The Aug. 5 op-ed by Rep. Pramila Jayapal (D-Wash.), “The facts about Medicare-for-all,” admirably called for a fact-based debate regarding single-payer health care. But it would help if she accurately represented the facts surrounding her bill — starting with its title — because the legislation has little to do with providing Medicare to all.
Jayapal criticized her fellow Democrats for “incit[ing] fear and sow[ing] confusion” by stating that, under her proposal, “Medicare goes away as you know it.” But a HuffPost article conceded that, “as a point of fact, the Medicare program envisioned under [Jayapal’s bill] is not the program as it exists today.” Moreover, Section 901(a)(1) of Jayapal’s own bill states that “no benefits shall be available under title XVIII of the Social Security Act” — Medicare — after the bill’s new program were to take effect.
A fellow with the Urban-Brookings Tax Policy Center at the Urban Institute recently wrote of the plan from Jayapal and Sen. Bernie Sanders (I-Vt.), “You can call it many things — from ambitious to unrealistic. But please don’t call it Medicare.” That Jayapal refused to describe her own plan accurately should cause readers to question what other inconvenient truths she has ignored regarding her socialized-medicine scheme.
This post was originally published in The Washington Post.
Over the weekend, more details emerged about how Obamacare is transforming the American workforce – and not for the better. The New York Times reported on many small firms not hiring new workers, or scaling back hours for existing workers, to avoid the law’s new taxes. And the Huffington Post reported that Wal-Mart has changed its employment policy, eliminating health insurance benefits for new part-time workers – thereby dumping them on to Obamacare’s exchanges:
Walmart, the nation’s largest private employer, plans to begin denying health insurance to newly hired employees who work fewer than 30 hours a week, according to a copy of the company’s policy obtained by The Huffington Post. Under the policy, slated to take effect in January, Walmart also reserves the right to eliminate health care coverage for certain workers if their average workweek dips below 30 hours.…
Labor and health care experts portrayed Walmart’s decision to exclude workers from its medical plans as an attempt to limit costs while taking advantage of the national health care reform known as Obamacare….“Walmart is effectively shifting the costs of paying for its employees onto the federal government with this new plan, which is one of the problems with the way the law is structured,” said Ken Jacobs, chairman of the Labor Research Center at the University of California, Berkeley.
“Walmart likely thought it didn’t need to offer this part-time coverage anymore with Obamacare,” said Nelson Lichtenstein, director of the Center for the Study of Work, Labor and Democracy at the University of California, Santa Barbara. “This is another example of a tremendous government subsidy to Walmart via its workers.”
In pursuing lower health care costs, Walmart is following the same course as many other large employers. But given its unrivaled scale, Walmart’s policies tend to influence American working conditions more broadly. Tom Billet, a senior consultant at Towers Watson, a professional services firm that works with large companies to develop benefit plans, said other companies are also crafting policies that will exclude some part-time workers from medical coverage. Billet portrayed the growing corporate interest in separating out part-time workers as a reaction to another aspect of Obamacare – the new rules that require companies with at least 50 full-time workers to offer health coverage to all employees who work 30 or more hours a week or pay penalties.
One major bottom-line question in this development relates to how many more people will be added to government health rolls by this apparent trend. In last month’s job data, the Bureau of Labor Statistics estimated nearly 28 million Americans work part-time – defined by the BLS as fewer than 35 hours per week. Using Obamacare’s less stringent 30 hours per week standard would reduce that 28 million number somewhat – and many part-time workers do not have access to employer-provided health insurance currently. (Of firms offering insurance to their employees, 28% extend that offer to part-time workers as well – a fact which only indirectly illuminates the number of part-time workers receiving insurance coverage from their employer.)
All that said, the point remains that millions – and perhaps tens of millions – of part-time workers who currently receive insurance from their employers could lose it due to Obamacare – and federal taxpayers will be stuck paying the bill. That’s not “reform,” and it’s not a change millions of American workers, to say nothing of American taxpayers, can believe in.
The liberal group Families USA released another report that supposedly makes the case for Obamacare – but in reality just demonstrates the lengths liberals will go to in order to gin up support for their flawed law. The report claims that “64.8 million non-elderly Americans have been diagnosed with pre-existing conditions that could lead to denials of coverage, absent health reform.”
There are several problems with this claim. First, the Administration released a report last year claiming that 129 million individuals have pre-existing conditions and “could be denied affordable coverage.” In other words, the Families USA study also claims that the number of individuals with pre-existing conditions has just been cut in half when compared to the prior HHS report. Which is another way of saying the Families USA report implicitly admits that the HHS study is flawed, biased, and should not be considered reputable. (But hey, what does a difference of a mere 65 million people make among friends?)
Second, enrollment in pools for people with pre-existing conditions is nowhere near as high as the Families USA report would suggest. According to the most recent data released by the Administration, 73,333 individuals with pre-existing conditions are enrolled in the federal high-risk pool program established under Obamacare. These enrollment data do not come anywhere close to earlier projections – the Medicare actuary originally projected enrollment at 375,000 individuals in 2010, and Congressional Budget Office estimated up to 700,000 individuals would attempt to enroll in the program by next year. To put it another way, the number of enrollees in pre-existing condition pools under Obamacare is .11% of the 64.8 million people Families USA claims have pre-existing conditions.
Finally, it’s worth pointing out that today’s report was conducted for Families USA by the Lewin Group. The Huffington Post and other liberal allies called Lewin a front group for insurers back in 2009, when it released studies showing how a government-run health plan could cause millions to lose their health insurance. Surprisingly, we have yet to see HuffPo and other liberal groups similarly criticizing today’s Families USA/Lewin study as being biased by a tainted insurer front group, when it helps trumpet the talking points of Obamacare supporters.
It’s true that the problem of individuals with pre-existing conditions is real – but nowhere near as pervasive as the types of reports produced by HHS and Families USA would have you believe. That’s why Republicans have offered and supported targeted solutions that would solve this problem WITHOUT a 2700-page law intruding into every corner of the American health sector. The trumped-up claims in this latest Families USA report once again illustrate that while pre-existing conditions are a problem for some Americans, Obamacare is far from the right solution.
The liberal advocacy group Families USA is out today with a new report claiming that 3.2 million small businesses are eligible for the new health insurance tax credit created by Obamacare. However, prior studies and claims – including reports from the Administration itself – demonstrate that Families USA’s “conclusions” vastly overstate Obamacare’s benefits for small businesses, while understating its drawbacks. Here’s what you need to know about the study, and the issue:
- Even the Administration admits take-up of the small business credit has been much lower than expected, and lower than today’s report claims. While today’s study claims that 3.2 million small businesses are eligible for the credit, a February Administration fact sheet conceded that only 360,000 firms will actually benefit from the credit in 2011. That’s only 11% of the number hyped in today’s report.
- The study omits many firms from its definition of “small business,” to make the credit seem more important than it is. The report admits that there are many ways to define small business. However, it then proceeds to use the narrow definition of small business included in Obamacare – firms with fewer than 25 employees. In other words, according to the study (and the law), a restaurant with 30 workers is NOT a small business, and does not need help funding its health insurance costs.
- The credit is administratively cumbersome and complex, leading many small businesses not to bother claiming it. For instance, small businesses have to fill out seven separate worksheets in order to receive the credit. Republicans have pointed out the credit’s administrative complexities since the law passed – and the low take-up rates for the credit are evidence of that fact.
- The credit provides little incentive for firms to start offering coverage – the credit’s benefits are time-limited, while the rising costs from offering coverage are permanent. While the credit will expire for most firms by 2016, firms who use the credit to start offering coverage will face higher costs over time. There are also premium increases for those small firms that do offer coverage; the law contains dozens of mandates to be implemented over the next several years, each of which could raise premium costs by 1-3 percent. An article in the New York Times last year highlighted the skyrocketing premium increases faced by small businesses, profiling small firms receiving premium increases of 20, 40, even 60 percent or more. According to a CBO analysis, the average tax credit would only cover about HALF of the cost of a 20 percent increase in premiums – meaning premium costs will STILL go up every year, even if a company qualified for the credit.
- Liberals are now trying to blame conservatives for the flaws in a tax credit they designed. The Families USA report includes a line claiming that “the current heated political debate about [Obamacare] has created additional barriers to effectively reaching [sic] America’s small business owners with the facts about this new tax credit.” However, the debate about Obamacare didn’t stop the Administration from spending nearly $1 million in taxpayer funds ($990,000, to be precise) to fund 4 million postcards promoting the tax credit – none of which helped improve enrollment, as noted above. The facts are that the poor design of the tax credit – like the poor design of the entire law – has led firms to reject this option, just as the American people continue to reject Obamacare.
Finally, it’s worth pointing out that today’s report was conducted for Families USA by the Lewin Group. The Huffington Post and other liberal allies called Lewin a front group for insurers back in 2009, when it released studies showing how a government-run health plan could cause millions to lose their health insurance. It will be worth watching to see whether the HuffPo and other liberal groups will similarly criticize today’s Families USA/Lewin study as being biased, when it helps trumpet the talking points of Obamacare supporters.
The Huffington Post reported late Friday that, effective today, the Administration is ending a program giving $100 fees to insurance agents and brokers that refer customers to Obamacare’s new high-risk pool for individuals with pre-existing conditions. Last May, the Administration instituted a $100 broker referral fee in an attempt to increase otherwise underwhelming enrollment in the high-risk pool program. One individual active among insurance brokers provided an interesting explanation as to why the Administration discontinued the referral fee program: “They [i.e., the Administration] said enrollment’s up to where we want it to be, basically, and we don’t need your [i.e., brokers’] services anymore.”
According to the most recent data released by the Administration, 56,257 individuals with pre-existing conditions are enrolled in the federal high-risk pool program established under Obamacare. Six states have enrollment of fewer than 100 individuals – the District of Columbia’s pool, for instance, has but 44 enrollees. The current enrollment data do not come anywhere close to earlier projections – the Medicare actuary originally projected enrollment at 375,000 individuals in 2010, and Congressional Budget Office estimated up to 700,000 individuals would attempt to enroll in the program by next year.
Two key points follow from the underwhelming enrollment in the pre-existing condition coverage, and the Administration’s claims enrollment is satisfactory:
- It’s difficult for the Administration to argue that 129 million individuals have pre-existing conditions and “could be denied affordable coverage.” The 56,257 individuals enrolled in the new federal high-risk pool as of February 29 represent only .04% of the total number of Americans the Administration claimed suffer from pre-existing conditions.
- Obamacare spends $2.6 trillion in its first decade of full implementation, largely to ensure that those with pre-existing conditions have access to coverage. At this rate and based on these metrics – $2.6 trillion in spending, and 56,257 participants – the federal government will spend $4,621,647.08 per year for every person with pre-existing conditions newly enrolled in coverage. That’s not just enough money to buy each person with pre-existing conditions a platinum-plated insurance policy – that’s enough to buy each one a small hospital.
That the Administration is content with high-risk pool enrollment of just over 50,000 persons with pre-existing conditions shows that the problem of individuals with pre-existing conditions is real, but not insurmountable. More to the point, it doesn’t take a 2700-page, $2.6 trillion law the American people didn’t need or want – taking away the health coverage of millions in the process – to provide access to about 56,000 individuals with chronic or pre-existing conditions.
Several media outlets reported over the weekend that White House officials participated in a conference call with pro-choice groups late last week regarding the status of contraceptive coverage mandates related to Obamacare. The call came amidst rumors that the Administration may expand conscience exemptions to the contraception mandate, so that Catholic hospitals and other faith-based institutions may continue to offer health insurance coverage not in conflict with their religious beliefs.
Two claims in these articles merit rebuttal. The first, in the New York Times, is the White House’s claim that including contraceptive coverage in a package of mandatory women’s services was “based on science.” Unfortunately for the White House, Administration officials themselves undermined this assertion back in February, as quoted in another Times piece:
Administration officials said they expected the list [of required benefits] to include contraception and family planning because a large body of scientific evidence showed the effectiveness of those services. But the officials said they preferred to have the panel of independent experts make the initial recommendations so the public would see them as based on science, not politics.
In other words, the Administration decided back in February to require coverage of contraceptive services, and merely used the public process to provide political cover to a decision that had already been made by Administration officials.
The second was an allegation by Rep. Nita Lowey in a Huffington Post article stating that the Administration was playing politics by considering an expansion of the conscience exemption. Unfortunately, this Administration has been playing politics all along – as noted above, the process leading to the conscience regulations appears to have been rigged well in advance to achieve an outcome favorable to the President’s liberal supporters. Additionally, the Administration recently rejected renewing a human trafficking grant previously awarded to the United States Conference of Catholic Bishops, and the Washington Post explained why: “Senior political appointees at HHS awarded the new grants to the bishops’ competitors despite a recommendation from career staffers that the bishops be funded based on scores by an independent review board.”
Given these developments, some have written that “a part of [the Obama] Administration is at war with Catholic leaders and Catholic belief.” Just as relevant is whether or not the Administration that claimed to end the “war on science” has on two separate occasions related to contraceptive issues manipulated the process, and/or overridden the recommendations of non-partisan experts, to achieve political victories for its liberal allies.
Several stories over the past month have focused on developments in Obamacare’s high-risk pool program for individuals with pre-existing conditions. The Administration has released updated totals of enrollment in the program, and the Government Accountability Office released its own report analyzing the program’s first year of operations.
Two important themes have emerged. First, the low enrollment in the program should serve as some indication that the problem of individuals with pre-existing conditions who cannot obtain insurance, while significant, is not nearly as dire as liberals would suggest. Earlier this year, for instance, the Administration released a report alleging that 129 million individuals had pre-existing conditions and “could be denied affordable coverage.” In reality, however, only about 27,500 individuals were enrolled in the new federal high-risk pool as of June 30 – that’s only .02% of the total number of Americans the Administration claimed suffer from pre-existing conditions. And even the Huffington Post admitted earlier this week that 98% of funds for the risk pool program have not been spent after nearly a full year of operations.
What’s just as interesting are the stories of the people who ARE enrolling in the new federal program. The Huffington Post article discussed one individual with a pre-existing condition who was contemplating abandoning her private insurance to enroll in the government-run program. Despite the fact that the new federal risk pool requires a six-month waiting period – designed to discourage individuals who have coverage now from dropping it – other stories have emerged of people leaving private coverage to enroll in the taxpayer-funded risk pool program.
Unfortunately, these kinds of stories could become all too common in future years, as Obamacare’s coverage expansions come online. Low-income individuals may drop their private coverage to obtain “free” Medicaid funded by taxpayers. Others may look to drop their private individual coverage to receive government subsidies on Exchanges. And the biggest change of all could come when individuals and employers mutually collude to drop health insurance, because both the employee and employer will be better off (even though taxpayers will be on the hook for trillions more in insurance subsidies).
The stories outline above provide a clear indication that the phenomenon of “crowd-out” – that is, individuals dropping private coverage to obtain a taxpayer-funded benefit – clearly exists, and is bound to plague the launch of Obamacare’s insurance subsidies in 2014. After all, one would hardly expect individuals with pre-existing conditions to want to drop their insurance coverage, yet this week’s stories indicate that some are doing just that. And if even the sickest individuals are dropping coverage to obtain taxpayer-subsidized benefits, what leads Democrats to think that everyone else won’t just follow?
Yesterday the National Council on Aging released a poll highlighting seniors’ views on the health care law. The poll was funded by a grant from the Atlantic Philanthropies, a liberal foundation headed by a Huffington Post blogger and focused on “enduring social change.” Perhaps unsurprisingly given the poll’s sponsor, the survey contained a number of “objective” questions where the facts, as categorized by non-partisan experts, vary significantly from the “correct” answers asserted by the pollsters:
- The survey says that the law will not “result in future cuts to your basic Medicare benefits,” but the Medicare actuaries concluded that about 15 percent of hospitals and related Medicare providers could become unprofitable within ten years, “possibly jeopardizing access to care for beneficiaries.”
- The survey says that the law will not “increase the federal budget deficit over the next ten years and beyond,” but the Medicare actuaries found that the Medicare savings provisions “are unlikely to be sustainable on a permanent annual basis,” and the Congressional Budget Office concluded that many of the law’s major savings provisions “might be difficult to sustain for a long period,” and should not be expected actually to occur.
- The survey says that the law will extend the solvency of the Medicare trust fund, but the Congressional Budget Office found that the provisions “would not enhance the ability of the government to pay for future Medicare benefits.”
- The survey says that the law “will improve the availability of long-term care at home for seniors with disabilities,” but the Medicare actuaries found the law’s new long-term care entitlement, the CLASS Act, “faces a significant risk of failure;” even one leading Democrat called the CLASS Act “a Ponzi scheme of the first order, the kind of thing Bernie Madoff would have been proud of.”
- The survey says that the law may or may not lead Medicare Advantage plans to “cut benefits and increase premiums,” but the Congressional Budget Office found that extra benefits for seniors would fall by an average of more than $800 per year by 2019 – and millions more seniors will lose their Medicare Advantage plan entirely.
Given the vast inconsistencies between the survey’s supposed “facts” and the assessments of independent observers, some may be encouraged to know that not a single person got all the “correct” answers defined by the poll’s sponsors. But others may question the implications of announcing a “Straight Talk for Seniors” campaign that, based on the questions above, relies on incomplete, inaccurate, or misleading assertions – and fails to consider the impartial statements of the non-partisan Medicare actuaries and CBO. Liberal groups supporting the law are entitled to their opinions, but not their own facts.