Friday, September 27, 2013

How high Obamacare/Democare will raise our fees for inferior medical care

The Obamacare Rate Map, an interactive tool for learning about health insurance prices under the Affordable Care Act, was produced by the Manhattan Institute. Click on the graphic to visit the map.
For months now, we’ve been waiting to hear how much Obamacare will drive up the cost of health insurance for people who purchase coverage on their own. Last night, the U.S. Department of Health and Human Services finally began to provide some data on how Americans will fare on Obamacare’s federally-sponsored insurance exchanges. HHS’ press release is full of happy talk about how premiums will be “lower than originally expected.” But the reality is starkly different.
Based on a Manhattan Institute analysis of the HHS numbers, Obamacare will increase underlying insurance rates for younger men by an average of 97 to 99 percent, and for younger women by an average of 55 to 62 percent. Worst off is North Carolina, which will see individual-market rates triple for women, and quadruple for men.
HHS releases a trickle of data and a load of spin
Earlier this month, I and two colleagues from the Manhattan Institute—Yevgeniy Feyman and Paul Howard—published an interactive map that detailed Obamacare’s impact on individually-purchased health insurance premiums in 13 states plus D.C. As the accompanying article described, Obamacare increased premiums in those states by an average of 24 percent.
But those states were largely blue states that had set up their own, state-based insurance exchanges. The big data dump that we’ve been waiting for, since then, is from the majority of states that didn’t set up their own state-based exchange. That data is the responsibility of the Obama administration, namely HHS. Finally, with less than a week to go before the exchanges are supposed to go on-line, HHS has released a slim, 15-page report and a press release that summarize some of the premium data.
“Premiums nationwide will also be around 16 percent lower than originally expected,” HHS cheerfully announces in its press release. But that’s a ruse. HHS compared what the Congressional Budget Office projected rates might look like—in 2016—to its own findings. Neither of those numbers tells you the stat that really matters: how much rates will go up next year, under Obamacare, relative to this year, prior to the law taking effect.
Former Congressional Budget Office director Douglas Holtz-Eakin agrees. “There are literally no comparisons to current rates. That is, HHS has chosen to dodge the question of whose rates are going up, and how much. Instead they try to distract with a comparison to a hypothetical number that has nothing to do with the actual experience of real people.”
Comparing pre-Obamacare and post-Obamacare premiums
The HHS report doesn’t provide enough details about Obamacare’s premiums for us to incorporate the data into our interactive map. Our map compares the five cheapest plans available on the market today to the five cheapest plans available on Obamacare’s exchanges. The HHS report offers only the cheapest bronze, silver and gold plans, and the second-cheapest silver plan.
We look at rates for 27, 40, and 64 year olds; and rates for men and women. (Under Obamacare, rates for men and women are the same, which has the net effect of disproportionately increasing rates for men, who generally paid less under the old system.) The HHS report offers rates for 27-year-olds; and rates for the average-aged exchange participant, a figure that varies by state, but seems to generally land in the mid-thirties.
So, we conducted two comparisons between pre-ACA data and post-ACA data, as reported by HHS. The first comparison is between the cheapest plan available to 27-year-olds pre- and post-Obamacare. The second is between the cheapeast plan available to the average exchange participant, and to the typical 40-year-old pre-Obamacare. We would have liked to have compared rates for older individuals, but HHS didn’t report that data.
27-year-olds will face rate increases as high as 279 percent
As you can see from the map above, many 27-year-olds will face steep increases in the underlying cost of individually-purchased insurance under Obamacare. For the states where we have data—the 36 reported by HHS, plus nine others that we had compiled for our map that HHS didn’t report—rates will go up for men by an average of 97 percent; for women, 55 percent. (In the few cases where HHS reported on states that our map includes, we went with HHS’ numbers.)
Worst off was Nebraska, where the difference between the cheapest plan under the old system and under Obamacare was 279 percent for men, and 227 percent for women: more than triple the old rate. Faring best was Colorado, where rates will decline for both 27-year-old men and women by 36 percent. The only other state to see a rate decline in this analysis was New Hampshire: 8 percent for both men and women.
(Still missing are data from Hawaii, Kentucky, Massachusetts, Maryland, Minnesota, and Nevada. The data from New York and New Jersey should be taken with a grain of salt, as their individual insurance markets are not like those of other states.)
40-year-olds will face rate increases as high as 305 percent
40-year-olds, surprisingly, will face a similar picture. The cheapest exchange plan for the average enrollee, compared to what a 40-year-old would pay today, will cost an average of 99 percent more for men, and 62 percent for women.
For this cohort, men fared worst in North Carolina, with rate increases of 305 percent. Women got hammered in Nebraska, where rates will increase by a national high of 237 percent. Again, Colorado and New Hampshire fared best, with 17 percent and 5-8 percent declines, respectively.
Remember that here, we aren’t conducting an exact comparison. Instead we’re comparing the lowest-cost bronze plan offered to the average participant in the exchanges, to the cheapest plan offered to 40-year-olds today. This approach artificially flatters Obamacare, because the median age of an exchange participant is, in most states, below the age of 40.
In both the 27-year-old and 40-year-old comparisons, we adjusted the pre-ACA rates to take into account people who would be charged more for insurance, or denied coverage altogether, due to a pre-existing condition, using the same methodology we’ve used in the past.
For most people, subsidies won’t counteract rate shock
All of the analyses I’ve discussed thus far involve changes in the underlying cost of health insurance for people who buy it for themselves. Many progressives object to this comparison, because it doesn’t take into account the impact of Obamacare’s subsidies on the net cost of insurance for low-income Americans.
I’ve long argued that it’s irresponsible to ignore the change in underlying premiums, because subsidies only protect some people. Middle-class Americans face the double-whammy of higher insurance premiums, and higher taxes to pay for other people’s subsidies. However, it is important to understand how subsidies will impact the decisions by Americans as to whether or not to participate in the exchanges.
If you click on the “Your Decision” tab on our interactive map, you will now find the results, as assembled by Yevgeniy, for the 13 states plus D.C. in our original database. Here’s the bottom line: most people with average incomes will pay more under Obamacare for individually-purchased insurance than they did before.
In the 13 states plus D.C. (which I will abbreviate as 13+DC), a 27-year-old would have to make 59 percent of the median income of his peers, or less, to come out ahead with regard to Obamacare’s subsidies. A 40-year-old would have to make less than 57 percent of the median income for his peers. On the other hand, older people fare better; the average 64-year-old who makes less than 111 percent of the median income for 64-year-olds will spend less on premiums than he did before.
However, the overall results make clear that most people will not receive enough in subsidies to counteract the degree to which Obamacare drives premiums upward. Remember that nearly two-thirds of the uninsured are under the age of 40. And that young and healthy people are essential to Obamacare; unless these individuals are willing to pay more for health insurance to subsidize everyone else, the exchanges will not serve the goal of providing coverage to the uninsured.
The bottom line: Obamacare makes insurance less affordable
For months, we’ve heard about how Obamacare’s trillions in health care subsidies were going to save America from rate shock. It’s not true. If you shop for coverage on your own, you’re likely to see your rates go up, even after accounting for the impact of pre-existing conditions, even after accounting for the impact of subsidies.
The Obama administration knows this, which is why its 15-page report makes no mention of premiums for insurance available on today’s market. Silence, they say, speaks louder than words. HHS’ silence on the difference between Obamacare’s insurance premiums and those available today tell you everything you need to know. Rates are going higher. And if you’re healthy, or you’re young, the Obama administration expects you to do your duty and pay up.

Wednesday, September 25, 2013

Obama's speech to UN misguided

Posted: 25 Sep 2013 05:08 AM PDT
(Scott Johnson)
The White House has posted the text of President Obama’s speech to the United Nations yesterday here. Paul has ably extracted the highlights, so to speak, and explicated them here.
Obama’s speech should be read in its entirety. The speech represents a comprehensive map of misreading, to borrow Harold Bloom’s phrase. It takes us on a tour of American interests focused on the Middle East and advertises the cluelessness that emanates from the top of the Obama administration. The speech deserves a knowledgeable line by line annotation exposing its errors and fatuities.
I find this to be incredibly offensive: “The ban against the use of chemical weapons, even in war, has been agreed to by 98 percent of humanity. It is strengthened by the searing memories of soldiers suffocating in the trenches; Jews slaughtered in gas chambers; Iranians poisoned in the many tens of thousands.” If this were a multiple choice test, we would ask: which of these doesn’t belong?
Or take this stray thought regarding Syria, for example: “It’s time for Russia and Iran to realize that insisting on Assad’s rule will lead directly to the outcome they fear: an increasingly violent space for extremists to operate.” Don’t you love it when Obama tells the mullahs what they want? It helps them understand the extent of their good fortune to be dealing with such a man.
Or this stray thought regarding Iraq: “Iraq shows us that democracy cannot be imposed by force.” I thought Iraq’s politics were developing in a positive manner. They certainly represent an improvement over Saddam Hussein. Obama presents the lesson of Iraq as a universal rule. What, I wonder, do Germany and Japan show us?
“Meanwhile,” according to Obama, “the Supreme Leader [sic] has issued a fatwa [sic] against the development of nuclear weapons, and President Rouhani has just recently reiterated that the Islamic Republic [sic] will never develop a nuclear weapon.” So what’s all the shouting about? (More on that supposed “fatwa” here.) Fresh from his diplomatic “triumph” in Syria, Obama is directing John Kerry to serve up one more, this time with respect to Iran nuclear program.
And that’s not all! Obama is also “determined to resolve the conflict between Palestinians and Israelis.” There is the testy problem of the permanent Palestinian war on Israel, but it doesn’t exist in the world according to Obama. Obama ascribes the wish for “peace” to the Palestinians: “[T]hey recognize that two states is [sic] the only real path to peace…” Although the evidence to the contrary is abundant, Obama finds it in his meeting with young Palestinians in Ramallah. So no problem.
And then there is this: “Friends of Israel, including the United States, must recognize that Israel’s security as a Jewish and democratic state depends upon the realization of a Palestinian state.” I doubt it, but this is a weird formulation in any event. Obama is speaking for the United States and this assertion is one of many errors that he “recognizes” to be true. Doesn’t the United States recognize it? I guess he is directing that statement to the likes of me.
Despite the overwhelming evidence to the contrary, Obama sees Israel as the key to the conflicts roiling the Middle East: “All of us must recognize that peace will be a powerful tool to defeat extremists, and embolden those who are prepared to build a better future.” What unadulterated claptrap.
If the White House speechwriters had inserted a thematic cue like “Message: I care” into the speech, it would have been “Message: I am a chicken ripe for the plucking.”

Saturday, September 21, 2013

Obamacare denies coverage to 30 million

CBO: Obamacare to Cover Millions Fewer Than Before Supreme Court Decision

Earlier today, the Congressional Budget Office (CBO) released an updated cost estimate for Obamacare that showed that the law will cost less over 10 years than last predicted—because fewer people will be covered.
Now, although Obamacare spends more than $1 trillion, CBO predicts it will leave 30 million Americans uninsured, falling far short of what was promised.
The reason for the changes to the law’s cost projection is the recent Supreme Court ruling. Though the Court allowed Obamacare’s individual mandate to stand as a tax, it deemed a separate provision—the Medicaid expansion—to be unconstitutional. As a result, states can choose not to expand their Medicaid programs and are no longer at risk of losing all their federal Medicaid dollars if they don’t. As Heritage health policy expert Nina Owcharenko explains, “If the Administration’s attempt to centralize health care decision making in Washington was unworkable, its unconstitutional imposition on the states has made its problems even worse.”
As a result of the Court’s decision, the outlook for the law has changed. Here are the main takeaways from the CBO’s latest report:
  • Obamacare will cost less… The new CBO scoring shows that the net cost of Obamacare will be $84 billion less over the next 10 years than predicted in its last analysis in March 2012. Spending on the Medicaid and the Children’s Health Insurance Program expansion will fall by $289 billion, while increased spending on the exchanges to cover some of those who will no longer qualify for Medicaid will cost $210 billion. The law will now add $1.17 trillion in new government spending over 10 years—paid for by massive tax hikes on all Americans and robbing money from the Medicare program.
  • …Because more people will be uninsured. Obamacare will cost less because it will insure fewer people. While the Medicaid expansion extended to all individuals below 138 percent of the federal poverty line, the exchange subsidies are only available to those earning between 100 percent and 400 percent of the federal poverty level, which means only a portion of would-be new Medicaid enrollees will qualify for subsidies. In 2022, this will add 3 million more to the number of Americans who will still be uninsured under Obamacare.
  • Obamacare falls far short of its promise for universal coverage. Since day one, it’s been clear that Obamacare will not achieve universal coverage, and every time CBO revisits the law, the numbers show just that. In March 2010, when the law passed, CBO predicted that there would be 22 million people still without insurance in 2019. In March 2012, the estimate increased to 27 million in 2022. Now, the number has once again increased—to 30 million. So Obamacare leaves just as many people uninsured as it covers.

Disgusting Dems and ben ghazzi

Posted: 20 Sep 2013 05:02 AM PDT
(Scott Johnson)
Last night John commented on the behavior of the Democrats during the House Oversight Committee hearing yesterday on Benghazi. Democratic committee members walked out on the testimony of Patricia Smith and Charles Woods, the mother and father respectively of two of the men who were killed by terrorists in the Benghazi assault. John observed that the Democrats on the committee didn’t even have the decency to listen to what these victims of the Obama administration’s gross negligence had to say.
Why would the Democrats do that? They would say that they were protesting the politicization of Benghazi. Their thesis is that looking back at events in order to assess fault and allocate responsibility. Assessing fault and allocating responsibility is political in this case because fault and disgrace run up a chain of Democratic officeholders ending in Hillary Clinton and Barack Obama. The thesis that applies to account for the Democrats’s behavior in this case is the one from A Few Good Men: They can’t handle the truth.
John focused on the second half of the House Oversight Committee hearing yesterday. The first half of the hearing was previewed in good stories by Sharyl Attkisson and Josh Rogin earlier this week and also deserves attention.
Following Benghazi then Secretary of State Clinton convened an Accountability Review Board to conduct a a phony baloney investigation leading to phony baloney findings to protect Clinton and Barack Obama in their phony baloney jobs. The ARB never got around to interviewing the four mid-level employees it found at fault in connection with the Benghazi assault. The unclassified version of the ARB report is posted online here.
The unwritten mission of the ARB was to designate a few mid-level employees to serve as scapegoats for more senior officials including Clinton and Obama. The ARB duly designated four such employees who were placed on administrative leave following the release of the ARB report. Secretary Kerry has now (rightly) reinstated all four employees who were disciplined as a result of the ARB report. I wrote about the reinstatement of Ronald Maxwell here.
The first half of the House Oversight Committee hearing yesterday was devoted to the ARB. ARB leaders Thomas Pickering and Michael Mullen appeared before the committee as witnesses.
The Weekly Standard’s Steve Hayes attended the hearing. Steve reports that the testimony validated the skepticism of ARB critics and raised new questions about the independence of its work as well as the reliability of their conclusions. Steve concludes that the testimony of Pickering and Mullen discredited the ARB. Among the revelations in the testimony at yesterday’s hearing:
*Secretary of State Hillary Clinton handpicked the two leaders of the ARB who were given the job of investigating her department.
*Cheryl Mills, the chief of staff and senior counselor to Secretary Clinton, was intimately involved with the ARB panel from the beginning. She called the leaders at Clinton’s behest to ask them to serve, she was briefed regularly on the investigation as it unfolded and she received a draft copy of the report before it was finalized.
*Several senior Clinton advisers were provided draft copies of the ARB report before it was released to the public.
*The vice chairman of the ARB testified that he called Mills to warn her that an impending appearance of Charlene Lamb before Congress would be problematic for the State Department. Lamb had done poorly in her interview with the ARB, Mullen said, and he called Mills because he was worried that a poor performance before Congress would cause problems for the State Department and its leadership. When Representative Jim Jordan asked Mullen if he would have placed the call to Mills if Lamb had performed well, he said no.
*The chairman of the panel acknowledged at least one instance in which language in the report was softened after an early draft was sent to Clinton and her top aides. “The draft, as I believe it went to her, said the security posture was grossly inadequate for Benghazi, period. And we made the editorial correction recognizing that there was certainly a very real point that ‘grossly’ was probably not applicable to Benghazi in light of the changes that the State Department had made, but it was clearly applicable to dealing with the specific circumstances of the attack.”
*The vice chairman testified in his deposition that the ARB received “very specific tasking from Secretary Clinton on her expectations with respect to this board” and that nobody on the board had any input on the scope of their work.
*The panel was largely staffed by current and former State Department officials and worked out of State Department offices.
*The ARB did not speak with nine key military officials on the ground in Libya or Germany who were deeply involved in the US response to the attacks. Among those who was never interviewed: Lt. Colonel Steven Gibson, who was on the ground in Tripoli and whom State Department official Greg Hicks has testified was on the receiving end of the “stand-down” order that Obama officials have repeatedly disclaimed.
*Although the ARB did not interview Secretary Clinton as part of its investigation, they provided her with a two-hour briefing about the details of the report before it was finalized and released to the public.
*The board did not interview either Cheryl Mills or Deputy Secretary of State Thomas Nides, another close adviser to Clinton.
*None of the interviews the ARB conducted were recorded in any fashion – no audio, no video, no court reporter. The only record of those sessions is in notes taken by a staff member. According to the vice chairman: “The staff would put a summary of the interview together. We would – the members would be able to review that summary shortly after the interview.” (Those summaries and the notes that produced them have not been provided to Congress).
*The ARB did not investigate the Obama administration’s public response to the attack or the role that senior State Department officials played in shaping that narrative. That response included the highly misleading claim that the attacks had come as a reaction to an anti-Islam video and many other claims that were later shown to be false. Emails between top State Department officials and others in the Obama administration, first reported by TWS last spring, revealed that several top State Department officials were involved in crafting the administration’s post-attack talking points. And Susan Rice, then US Ambassador to the United Nations, a top State Department official, famously blamed the video in her appearances on the Sunday talk shows shortly after the attack. The ARB wasn’t interested.
Steve begins and ends his report with comments regarding the media’s lack of interest in the proceedings. If the media were not a Democratic protection racket, of course, this would all be big news. But they are and it’s not.

Saturday, September 7, 2013

Far left economists even acknowledge Obama catastrophe

Posted: 06 Sep 2013 08:14 AM PDT
(John Hinderaker)
Better late than never, I suppose: Paul Krugman now says that the five years of the Obama administration have been “years of tragic waste,” and that the nation’s economic policies during that time have been “an astonishing, horrifying failure.” One wonders: what took Krugman so long to figure that out?
Of course, Krugman thinks the problem with Obama’s policies is that the stimulus was too small, the United States isn’t far enough in debt, and we don’t have a big enough public sector. More cowbell! The salient point, I think, is that we can say it is now unanimous: Left and Right agree that Obamanomics has been an utter failure. The only question at this point is whether to go even farther left–to, what, the policies of Fidel Castro or Kim Jong-un?–or return to the principles of limited government and a free market that produced our prosperity in the first place. Seems like an easy choice.
Maybe Krugman’s pessimism was the result of getting a look at today’s jobs numbers. Not only was August’s job creation number an anemic 169,000, but the numbers for June and July were revised sharply downward, with July’s total a pathetic 104,000. And these new jobs are just about all part-time in any event. Grim news, indeed

Monday, September 2, 2013

Israeli dismayed by Obama, his gross incompetence

Israel dismayed by Obama, his gross incompetence

Israeli leaders largely held their tongues after President Obama announced Saturday that he would seek congressional approval before striking Syria.
But privately, as David Horovitz reports at Times of Israel, Israeli leaders are stunned and deeply worried that Obama's decision to put off action in Syria means no future attack in Iran.
the president has set a precedent, in seeking an authorization from Congress that he had no legal requirement to seek — and that Congress was not loudly demanding — that may complicate, delay or even rule out credible action to thwart a challenge that dwarfs Assad’s chemical weapons capability: Iran’s drive to nuclear weapons.
At the very least, Obama has given Assad more time to ensure that any eventual strike causes a minimum of damage, and to claim initial victory in facing down the United States. At the very least, too, Obama has led the Iranians to believe that presidential promises to prevent them attaining nuclear weapons need not necessarily be taken at face value.
Horovitz concludes that Israeli leaders hope that Barack Obama wakes up and remembers that America is the most powerful military force in the world and has acted out of moral duty to prevent carnage in the world before.
But that maybe asking too much of a president who looks to Europe, and not America's great traditions, for his guidance.

Obama's staggering incompetence
Thinking Through Our Syrian Options
Peter Wehner | @Peter_Wehner 09.01.2013 - 12:15 PM

On the lead-up to a likely strike against Syria by the United States, there are some things most of us can agree on.

One is that Bashar al-Assad is a malevolent figure. Two, a de minimis strike–one that is mostly symbolic and does nothing to alter the course of the war–is worse ...than doing nothing. And three, President Obama has handled the Syrian situation with staggering incompetence.

The list of mistakes by Mr. Obama includes, but is by no means limited to, declaring two years ago that Assad must go (and doing nothing to achieve that end); declaring one year ago that if Syria used chemical weapons it would be crossing a “red line” that would constitute a “game changer” (Assad crossed the “red line,” for months nothing happened, and whatever Obama does, he’s made it clear it will not constitute a “game changer”); signaling to our enemies, in advance, the details of our expected operation–thereby making a strike, if it occurs, the most telegraphed and reluctant military action in American history; doing a miserable job building a coalition to support a military strike (Obama’s “coalition of the willing” might include all of two nations); doing a miserable job building support among the American people (they are decidedly unenthusiastic about a military intervention in Syria); and signaling he was going to bypass congressional authorization for military use of force before reversing course and declaring on Saturday that he would seek authorization–but only after Congress returns from its summer recess (thereby sending the message to Congress, the American public, and the world that there’s no real urgency to a strike, despite the secretary of state saying that what Syria has done is “morally obscene”). This is Keystone Cops material.

That said, where there is a real difference of opinion, including among conservatives, is whether an effective show of force that would alter the balance of power in Syria would be worthwhile.

Some military analysts, like (retired) General Jack Keane, believe the more moderate and secular rebel forces (like the Free Syrian Army) are in fairly strong shape and, if given the training and arms they need, could emerge as a powerful force in a post-Assad Syria. Others, like Colonel Ralph Peters, believe the rebel forces that are strongest in Syria right now and most likely to emerge as dominant in a post-Assad Syria are al-Qaeda affiliates like Jabhat al-Nusra. I will admit it’s unclear to me–and I suspect fairly unclear to almost everyone else–what would happen if Assad left the scene. Which makes knowing what to do, and what to counsel, difficult.

So what is the best outcome we can reasonable hope for? What is the worst outcome we should be most prepared for? What are the odds of each one happening? How likely, and in what ways, will Syria retaliate? How reliable is the FSA? Is Jabhat al-Nusra (an al-Qaeda affiliate) “generally acknowledged to be the most effective force fighting al-Assad,” in the words of CNN’s Peter Bergen? If the (relatively) moderate rebels did receive the aid they need, what are their chances of success? And what would success look like? Taking control of Syria (which is hardly likely)? Taking control of parts of Syria? Participating in a coalition government? Comprised of whom?

These are just some of the difficult, and largely unknowable, questions one has to ask prior to endorsing a military strike.

There would be a significant cost to doing nothing in Syria. There could be significant benefits if we act militarily (including delivering a damaging blow to Syria’s sponsor states, Iran and Russia, as well as to Hezbollah). And it’s also possible that things could be worse–from the standpoint of America, Israel and the region–if Assad is attacked and/or overthrown and jihadists emerge in a dominant position. “The hard truth is that the fires in Syria will blaze for some time to come,” according to Ambassador Ryan Crocker. “Like a major forest fire, the most we can do is hope to contain it.”

In all of this I’m reminded of what Henry Kissinger wrote in his memoir White House Years:

Statesmanship requires above all a sense of nuance and proportion, the ability to perceive the essential among a mass of apparent facts, and an intuition as to which of many equally plausible hypotheses about the future is likely to prove true.

Barack Obama has no such perception and intuition; he has proved to be singularly inept at such presidential decision-making. But we cannot unwind what has happened. We are where we are. Syria is a nation that has been ripped apart. The window for a useful American intervention may have closed. And even if it hasn’t, it would require a strategic thinker and statesman of remarkable skill to deal with a dozen moving parts, all which need to be carefully calibrated, in order to help Syria heal; in order for a stable, non-sectarian and non-virulent regime to emerge.

It’s much clearer to me what we shouldn’t do than what we now should do. I suppose that’s sometimes where we find ourselves living in this most untidy world. And when it comes to predicting the course of events and anticipating various contingencies, especially in the Middle East, modesty is probably more appropriate than certitude