Category Archives: Obamacare

California bill would create health care price controls

government solve all problems

But, but…I thought Obamacare was suppose to reduce the cost of health care?

From Sacramento Bee: California’s government would set prices for hospital stays, doctor visits and other health care services under legislation introduced Monday, vastly remaking the industry in a bid to lower health care costs.

The proposal, which drew swift opposition from the health care industry, comes amid a fierce debate in California as activists on the left push aggressively for a system that would provide government-funded insurance for everyone in the state.

Across the country, rising health care costs have put the industry, lawmaker and employers and consumers at odds.

The proposal in California would affect private health plans, including those offered by employers and purchased by individuals. A nine-member commission appointed by the governor and legislative leaders would set prices for everything from a physical exam to an allergy test to heart bypass surgery. No other state has such a requirement.

“If we do not act now, I’m concerned that health care prices will become unsustainable,” Assemblyman Ash Kalra, a freshman Democrat from San Jose who wrote the legislation, said in a news conference in Sacramento.

The measure faces an uphill battle in the Legislature, where lawmakers are generally cautious about making drastic changes to the health care system and are already juggling a wide range of ambitious proposals.

The proposal is backed by influential unions including the Service Employees International Union, Unite Here and the Teamsters. The unions are frustrated that health care costs are gobbling an increasing share of employee compensation.

“Every dollar that we spend on rising health care prices is a dollar that comes out of a worker’s pocket,” said Sara Flocks, policy coordinator for the California Labor Federation, a union coalition. “This is something that is eating up our wages and it is increasing income inequality. This is a fundamental question of fairness.

Health care providers say price controls would encourage doctors to move out of state or retire, making it harder for people to see a physician when they’re sick, and force hospitals to lay off staff or, in some cases, close their doors.

The California Medical Association, which represents physicians, called the proposal “radical” and warned that it would reduce choices for consumers.

“No state in America has ever attempted such an unproven policy of inflexible, government-managed price caps across every health care service,” Dr. Theodore Mazer, the CMA president, said in a statement.

Under Kalra’s bill, prices would be tied to Medicare’s rate for a particular service or procedure, with that price as a floor. There would be a process for doctors or hospitals to argue that their unique circumstances warrant payments higher than the state’s standard rate.

Paying hospitals 125 percent of Medicare’s rate would cut $18 billion in revenue and force them to trim nurses and other support staff, said Dietmar Grellman, senior vice president of the California Hospital Association. Private insurers make up for the low payments from government-funded health care, which doesn’t cover the full cost of care, he said.

“That’s why their bill is such an empty promise,” Grellman said. “They take money out of the system with rate regulation, but then they don’t address the huge gaping hole that’s created by Medicare and Medicaid.”

In recent decades health care spending has risen faster than inflation and wages while employers and health plans have shifted more of the costs onto consumers through higher premiums, deductibles and copays. Americans spend more per capita on health care than other developed countries.

Meanwhile, a wave of consolidation by hospitals, physician groups and insurance companies has given industry players more power to demand higher rates.

DCG

Thousands mistakenly enrolled in California’s Medicaid expansion

you don't say

Shocker, not.

From CNN Money: California signed up an estimated 450,000 people under Medicaid expansion who may not have been eligible for coverage, according to a report by the U.S. Health and Human Services’ chief watchdog.

In a Feb. 21 report, the HHS’ inspector general estimated that California spent $738.2 million on 366,078 expansion beneficiaries who were ineligible. It spent an additional $416.5 million for 79,055 expansion enrollees who were “potentially” ineligible, auditors found.

Auditors said nearly 90% of the $1.15 billion in questionable payments involved federal money, while the rest came from the state’s Medicaid program, known as Medi-Cal. They examined a six-month period from Oct. 1, 2014, to March 31, 2015, when Medicaid payments of $6.2 billion were made related to 1.9 million newly eligible enrollees.

There were limitations to the California review, however. The audit extrapolated from a sample of 150 beneficiaries. The authors reported a 90% confidence level in their results — whereas 95% would be more common. That meant that the number of those ineligible could have been as low as 260,000 or as high as 630,000.

“If HHS has a strong reason to believe that California is systematically making enrollment errors, it would be helpful to show that in a more robust analysis,” said Ben Ippolito, a health care economist at the American Enterprise Institute, a conservative think tank. “The federal government should ensure that states are being good stewards of federal money.”

Nonetheless, the audit highlighted weaknesses in California’s Medicaid program, the largest in the nation with 13.4 million enrollees and an annual budget topping $100 billion, counting federal and state money. Medicaid covers one in three Californians.

The inspector general found deficiencies in the state’s computer system for verifying eligibility and discovered errors by caseworkers. The Medicaid payments cited in the report covered people in the state’s fee-for-service system, managed-care plans, drug treatment programs and those receiving mental health services.

California’s Department of Health Care Services, which runs Medi-Cal, said in a statement that it agreed with nearly all of the auditors’ recommendations and that the agency “has taken steps to address all of the findings.”

In a written response to the inspector general, California officials said several computer upgrades were made after the audit period and before publication of the report that should improve the accuracy of eligibility decisions.

Among the 150 expansion enrollees analyzed in detail, 75%, or 112, were deemed eligible for the Medicaid program in California. Auditors discovered a variety of problems with the other 38 enrollees.

During the audit period, 12 enrollees in the sample group had incomes above 138% of the federal poverty line, making them ineligible financially for public assistance, according to the report.

In other instances, beneficiaries were already enrolled in Medicare, the federal health insurance for people 65 and older or who have severe disabilities, and did not qualify for Medi-Cal. Onewoman indicated she didn’t want Medi-Cal but was enrolled anyway.

In 2014, the state struggled to clear a massive backlog of Medi-Cal applications, which reached about 900,000 at one point. Many people complained about being mistakenly rejected for coverage, or their applications were lost in the state or county computer systems.

California was one of 31 states to expand Medicaid under the 2010 Affordable Care Act. The health law established a higher federal reimbursement for these newly eligible patients, primarily low-income adults without children. After expansion started in 2014, the HHS inspector general’s office began reviewing whether states were determining eligibility correctly and spending taxpayer dollars appropriately.

Read the rest of the story here.

DCG

Seattle Mayor’s plan for free college: No US citizenship or minimum GPA required

jenny durkan

From Seattle Times: One of Seattle Mayor Jenny Durkan’s top goals is to make community college free for every Seattle high-school graduate, and last week, she rolled out a program that would do so over several years.

The plan, which would likely work in concert with College Bound and other state and federal aid programs, would pay for two years of community college for every Seattle public high-school graduate. It will not have an income or GPA cutoff, nor does it require students to sign up years in advance or exclude students who have gotten into legal trouble.

Her proposal coincides with a new report by a progressive think tank, The Century Foundation, that examines the success of so-called “promise” programs — which guarantee to pay tuition for graduates of a state’s high school — and details those elements that lead to a high success rate.

Author Jennifer Mishory, a Century Foundation senior fellow, says simple plans tend to work best. Plans that have fewer restrictions tend to attract more students. “The clearer the message, the easier it is to understand for students who might not otherwise enroll,” she said.

Mishory already counts Washington as one of the 16 “promise” states, although the program is far from simple. Washington’s College Bound program pays college tuition and fees for students who are low-income, sign up by eighth grade, maintain at least a C average and don’t get into legal trouble. It’s good for both two- and four-year colleges.

Durkan’s plan represents the expansion of an idea first launched in 2008. Called the 13th Year, it began as a partnership between Cleveland High School and South Seattle College and guaranteed every graduate a year at the college tuition free. It was funded by private donations.

No US Citizenship Required: Durkan’s proposal would also be open to all students regardless of citizenship status. That’s true as well for the State Need Grant. And this session, the Legislature passed a bill expanding College Bound to include students who have Deferred Action for Childhood Arrival (DACA) status, known as dreamers.

The Cost: Durkan’s office estimates the expansion will cost $1.7 million in 2018-19, and will serve about 1,000 high-school and college students, including outreach and college preparation services. About 215 students will receive 13th-year scholarships, and an estimated 120 students will be eligible to receive 14th-year scholarships. The money will come from the city’s general fund, the sweetened-beverage tax and the Seattle Colleges.

As more students take advantage of the program, the costs will increase — to $4.4 million in 2019-20, $5.7 million in 2020-21 and $6.3 million in 2021-22.

Read the whole story here.

About the progressive think tank, The Century Foundation (TCF), whose report was cited in this article:

  • “The Century Foundation is a progressive, nonpartisan think tank that seeks to foster opportunity, reduce inequality, and promote security at home and abroad.”
  • Mark Zuckerman, President of TCF: Mark served in the Obama White House as the deputy director of the Domestic Policy Council, leading teams on key initiatives, including reducing student debt, increasing accountability at for-profit educational institutions, reducing workplace discrimination, increasing wages for home health care workers, and expanding access to job training. Prior to that, as staff director of the House Education and Labor Committee, he helped win passage of landmark legislation such as the Affordable Care Act; the Lilly Ledbetter Fair Pay Act; the Healthy, Hunger-Free Kids Act; and the Student Aid and Fiscal Responsibility Act.
  • Melissa “break through our private idea that kids belong to their parents” Harris-Perry is an advisor to the foundation.

And take a wild guess as to who also has ties to TCF…

  • Richard Leone, former president of TCF (1989-2011), was a member of the board of directors of Center for American Progress (CAP). CAP is the think tank conceived by George Soros and headed by former Clinton chief of staff John Podesta.
  • In 2005, TCF and CAP launched the Security and Peace institute (SPI). The SPI “will build on the work of both of its parent organizations by promoting a shared foreign policy agenda for the United States and its international partners.”
  • The director of the SPI was Morton H. Halperin, a senior advisor to George Soros’ Open Society Foundations.

If this free college plan is something that Soros and Company are pushing, you know the message is clear: promote progressive ideology and policies at any cost to taxpayers.

DCG

Hollyweird still believes we care about them: Stars launch “Glam Up the Midterms” to get millennials to vote

Because apparently this process – when election day is, how to register to vote, and who the candidates are – is too complicated for some people to figure out. Shouldn’t the public education system have taught millennials how this whole election thing works?

Hint: If millennials can’t access the internet to figure out the election process, maybe they shouldn’t be voting.

From Hollyweird Reporter: Funny or Die has commissioned Billy Eichner and other big-name comedians to encourage millennials to vote during the Nov. 6 midterm elections with the launch of the “Glam Up the Midterms” campaign. 

“I had a dream last night that several small town Americans called me and were begging me to have more TV and film personalities lecture them about politics,“ Eichner said of the campaign. “So I’m here to answer their prayers!

According to an NBC news poll, only 12 percent of millennials voted in the last midterm election, something that Eichner wants to change by bringing various stars to districts across the country. Comedians participating in the campaign include James Corden, Sarah Silverman, Seth Meyers, Jimmy Kimmel, Conan O’Brien, John Oliver, Robin Thede, Andy Cohen and Chelsea Handler.

In all seriousness, I have certainly skipped more than a few midterm elections in my day — and now I deeply regret it,” the Emmy-winning actor said. “So, after years of shouting at people on Billy on the Street, I’ve decided it’s time to use my voice to do some good and to encourage young people all across the country not to make the same mistakes I did. Say what you will about me, I have a lot of energy and I can’t wait to use it to help get out the vote and help ‘Glam Up The Midterms’ on Nov 6th!”

During former president Barack Obama’s term, Funny or Die helped raise awareness about Obamacare with the president’s appearance on Zach Galifianakis’ Between Two Ferns. Funny or Die indicated that Trump wasn’t as game as Obama or even former Democratic presidential candidate Hillary Clinton, who sat for a Between Two Ferns interview.

“Sadly, the former host of Celebrity Apprentice won’t return our phone calls,” Funny or Die DC’s head writer David Litt joked of Trump. “But we’ll be working with artists across the country to increase the number of Americans – especially young people – who vote in 2018.”

The campaign will work to convince voters under the age of 40 to fight for democracy and take the time to vote in November. 

The “Glam Up the Midterms” portion starts at the 2:41 mark in the above video.

DCG

Rosie O’Donnell bribes Congress; tells critics to ‘suck my d*ck’

First she promised that she’d leave the U.S. if he’s elected — a promise she reneged on.

Then she threatened his life by promoting an online “Push Trump Over the Cliff” game.

Then she actually rooted for North Korea and its homicidal fat-boy dictator.

Still seething with uncontained rage over Trump being elected President a year ago, America’s most hated celebrity Rosie O’Donnell actually resorted to bribing Congress so as to thwart the passage of Trump’s and the Republicans’ tax plan.

On Tuesday night, distraught that the House of Representatives had passed the the tax bill, O’Donnell tweeted a bribe of $2 million each to two RINO senators, Susan Collins (ME) and Jeff Flake (AZ), if they would vote against the bill.

What O’Donnell did is, of course, against the law, specifically 18 U.S. Code §201, punishable with up to $12m in fines and/or imprisonment for as much as 15 years.

Daily Wire‘s editor-in-chief Ben Shapiro was among O’Donnell’s critics.

Shapiro tweeted that Trump should order Attorney General Jeff Sessions to investigate O’Donnell for her bribery, to which the foul-mouthed lesbian responded by telling him to “suck” her imaginary “dick”.

Yesterday morning, the Senate passed the tax bill, which also deals a blow to Obamacare by eliminating the individual mandate.

President Trump must be ROLF.

Here’s to you, Rosie O’Donnell!

H/t Big Lug

~Eowyn

Seattle school bus drivers strike over health care costs

small violin

Their out-of-pocket medical expenses are too high? In 2015 my health insurance cost $380/month. This year it went up to $550/month. Next year it will cost me $702/month and my deductible is going up from $6,800 to $8,550 (and I pay everything out-of-pocket because my plan covers nothing until I meet my deductible). Welcome to my world!

From Seattle Times: Olivia Moore sees the same kids every day on the yellow school bus she drives to and from Seattle’s Montlake Elementary and Washington Middle schools. She and her riders are close. One girl is mercilessly bullied, and eagerly tells Moore if she’s had a good day or not when she steps on the bus. When Moore was diagnosed with basal- cell carcinoma, another young girl gave her a card.

Moore, 26, doesn’t qualify for the health-care plan offered by First Student, the bus contractor for Seattle Public Schools, because she can’t get enough hours. So instead, she makes appointments at community health centers.

She cited her health as one reason she joined the picketing Wednesday for the one-day strike called by Teamsters Local 174, the union that represents 400 Seattle school-bus drivers. The Teamsters announced the strike Tuesday after contract talks with First Student stalled.

“I want to get this (cancer) taken care of so I can be there for my kids, whom I love to death, and I want to make sure they get to school safely and they have someone they can approach if they ever have any issues,” said Moore.

First Student “supports and cares deeply about employees,” a First Student representative said in a prepared statement sent Wednesday afternoon. He added that the company offers competitive pay and benefits.

But on the picket line outside a bus lot in South Park, bus drivers told stories of having to declare bankruptcy, pay for expensive medication out of pocket or live paycheck to paycheck.

They say First Student promised last year to negotiate health care and retirement plans, but has not. The two sides appear far from an agreement.

Meanwhile, families of about 12,000 Seattle students scrambled to get their children to school without their usual yellow-bus service.

First Student is in the first year of a three-year contract with the school district, which is worth at least $27 million a year. Bus drivers are paid between $18 and $25 an hour, and drivers who work 30 hours a week or more are eligible for health- care benefits.

Moore said she works just under 30 hours a week. Hours are based on seniority, and she’s only driven for two school years, so she’s low on the list. Her annual income is too high for her to qualify for Obamacare.

Some drivers who do qualify for the health-care plan said they still can’t afford it, and those who can said it doesn’t provide much beyond a doctor’s office visit.

Dana Bland, 63, has driven buses in the Seattle area for 30 years. First Student, he said, has had the worst medical plan of the several contractors he’s worked for — but he wants to work in Seattle, and that means working for First Student.

But his health-care costs have gone way up. In the early 1990s, he said, he paid only $250 for a weekslong hospital stay when he worked for Laidlaw Education Services. (Seattle contracted with Laidlaw for 30 years, until 2002, when it went with First Student and Durham to save money; both were nonunion operators at the time.)

In 2013, while working for First Student, Bland had to file for bankruptcy because he couldn’t afford his medical bills after a four-day hospital stay.

Earl Johnson, 65, qualifies for the First Student medical plan but said the deductible is more than $6,000, so he pays out of pocket instead.

Read the rest of the story here.

DCG

Big rate hikes for health insurance will slam Washingtonians

O laughs

Obamacare going as planned…

This is not happening just in Washington. I have health insurance with BCBS OK and pay $550/month – up from $380/month last year. I have no co-pays (I pay the full contracted price when I walk through the doctor’s door) and a $6,800 annual deductible. BCBS informed me that my wonderful plan is being eliminated and I will soon receive my options for next year. I can hardly wait to see how much I get slammed.

From MyNorthwest.com: Open enrollment for health insurance in 2018 starts on Nov. 1 and thousands of people in Washington state will see big increases in their premiums.

The state’s insurance commissioner will officially release rates next week, and his office is warning that hundreds of thousands of people who do not get their insurance through an employer, will see a rate hike in the double digits.

Some 330,000 Washingtonians don’t get health insurance through an employer.

“I’m one of the folks who has to go out and get insurance on my own,” said Edward Weatherly, who is currently working a temp job. His monthly premiums?  “It costs me about $430 a month,” Weatherly said.

And the state’s insurance commissioner, Mike Kreidler, says rates for 2018 will go up – by a lot. “We’re looking at rate increases that are going to be in the 20s (percentage). We haven’t seen that, except going back before the Affordable Care Act,” Kreidler said.

The ones hardest hit will be the middle class – people who don’t qualify for a subsidy.

“It’s that person who doesn’t receive any help that I’m worried about. That’s going (to) say, ‘I’m going to hit the wall and I can’t afford this any longer,’” Kriedler said.

Weatherly is one of those individuals. He says it’s already difficult to make ends meet. “In addition to the rent, it’s pretty tough every month,” Weatherly said. “And there have been a couple of times I’ve thought about letting the insurance go.”

It gets worse – the insurance commissioner says people who are not subsidized with the most popular “Silver Plan” could see even more dramatic rate hikes. “On top of the mid-20 percent rate increase, they could see a 9 to 27 percent (increase) on top of that,” Kreidler said.

He says one reason for the steep increases is the uncertainty coming out of Washington, D.C. “I don’t care if they call it ‘Trumpcare’ whatever it is. But you’ve got to do something to make sure you’re taking care of the people. Access to affordable quality health insurance,” he said.

Weatherly says he’s hoping for a change.

I’m hoping we just get to a point where it becomes a right. So many things that we argue about, at both the national and the state level, that to me in the overall scheme of things don’t mean anything. It’s not life and death. Whereas health insurance, to me, is life and death,” Weatherly said.

The state insurance commissioner plans to release official rate hikes Thursday. Where you live could also impact how much your rates will go up, and the rates will be broken down by region, insurer and plan.

DCG