Tag: tax

The Coburn-Burr-Ryan-Nunes Mandate-Price-Control Bill

Today, Senators Tom Coburn (R-OK) and Richard Burr (R-NC), along with Reps. Paul Ryan (R-WI) and Devin Nunes (R-CA) announced that they will introduce a health care reform bill. If my reading of the bill summary is correct, their bill would:

  • Mandate that states create a new regulatory bureaucracy called a “State Health Insurance Exchange,”
  • Mandate that all plans offered through those exchanges meet federal regulatory standards,
  • Mandate “guaranteed issue” in those exchanges,
  • Mandate “uniform and reliable measures by which to report quality and price information,”
  • Impose price controls on those plans by prohibiting risk-rating,
  • Launch a government takeover of the “insurance” part of health insurance, by means of a “risk-adjustment” program intended to cope with the problems created by price controls, and
  • Fall just short of an individual mandate by setting up (mandating?) automatic enrollment in exchange plans at “places of employment, emergency rooms, the DMV, etc.” – essentially, trying to achieve universal coverage by nagging Americans to death.

Needless to say, I am troubled.

The bill summary is self-contradictory. On the one hand, it lists “No Tax Increases” as a core concept. Do its authors not know that imposing price controls on health insurance premiums imposes a tax on healthier-than-average consumers? And where do they think the money for “risk-adjustment” payments will come from? Heaven?

The bill sponsors seem to want to cement in place the monopoly regulation that currently exists at the state level – when they’re not encouraging Congress to take over that function. Have they abandoned their colleague Rep. John Shadegg’s (R-AZ) proposal to allow for competitive regulation of health insurance?

And if Massachusetts created an “exchange” on its own, why do other states need federal legislation?

The bill includes some ideas for which I have more sympathy, like its tax-credit proposal and expanding health savings accounts.

But the above provisions would sow the seeds of a government takeover of health care – so much so that The Washington Post’s Ezra Klein is salivating:

The word of the day is “convergence.” That – and that alone – is the definitive message of the conservative health reform alternative developed by Sens. Tom Coburn (Okla.) and Richard Burr (N.C.), as well as Rep. Paul Ryan (Wisc.). For now, some of the key provisions are about as clear as mud. The plan’s changes to the tax code, in particular, are impossible to discern. So I’ll do another post when I can get some clarity on those issues. The politics, however, are perfectly straightforward.

A superficial read of the Patients’ Choice Act – which I’ve uploaded here – would make you think you’re digging into a liberal bill. A fair chunk of the rhetoric is lifted straight from Sen. Ted Kennedy’s office. “It is time to publicly admit that the health care system in America is broken,” begins the document. “Health care is not a commodity in the traditional sense,” it continues. “States should provide direct oversight of health insurers to make sure they are playing by fair rules,” it demands. The way we pay private insurers in Medicare “wastes taxpayer dollars and lines the pockets of insurance executives,” it says. Elsewhere, it praises solutions that have worked in several European countries.”

And though it’s still too early to say how the policy fits together, it’s clear that many traditionally Democratic concepts have been embraced. To put it simply, the plan wants to encourage a version of the Massachusetts reforms – which it calls a “well-known, bi-partisan achievement of universal health care” – in every state. There are some differences, of course. The plan doesn’t have an individual mandate. It doesn’t have an obvious tax on employers. But it strongly endorses State Health Insurance Exchanges. And that, for Republicans, is a radical change in policy.

This idea – present in every Democratic proposal but absent in Arizona Sen.John McCain’s plan – would empower states to create heavily regulated marketplaces of insurers. The plans offered would have to “meet the same statutory standard used for the health benefits given to Members of Congress.” Cherrypicking would be discouraged through risk adjustment, which the PCA calls “a model that works in several European countries.” The government would automatically enroll individuals in plans whenever they interacted with a government agency and states would be able to join into regional cooperatives to increase the size of their risk pool.

In essence, Coburn, Burr, and Ryan are abandoning the individual market entirely. Like Democrats, they’re arguing that individuals cannot successfully navigate the insurance market, and they need the protection of government regulation and the bargaining power that comes from a large risk pool. This is literally the opposite approach from McCain, who attempted to unwind the employer-based insurance and encourage families to purchase health coverage on the individual market. The core elements of this plan, in other words, make it the same type of plan Democrats are offering. A plan that enlarges consumer buying pools rather than shrinks them. It’s pretty much exactly what I’d expect a Blue Dog Democrat to propose. And it’s further evidence that the argument over health reform is narrowing, rather than widening. And it’s narrowing in a direction that favors the Democrats.

UPDATE: After discussions with Sen. Coburn’s staff, I happily issued a few corrections. Still, concerns remain.

Rush Limbaugh Is Not the Problem

Brink Lindsey’s post, triggered by Jerry Taylor’s controversial critique of conservative talk radio at National Review online,  is part of a much-needed debate about the changes needed to create more fertile soil for limited-government – a task that is especially difficult given the GOP’s decade-long embrace of statist economic policy.

But in the spirit of friendly disagreement, the problem is not Rush Limbaugh and Sean Hannity. Talk radio, after all, existed when Republicans were riding high and promoting small government in the 1990s.

The real problem is that today’s GOP politicians are unwilling to even pretend that they believe in limited government. In such an environment, it is hardly a surprise that anti-tax and anti-spending voters decide that talk show hosts are de facto national leaders.

This does not mean that Rush Limbaugh is always right or that Sean Hannity never engages in demagoguery. But I suspect if any of us had to be live on the air three hours every day and support our families by attracting an audience, our efforts to be entertaining might result in an occasional mistake - either factually or rhetorically. Heck, when I had to be on the air for just one hour each day in the mid-1990s for the fledgling conservative television network created by the late Paul Weyrich, I’m sure I had more than my share of errors.

This being said, I agree with Brink’s main points about conservatism being adrift. How come there were no tea parties when Bush was expanding the burden of government? Why didn’t conservative think tanks rebel when Bush increased the power of the federal government? Where were the supposedly conservative members of the House and Senate when Bush was pushing through pork-filled transportation bills, corrupt farm bills, a no-bureaucrat-left-behind education bill, and a massive entitlement expansion?

I sometimes wonder if the re-emergence of another Reagan would make a difference, but Brink (and Posner, et al) offer compelling reasons to believe that the problems are much deeper.

On Taxing Employer Health Benefits

Democrats in Congress are reportedly considering taxing employer-provided health insurance benefits as a way to pay for their health care reform plan.  And, even though he brutally attacked John McCain for something similar (see below) during the campaign, President Obama may now go along with the idea.

Much of the media coverage around the idea has equated this tax hike with the McCain plan and other proposals by advocates of market-based health reform over the years that would shift the tax break from employer-provided insurance to individual insurance.  However, there is an important distinction.  The market-based proposals would have taxed employer-provided health benefits (treating them as taxable compensation), but would have provided workers with a deduction or credit for purchasing insurance regardless of whether they receive it through work or pay it on their own.  The result, for all but a handful of workers with the most expensive gold-plated employer plans, would have been tax neutral.  In fact, many workers would receive a net tax cut.   The shift in tax treatment was simply part of a larger strategy to move from a system of employer-provided insurance to one where health insurance was personal, portable, and owned by workers.

The plan being discussed by Congress, on the hand, is simply a tax hike.  It is not revenue neutral—it is a $1 trillion tax increase that will fall heavily on the middle-class.  It is designed not to change the system, but simply to raise revenue. 

That’s a very different thing!

Support for Private School Choice Officially “Mainstream”

The USA Today editorializes this morning in support of the DC voucher program and school choice in general. That’s a shift from last year when Robert Enlow of the Friedman Foundation had to respond to their dismissal of vouchers. From the enlightened board:

As an Education Department spokesman says, “The unions are not happy.” But 20 million low-income school kids need a chance to succeed. School choice is the most effective way to give it to them.

The shift of center-left elite opinion on school choice is a hugely important development, as I noted with the first wave of mainstream media attention to the DC voucher program’s death-sentence:

When elites unite on mainstream issues, the public’s response is relatively nonideological and lopsided. School choice is progressively mainstreaming, slowly but surely moving from a polarized elite debate to one where the intensity and support is weighted in favor of school choice.

When an issue that used to be considered free-market fringe is embraced as a moral litmus test for politicians by liberal editorial boards, the issue-argument has been won. That’s certainly not to say the policy war has been won, but an important battle toward realizing that goal has been.

The opposition’s intensity and moral certitude is bleeding out one program at a time. School choice is no longer an abstract proposition; faces and lives are attached to the 24 private school-choice programs in 14 states and the District of Columbia. In the past four years, four education tax-credit programs have passed that serve at least low-income children…

School-choice opponents might have won the battle over vouchers in the District, but they are losing the larger war. They have inadvertently revealed what’s truly at stake; not funding issues or public school ideology, but our promise to all children of a fair shot at success in life.

Choice opponents are on the wrong side of right and the wrong side of history.

Drop the Soda, or Else!

Government is busy trying to protect us from ourselves.  It tosses nearly a million people in jail every year for marijuana offenses.  City councils, state legislators, and Congress all add ever more restrictions on cigarette smoking.  Legislators demand action to stop steroid use by athletes.  And the Senate Finance Committee is considering a “fat tax” on sugared drinks.

This isn’t the first time legislators have considered trying to squeeze a little money out of us while micro-managing our lives.  Editorializes the Boston Herald:

Earlier this year Gov. Deval Patrick proposed a 5 percent tax (more if the sales tax is raised) on sweetened drinks and candy bars under the pretext of battling obesity (while thinning out our wallets). Happily we haven’t heard much about it lately. But yesterday on Capitol Hill the Senate Finance Committee heard testimony about helping to fund President Barack Obama’s massive health care expansion in part with a similar tax.

The Congressional Budget Office estimates that a 3-cent tax per 12-ounce sweetened drink - including sports drinks and iced teas - would bring in $24 billion over four years.

“Soda is one of the most harmful products in the food supply,” said Michael Jacobson, head of the Center for Science in the Public Interest, which gives you some idea of the mindset here. Jacobson would also like to raise taxes on alcoholic beverages.

If the American people don’t start saying no, there won’t be much liberty left to preserve.

Obama’s Broken Toaster

APTOPIX ObamaRecently on Leno, President Obama compared some financial products to an exploding toaster. His words:

When you buy a toaster, if it explodes in your face there’s a law that says your toasters need to be safe. But when you get a credit card, or you get a mortgage, there’s no law on the books that says if that explodes in your face financially, somehow you’re going to be protected.

So this is – the need for getting back to some common sense regulations – there’s nothing wrong with innovation in the financial markets. We want people to be successful; we want people to be able to make a profit. Banks are critical to our economy and we want credit to flow again. But we just want to make sure that there’s enough regulatory common sense in place that ordinary Americans aren’t taken advantage of, and taxpayers, after the fact, aren’t taken advantage of.

While I think we would all like to get to “common sense” regulation – arriving at such is unlikely if one’s understanding of the very problem is flawed, as seems to be the president’s.

Unlike broken toasters, mortgages and credit cards do not fail to pay themselves – borrowers fail to pay, almost always for a reason that has little to do with the characteristics of the loan itself. There is a wealth of empirical data documenting the causes of bankruptcy, mortgage and credit card default – much of which has been assembled by those on the left (take a look at any of Professor Elizabeth Warren’s work on bankruptcy). The fact is that the number one cause of all of these events is job loss. If the president has a plan for a mortgage that protects you from losing your job, I would love to see how that’s going to work. After job loss, comes unexpected health bills and divorce.

My hope had been that Obama’s talk about broken toasters was just a little pandering and could be safely ignored. However, judging from the structure of his foreclosure relief plan, he appears to believe that if we just lower the borrower’s rate, all would be saved. The sad truth is that his foreclosure plan does nothing for those really in need – who have lost their job for instance – they are simply out of luck. But then helping people who have lost their job would undermine the argument that it is all the fault of the product.