White House Spins Article About 34% Increase in Ohio Healthcare Premiums As Good News

David Simas, Deputy Senior Advisor for Communications & Strategy, tweets (and White House retweets) a link to an article with “More good ACA [Obamacare] news. 21% savings on premiums for Ohioans who buy their own health insurance because of the ACA.”

Indeed, the article begins: “Ohioans who buy their own health insurance should see an average out-of-pocket savings on premiums of 21 percent because of taxpayer subsidies under the Affordable Care Act, according to a new study by the Rand Corp., a widely respected think tank.”

But the 21% is not a savings over current premium levels, but projected increased premiums [emphasis added]:

Christine Eibner, a senior Rand economist and lead author of the study, told us in a telephone interview this afternoon that she considers this is a realistic way of comparing premiums. It compares premiums for coverage people will get on the exchange with coverage they have or would have had without Obamacare.

Based on that calculation, the average premium for individual policies in Ohio would rise by $900, or 22.65 percent...

The price hike would be offset for many Ohioans by the taxpayer subsidy.

So the 21% “savings” doesn’t actually even quite make up for the 22.65 percent increase in average premiums.  And the savings are only for those getting subsidies.  Those paying the full premium themselves will get hit with the full 22.65 percent increase.

It should be noted also that the increase in the raw comparison of premiums, before Rand adjusted for what it considered pertinent factors, was even higher:

Without factoring in subsidy offsets and the policies that people are likely to buy, premiums for individual policies in Ohio will average $5,312 in 2016, according to figures from Rand. That’s 34 percent higher than the average for individual premiums without Obamacare, Rand’s figures show.  But that, too, is a high estimate that does not factor what kind of coverage people will actually buy on the exchange...

And this is the kind of article the Obama administration considers good news worth promoting.


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

White House: GOP Intimidating Obamacare Navigators

    On Friday, David Simas, the White House Deputy Senior Advisor for Communications & Strategy, raised the alarm: "House GOP targets hospitals, homeless shelters, food banks & senior centers educating people about ACA." In case that did not sound dire enough, he added the hashtag "#Intimidation."  Subtle it was not.  So what did those dastardly Republicans do?  Were there veiled threats of "That's a nice homeless shelter you've got there.  It'd be a shame if anything were to happen to it"?  Were they siccing the IRS on non-profits (at least the ones the IRS isn't already hounding)?  Not quite.
    In fact, the House Energy and Commerce Committee was simply exercising what is known as "oversight," or is known as oversight when the person using the term agrees with the action.  The action here is, according to Kaiser Health News, "asking recipients of the $67 million in health law navigator grants to brief the panel on how they intend to spend the money."  HHS announced the $67 million in grants on August 15, just two weeks ago.  Rep. Henry Waxman, the panel's ranking Democrat, had the hutzpah to say that:

the timing of the letters was "particularly suspect. You are insisting on voluminous document productions by Sept. 13, just when these groups need to be focused on their mission of helping uninsured Americans enroll for coverage." He added that the requests may have been sent "solely to divert the resources of small, local community groups just as they are needed to help with the new health care law."

    Rep. Waxman's complaint about timing is especially rich when you consider that Obamacare was passed in 2010, and yet navigators grants were announced a mere 45 days before the exchanges are due to open.  The GOP issued the informational requests within two weeks of learning the identities of these groups, has given them two weeks to respond, and will then have two weeks before Obamacare launches to process the responses and take appropriate action.  It is difficult to imagine what timing would have been acceptable to Rep. Waxman.
    The Republicans' concern is due to questions about security, screening, and training of navigators that will need to take place in a rather limited time.  Navigators will essentially be performing a service that for years professional brokers have provided, but with considerably less experience and education than brokers.  As Kaiser explains:

Navigators will provide assistance on the phone and in person to individuals signing up for coverage in the health law’s insurance marketplaces, as well as for public programs including Medicaid and the Children's Health Insurance Program. They will receive 20 hours of online training and have to pass a test before they can start working. Their efforts could include help in evaluating health plans for sale on the marketplaces, also known as exchanges. They are not, however, allowed to expressly tell people which policy to choose.

    The requirements are not exactly arduous.  Though the grant recipients have been screened by HHS, states "may choose to require minimum eligibility criteria and background checks" for the individuals tasked by the grant recipients to assist the public.  The most HHS has promised is to "take appropriate action if complaints of fraud and abuse arise."  With sensitive health information and private data, including social security numbers, potentially at risk, this reassurance is cold comfort.
    The 20-hour training of the navigators reminds me of an episode of the classic TV show from the 1960s-70s, Hogan's Heroes.  A recurring character, Col. Crittendon, a bumbling English officer, tells his fellow prison camp inmates who are planning a sabotage raid that he has commando training.  When they inquire about it, he tells them it was rigorous.  He didn't think he was going to make it, and it took every bit of grit and determination to soldier through.  He says it was worth every minute, but "I wouldn't want to go through a weekend like that again."
    Although a potential navigator might have to burn the midnight oil to get in 20 hours of online training in a weekend, it is certainly doable.  And more so since HHS cut the requirement from 30 hours just a few weeks before the $67 million in grants was announced.  Rather than intimidation, the GOP is performing due diligence to be sure future callers to the Obamacare help line aren't relying on modern day Col. Crittendons to help them get the most for their healthcare dollars.

Medicaid Accidentally Overpays $88M to Alabama

    The State of Alabama received bonus payments from Medicaid for 2009 and 2010 that were a stunning 13 times higher than the state was eligible for.  So says the inspector general (IG) for Health and Human Services in a report released on Wednesday.  Instead of $7.1 million, Alabama received $95.3 million in performance bonuses related to the Children's Health Insurance Plan (CHIP) for the years in question.  As a consequence, the state owes the federal government a refund of about $88 million.
    The overpayment was not the result of a complicated series of errors or deliberate misrepresentation, but rather a very simple error, as the report spells out:

The State agency overstated its current enrollments because, rather than reporting a monthly average enrollment of qualifying children, it reported to CMS [Centers for Medicare & Medicaid Services] the total number of all qualifying children that had been enrolled in its program for each year reviewed.

    In other words, even children who qualified for CHIP for only a few months during the year were counted as if they were qualified the entire year.  That means the number of qualified children was overstated by more than 90,000.
    The IG choose to investigate the payments to Alabama because the state received over one-third (34%) of all such bonus payments to all states for 2009-2010:

We reviewed the bonus payments that Alabama received for FYs 2009 and 2010 because the amounts of the payments were relatively high compared with those of other States receiving bonus payments.  Alabama received $95 million (34 percent) of the $281 million in bonus payments made to all States for these 2 years.

    It is unclear why this imbalance did not raise any red flags at CMS prior to the IG's audit.
    According to a report on the Alabama-based website al.com, the State of Alabama wants to work out a repayment plan for the $88 million with the federal government.  The state's health office Dr. Don Williamson is quoted as saying that he believes the state Medicaid "acted in good faith" when filing for the refunds.
    Initially, Alabama disputed the findings in a May 2013 letter to CMS from acting Alabama Medicaid commissioner, Stephanie McGee Azar:

"Alabama Medicaid believes that it qualified for the bonuses at issue," according to the letter dated May 17, 2013. "CMS has worked closely with Alabama Medicaid in preparing the state's yearly bonus application in compliance with federal requirements since the State's first submission in 2009."

    The bonus payments were authorized in the Children’s Health Insurance Program Reauthorization Act of 2009 (CHIPRA).  According to the report [emphasis added]:

[Q]ualifying States may receive bonus payments for FYs 2009 through 2013 to offset the costs of increased enrollment of children in Medicaid.  A State is eligible for a bonus payment if it increased its current enrollment of qualifying children (current enrollment) above the baseline enrollment of qualifying children (baseline enrollment) for a given year as specified in CMS guidance.  A State must also have implemented at least five of the Medicaid enrollment and retention provisions specified in CHIPRA. 

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

U.N. Secretary General: 'Give Peace a Chance' in Syria

    Even as United Nations personnel are in Syria trying to investigate chemical weapons claims that have further exacerbated that country's bloody civil war, U.N. Secretary-General Ban Ki-moon was incongruously tasked with the celebration of the centennial of the Peace Palace in The Hague.  After praising the 100 year old "magnificent building" that houses the International Court of Justice, the Permanent Court of Arbitration, the Hague Academy of International Law and the Peace Palace Library, the Secretary-General urged all sides in Syria to "give peace a chance," noting the presence of the weapons inspectors currently in the country.  He also questioned the wisdom of supplying arms to either side in the conflict, asking "what have those arms achieved but more bloodshed?"
    Here are his full remarks on Syria:

Above all, I think about Syria, where a catastrophic civil war has killed more than 100,000 people by now, ignited sectarian tensions and generated instability across the region.
Now we have reached the most serious moment in this conflict.
The latest escalation has caused horrendous casualties.  And through images unlike any we have seen in the 21st century, it has also raised the spectre of chemical warfare.
The use of chemical weapons by anyone, for any reasons, under any circumstances, would be an atrocious violation of international law.
It is essential to establish the facts.  A United Nations investigation team is now on the ground to do just that.
Just days after the attacks, they have collected valuable samples and interviewed victims and witnesses. The team needs time to do its job.
Here in the Peace Palace, let us say: Give peace a chance.  Give diplomacy a chance.  Stop fighting and start talking.
And here in this hall dedicated to the rule of law, I say: let us adhere to the United Nations Charter.
To those providing weapons to either side, we must ask: what have those arms achieved but more bloodshed?
The military logic has given us a country on the verge of total destruction, a region in chaos and a global threat.  Why add more fuel to the fire?
We must pursue all avenues to get the parties to the negotiating table.  The joint envoy of the United Nations and the Arab League continues his efforts.
Most of all, the Security Council of the United Nations must uphold its responsibilities under the Charter - moral and political responsibilities under the Charter of the United Nations.
Syria is the biggest challenge of war and peace in the world today.  The body entrusted with maintaining international peace and security cannot be missing in action.  The Council must at last find the unity to act.  It must use its authority for peace.

    So far, Russia and China have opposed any action by the UN against Syria.

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

President Obama's Meeting With Mayors About Youth Violence Included One Republican

    President Obama and Attorney General Holder met with a group of 18 mayors at the White House on Tuesday afternoon.  The meeting was billed as a discussion "with mayors from cities around the country to discuss reducing youth violence." And although Republicans hold about a quarter of mayoral positions in the fifty largest cities in the U.S., only one Republican mayor was in attendance at the meeting,  Greg Ballard of Indianapolis.  The remaining mayors included sixteen Democrats and one Independent.
    According to recent data, there are twelve Republicans among the mayors of the fifty largest U.S. cities.  Twelve of the eighteen cities represented at the White House meeting are among those fifty.
    Some of the smaller cities represented at the meeting have high profile mayors, such as Corey Booker of Newark, NJ.
    Many of the cities appear on various Most Dangerous City lists, which may give an indication as to why the White House included them on the guest list.
    The White House released a short summary of the meeting:

President Obama and Attorney General Holder met this afternoon with a group of mayors from around the country to discuss strategies to reduce youth violence. The President reiterated that government alone can never fill the void that causes a child to turn to violence, but that we all have a responsibility to do our part to create safe communities and save lives. The President applauded the mayors for their local efforts to combat violence, solicited their input about proven methods, and pledged his Administration’s partnership. He also vowed to continue doing everything in his power to combat gun violence through executive action and to press Congress to pass common-sense reforms like expanding the background check system and cracking down on gun trafficking.

    Here is the complete list of mayors in attendance:

• Mayor Greg Ballard (Indianapolis, IN)
• Mayor Tom Barrett (Milwaukee, WI)
• Mayor Cory Booker (Newark, NJ)
• Mayor Vincent Gray (Washington, DC)
• Mayor Sly James (Kansas City, MO)
• Mayor Kevin Johnson (Sacramento, CA)
• Mayor Mitch Landrieu (New Orleans, LA)
• Mayor Mark Mallory (Cincinnati, OH)
• Mayor Michael Nutter (Philadelphia, PA)
• Mayor Annise Parker (Houston, TX)
• Mayor Jean Quan (Oakland, CA)
• Mayor Stephanie Rawlings-Blake (Baltimore, MD)
• Mayor Kasim Reed (Atlanta, GA)
• Mayor RT Rybak (Minneapolis, MN)
• Mayor Francis Slay (St. Louis, MO)
• Mayor Dayne Walling (Flint, MI)
• Mayor Molly Ward (Hampton, VA)
• Mayor AC Wharton (Memphis, TN)

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

Census: Households With Children with an Unemployed Parent Increased 33 Percent from 2005 to 2011

    A Census Bureau report released on Tuesday says that the number of households with children under 18 with at least one unemployed parent increased by 33 percent between 2005 and 2011 from 2.4 million to 3.2 million.  In addition, home ownership among households with children under 18 declined by 15 percent to 20.8 million during that same time period.
    The report is entitled America's Families and Living Arrangements: 2012 and touches on all aspects of the living arrangements of Americans.  Jamie Lewis a demographer for the Census Bureau and co-author of the report says that while the recession had an impact, the effects have not dissipated since the recession ended:

Home ownership among families declined, while food stamp receipt and parental unemployment increased. Even after the recession officially ended in 2009, these measures remained worse than before it began.

    Other parts of the report show some dramatic changes in American households in the last several decades.  For instance:

The share of households that consisted of married couples with children shrunk by half between 1970 and 2012, from 40 percent to 20 percent. At the same time, the percentage of households consisting of a person living alone climbed from 17 percent to 27 percent.

    Some other notable report findings:

• A higher percentage of young adults age 25 to 34 lived in their parents' home in 2012 than in the early 2000s. For men of this age, the share living in their parents' home increased from 13 percent in 2000 to 17 percent in 2012. The increase for women age 25 to 34 went from 8 percent in 2000 to 10 percent in 2012.
• According to the 2011 American Community Survey, there were 605,000 same-sex couple households, including both married and unmarried couples, of whom 284,000 were male and 321,000 were female couples.
• Most family groups with children (63 percent) were maintained by married couples.
• A higher percentage of black (55 percent) and Hispanic (31 percent) children lived with one parent than white non-Hispanic (21 percent) or Asian children (13 percent).
• Between 1970 and 2012, the average number of people per household declined from 3.1 to 2.6. 

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

Got A Teen Smoker? Get the National Institutes of Health Latest App, Brrrd Brawl!

    Look out, Angry Birds™.  The National Institutes of Health is moving in on the avian-altercation segment of the mobile device game market.  The description of the new phone app game from the nation’s premier medical research agency says it all:

The penguins are coming, the penguins are coming! When the turkeys of Fred’s Family Farm hear the news that a penguin army is on their way to take over, it’s time for a BRRRD BRAWL! This game is a casual mobile game developed in support of Smokefree Teen (SfT). It was created to help teens quit smoking by offering a better option for "idle hands".

    With the number of game apps currently in the iTunes app store alone being somewhere north of 100,000, including multiple variations of Angry Birds™, it is unclear what it is about a turkey-penguin dustup that will have teens abandoning their smokes to aid Fred’s Family Farm in the desperate attempt to fight off an invasion from the frozen continent.

    In this case, it appears that idle hands are the NIH's workshop.