Tag: manhattan institute

The New Republic: Obama Kinda Lied a Little about Obamacare

On Monday, The New Republic’s Jonathan Cohn admitted that President Obama “made a misleading statement about Obamacare rates” during his press conference on Friday. The magazine’s Twitter feed (@tnr) announced:

Whoops! The president (accidentally, we think) told a little #Obamacare lie on Friday.

During his press conference, the president said:

[When it comes to people without access to employer-sponsored coverage,] they’re going to be able to go on a website or call up a call center and sign up for affordable quality health insurance at a significantly cheaper rate than what they can get right now on the individual market. And if even with lower premiums they still can’t afford it, we’re going to be able to provide them with a tax credit to help them buy it. [Emphasis added.]

The problem, Cohn writes, is that:

while some people will pay less than they pay today, some will pay more. They will primarily be young, healthy men who benefited from preferential pricing in the past, were content with coverage that had huge gaps, and are too wealthy to qualify for the law’s tax credits—which are substantial but phase out at higher incomes…

But somebody listening to Obama’s press conference probably wouldn’t grasp that distinction. They’d come away thinking their insurance will be cheaper next year. For some, it won’t be. Obama isn’t doing himself, or the law, any favors by fostering a false expectation.

California Officials Deliberately Mislead Public on Obamacare Rate Shock

Ever since Obamacare became law, I have been counseling states not to establish the law’s health insurance “exchanges,” in part because:

to create an Exchange is to create a taxpayer-funded lobbying group dedicated to fighting repeal. An Exchange’s employees would owe their power and their paychecks to this law. Naturally, they would aid the fight to preserve the law.

California was the first state both to reject my advice and to prove my point.

Officials operating California’s exchange–which the marketing gurus dubbed “Covered California“–recently and deliberately misled the entire nation about the cost of health insurance under Obamacare.

They claimed that health plans offered through Covered California in 2014 will cost the same or less than health insurance costs today. “The rates submitted to Covered California for the 2014 individual market,” they wrote, “ranged from two percent above to 29 percent below the 2013 average premium for small employer plans in California’s most populous regions.”

See? No rate shock. California’s top Obamacare bureaucrat, Peter Lee, declared his agency had hit “a home run for consumers.” Awesome!

Unfortunately, anyone who knows anything about health insurance or Obamacare knew instantly that this claim was bogus, for three reasons.

  1. Obamacare or no Obamacare, health insurance premiums rise from year to year, and almost always by more than 2 percent. So right off the bat, the fact that Covered California claimed that premiums would generally fall means they’re hiding something. 
  2. Obamacare’s requirement that insurers cover all “essential health benefits” will force most people who purchase coverage on the “individual” market (read: directly from health insurance companies) to purchase more coverage than they purchase today. This will increase premiums for most everyone in that market.
  3. Obamacare’s community-rating price controls (also known as its “pre-existing conditions” provisions) will increase premiums for some consumers (i.e., the healthy) and reduce premiums for others (i.e., the sick). So it is misleading for Covered California to focus on averages because averages can hide some pretty drastic premium increases and decreases.

Roy: “The Arkansas-Obamacare Medicaid Deal: Far Less Than It First Appeared”

At Forbes.com’s Apothecary blog, the Manhattan Institute’s Avik Roy is cool to the idea of states implementing ObamaCare’s Medicaid expansion by putting those new enrollees in ObamaCare’s health insurance “exchanges”: 

When Arkansas Gov. Mike Beebe (D.) first announced that he had reached a deal with the Obama administration to use the Affordable Care Act’s private insurance exchanges to expand coverage to poor Arkansans, it seemed like an important, and potentially transformative, development. The myriad ways in which the traditional Medicaid program harms the poor have been well-documented, and it looked like Beebe had come up with an attractive—albeit expensive—way to provide the poor with higher-quality private insurance. A Good Friday memo from the U.S. Department of Health and Human Services, however, splashes cold water on that aspiration. It’s now clear that the Beebe-HHS deal applies a kind of private-sector window dressing on the dysfunctional Medicaid program, and it’s not obvious that the Arkansas legislature should go along.

The first reason states should not pursue the Beebe plan is that, like a straight Medicaid expansion, it would inhibit the pursuit of low-cost health care for the poor. 

The second reason is that it would cost even more than putting those new enrollees in the traditional Medicaid program. Economist Jagadeesh Gokhale, who advises the Social Security program on how to make these sorts of projections, estimates a straight Medicaid expansion would cost Florida, Illinois, and Texas about $20 billion in the first 10 years. And that’s in the wildly unrealistic event that the feds honor their committment to cover 90 percent of the cost. President Obama has already proposed abandoning that committment. Congressional Budget Office projections suggest the “Beebe plan” would increase the cost of the expansion by 50 percent. That too should be enough reason to reject the Beebe plan. Neither the state nor the federal government have the money to expand Medicaid at all. Volunteering to make the expansion even more expensive is lunacy. 

The Beebe administration is trying to make its plan seem no more expensive than a straight Medicaid expansion. How? By simply assuming state officials would voluntarily make a straight Medicaid expansion so expensive that the Beebe plan wouldn’t cost a penny extra. The illogic goes like this. If Arkansas were to expand traditional Medicaid, the state would likely need to increase Medicaid payments to doctors and hospitals in order to secure adequate access to care for new enrollees. That would make a straight Medicaid expansion so expensive that the Beebe plan would be no more costly, and might even cost less. 

It’s true, states that implement ObamaCare’s Medicaid expansion would have to increase provider payments to give new eligibles decent access to care. The problem is that Medicaid never does that. Medicaid is notorious for paying providers so little that it access to care is lousy. Medicaid does so year after year, even if people sometimes die as a result. The Beebe administration simply assumed that state officials would magically change such behavior, increase Medicaid’s provider payments to the same levels private insurers pay, and thereby volunteer to make an already-expensive Medicaid expansion even more unaffordable. In that fantasy world, the Beebe plan would be no more expensive. As an indication of how implausible that assumption is, no one had been talking about combining a straight Medicaid expansion with higher provider payments until the Beebe administration needed to make the governor’s plan seem slightly less unaffordable. 

Roy has soured on Beebe-style plans since reading some of the terms and conditions the Obama administration issued on Friday. Yet he still imagines there might be free-market-friendly ways to implement a massive expansion of the entitlement state. Thus he counsels states only to expand Medicaid in exchange for real reforms. We’ve heard that song and dance before. Republicans said the State Children’s Health Insurance Program and Medicare Part D – two Republican initiatives – would lead to Medicaid and Medicare reform. Instead, government got bigger and reform went nowhere. Lucy is going to pull the football here, too. If it is Medicaid reform you seek, the only free-market Medicaid reforms are Medicaid cuts. Roy’s criticisms of the Beebe plan are welcome, though it’s odd to find him to the left of officials in the 15 or more states that are flatly rejecting the expansion.

Walter Olson Joins Cato

I’m pleased to report that Walter Olson, known to many Cato@Liberty readers for his Overlawyered website, has joined the Cato Institute. Wally led the Manhattan Institute’s litigation reform program for more than a quarter of a century. He’ll be a senior fellow in our Center for Constitutional Studies, with a wide-ranging portfolio.

A Yale graduate, Wally began his career at Regulation magazine, back when it was published by the American Enterprise Institute. He has authored three books, 1991’s The Litigation Explosion, 1997’s The Excuse Factory, and 2003’s The Rule of Lawyers, and countless articles. And another book will be out in the fall on bad ideas coming from the legal academy, Schools for Misrule. At PointofLaw.com, Jim Copland, director of Manhattan’s Center for Legal Policy, gives us a rich account of Wally’s contributions. We’re delighted to have Wally on board.

All Shook Down

Steven Malanga of the Manhattan Institute writes in the Wall Street Journal about Andy Stern’s retirement from the Service Employees International Union (SEIU). He noted that Stern’s

principal legacy will be having headed up a union that managed to add 1.2 million members during a time when overall unionization rates continued to plunge in the U.S.

But it’s important to understand how Mr. Stern pulled this off, because his union’s story is really the story of the transformation of the labor movement in America. The SEIU did not win its most significant victories on the picket lines, but rather in backroom political deals with legislative leaders, especially in states like California where the political class is already union-friendly.

Those deals helped the SEIU to organize workplaces that are nominally considered part of the private sector but actually are heavily controlled and influenced by government regulation, most especially in health care.

The article mentions Malanga’s forthcoming book, Shakedown: The Continuing Conspiracy Against the American Taxpayer.

Which is not to be confused with Shakedown: How Corporations, Government, and Trial Lawyers Abuse the Judicial Process, published by Cato Institute chairman Robert A. Levy in 2004. Then again, there probably are some points of overlap.

Hail, Bloomberg, Magister Populi

New York mayor Michael Bloomberg has been elected to a third term, despite the two-term limits that New Yorkers voted for twice. His biggest challenge was persuading the City Council to overrule the voters, but he managed that trick thanks to his absolute mastery of money and politics in the Big Apple. And on election day, even his $100 million campaign barely overcame popular anger over the repeal of term limits.

Personally, I wish the Council had just given Bloomberg another term. Don’t get rid of term limits. Just do like the Romans used to do in an emergency. Name Bloomberg “dictator,” an extraconstitutional position with extraordinary authority but limited duration. Then you keep the rules, you just make an exception. And I’m sure Bloomberg would be willing to be addressed as Dictator for the duration of the emergency powers.

Instead, Bloomberg used his money and connections to get the Council to allow all the city officeholders to serve three terms, instead of the two that the people had twice voted for.

He said it was because of the financial crisis – just as Rudolph Giuliani had suggested that the city shouldn’t elect a new mayor in the aftermath of 9/11. Of course, as Nicole Gelinas of the Manhattan Institute has shown, New York’s revenues rose 41 percent between 2000 and 2007, while spending increased even faster, so it’s not clear why he’s the man you need in a financial crisis.

But the plutocrat mayor used his personal wealth – and the city’s tax dollars – to pressure people to support his bid to stay in office. Last year the New York Times reported:

The mayor and his top aides have asked leaders of organizations that receive his largess to express their support for his third-term bid by testifying during public hearings and by personally appealing to undecided members of the City Council. …

The requests have put the groups in an unusual and uncomfortable position, several employees of the groups said. City Hall has not made any explicit threats, they said, but city officials have extraordinary leverage over the groups’ finances. Many have received hundreds of thousands of dollars from Mr. Bloomberg’s philanthropic giving and millions of dollars from city contracts overseen by his staff.

Sounds like a lot of overlap between his personal philanthropy and the city’s own spending, and the Times doesn’t seem to find anything odd about that aspect of the story. And then the New York Post found that the mayor’s tax-funded “slush fund” was being enlisted in the campaign, too:

Mayor Bloomberg showered cash on key City Council members with the power to kill a term-limits extension bill in the last year.

Members of the council’s Government Operations Committee have received millions from Hizzoner’s slush fund, a once-secret pot of taxpayer money the mayor doles out to favored lawmakers for their pet causes….

Five members of the committee secured $3.1 million from the $5.3 million stash in Bloomberg’s 2008 budget. Only three other council members received funds from the mayor in the last year.

And the New York Daily News noted that everyone working for Bloomberg at the City Council hearings is on Mayor Mike’s payroll one way or another:

There was the mayor’s legal counsel and the city’s corporation counsel, both paid with tax dollars, testifying that Bloomberg can and should get another term.

There were aides from the mayor’s Community Assistance Unit, who rounded up pro-Bloomberg speakers from the community and religious and civic groups they work with all day long – many of which thrive on city grants.

There were the dozens of “Ready, Willing and Able” guys from the Doe Fund, which gets funding from the city – and used its vans to bring people to the hearing.

That’s why – to return to my Roman theme – union boss Dennis Rivera came to praise Bloomberg, not to bury him, at a recent campaign event. Hail Bloomberg, Magister Populi, Magister Urbi.