Obamacare Repeal, Planned Parenthood Defunding Bill Will Go to Obama

For the first time, Congress will send a bill that repeals Obamacare and defunds Planned Parenthood to President Barack Obama’s desk.

Republicans used the budget reconciliation process—a fast-track method to avoid a filibuster from Senate Democrats—to pass the Restoring Americans’ Healthcare Freedom Reconciliation Act earlier this month. The GOP-controlled House will vote on the bill next week.

“You can use this bill once a year, and we used it for this,” House Speaker Paul Ryan recently said on Bill Bennett’s radio show.  

“In doing so, we’re forcing the president to confront the failures of this law once and for all,” a statement from Ryan’s office said. Although the House has passed several repeal measures, this is the first to reach Obama’s desk.

“This bill effectively repeals the mandates and taxes at the heart of the law.”

After allegations were raised this year that Planned Parenthood is harvesting and selling baby body parts, Republicans have worked to stop federal funding for the nation’s largest abortion provider. The reconciliation bill shifts funds to community health centers instead.

The version of the reconciliation bill initially passed in the House in October and was amended by the Senate in December. The House plans to vote on the Senate-passed legislation when Congress returns from recess next week.

>>> How Mike Lee and Matt Bevin Saved the Obamacare Repeal Bill

Obama is expected to veto the bill. It would take a two-thirds vote by the House and Senate to override a presidential veto.

The post Obamacare Repeal, Planned Parenthood Defunding Bill Will Go to Obama appeared first on The Daily Signal.

A Medicaid Budget Gimmick That’s Defrauding Taxpayers

The Washington Post editorial board has long considered itself the “adult in the room” on fiscal matters, all but endorsing the Simpson-Bowles plan and other trendy fiscal proposals. It also allied itself with respectable centrist groups like the Committee for a Responsible Federal Budget in calling out Congress for engaging in budget gimmicks to hide its spending appetite.

However, a major recent flip-flop from the paper’s editorial writers should turn heads and spark action in Congress.

The issue at hand is a budget gimmick used by states regarding Medicaid provider taxes. In truth, this gimmick could more accurately be referred to as straight-up fraud (were the federal government not complicit in it).

Here’s how it works: Under Medicaid, the federal government promises to reimburse states for a majority of their Medicaid spending, most of which involves reimbursements to health care providers. Therefore, states collude with health care providers in the following manner: They tell providers that they will tax them (so-called “provider taxes”), bringing in more revenue to the state.

The state then promises to filter that money back to those same providers in the form of higher Medicaid reimbursements. States then bill the federal government for this added cost. Because the federal government provides more than 50 percent of total Medicaid funding, both state governments and Medicaid providers are made better off by the arrangement, while the federal government is stuck footing a larger bill it had no part in creating.

The scheme is so complicated that even a visual flow chart doesn’t quite do it justice. But the impact is very real: States can bilk federal taxpayers to expand their Medicaid programs and enrich their providers at no cost to themselves.

Why is this important now? Well, because this is exactly the budget gimmick that Virginia Gov. Terry McAuliffe (and other states around the country) is attempting to exploit to badger his legislature into accepting a “cost-free” Medicaid expansion under Obamacare.

McAuliffe, a Democrat, is hardly alone. In fact, in July 2014, the Government Accountability Office warned of “states’ increased reliance on funds from health care providers” to fund their Medicaid programs at the federal government’s expense.

Here’s where The Washington Post comes in: In 2012, The Post called this action “manipulat[ive]” and favorably cited Sen. Richard Durbin, D-Ill., who called it “a bit of a charade.” In fact, the paper called cracking down on this gimmick a “much-needed Medicaid reform.”

Fast-forward to 2015, and now that this budgetary charade would allow neighboring Virginia to dump the cost of its Medicaid expansion on the federal government, The Washington Post is changing its tune, calling the gimmick “fiscally sound, humane, and elegant.” You can’t make this reverse-NIMBYism up.

If conservatives want to address Obamacare’s second-largest cost and largest coverage expansion, Medicaid provider taxes should be high on their target list. And Congress is more than capable of shutting down this spigot.

Back in 1991, Congress passed legislation (P.L. 102-234) restricting the use of provider taxes to finance Medicaid spending. More needs to be done, however, especially at this very moment, with many states continuing to consider expanding their Medicaid programs under Obamacare and many willing to do so only if they can hide the corresponding costs from their constituents.

There is bipartisan recognition that this issue needs to be addressed. President Barack Obama’s fiscal year 2012 budget proposed over $18 billion in savings by limiting Medicaid provider taxes. The Simpson-Bowles Fiscal Commission proposed eliminating the “Medicaid tax gimmick,” saving $44 billion.

There is currently legislation before Congress, H.R. 1400, sponsored by Rep. Morgan Griffith, R-Va., that would begin to crack down on Medicaid provider taxes. Congress needs to do much more, but Griffith’s bill would be a good start toward showing states that Congress has this gimmick in its crosshairs—a gimmick being massively exploited by Obamacare.

Congress’ recent effort to repeal Obamacare’s Medicaid expansion as part of its reconciliation bill was a big first step toward showing states that federal support for their Medicaid largess is limited at best.

Until Obamacare is fully repealed, Congress can go farther by sharply reducing Obamacare’s enhanced match rate, which has the unfortunate combination of being both unaffordable and grossly unequal, providing greater support toward able-bodied childless adults (including some prisoners) than for the truly needy.

But one clearly bipartisan thing Congress should strive to achieve over the next year would be to end the Medicaid provider tax gimmick, thus granting more transparency and accountability into states’ decision on whether or not to expand their Medicaid programs.

Originally published by Heritage Action for America.

The post A Medicaid Budget Gimmick That’s Defrauding Taxpayers appeared first on The Daily Signal.

This Senator Thinks Bipartisan Changes Can ‘Fix’ Obamacare

“Step-by-step” changes to Obamacare are the way to improve the health care system, the chairman of the Senate’s committee on health issues says.

Sen. Lamar Alexander, R-Tenn., predicts that bipartisan changes to President Barack Obama’s signature health care law will occur over the span of a few years.

“I think over the next four or five years it’ll be changed step by step toward a health care system with more freedom for people to find policies, more choices and hopefully lower prices,” Alexander was quoted as saying by Roll Call.  “[W]e need to keep in mind health care costs as we try to fix Obamacare.”

Such an Obamacare “fix” cannot be done in a “partisan way,” he said in the interview with C-SPAN.

>>> How Mike Lee and Matt Bevin Saved the Obamacare Repeal Bill

As chairman of the Health, Education, Labor, and Pensions Committee, Alexander said, one of his top priorities was reforming the No Child Left Behind Act of 2002. Alexander compared the model for the No Child Left Behind “fix” to bipartisan efforts needed to change Obamacare, reported Roll Call.

A bipartisan No Child Left Behind rewrite—the Every Student Succeeds Act—was signed into law by Obama earlier this month. Conservatives said the compromises spearheaded by Alexander and Sen. Patty Murray, D-Wash., did not go far enough to get Washington out of state and local education decisions.

But Obama called it a “Christmas miracle” and “a true bipartisan effort, a reminder of what can be done when people enter into these issues in a spirit of listening and compromise.”

“So I was telling Lamar we should do this more often,” Obama said, referring to Alexander.

Health insurance premiums are on the rise, according to recent reports, and insurance options could be limited as the workforce shrinks because of regulations under Obamacare.

Many health insurance co-ops created under Obamacare have failed, forcing consumers to find new health care coverage.

Conservatives—especially in the House—have worked to repeal Obamacare and replace it with a consumer-focused system, but their efforts got nowhere in the Senate until this month.

“Republicans have a plan to create a bridge away from Obamacare,” Alexander wrote in a Washington Post column early this year co-authored by Sens. Orrin Hatch, R-Utah, and John Barrasso, R-Wyo.

The post This Senator Thinks Bipartisan Changes Can ‘Fix’ Obamacare appeared first on The Daily Signal.

How Overregulation Led to the Collapse of Obamacare’s Largest Co-Op

A new report examining the collapse of Health Republic of New York, Obamacare’s largest co-op, said its failure—which may lead to a $265-million loss of taxpayer dollars—can be attributed in part to heightened regulatory control by the state.

According to the analysis from the Albany, New York-based Empire Center, a “breakdown” in oversight from the state Department of Financial Services and artificial cuts in Health Republic’s premiums may have led to the ultimate failure of the consumer operated and oriented plan, or co-op.

Of the 23 co-ops created under the health care law, just 11 remain.

“The rapid rise and costly fall of Health Republic Insurance of New York … is a cautionary tale for policymakers in Albany as well as in Washington,” the report’s author, Bill Hammond, wrote. “Despite heavy federal subsidies and robust enrollment growth, Health Republic lost money at such a clip that state regulators forced it to shut down as of Nov. 30, on barely two months’ notice.”

Health Republic, one of 23 co-ops implemented under Obamacare, sold the cheapest plans available on New York’s state-run exchange and enrolled more than 200,000 customers in coverage. According to the Empire Center, Health Republic offered consumers broad networks, and its plans were significantly cheaper than those sold by competitors like UnitedHealthcare and Aetna.

As a result of its low premiums, Health Republic experienced significant losses in 2014, as its customers’ medical claims and administrative costs outpaced the revenue it was bringing in through premiums.

To remedy its losses, Health Republic requested a 15.4 percent increase in rates for individuals and 5.9 percent increase in rates for small group plans in 2015. The state Department of Financial Services, though, approved lower rate-hikes, which the Empire Center said squeezed the market.

“Although Health Republic’s premiums were already among the very lowest in the state—and though its financial report showed it was losing money—the fledgling company did not escape the state’s rate-setting knife,” the report said.

Health Republic did not immediately return The Daily Signal’s request for comment.

For 2016 coverage, Health Republic requested a 14.4 percent rate hike for individual plans and a 20 percent increase for small group plans. The state lessened the hike for individuals to 14 percent, and approved Health Republic’s request for small group plans.

Like many of the other 23 co-ops—which received a total of $2.5 billion from the federal government—Health Republic relied on money from Obamacare’s risk corridor program to boost its bottom line. The risk corridor program sought to limit the risk for insurers in the market.

According to the Empire Center, Health Republic requested $243 million from the risk corridor program. However, the Centers for Medicare and Medicaid Services announced in October it would pay just 12.6 percent of the requested payments.

As a result, Health Republic, along with seven other co-ops, announced it would be closing its doors after experiencing significant losses and receiving lower-than-expected payments from the risk corridor program.

“Had New York’s regulators ordered higher rates for Health Republic from the beginning, the company could have avoided some of the steep losses that made it so dependent on risk-corridor funding,” Hammond wrote. “While it’s unclear that such action would have been enough to save the company, DFS’s rate-cutting, in retrospect, was unquestionably unproductive.”

Health Republic closed its doors Nov. 30, leaving some of its 215,000 customers to find coverage for a month—or go without—and secure new insurance for 2016 through the state-run exchange.

“If the goal is making health coverage more affordable, the surest way to achieve that objective is not for the state to impose price controls, but for it to roll back its own high taxes and costly coverage mandates,” the report said.

The post How Overregulation Led to the Collapse of Obamacare’s Largest Co-Op appeared first on The Daily Signal.

Central committee write-in candidates

If you missed the December 16th deadline to file to run for county central committee in the 2016 Ohio primary, there still may be a way to get yourself (or others you are recruiting) elected to central committee. In many precincts, as usual, NO candidate will have filed to run for 2016. These precincts can be won by […]

How the Spending Deal’s Risk Corridor Provision Would Affect Obamacare Co-Ops

A provision of the omnibus spending bill prohibiting taxpayer dollars from being used to “bail out” insurers under Obamacare’s risk corridor program could jeopardize the future of the co-ops created under the health care law.

Republicans included language restricting the use of taxpayer dollars for Obamacare’s risk corridor program, which they call a taxpayer-backed insurer bailout, in the $1.1-trillion omnibus spending bill released early Wednesday morning.

The language mirrors that included in last year’s government spending bill, which prohibits the Centers for Medicare and Medicaid Services from using taxpayer dollars to make up any difference between what insurers incurring losses request and what is put into the program by those that are profitable.

And though health policy experts predicted such action from Congress, smaller insurance companies like Obamacare’s co-ops could find themselves in financial trouble should they experience losses.

“It’s very problematic and challenging for small plans, and particularly the co-ops,” Caroline Pearson, senior vice president at Avalere Health, told The Daily Signal. “The issue really is because the co-ops only have exchange business, they can’t spread the losses associated with the risk corridors across premiums in other channels or other markets, and so, as a result, they just cannot make up the shortfalls that are likely to occur as a result of the risk corridors.”

In addition to implementing the risk corridor program, the health care law also authorized and funded the creation of 23 consumer operated and oriented plans (co-ops). Of the 23 nonprofit insurers created, 12 have closed their doors, with many attributing their decision to the risk corridor program after receiving just 12 percent of their requested amounts.

More than 1 million Americans were insured by the co-ops, and they received a total of $2.5 billion in loans from the government.

Chart: Kelsey Lucas/Visualsey

Chart: Kelsey Lucas/Visualsey

“We expected they weren’t going to get the money, but that’s likely to continue to be a problem,” Pearson said of the language in the omnibus. “Really, any plan that is mostly operating in the individual market, any of the local plans, it’s a huge problem for them.”

Contrary to the co-ops, which sell coverage primarily on the federal and state-run exchanges and operate only in the health insurance market, larger insurers are likely to fare better should they receive less from the risk corridor payments than anticipated next year.

Pearson said national carriers likely weren’t expecting to receive the full payments in 2014 and will assume the same for payments for 2015 and 2016.

“They will just spread that across premiums across all businesses, and they can absorb [the losses],” she said. “They’re still upset, but they can manage through it.”

‘Not Counting On It’

Ed Haislmaier, a health policy expert at The Heritage Foundation, disagreed that the remaining 11 co-ops would feel the squeeze should they receive less in risk corridor payments again.

Haislmaier said those that have survived did so because they weren’t counting on the money.

“That doesn’t mean they’re out of the woods elsewhere,” he told The Daily Signal, “but a lot of these insurers haven’t been counting on the money that’s still in there.”

For example, HealthyCT, Connecticut’s co-op, did not rely on payments from the risk corridor program to make up losses it incurred in 2014, Ken Lalime, its chief executive officer, told The Daily Signal. The co-op fared better than most last year and is not counting on 2015 payments.

“It was one of the tools to allow all insurers to be able to take on unknown risk,” he said of the risk corridors. “Without it in place, it does make things a little more complicated. We’d love the [full funding] to come back, but we’re not counting on it.”

Lalime said there’s “not a lot of confidence” the program has a long-term future, but he does hope Congress will act to reinstate the original language.

“The co-ops in general have just done a fabulous job in bringing new ideas, innovation, and additional competition to the marketplaces. I think we’ve brought an awareness to the marketplace that you can do some of these things and step into a space that’s ill-defined,” Lalime said. He continued:

I’m proud of those that could, but I feel bad for those that relied on funding from a component of the premium stabilization [the risk corridor program], and that was unable to be funded at a full rate.

Higher Premiums

Despite their disagreement on how the risk corridor program will affect the remaining co-ops, Pearson and Haislmaier agreed that consumers are likely to see increased premiums in 2017 as insurers decide how to address losses and the potential for lower risk corridor payments.

“There’s only so much that [insurers] can increase premiums,” Pearson said. “They’re limited, but we’re seeing larger 2016 increases in the exchange markets as it is, and that’s likely to continue in 2017. I expect two years of double-digit increases.”

Haislmaier said insurers were likely to increase the cost of plans either way as they got used to the market. However, the change in risk corridor funding likely speeds it up.

“This accelerates it marginally as opposed to delaying it,” he said.

The risk corridor program is in effect until 2017. The program seeks to provide stability in the health insurance market by spreading the risk insurers may incur by providing coverage to more unhealthy and costly patients than in the past.

Under the program, insurance companies that make an excess profit pay into a fund operated by the federal government. Those that incur excess losses, meanwhile, receive money from the fund.

If there is a shortfall between what insurers pay into the program versus what insurers who lost money request, taxpayer dollars cover the difference.

During last year’s debate over the 2015 government spending bill, Republicans, led by Sen. Marco Rubio, R-Fla., secured language prohibiting the Centers for Medicare and Medicaid Services from using taxpayer dollars to cover any shortfall.

The Obama administration announced in October that the risk corridor program would pay $362 million to insurance companies who incurred excess losses. Those insurers requested $2.87 billion, leaving a $2.5-billion shortfall taxpayers—through the original design of the program—would have covered.

Inclusion of language regarding the risk corridor program is considered a victory for conservative lawmakers and outside groups, who pushed House and Senate leaders to eliminate the federal government’s ability to use taxpayer dollars to pay insurance companies suffering excess losses.

The post How the Spending Deal’s Risk Corridor Provision Would Affect Obamacare Co-Ops appeared first on The Daily Signal.

The 2016 election was decided last night

The picture above is of last night’s (December 3, 2015) Clermont County Republican Party endorsement meeting for the 2016 primary. Few were even aware the meeting took place. No media or press was in attendance. It was “members only” for the local central committee. But make no mistake, this meeting, with less than 140 people […]