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Saturday, May 18, 2013

CBO on ObamaCare: Uninsured Remain Above 30 Million Through 2023

    When the most recent Congressional Budget Office (CBO) report on the Affordable Care Act came out last week, most media outlets, particularly conservative ones like the Washington Examiner, focused on the doubling of the costs of the program since it was first scored in 2010.  Philip Klein writes:
When President Obama was selling his health care legislation to Congress, he declared that “the plan I’m proposing will cost around $900 billion over 10 years.” But with the law’s major provisions set to kick in next year, a new analysis by the Congressional Budget Office projects that the law will cost double that, or $1.8 trillion. 
    While the cost increase is certainly noteworthy and was predicted by the opponents of the legislation, the CBO report includes a second aspect of the effects of ObamaCare, or perhaps more appropriately the lack of effect.  Besides the promise that ObamaCare would help control costs, the elimination of barriers to obtaining health insurance to the current uninsured was one of its largest selling points.  It is interesting to note then that under CBO projections, the number of uninsured in the country never drops below 30 million.  Under the heading "Uninsured Under the Affordable Care Act", here are the projections for next decade for "Number of Uninsured Nonelderly People":
2013 - 55,000,000
2014 - 44,000,000
2015 - 37,000,000
2016 - 31,000,000
2017 - 30,000,000
2018 - 30,000,000
2019 - 30,000,000
2020 - 30,000,000
2021 - 31,000,000
2022 - 31,000,000
2023 - 31,000,000
    Also according to CBO projections, this level of uninsured persons persists despite the increase of those on Medicaid and CHIP (Children's Health Insurance Program) from 36,000,000 in 2013 to 47,000,000 in 2023.  Not even the heavily subsidized exchanges will apparently be able to shrink the uninsured population. By 2023, the number of subsidized exchange enrollees is projected at 20,000,000 with an average subsidy of $7,900 for a total of $158 billion.
    It is unclear from the CBO report exactly who these continued uninsured are and how they will obtain healthcare.  But assuming the CBO's projections are accurate, it seems fair to speculate that when the number of uninsured plateaus at 30,000,000 for several years or even begins to increase again, calls will begin afresh for healthcare reform that will provide insurance to those chronically uninsured.  And if ObamaCare's detractors are correct that the law will not lower costs and improve healthcare in the ways promised, the same reasons may be resurrected to push for ObamaCare II: the uninsured clogging emergency rooms, neglecting preventive care, and driving up costs for the rest who are "playing by the rules."
    The reviews coming in so far on ObamaCare are decidedly mixed, and full implementation is still seven months off.  It will be years before the story plays out.  If the Democrats still control the White House after 2016, those uninsured will be on display as 30,000,000 reasons to "finish what we started."  And as everyone knows, the sequel is never as good as the original.

Friday, May 17, 2013

Commerce Department: $3.4M "Disaster Recovery" Grant to School for Chefs

    The Commerce Department's Economic Development Administration announced on Monday the awarding of $7.8 million in grants to "Support Disaster Recovery" in several states and the U.S. Virgin Islands.  Acting Secretary Rebecca Blank said the money was for:
...economic recovery in Connecticut, Illinois, Missouri, New York, and the U.S. Virgin Islands following natural disasters in 2011.
“The Obama administration is committed to helping communities impacted by natural disasters rebound and rebuild stronger than ever,” said Acting Secretary Blank. “The EDA grants announced today will strengthen local capacities in Connecticut, Illinois, Missouri, New York, and the U.S. Virgin Islands by rebuilding their infrastructure, supporting local industry, creating jobs, and enhancing their ability to respond to future disasters.”
    Some of the projects included the rehabilitation of a pumping station in Stamford, CT; a new wastewater treatment plant in Savannah, IL; and a $2 million revolving loan fund for small to medium enterprises in the U.S. Virgin Islands.  However, more than one-third of the money is being directed to a school for chefs in Hyde Park, NY.  The press release explains:
In New York, a $3.4 million EDA grant to the Culinary Institute of America in  Hyde Park, New York, will support the Hudson Valley Food and Beverage Alliance, which will operate a new training facility for agribusinesses located in the Hudson Valley. The region’s agriculture-based economy suffered severe damage from Hurricane Irene and Tropical Storm Lee in 2011. According to grantee estimates, the new facility will generate up to $5.1 million in new revenue in the Hudson Valley and will support 32 full-time jobs.
    The grant is reminiscent of the projects funded by the 2009 stimulus bill from the president's first term, but the Commerce Department notes that funds are "part of a $200 million appropriation made by Congress to EDA to help communities that received a major disaster designation in fiscal year 2011 with long-term economic recovery and infrastructure support."  The press release did not indicate if the $5.1 million in revenue is an annual estimate, nor did it indicate how long those 32 full-time jobs would be supported.  However, for the northeast region of the country still reeling from monster storm Sandy's hit in October 2012, a $3.4 million grant to a culinary school (tuition is about $27,000/year) might seem better directed towards more concrete infrastructure restoration.

AG Holder's Non-Answer on Warrants for Email

    At a Congressional hearing on May 15, Attorney General Eric Holder faced some rather hostile questions from lawmakers regarding recent Obama administration scandals, such as the IRS targeting of conservative non-profits, the Justice Department acquisition of Associated Press phone records, and Benghazi. However, about three hours into the hearing, a relatively friendly questioner, Susan DelBene (D-WA), inquired about a recent report from the ACLU concerning FBI documents that suggest that the FBI does not need a warrant to obtain access to at least some private emails.  The attorney general's answer was barely an answer at all, despite The Hill's assertion that "Holder backs warrant requirement for most email searches":
Attorney General Eric Holder said on Wednesday that the Justice Department will likely support legislation requiring law enforcement officers to obtain a warrant before accessing private online messages, such as emails or Facebook messages.
"It is something that I think the Department will support," Holder said in testimony before the House Judiciary Committee.
He urged Congress to exempt "certain very limited circumstances" such as civil investigations.
"But the more general notion of having a warrant to obtain the content of communications from a service provider is something that we support," Holder said.
    However, The Hill's article actually reports Holder's answer to DelBene's follow up question.  Here is the full exchange, beginning with DelBene's original question regarding obtaining certain emails without a warrant:


    Perhaps The Hill was simply being kind to the attorney general by not printing his initial answer given the lack of coherence.  Whatever enthusiasm Mr. Holder showed for updating legislation, he was clearly not anxious to surrender the freedom the FBI and the Justice Department currently assume the right to exercise.  This non-answer combined with the non-apology for the seizure of AP phone records cannot give privacy advocates a good feeling about this administration's view of government's limits on its investigative powers.

Wednesday, May 15, 2013

White House: Million, Billion, Whatever

    The White House briefly confused millions and billions today in a tweet about the money seniors have saved on prescriptions due to ObamaCare:


    The tweet was deleted within minutes and replaced with the adjusted figure:
    Instead of the usual #ObamaCare hashtag, the White House used one with a more personal feel: #Obamacares.

Tuesday, May 14, 2013

The Seeds of the Benghazi Talking Points

    Last week, the Benghazi talking points took center stage in the ongoing investigation of the 9/11 anniversary attacks in Libya.  Jay Carney came under intense questioning at Friday's White House press briefing as he struggled to justify the dozen iterations of talking points before Susan Rice used the final version for her now-infamous five Sunday talk show appearances on September 16, 2012.  However, a background briefing by the State Department four days before Rice's appearances provides the earliest extended look at the information used to prepare those talking points.
    On September 12, in the evening following the attacks, three unnamed Senior Administration* officials briefed journalists via teleconference on the rapidly developing story.  Although President Obama and Secretary of State Clinton had already made some public statements, this briefing contained far more detail than any previous remarks.  As the teleconference commenced, the most striking part about it was is the complete absence of any mention of "protests" or "demonstrations":
So let me give you a little bit of the chronology to the best of our knowledge. Again, the times are likely to change as it becomes a little bit more precise, but this is how we’ve been able to reconstruct what we have from yesterday.
At approximately 4 p.m. Eastern Daylight Time yesterday, which was about 10 p.m. in Libya, the compound where our office is in Benghazi began taking fire from unidentified Libyan extremists. By about 4:15, the attackers gained access to the compound and began firing into the main building, setting it on fire...
     Later in the briefing, a journalist asks a question about protests [emphasis added]:
QUESTION: ...[T]he larger question is, you didn’t talk at all about the protests. You started your timeline with that the firing began. Can you talk about the timeline of when the protests started, how that fit in with it, and your sense of whether or not the protestors and the assailants were the same?...
SENIOR ADMINISTRATION OFFICIAL ONE: ...With regard to the protests – I assume you’re not talking about protests in Cairo, are you? You’re talking about protests in Benghazi?... We frankly don’t have a full picture of what may have been going on outside of the compound walls before the firing began. So I really just don’t have any specifics on that at the moment. I apologize.
    It is apparent that the idea of protests at Benghazi had not yet even entered into the discussion at the State Department.  The official in fact clarifies that the questioner is not referring to the protests outside the Cairo Embassy which of course had dominated the news the previous day.  Another journalist raised the Cairo protests again later in the briefing:
QUESTION: ...Do you believe that this attack was in any way related to the incident in Cairo? You suggested this attack in Benghazi was more complex; so is it safe to rule out that this was a reaction to the inflammatory internet video?

SENIOR STATE DEPARTMENT OFFICIAL ONE: ...With regard to whether there is any connection between this internet activity and this extremist attack in Benghazi, frankly, we just don’t know. We’re not going to know until we have a chance to investigate. And I’m sorry that it is frustrating for you that so many of our answers are “We don’t know,” but they are truthful in that.
    Again, when given the opportunity to connect the Cairo protests with Benghazi and the anti-Muhammad video, the State Department official referred to the lack of "any connection between this internet activity and this extremist attack in Benghazi," not "the protests in Benghazi."  This complete absence of "protests" or "demonstrations" in the State Department's discussion of Benghazi makes the revision in the talking points (via Foreign Policy) changing "attacks" in the first version to "demonstrations" in the third version even more curious.
    A second point of contention regarding the talking point revisions relates to the spontaneous versus planned nature of the attacks and the participation of al-Qaeda or al-Qaeda affiliates.  Andrea Mitchell raised this question early in the briefing:
QUESTION: ...there’s a lot of reporting now on this being linked to a terror attack, an organized terror attack – possibly al-Qaida sympathetic or al-Qaida linked. Can you speak to that?
SENIOR ADMINISTRATION OFFICIAL ONE: ... Frankly, we are not in a position to speak any further to the perpetrators of this attack. It was clearly a complex attack. We’re going to have to do a full investigation. We are committed to working with the Libyans both on the investigation and to ensure that we bring the perpetrators to justice. The FBI is already committed to assisting in that, but I just – we’re – it’s just too early to speak to who they were and if they might have been otherwise affiliated beyond Libya.
    As the administration has stressed in defense of the early statements, the official declined to confirm or deny the suspected participation of al-Qaeda groups.  In fact, Mitchell's question contains the only reference to al-Qaeda or "terror" in the entire briefing, and yet the first version of the talking points prepared by the CIA included multiple references to al-Qaeda and its affiliates.  This is perhaps an early indication of the differences between the State Department and the CIA that would eventually lead to the twelve revisions in the following days.
    Regardless, the State Department official did note that "[i]t was clearly a complex attack."  In fact, "attack" or "attackers" is used twelve times throughout the briefing.  By contrast, in reference to Benghazi, "protest", "demonstration", and "spontaneous" are not used at all.
    A third and final point raised over the talking point revisions was the removal of references to prior attacks in Libya in the months leading up to September 11.  A questioner raised the issue of prior security incidents at the briefing:
QUESTION: ...Listen, there’ve been troubles in Benghazi for some time now. I understand the Consulate was attacked or bombed two, three months ago. The British have put out threat warnings about Benghazi. Was there any consideration before the attack yesterday of beefing up security there? 
SENIOR ADMINISTRATION OFFICIAL ONE: Well, again, I’m not going to get into the specifics of how we were postured in terms of security at our mission in Benghazi beyond what I said. So – because we don’t ever talk about the details of those kinds of things.
What I would say, though, is that we did, as we did in missions around the world, review the security there in the context of preparing for the anniversary of September 11th. And at that point, there was no information and there were no threat streams to indicate that we were insufficiently postured.
    Although the official stated that "we did, as we did in missions around the world, review the security there in the context of preparing for the anniversary of September 11th," an overview of State Department warnings and alerts shows a clear drop off between 2011 and 2012 in 9/11 anniversary warnings.
    After the background briefing on September 12 and over the next three days, the information the administration had presented in this briefing was combined with new information that continued to be gathered by intelligence and other agencies and ultimately led to the talking points used by Susan Rice.  It was also during this time, as reported this week by The Weekly Standard, that the Overseas Security Advisory Council withdrew a report that had been issued on September 6, five days before the attack, entitled "Terrorism and Important Dates."  The report downplayed the likelihood of a 9/11 anniversary-date attack by al-Qaeda or other terror groups, noting that concerns over such attacks are often due to "increased media attention to the issue."  A State Department official contacted via email said the report was withdrawn because "the content had expired," and did not respond to requests for further clarification.
    The removal of references to prior security incidents from the talking points and the withdrawal of the Terrorism and Important Dates report suggests that the administration was not inclined to draw attention to its pre-Benghazi posture on diplomatic security and preparedness.  Indeed, State Department spokesperson Victoria Nuland wrote in an email, such reminders "could be abused by members [of Congress] to beat up the State Department for not paying attention to warnings, so why would we want to feed that either?"
    Clearly the information during the first few days and even weeks after the Benghazi attacks was incomplete and even contradictory.  But in retrospect, it is clear that the Obama administration understood almost from the beginning the politically vulnerable position it was in due to its actions (and inaction) before, during, and as soon became apparent, after the attacks.  The clear frustration of the White House press corps during Friday's press briefing with Jay Carney may be another sign that the concerns over the last eight months of mainly conservatives and Republicans are beginning to spread.  Even Democrats at the Benghazi congressional hearings on Wednesday were openly calling for additional hearings to resolve the many remaining unanswered questions of Benghazi and the deaths of four Americans.  The coming weeks and months will be a strong test of the sincerity of an administration that has claimed on many occasions to be the most transparent in history.  The continuing obfuscation on Benghazi by administration officials up to and including the president is casting further doubt on that claim.

*Post originally said "State Department"

Note: A version of this article first appeared at The Weekly Standard.

Monday, May 13, 2013

W.H. Retweets Article on Rising Insurance Costs

    Today, the White House retweeted a link to an OregonLive.com story on competition among healthcare insurers purportedly instigated by ObamaCare:
    The story is entitled "Two Oregon insurers rethink 2014 premiums as state posts first-ever rate comparison" and begins as follows:
This is what competition looks like: One health insurer wants to charge $169 a month next year to cover a 40-year-old Portland-area non-smoker. Another wants $422 a month for the same standard plan.
The new health insurance marketplace envisioned by federal health reforms doesn't formally kick in until fall. But it already is taking shape – and consumers for the first time can compare, premium by premium, identical plans by different insurers.
    Some of the insurance players in Oregon give at least partial credit to the new "marketplace" instituted by ObamaCare for lowering the projected 2014 rates for Oregon health insurance consumers:
"Posting rate comparisons company-by-company is a taste of what is to come," says Cheryl Martinis of the Oregon Insurance Division. 
Judging by the reaction, there's already an impact. 
Providence Health Plan on Wednesday asked to lower its requested rates by 15 percent. Gary Walker, a Providence spokesman, says the "primary driver" was a realization that the plan's cost projections were incorrect. But he conceded a desire to be competitive was part of it.
    However, one gets the idea that perhaps the White House retweeted the link without reading the entire article.  Further in the story comes this [emphasis added]:
The easy rate comparison is only one of the changes consumers who buy their own insurance can expect in 2014. 
Another is higher premiums in the 2014 individual market, though for many people they'll be offset by tax credits. The higher rates are because people with pre-existing conditions can no longer be denied coverage. Also, plans have to offer stronger benefits than they used to, leading to higher premiums. 
The changes have spawned much speculation, with some predicting "rate shock" for people who buy their own policies. Now consumers can see for themselves what premiums could be available, at least for certain plans. 
    This might appear to be a classic case of burying the lead.  Competition, yes, but higher rates?  And due to the Affordable Care Act?  However, the article quickly adds the saving grace that may have tipped the scales in the White House retweet decision.  Federal government income-based subsidies of the higher rates :
Meanwhile, at least half the potential customers who buy their own insurance will qualify for a sliding scale of income-based tax credits that could more than-eliminate any price hikes. Nearly 400,000 Oregonians are expected to purchase their own insurance as tax credits lure previously uninsured consumers. 
In addition to comparing insurance plans, Cover Oregon can enroll people and qualify them for tax credits. 
     So, the Obama administration pushed through a 2,800 page piece of legislation that cut consumer choice (I mean "simplified the health insurance system") and raised rates by forcing companies to accept sick customers (I mean "eliminated unfair exclusions for pre-existing conditions") and to offer benefits that not everyone wants or needs (I mean "offer stronger benefits".)  But not to worry.  The government will kick in the difference.  And lower the deficit.  And improve health outcomes.

    What could possibly go wrong?


Note:  This article first appeared at The Weekly Standard.

Friday, May 10, 2013

Presidential Rank Awards in the "Era of Federal Austerity"

    On April 25th, a black-tie dinner was held at the State Department to recognize the 2012 winners of the Presidential Rank Awards.  Each year, according to guidance from the Office of Personnel Management, the president awards the "ranks of Distinguished Executive and Meritorious Executive on a select group of career senior executives who have provided exceptional service to the American people over an extended period of time."
    In addition to a framed certificate from the president, the two ranks of awards come with a bonus equal to 35% of base pay and 20% of base pay respectively. (The pay freeze currently in place for federal workers did not apply to these awards.) This year, according to Government Executive, the Distinguished Executive awards totaled 54, and Meritorious Executive awards totaled 78.
    While it was noted that together the winners had saved the federal government $94 billion, "SEA [Senior Executives Association] President Carol A. Bonosaro, the banquet’s master of ceremonies, told Government Executive she was disappointed that the number of winners has shrunk in the current era of federal austerity." Bonosaro noted there were no winners from the intelligence agencies because the White House had not responded in time:
Bonosaro said the hold-up on intelligence agency winners comes from the White House. She also worried the administration was behind schedule in setting in motion the process for selecting the 2013 Distinguished Rank winners. That months-long process usually starts in November, Bonosaro said, and involves agency nominations, OPM vetting, and further review by panels and the White House. There’s also the banquet preparations, she added. “We can’t give a party like this overnight.”
    Oddly, given the absence of any winners from the intelligence agencies, the keynote speaker for the evening was General James Clapper, director of national intelligence.  Several other high ranking administration official attended also.  Government Executive inquired of the White House about the delay in declaring intelligence agency winners, but had not received a response by the time the article was published.
    As a footnote:  Although Carol Bonosaro referenced "current era of federal austerity," the austerity did not extend to the framing of the award certificates.  A contract for 135 custom made "mahogany stained poplar wood frames with gold leaf liner" was awarded to Artline Wholesalers.  At $28,464.75, the total contract breaks down to $210.85 per frame.  Although one can carry austerity only so far, a similar frame may be had at Wal-Mart for the everyday low price of $22.97, although it is not clear if glass is included. And no sales tax!  At least for now...