From Illinois comes word that a $4 million federal grant from the Centers for Disease Control awarded last week to Cook County “will be used to establish community gardens” and “to develop of [sic] pedestrian and bicycle paths” that are intended to “increas[e] physician activity in schools, [and] promote walking and biking to and from school.” While it’s unclear where exactly the funding for this particular CDC grant came from, it is clear that the health care law includes a new $15 billion slush fund to finance “community transformation grants” that could include bike paths, grocery stores, and jungle gyms. Also of note: The omnibus bill that Democrats were forced to withdraw last December included a full $750 million in spending out of the Prevention and Public Health “slush fund,” including $630 million to the CDC – which could be used to fund additional bike path and garden grants.
When Republicans highlighted these wasteful projects during the health care debate, liberals called it one of the “best lies about the new health care law” that the slush fund could be used for things like jungle gyms. Yet less than a year after the bill was signed into law, the EXACT types of grants that Republicans criticized are being awarded using hard-earned taxpayer dollars. So while Speaker Pelosi famously said that we had to pass the bill to find out what’s in it, Republican predictions of dubious federal spending on bike paths and other types of projects have been proven correct.
More importantly, at a time when the federal government faces an all-time deficit of nearly $1.5 trillion this fiscal year – and Illinois is imposing a massive 67% increase in state income tax rates to cover its own budget shortfall – many may wonder whether the government should be spending taxpayer dollars funding bike paths and community gardens.
Over the weekend, both the New York Times and Kaiser Health News ran stories about the dire warnings being issued from several states regarding their Medicaid programs. Facing massive budget shortfalls, governors as politically diverse as Florida’s Rick Scott and New York’s Andrew Cuomo are looking to achieve significant savings from their Medicaid programs.
However, the restrictions written into the health care law and the “stimulus” bill (which gave states temporary Medicaid relief) prevent states from reducing their eligibility requirements (i.e., cutting the budgetary coat to meet a state’s fiscal cloth) until the law takes full effect in January 2014. Arizona’s Governor has already requested a waiver from the requirements, but it’s unclear whether the federal government will approve such a request, from Arizona or any other state. If the Administration does not, some states may then face other, even more difficult, budgetary choices. The National Governors Association and Republican Governors Association have both written to the Administration objecting to these “maintenance of effort” requirements, which the RGA said would have “unconscionable” effects.
Kaiser Health News quotes two other possible “solutions” to the Medicaid dilemma, neither of which would have much appeal to most Republicans. Referring to the Medicaid program, HELP Committee Chairman Harkin suggested that “maybe the federal government should take over the whole thing.” (Remember, these are the folks arguing that the health care law is NOT a government takeover of health care.) Besides just shifting costs from the states to the federal government, such a one-size-fits-all program would stifle states’ flexibility (not to mention sovereignty) in a way that allows them to generate innovative solutions on health care – including solutions that are more market-based.
The other option floated by several Democrats – including Finance Committee Chairman Baucus, HELP Committee Chairman Harkin, and former Speaker Pelosi – would extend federal Medicaid aid first included in the “stimulus” until 2014. That however raises two important problems of its own. First, such a move would cost hundreds of billions of dollars – likely wiping out the purported deficit “savings” from the health care law. Second, if states’ Medicaid programs are in such a poor state that they require a federal bailout for over five years (the “stimulus” aid was made retroactive to late 2008, and Democrats want to extend it until 2014), why on earth should the federal government be forcing MORE individuals on states’ strapped Medicaid rolls in the years after 2014?
In a story this morning about a new Medicaid advisory commission, Politico quotes commission member Sara Rosenbaum as saying that the advisory body should “not add…one cent to the burden of the states.” It’s unfortunate that Democrats didn’t take the same tack before imposing the new and onerous unfunded mandates on state Medicaid programs included in the health care law.
This morning’s HHS report on premiums makes several questionable claims, including one about the potential long-term savings associated with the health care law. Page 9 of the report includes the following paragraph:
Independent analysts suggest that the combination of these policies could slow the growth of health spending by 1 percentage point a year starting in 2014. By 2019, this could save 9 percent or $2,000 for a family policy, in addition to the savings that come from the policies implemented in 2014.
The footnote in the report cites a paper by economist David Cutler released earlier this month to support its claims. There’s just one problem with citing David Cutler, however: His own website indicates that he was a PAID advisor to the Obama presidential campaign. Under “outside activities,” the “Obama presidential campaign” is listed among a list of “activities…listed where the compensation was over $3,000 in a calendar year for non-profit or government activities, or over $500 for for-profit activities.” In other words, Cutler’s own website suggests he received several thousand dollars from the Obama presidential campaign.
During his time as a campaign advisor, Cutler co-wrote the famous memo attempting to defend candidate Obama’s assertion that his health plan would save $200 billion per year, or $2,500 per family – claims that the campaign alleged would occur within Obama’s first term. Now the Cutler report cited by HHS claims that families could save a smaller amount (i.e., $2,000 vs. $2,500) over a MUCH longer time span – an example of the soft bigotry of low expectations if ever one existed.
These contradictions raise obvious questions, on both process and substance:
- How on earth can a PAID advisor to the Obama campaign be considered an “independent analyst” by HHS – or any other reasonable outside observer?
- How does repeating claims from a paid campaign advisor with a financial interest in defending the Obama agenda – and failing to disclose this MAJOR conflict of interest – not constitute taxpayer-funded propaganda?
- If both Cutler and the White House can’t defend their prior allegations that health “reform” will cut premiums by $2,500 per family, why should anyone believe their claims – on premiums, job creation, or anything else for that matter – now?
HHS Secretary Sebelius is preparing to release a report this morning claiming premiums will go down thanks to the health care law – an interesting turn of course, because the Secretary herself conceded just a few months ago that premiums will still continue to rise. At a briefing back in September, the Secretary admitted that “I think the rate increases are likely to continue to be somewhat substantial” (Clip can be found here; relevant exchange starts at 4:15.)
It’s also worth noting that page 5 of the HHS report cites as a “success story” an Iowa insurance decision that “reduced a 60 percent proposed increase to 16.5 percent.” Since when does a 16.5 percent premium increase represent progress?
Remember, candidate Obama promised repeatedly that premiums would go DOWN by an average of $2,500 per family – not that they would go up by “only” 16.5 percent. (Progress on candidate Obama’s pledge is demonstrated below; a full list of campaign quotes follows my signature.) How does this violation of a clear campaign promise represent change Americans can believe in?
The Administration’s “report” on premiums is out, and as expected the survey quotes misleading Congressional Budget Office data to claim that premiums would be 20 percent lower under the health care law. Here’s the relevant paragraph from page 7 of the report:
Together, these savings range from 14 to 20 percent. CBO also assumed that individuals and families would have, on average, coverage that is more comprehensive than what they have now, meaning that the savings would offset by higher premiums due to better coverage. It is important to note that this benefit enhancement is a choice, not a requirement.
The report acknowledges that premiums would go up due to individuals buying richer benefit packages, but claims that these decisions will be entirely voluntary. Unfortunately for the Administration, however, that is NOT what the CBO stated in its analysis. Here’s the relevant paragraph from page 7 of the CBO’s November 2009 report:
Average premiums would be 27 percent to 30 percent higher because a greater amount of coverage would be obtained. In particular, the average insurance policy in this market would cover a substantially larger share of enrollees’ costs for health care (on average) and a slightly wider range of benefits. Those expansions would reflect both the minimum level of coverage (and related requirements) specified in the proposal and people’s decisions to purchase more extensive coverage in response to the structure of subsidies.
In other words, CBO admitted that while some Americans would choose to purchase additional coverage voluntarily, many Americans would face higher premiums due to the mandates contained in the law. For the Administration to claim that “this benefit is a choice, not a requirement” in all cases is COMPLETELY FALSE.
During the last several weeks, liberal commentators and health law supporters have criticized Republicans’ “war” on the Congressional Budget Office, even though Republicans haven’t criticized the professionalism of CBO’s analysts, but rather the assumptions that the Democrat majority forced CBO to presume when scoring health care legislation. But now that Democrats have both twisted and ignored critical points in the CBO’s analysis to make completely false statements about the law’s effect on premiums, will those same liberals have the same level of outrage about the misleading allegations in the Administration’s “report?”
The Administration is scheduled to release a “report” on premiums later today; while the report itself has not been released, Politico has an article summarizing its contents. The full story is pasted below my signature; here are the critical sentences:
The report, to be released by HHS later today, argues that individuals and families purchasing coverage through the exchanges in 2014 will save 14-20 percent over what coverage would cost them if the law had never been enacted….
The report’s claims are likely to be challenged by Republican opponents of health care reform. The report is based on projections contained in a November 30, 2009 analysis of the ACA. But the Administration omits a part of the CBO’s analysis, which is being used by the law’s opponents to claim that the law actually increases premiums.
The ACA requires the purchase of benefit packages that are more comprehensive than what many Americans would otherwise buy. These more generous benefit packages may mean higher premiums, though they may also lower Americans’ out-of-pocket costs. HHS does not factor in the “benefit buy-up” because it believes comparing the cost of the same level of coverage gives a more accurate picture of the law’s effect on premiums.
As a reminder, the Congressional Budget Office found that the Senate bill would RAISE premiums by an average $2,100 per family. While the Administration claims that the Exchanges would reduce costs on their own, CBO found that premiums will go up because individuals would be FORCED to buy richer policies. In other words, the increased mandates in the law – because Democrats and government bureaucrats believe that some Americans’ coverage is “insufficient” – will RAISE premiums. Even President Obama admitted at the White House summit last February that he was incorrect in his exchanges on this matter with Sen. Alexander, and that the law will raise premiums by $2,100 on average per family in the non-group market.
What does it say about this Administration that it continues to peddle information that the President himself acknowledged was incorrect and misleading? And how is breaking the President’s campaign promise to lower premiums by $2,500 per family “change we can believe in?”
Cognitive dissonance alert: Even as Secretary Sebelius is testifying before the HELP Committee that the health care law is good for the economy, Abbott Labs decided to lay off nearly 2,000 employees thanks to the very same measure. Bloomberg reports that an Abbott press release noted the layoffs came “in response to changes in the health care industry, including U.S. health care reform and the challenging regulatory environment.”
In her prepared testimony this morning before the HELP Committee, HHS Secretary Sebelius claims that a Business Roundtable study* found that the health care law will reduce premium costs for large employers by $3,000 per year. But in reality, that’s not what the report said at all – in fact, it only presumes a reduction in the increase of premiums, NOT the reduction in absolute terms the President promised during his campaign. But don’t take my word for it: Look at Exhibit 1 of the study (depicted below), which study illustrates that under the maximum achievable “savings,” large employer premiums in 2019 will be $23,151 per family – or $12,408 higher than they were in 2009. How is a $12,400 increase in premiums – as opposed to the $2,500 reduction that candidate Obama repeatedly promised – a change that struggling middle-class families can believe in?
* A further note on the Business Roundtable study: Its last page notes that the estimates referred to above (and depicted below) were generated in the following way: “We assumed that discretely identified savings opportunities found in health care reform, could, when fully implemented, reduce the overall cost trend by 15% to 20%.” In other words, the study started out with savings under the law being assumed. That might prove convenient for the Administration and its allies – but the non-partisan Medicare actuary disagrees, publishing an analysis indicating the law would raise costs by more than $310 billion, and just yesterday calling “False” the Administration’s stated goal of reducing health care costs.
Sen. Enzi’s staff have compiled a report finding that children in at least 20 states are unable to obtain child-only health insurance, thanks to the clumsy way the law’s ban on pre-existing condition exclusions has taken effect. In other words, in many cases, the individuals targeted by the law for assistance are some of the ones directly suffering as a result of its many flaws. That report can be found here.
It’s also worth noting that in a Politico story on the matter, advocates claim “that the damage could have actually been a lot worse, had [states] not taken aggressive action to intervene.” It’s interesting first that having “only” 20 states not selling child-only policies is being claimed by some as progress, and second that the apparent “solution” to government intervention (i.e., a bad law passed by Congress) is yet more government intervention, in the form of “aggressive action” by state governments and regulators. It’s enough to bring to mind the famous quote that “The nine most terrifying words in the English language are, ‘I’m from the government and I’m here to help.”
Also, the Ways and Means Committee has posted video of Rep. Tiberi’s exchange yesterday with Council of Economic Advisers Chairman Austan Goolsbee, in which Mr. Goolsbee claimed it is “not accurate” to describe the individual mandate as a tax. That video can be found here.
Testifying before the House Ways and Means Committee this morning, Council of Economic Advisors Chairman Austan Goolsbee has repeated Administration claims that the health care law will create jobs, citing a paper from economist David Cutler on this issue. However, Cutler was the also same Obama campaign adviser who co-wrote the famous memo attempting to defend candidate Obama’s assertion that his health plan would save $200 billion per year, or $2,500 per family. This of course raises an obvious question: If both Cutler and the White House can’t defend their prior allegations that health “reform” will cut premiums by $2,500 per family, why should anyone believe their claims on job creation now?