large number of Democrats who believe that health insurance should pay almost every medical bill, you would think that the law passed by a Democratic Congress without a single Republican vote would strongly encourage such a plan. If you’re inclined to think that, you are mistaken, however.

“Any plan that pays more than 92% of expected health care costs for the average enrollee is illegal under Obamacare.”

Get ready to change your health insurance more often than you change your auto insurance.

September 23rd, 2014 at 5:24 pm
New ObamaCare Glitch Could Cost Doctors Millions

Doctors who spent heavily trying to comply with ObamaCare’s electronic health records mandate could still be hit with costly penalties.

ObamaCare gives doctors until October 1, 2014, to switch from paper-based to electronic health records. Failure to comply results in losing 1 percent of federal reimbursements for treating Medicare patients.

Here’s the rub.

“[P]hysicians who went electronic for the first time this year are discovering that [the Centers for Medicare and Medicaid Services, or CMS] won’t be ready to officially register the evidence of their work until mid-October. That means they will miss the Oct. 1 deadline, and CMS will withhold 1 percent of their 2015 Medicare payments,” reports Politico.

That means that a doctors’ group like Morganton Eye Physicians in North Carolina spent $1.3 million to buy and implement new software – and added $250,000 to its annual operating budget – only to be threatened with a $65,000 penalty because the federal government can’t meet its own compliance deadline.

One would think CMS has a moral obligation to waive compliance until the agency is able to do its job, but so far it’s requiring doctors to submit to a cumbersome hardship process. How does a business politely explain that the hardship exists completely because of government ineptitude?

Welcome to ObamaCare’s bureaucratic hell. More episodes to follow.

September 22nd, 2014 at 6:49 pm
ObamaCare’s 7.3 Million Enrollments May be False

Last week the Obama administration released its first official headcount of ObamaCare enrollments since applauding itself for 8 million initial sign-ups.

The current enrollment is 7.3 million, according to the Centers for Medicare and Medicaid Services (CMS).

But there’s reason to be suspicious.

“Under ObamaCare, after a person has paid their first premium, a health plan can’t cancel anyone until they have gone three months without making a payment,” writes health care policy expert Bob Laszewski.

By saying that the 7.3 million number includes all enrollments that have occurred through mid-August, CMS is “effectively double counting by including the ‘adds’ while also keeping the ‘deletes’.” That means the 7.3 figure “also still includes every person who has failed to make a premium payment in June, July, and August – since the carriers can’t yet knock them off the rolls,” explains Laszewski. “The health plans tell me there is a 2% to 4% monthly attrition rate. That means the 7.3 million could be overstated by 6% to 12% of the total.”

Unfortunately, the most transparent administration in history refuses to release the monthly enrollment numbers since ObamaCare went online. That makes it impossible to verify whether the 7.3 million is accurate.

If the Obama administration is so proud of its new number, why not release the data on which it’s based?

September 18th, 2014 at 1:41 pm
Gates: Obama’s ISIS Strategy Is “Unattainable”

Intentionally or not, President Barack Obama’s current strategy for defeating and destroying ISIS is “unattainable,” says his first Defense Secretary, Robert Gates.

“…there will be boots on the ground if there’s to be any hope of success in the strategy. And I think that by continuing to repeat that [there won’t be troops on the ground], the president in effect traps himself,” Gates said on CBS This Morning.

“I’m also concerned that the goal has been stated as ‘degrade and destroy’ or ‘degrade and defeat’ ISIS,” because it sets an “unattainable” goal.

Gates is speaking from experience. As Defense Secretary for both Obama and George W. Bush, he saw the United States military inflict “some terrible blows” against al Qaeda – including the killing of Osama bin Laden. But even after 13 years of warfare, al Qaeda hasn’t been destroyed or completely defeated.

Ironically, Gates indicated that the bluster of Joe Biden may come closer to the mark. In a speech earlier this month in New Hampshire, the vice president said that ISIS terrorists should know that the United States “will follow them to the gates of hell until they are brought to justice…”

Meting out some measure of justice – be it death on the battlefield or convictions for war crimes – to specific ISIS members is a realistic goal, if ground troops are used.

The confusing aspect about Obama’s current ISIS policy is that it is both too little (no ground forces) and too much (complete destruction). Untethered from reality, it’s a strategy that looks like it is set up to fail.

H/T: Weekly Standard

September 18th, 2014 at 1:10 pm
A “Cover-Up” of Healthcare.gov’s Security Risks?

At least one Obama administration official is complaining of a “cover-up” that seeks to conceal “high-risk” security weaknesses in Healthcare.gov, the federal website where millions of Americans input their private health and financial data.

The explosive allegation came to light when House Oversight Committee investigators uncovered an email from a mid-level official at the Centers for Medicare and Medicaid Services (CMS) saying she is “tired of the cover-ups,” and that she intended to give “a truthful update of exactly what was going on” in a status report she was tasked to write.

CMS is the federal agency responsible for overseeing the development, launch and maintenance of Healthcare.gov.

Investigative reporter Sharyl Atkisson broke the story for The Daily Signal.

The timing is particularly bad for CMS Administrator Marilyn Tavenner who is scheduled to testify before the House Oversight Committee today.

Previous reporting documented specific instances where CMS officials in charge of the website’s security were either mislead or kept in the dark about the portal’s “limitless” security risks.

This new revelation will only increase the suspicion that the integrity of Americans’ private information takes a backseat to whatever saves face for the Obama administration.

Tags:
September 16th, 2014 at 7:03 pm
Top Minnesota ObamaCare Insurer Leaving Exchange

The largest player on Minnesota’s ObamaCare exchange is dropping out, and not even the promise of federal subsidies can get it back.

Earlier today PreferredOne – an insurance company that covered 59 percent of Minnesota’s ObamaCare population – announced that it will not offer health care plans next year paid for with ObamaCare subsidies.

Apparently, the decision is being driven by high administrative costs associated with doing business with MNsure. Even after hiring an additional 50 workers to handle the exchange’s post-launch fixes and tweaks, PreferredOne says continuing to participate is financially unsustainable.

The move makes it likely that MNsure’s ObamaCare rates will jump since PreferredOne sold the lowest cost option. Those rates will be released sometime in October – just weeks before the midterm elections.

September 15th, 2014 at 7:02 pm
Harkin Lashes Hillary to ObamaCare

In what some observers presume is an early sign of a presidential run, over the weekend Hillary Clinton spoke at a high-profile political event for Iowa’s retiring Democratic U.S. Senator Tom Harkin.

Though Clinton had her own gaffe, the biggest surprise was how much credit Harkin heaped on her for passing ObamaCare – even though she wasn’t even in Congress!

“One of the things she always worked on was advancing this concept, this idea that health care should be a right and not a privilege in this country,” said Harkin. “So, Hillary was not there when the Affordable Care Act was signed into law, she was of course secretary of state, but I want you all to know that her fingerprints are all over that legislation. It would not have happened without her strenuous advocacy in that committee all those years.”

Any hopes Clinton had of distancing herself from a law that only gets more unpopular is gone. All opponents have to do is show her smiling behind a gushing Harkin to make the connection.

Don’t like ObamaCare? Blame HRC.

No conservative could have said it better.

September 12th, 2014 at 6:57 pm
ISIS or ISIL?

If you’re confused about what to call the newest terrorist threat – ISIS or ISIL – Daniel Pipes, the renowned conservative Middle East expert, has an answer.

Whichever one you want.

The Obama administration prefers “Islamic State in Iraq and the Levant” (ISIL), while almost everyone else uses “Islamic State in Iraq and Syria” (ISIS). At first blush, some commentators think they detect a subtle framing effect to blur any possible links between the rise of this group with Obama’s blundering Syria policy.

Pipes isn’t one of them. According to him, “both translations are accurate, both are correct, and both have deficiencies – one refers to a state, the other has an archaic ring.” Pipes should know since he wrote a book about the underlying history that gives rise to the translation difficulty.

Whatever one calls ISIS/ISIL, Pipes rightly focuses on the most important issue: “…ridding the world of this barbaric menace.”

September 12th, 2014 at 1:31 pm
Workers Paying More for Health Insurance under ObamaCare

As ObamaCare’s next open enrollment period draws near, some of the controversial law’s biggest backers are cheering a seven city survey claiming that health insurance premiums associated with it are dropping.

This leads liberal health policy expert Ezra Klein of Vox to say that “Obama’s signature accomplishment is succeeding beyond all reasonable expectation.”

But not if you get your health insurance from your employer, however.

“Employees are on the hook for more and more of their health care costs. Premiums are increasing so slowly in part because employers are continuing to shift toward higher deductibles, requiring employees to pay more out of their own pockets before their health care plans kick in,” explains Sam Baker in National Journal.

Comparing monthly premium rates year-to-year makes sense if that’s the best single indicator of how ObamaCare is impacting paychecks. But it isn’t. For employees working in the real economy the shift to high deductible plans means more out-of-pocket spending every time they visit the doctor.

Translation: ObamaCare makes health insurance for workers more expensive.

When it comes to measuring ObamaCare’s success, we need to make sure we’re looking at the most relevant data. Otherwise, we risk scoring political points at the expense of the truth.

September 10th, 2014 at 7:14 pm
IRS re Lost Emails: Oops, We Did It Again

The Obama administration has a penchant for releasing damaging disclosures on Fridays.

The most recent example was last Friday’s admission by the IRS that – in addition to losing potentially incriminating emails from Lois Lerner’s account – it also can’t find emails from five other employees connected to the conservative targeting scandal.

Two of the five worked in the agency’s Cincinnati office where most of the bad behavior took place. The others include Lerner’s technical adviser, a group manager in the tax-exempt division and a tax law specialist, reports Fox News.

The IRS says all five permanently lost access to emails sought by congressional investigators when their hard drives crashed. The agency’s Inspector General is testing the drives to see if any emails can still be recovered.

Republicans in Congress are not amused.

“The IRS’s ever-changing story is practically impossible to follow at this point, as they modify it each time to accommodate new facts,” Rep. Darrell Issa (R-CA), Chairman of the House Oversight Committee, said. “This pattern must stop.”

More likely it will continue.

September 9th, 2014 at 7:51 pm
ObamaCare’s Popularity Dropping Ahead of Midterms

“Just 35 percent of voters now support the Affordable Care Act, down 3 percentage points from May, according to a monthly poll by the Kaiser Health Foundation,” reports The Hill.

Moreover, the poll found that 47 percent of respondents feel negatively about the law, otherwise known as ObamaCare.

The RealClearPolitics average of six national polls is even worse: 53.8 percent say they oppose the law, with only 40.3 percent in favor.

Little wonder that the controversial health law is so unpopular. States are continuing to resist Medicaid expansion under ObamaCare’s terms for fear of a Trojan horse spending spree, and consumers are getting shut out of some of the country’s best hospitals.

All this and it is still almost two months until the midterm elections.

President Barack Obama may not be on the ballot this year, but his eponymous health law surely is.

September 3rd, 2014 at 8:08 pm
Wyoming Latest to Consider Medicaid Expansion

In my column this week, I explain how not every Medicaid expansion through ObamaCare is necessarily a bad thing. The crux of my argument is that states that use the extra money to move the program in a more market-friendly direction – and as a consequence, make it more cost-conscious and consumer-driven – should be given a chance to test their ideas.

This means that Republican governors in Indiana, Iowa, Pennsylvania – and now perhaps Wyoming – should be given some space before conservatives conflate them with other GOP leaders who simply expanded Medicaid without bothering to wring any reforms from the Obama administration.

Every state is already in the business of participating in Medicaid. If conservatives are willing to consider Paul Ryan’s Medicare reform a step in the right direction, then we should extend the same courtesy to Republican governors who are trying to do something similar with Medicaid.

At least for now.

September 2nd, 2014 at 7:28 pm
Tennessee Opts Into ObamaCare Medicaid Expansion

Another news cycle, another Republican governor decides to expand Medicaid with ObamaCare dollars.

Last Friday, Tennessee Republican Governor Bill Haslam joined Pennsylvania’s Tom Corbett, Indiana’s Mike Pence and others in trying to carve out a middle ground between a straight yes or no on expansion.

Haslam hasn’t committed himself to specifics, saying only that “sometime this fall” his administration will submit an alternative plan to federal regulators.

States like Wisconsin, Indiana, Pennsylvania, Arkansas and Iowa have won various levels of approval to use ObamaCare’s increased Medicaid funding to provide subsidized health insurance plans to some of the poorest members of their populations.

Expanding Medicaid is a tempting offer because the federal government pays for about half of every dollar spent on the state’s program. ObamaCare makes taking the plunge almost irresistible since it pays for every dollar of expansion until 2017, and 90 percent of all new spending until 2020.  For sitting governors with term limits, that translates into an opportunity to get lots of credit for helping poor people before most of the bill comes due.

The politics of ObamaCare are constantly evolving, and the lesson for conservatives about the law’s Medicaid expansion is this: Unless there is a credible alternative to growing government, many politicians will opt for good press and worry about the policy implications later.

Heading into the 2016 presidential cycle, there needs to be a way to determine which ideas adhere to constitutional principles, preserve the free market and bolster human flourishing – which includes access to health care.

The sooner, the better.

September 1st, 2014 at 6:54 pm
Marco Rubio Evolving on Immigration

If at first you don’t succeed, pivot to the next best alternative.

That seems to be the strategy used by U.S. Senator Marco Rubio (R-FL) as he positions himself for a potential White House run in 2016.

Rubio, once the darling of conservatives and a top GOP presidential contender, quickly fell out of favor with the grassroots when he supported a version of comprehensive immigration reform championed by the Obama administration and some of the most liberal members of Congress.

After the Senate’s “Gang of Eight” bill was pronounced dead-on-arrival in the House of Representatives, Rubio has since modified his position on how to pursue immigration reform. Unsurprisingly, it now aligns with what conservatives have said all along: secure the border first, build trust in the federal government’s commitment to the rule of law and national sovereignty, and only then discuss how to integrate illegal immigrants into American society.

Last week, Rubio sent a letter to President Barack Obama warning against a unilateral executive action that would grant some kind of legal status to as many as 5 million illegal immigrants. In Rubio’s words, such an act “will increase the perception of ambiguity in our laws, incentivize more people to immigrate here illegally, and significantly set back the prospects of real reform.”

It’s too early to tell whether Rubio’s repositioning will be enough to convince conservatives that he’s changed his principles instead of just his tactics. Until he can give a convincing explanation of why next time will be different, skepticism about his true beliefs will remain.

August 29th, 2014 at 6:09 pm
Pennsylvania Governor Says Yes to ObamaCare Medicaid Expansion

After years of rebuffing calls to participate in ObamaCare’s Medicaid expansion, Pennsylvania Republican Governor Tom Corbett is changing his mind.

Sort of.

While the announcement comes as a bit of a surprise, it doesn’t appear to be a total loss for fiscal conservatives. (Others may disagree, of course.)

According to the terms of the agreement between Gov. Corbett’s office and the Centers for Medicare and Medicaid, Pennsylvania won’t simply be expanding its Medicaid program. Instead, it will use the extra dollars made available under ObamaCare to pay for (i.e. subsidize) private health insurance plans for newly eligible state Medicaid beneficiaries.

The agreement stipulates that Corbett’s alternative is being allowed as a five-year “demonstration project,” meaning that its future is not assured. Much will depend on how the project’s measurements are defined, if the reforms Corbett supports are to survive.

For now, Pennsylvania joins the ranks of Indiana, Arkansas and Iowa as states that are attempting to use ObamaCare’s Medicaid expansion to decrease their uninsured population – without, of course, breaking the bank.

It’s hard to see how that will happen, but we now have at least four states offering themselves as very costly social science experiments. It should be interesting to see what the results will show.

August 27th, 2014 at 6:59 pm
IRS Erased Lois Lerner’s Blackberry AFTER Investigation Began

It’s been a rough five days for the Internal Revenue Service.

Last Friday attorneys at Judicial Watch, a conservative watchdog group, said Department of Justice lawyers revealed a second back-up system that stores all government emails.

Presumably, this includes the emails to and from former IRS manager Lois Lerner’s account; emails that are sought by investigators on the House Oversight Committee because of Lerner’s connection to the potentially illegal targeting of conservative advocacy groups.

If true – DOJ officials are disputing Judicial Watch’s account of the conversation – this casts a serious shadow on the IRS’s credibility, since Commissioner John Koskinen told Congress under oath that the emails had been lost in a hard drive crash.

However many back-up systems there are – and whether Koskinen knew the number – the Commissioner has another integrity crisis brewing.

“Thomas Kane, Deputy Assistant Chief Counsel for the IRS, wrote in a declaration, part of a lawsuit filed by Judicial Watch against the IRS, that [Lois Lerner’s] BlackBerry was ‘removed or wiped clean of any sensitive or proprietary information and removed as scrap for disposal in June 2012,” reports Fox News.

The date is significant because congressional staff members had already interviewed Lerner about her role in the targeting operation. Deleting messages from her government-owned smartphone after that meeting – but before preserving the contents– looks like a thinly veiled attempt to destroy evidence.

The House Oversight Committee will have its hands full when Congress returns from its August recess.

Expect to see some high-profile hearings.

August 26th, 2014 at 7:57 pm
DOJ: We Have Lois Lerner’s “Lost” Emails

Apparently, you can lie to Congress but not to Judicial Watch.

The conservative watchdog organization is publicizing an admission by the Department of Justice that government officials can access emails reportedly lost in a hard drive crash.

The messages – correspondence to and from former IRS manager Lois Lerner – have been sought by congressional investigators seeking more information about the agency’s targeting of conservative advocacy groups filing for tax-exempt status.

In sworn testimony, IRS officials have told members of Congress that thousands of emails sent from Lerner’s government account could not be retrieved because a back-up system had also been erased.

But now attorneys at the DOJ are singing a different tune.

“Judicial Watch President Tom Fitton said Justice Department lawyers informed him that the federal government keeps a back-up copy of every email and record in the event of a government-wide catastrophe,” reports the Washington Examiner.

That includes Lerner’s IRS emails.

But don’t expect them to be produced anytime soon. The DOJ is claiming that the newly revealed back-up system would be “too onerous to search,” but did say that Treasury Department inspectors are looking into it.

While the litigators wrangle, we’re left with yet more evidence that the Obama administration doesn’t mind playing fast and loose with the truth – even under oath.

The House of Representatives already voted back in May to hold Lerner in contempt of Congress for refusing to testify; making her the second administration official after Attorney General Eric Holder to receive such a dishonor.

If it’s true that top IRS brass lied under oath to Congress about the whereabouts of Lerner’s potentially damaging emails, one wonders what message House leadership would send to this latest act of executive defiance.