The Ryan Sinkhole
By THOMAS B. EDSALLUnlike the Republican platform, which has mostly been ignored outside of the abortion issue, the Paul Ryan budget is the core document of the 2012 campaign. It is the most explicit expression of the Republican agenda, endorsed by the party's presidential candidate, Mitt Romney, and backed by decisive majorities of House and Senate Republicans.
That much is known. What people have not been talking about enough is that the Ryan budget contains an $897 billion sinkhole: massive but unexplained cuts in such discretionary domestic programs as education, food and drug inspection, workplace safety, environmental protection and law enforcement.
The scope of the cuts - stunning in their breadth - is hidden. To find the numbers, turn to page 16 of the Concurrent Resolution on the Budget - Fiscal Year 2013. In Table 2, Fiscal Year 2013 Budget Resolution Discretionary Spending, in the far right hand column, you'll see the nearly $897 billion figure, which appears on the line marked "BA" for Budget Authority under Allowances (920) as $896,884 (because these figures are listed in millions of dollars).
According to the House Budget Committee, of which Ryan is the chairman:
The federal budget is divided into approximately 20 categories known as budget functions. These functions include all spending for a given topic, regardless of the federal agency that oversees the individual federal program. Both the president's budget, submitted annually, and Congress' budget resolution, passed annually, comprise these approximately 20 functions.
Within the 20 "budget functions" lurks - at number 19 - "Function 920." In a masterpiece of bureaucratic obscurantism, the explanation provided by budget committee reads as follows:
FUNCTION 920: ALLOWANCESFunction 920 represents a category called "allowances" that captures the budgetary effects of cross-cutting proposals or contingencies that impact multiple functions rather than one specific area of the budget. It also represents a place-holder category for any budgetary impacts that the Congressional Budget Office has yet to assign to a specific budget function. C.B.O. typically reassigns the budgetary effects of any legislation enacted within Function 920 once a new baseline update is released.
The importance of the nearly $1 trillion in unexplained and unspecified cuts that Ryan and the Republican party are proposing, under the catch-all rubric of "Function 920: Allowances," cannot be overestimated. These invisible cuts are crucial to the Republican claim that the Ryan budget proposal will drastically reduce the federal deficit (eliminating it entirely in the long run) and ultimately erase the national debt.
Medical debt still problem in Mass.
Scant change since passage of ’06 health law
Architects of the pioneering 2006 Massachusetts health law, which required most residents to have insurance, expected it would reduce families’ medical debt. But the most recent data suggest the scope of medical debt has remained largely unchanged.Temporary lapses in insurance coverage and increasingly common plans with high deductibles and copayments have contributed to medical debt, leaving some people struggling to pay bills for hospitals, doctors, and ambulance companies. Rising health costs and the recession also probably played a role.
AG ruling ends program of Canadian drugs in Maine, leading to higher medicine costs for many
Posted Sept. 07, 2012, at 8:55 p.m.AUGUSTA, Maine — Attorney General William Schneider’s determination that CanaRx, a Canadian firm that distributes prescription medications by mail, cannot be licensed in Maine imperils more than $3 million in annual savings budgeted for the state employees’ health plan.The decision affects approximately 1,200 Maine households, according to CanaRx senior program adviser Chris Collins. It also poses financial repercussions for the city of Portland and Guilford-based Hardwood Products Co., both of which have contracted with CanaRx for years.Through a program called MaineMeds, the Maine Division of Employee Health and Benefits contracted with CanaRx earlier this year to deliver brand-name prescription medications for conditions such as chronic asthma and cholesterol maintenance to state employees, their dependents and retirees who don’t qualify for Medicare. CanaRx offers reduced prices to plan providers and does not charge co-payments to participants, creating significant savings for both.The MaineMeds deal saved approximately $500,000 between mid-May and mid-August and “was on track to save more than $3 million” during the fiscal year that ends June 30, 2013, according to Mary Anne Turowski, director of politics and legislation for the Maine State Employees Association, the union that represents state workers.Those savings will have to be found elsewhere, after CanaRx shut down the MaineMeds program on Aug. 15, in response to an Aug. 14 letter from Schneider that reaffirmed his June 21 opinion that CanaRx was violating Maine law by distributing medications without a license.“An unintended consequence might be that the health plan will have to go back to the administration to ask for more money,” Turowski said, noting that roughly 900 people had enrolled in MaineMeds. The deal with CanaRx resulted, in part, from an effort to achieve savings after the Legislature flat-funded the state employees’ health plan for the current two-year budget cycle, she said.Laurie Williamson, executive director of the Maine Division of Employee Health and Benefits, did not return phone calls Thursday or Friday.DHHS will wait for federal OK before telling Medicaid recipients they’re losing coverage
AUGUSTA, Maine — The state’s Department of Health and Human Services will hold off on notifying certain Medicaid recipients that their coverage might be eliminated until the state secures the federal approval necessary to implement the cuts.MaineCare Services director Stefanie Nadeau told members of the Legislature’s Appropriations Committee on Friday that DHHS will await an OK from the federal Centers for Medicare and Medicaid Services or the outcome of court action Maine has taken to force federal officials to sign off on about $20 million in cuts to Maine’s Medicaid program before notifying recipients of reductions in Medicaid benefits.In August, Health and Human Services Commissioner Mary Mayhew told lawmakers her department planned to send notices to about 12,000 low-income parents to alert them that they might lose Medicaid coverage, pending federal approval.
AG ruling ends program of Canadian drugs in Maine, leading to higher medicine costs for many
Posted Sept. 07, 2012, at 8:55 p.m.
AUGUSTA, Maine — Attorney General William Schneider’s determination that CanaRx, a Canadian firm that distributes prescription medications by mail, cannot be licensed in Maine imperils more than $3 million in annual savings budgeted for the state employees’ health plan.
The decision affects approximately 1,200 Maine households, according to CanaRx senior program adviser Chris Collins. It also poses financial repercussions for the city of Portland and Guilford-based Hardwood Products Co., both of which have contracted with CanaRx for years.
Through a program called MaineMeds, the Maine Division of Employee Health and Benefits contracted with CanaRx earlier this year to deliver brand-name prescription medications for conditions such as chronic asthma and cholesterol maintenance to state employees, their dependents and retirees who don’t qualify for Medicare. CanaRx offers reduced prices to plan providers and does not charge co-payments to participants, creating significant savings for both.
The MaineMeds deal saved approximately $500,000 between mid-May and mid-August and “was on track to save more than $3 million” during the fiscal year that ends June 30, 2013, according to Mary Anne Turowski, director of politics and legislation for the Maine State Employees Association, the union that represents state workers.
Those savings will have to be found elsewhere, after CanaRx shut down the MaineMeds program on Aug. 15, in response to an Aug. 14 letter from Schneider that reaffirmed his June 21 opinion that CanaRx was violating Maine law by distributing medications without a license.
“An unintended consequence might be that the health plan will have to go back to the administration to ask for more money,” Turowski said, noting that roughly 900 people had enrolled in MaineMeds. The deal with CanaRx resulted, in part, from an effort to achieve savings after the Legislature flat-funded the state employees’ health plan for the current two-year budget cycle, she said.
Laurie Williamson, executive director of the Maine Division of Employee Health and Benefits, did not return phone calls Thursday or Friday.
DHHS will wait for federal OK before telling Medicaid recipients they’re losing coverage
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TweetAUGUSTA, Maine — The state’s Department of Health and Human Services will hold off on notifying certain Medicaid recipients that their coverage might be eliminated until the state secures the federal approval necessary to implement the cuts.
MaineCare Services director Stefanie Nadeau told members of the Legislature’s Appropriations Committee on Friday that DHHS will await an OK from the federal Centers for Medicare and Medicaid Services or the outcome of court action Maine has taken to force federal officials to sign off on about $20 million in cuts to Maine’s Medicaid program before notifying recipients of reductions in Medicaid benefits.
In August, Health and Human Services Commissioner Mary Mayhew told lawmakers her department planned to send notices to about 12,000 low-income parents to alert them that they might lose Medicaid coverage, pending federal approval.
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