Tag: mandate

The REAL ID Revival Bill Should Not Get a PASS

A draft Senate bill to revive the REAL ID Act has been leaked to to the anti-immigrant Center for Immigration Studies, and they find it wanting.

The bill is an attempt to smooth down REAL ID and make the national ID law more palatable. CIS is unhappy because they want a national ID implemented right away.

REAL ID is, of course, failing. Just ten months ago, the Bush Administration’s Secretary of Homeland Security granted waivers to every state in the country - not a single one of them was in compliance by the May, 2008 deadline, and several have statutorily barred themselves from complying.

Legislation to repeal REAL ID in both the House and Senate was introduced in the last Congress, but with an administration and Department of Homeland Security eager to demagogue the issue against a Democratic Congress, that legislation did not move. Repealing REAL ID would not have the same problem in the current Congress.

But since then, Washington’s wheels have been turning. The National Governors Association has turned into an advocate of reviving REAL ID because it hopes that federal dollars will flow behind federal mandates. They won’t, but reviving REAL ID will cement NGA’s role as a beggar for federal dollars in Washington. (Maybe other state legislator groups, as well.)

Everbody in Washington, D.C. salivates over the chance to make “deals” even if that means switching positions on issues of principle like whether the U.S. should have a national ID. We’ll be watching to see which political leaders reverse themselves and support this attempt at a national ID for their love of political dealmaking.

The working name of the REAL ID revival bill is the “PASS ID Act.” It should not be given a pass by opponents of a U.S. national ID and the REAL ID Act.

What ‘Universal Coverage’ Really Means: Higher Taxes, Government Rationing

An editorial in today’s Wall Street Journal earns that page a membership in the Anti-Universal Coverage Club.

The editors explain that the universal-coverage scheme Massachusetts enacted in 2006 is a perfect microcosm of what congressional Democrats are trying to foist on the rest of the nation: compel universal coverage now, worry about the costs later.

Massachusetts is three years into that strategy, thus its experience shows us where that strategy leads.  Much as my colleague Mike Tanner predicted (repeatedly), it leads to higher taxes and government rationing.  The WSJ editors write:

The state’s overall costs on health programs have increased by 42% (!) since 2006.

Like gamblers doubling down on their losses, Democrats have already hiked the fines for people who don’t obtain insurance under the “individual mandate,” already increased business penalties, taxed insurers and hospitals, raised premiums, and pumped up the state tobacco levy. That’s still not enough money.

So earlier this year, [Gov. Deval] Patrick appointed a state commission to figure out how to control costs and preserve “this grand experiment”…

The Patrick panel is considering one option to “exclude coverage of services of low priority/low value.” Another would “limit coverage to services that produce the highest value when considering both clinical effectiveness and cost.” (Guess who would determine what is high or low value? Not patients or doctors.) Yet another is “a limitation on the total amount of money available for health care services,” i.e., an overall spending cap…

[Patrick] reportedly told insurers and hospitals at a closed meeting this month that if they didn’t take steps to hold down the rate of medical inflation, he would.

The editors conclude:

The real lesson of Massachusetts is that reform proponents won’t tell Americans the truth about what “universal” coverage really means: Runaway costs followed by price controls and bureaucratic rationing.

More on that Massachusetts ‘Model’

Amid reports that the Obama administration, congress, and some conservative groups still consider Massachusetts to be a model for health care reform, the New York Times reveals that despite assessing insurers and hospitals, raising the penalty on noncompliant businesses, increasing premiums and co-payments for consumers, and raising the state tobacco tax, the program’s financing remains unsustainable.

Massachusetts has significantly reduced the number of people in the state who lack health insurance. However, it has not achieved, nor does it expect to reach, universal coverage. (The best estimates suggest that more than 200,000 state residents remain uninsured). And, significantly, roughly 60 percent of newly insured state residents are receiving subsidized coverage, suggesting that the increase in insurance coverage has more to do with increased subsidies (the state now provides subsidies for those earning up to 300 percent of the poverty level or $66,150 for a family of four) than with the mandate.

The cost of those subsidies in the face of predictably rising health care costs has led to program costs far higher than originally predicted. Spending for the Commonwealth Care subsidized program has doubled, from $630 million in 2007 to an estimated $1.3 billion for 2009.

Now the state is turning to a variety of gimmicks to try to hold down costs, including possibly cutting payments to physicians and hospitals by 3-5 percent. However, the Times quotes health reform experts who have studied the Massachusetts system as warning “the state and federal governments may need to place actual limits on health spending, which could lead to rationing of care.”

The more one looks at the Massachusetts “model,” the stronger the argument for keeping the government out of health care.