Koch-backed political network, designed to shield donors, raised $400 million in 2012
By Matea Gold,
The political network spearheaded by conservative billionaires Charles and David Koch has expanded into a far-reaching operation of unrivaled complexity, built around a maze of groups that cloaks its donors, according to an analysis of new tax returns and other documents.
The filings show that the network of politically active nonprofit groups backed by the Kochs and fellow donors in the 2012 elections financially outpaced other independent groups on the right and, on its own, matched the long-established national coalition of labor unions that serves as one of the biggest sources of support for Democrats.
The resources and the breadth of the organization make it singular in American politics: an operation conducted outside the campaign finance system, employing an array of groups aimed at stopping what its financiers view as government overreach. Members of the coalition target different constituencies but together have mounted attacks on the new health-care law, federal spending and environmental regulations.
Key players in the Koch-backed network have already begun engaging in the 2014 midterm elections, hiring new staff members to expand operations and strafing House and Senate Democrats with hard-hitting ads over their support for the Affordable Care Act.
Its funders remain largely unknown; the coalition was carefully constructed with extensive legal barriers to shield its donors.
But they have substantial firepower. Together, the 17 conservative groups that made up the network raised at least $407 million during the 2012 campaign, according to the analysis of tax returns by The Washington Post and the Center for Responsive Politics, a nonpartisan group that tracks money in politics.
A labyrinth of tax-exempt groups and limited-liability companies helps mask the sources of the money, much of which went to voter mobilization and television ads attacking President Obama and congressional Democrats, according to tax filings and campaign finance reports.
The coalition’s revenue surpassed that of the Crossroads organizations, a super PAC and nonprofit group co-founded by GOP strategist Karl Rove that together brought in $325 million in the last cycle.
The left has its own financial muscle, of course; unions plowed roughly $400 million into national, state and local elections in 2012. A network of wealthy liberal donors organized by the group Democracy Alliance mustered about $100 million for progressive groups and super PACs in the last election cycle, according to a source familiar with the totals.
The donor network organized by the Kochs — along with funding an array of longtime pro-
Republican groups such as the U.S. Chamber of Commerce, the National Rifle Association and Americans for Tax Reform — distributed money to a coalition of groups that share the brothers’ libertarian, free-market perspective. Each group was charged with a specialized task such as youth outreach, Latino engagement or data crunching.
The system involved roughly a dozen limited-liability companies with cryptic, alphabet-soup names such as SLAH LLC and ORRA LLC, and entities that dissolved and reappeared under different monikers.
The following is a pretty interesting article for us policy-wonks, and for anybody interested in some of the things going on in the White House during the development of the ACA. The last sentence in the article is revealing - what is a bug for most of the nation - out of control costs - is a feature for those inside the medical-industrial complex and its academic enablers.
FYI - "Health Care For America Now" is a group created to advocate for the passage of the ACA. It is not to be confused with similarly named "Health Care Now", a single payer advocacy group that was formed before HCAN. (I believe the similarity in names was no coincidence, but intended to cause confusion between the two groups.)
-SPC
The political network spearheaded by conservative billionaires Charles and David Koch has expanded into a far-reaching operation of unrivaled complexity, built around a maze of groups that cloaks its donors, according to an analysis of new tax returns and other documents.
The filings show that the network of politically active nonprofit groups backed by the Kochs and fellow donors in the 2012 elections financially outpaced other independent groups on the right and, on its own, matched the long-established national coalition of labor unions that serves as one of the biggest sources of support for Democrats.
The resources and the breadth of the organization make it singular in American politics: an operation conducted outside the campaign finance system, employing an array of groups aimed at stopping what its financiers view as government overreach. Members of the coalition target different constituencies but together have mounted attacks on the new health-care law, federal spending and environmental regulations.
Key players in the Koch-backed network have already begun engaging in the 2014 midterm elections, hiring new staff members to expand operations and strafing House and Senate Democrats with hard-hitting ads over their support for the Affordable Care Act.
Its funders remain largely unknown; the coalition was carefully constructed with extensive legal barriers to shield its donors.
But they have substantial firepower. Together, the 17 conservative groups that made up the network raised at least $407 million during the 2012 campaign, according to the analysis of tax returns by The Washington Post and the Center for Responsive Politics, a nonpartisan group that tracks money in politics.
A labyrinth of tax-exempt groups and limited-liability companies helps mask the sources of the money, much of which went to voter mobilization and television ads attacking President Obama and congressional Democrats, according to tax filings and campaign finance reports.
The coalition’s revenue surpassed that of the Crossroads organizations, a super PAC and nonprofit group co-founded by GOP strategist Karl Rove that together brought in $325 million in the last cycle.
The left has its own financial muscle, of course; unions plowed roughly $400 million into national, state and local elections in 2012. A network of wealthy liberal donors organized by the group Democracy Alliance mustered about $100 million for progressive groups and super PACs in the last election cycle, according to a source familiar with the totals.
The donor network organized by the Kochs — along with funding an array of longtime pro-
Republican groups such as the U.S. Chamber of Commerce, the National Rifle Association and Americans for Tax Reform — distributed money to a coalition of groups that share the brothers’ libertarian, free-market perspective. Each group was charged with a specialized task such as youth outreach, Latino engagement or data crunching.
Republican groups such as the U.S. Chamber of Commerce, the National Rifle Association and Americans for Tax Reform — distributed money to a coalition of groups that share the brothers’ libertarian, free-market perspective. Each group was charged with a specialized task such as youth outreach, Latino engagement or data crunching.
The system involved roughly a dozen limited-liability companies with cryptic, alphabet-soup names such as SLAH LLC and ORRA LLC, and entities that dissolved and reappeared under different monikers.
The group that got health reform passed is declaring victory and going home
By Harold Pollack,
It’s hard to remember now, as the Affordable Care Act’s biggest programs come into effect, but many central decisions regarding Obamacare’s structure were made before anyone expected Barack Obama to be president. By the time he was a serious contender, Obama, Hillary Rodham Clinton and John Edwards had all coalesced around strikingly similar health plans that would, in broad outline, become Obamacare.
This prehistory was essential to health reform’s passage. Key constituencies that advocated for health reform negotiated compromises well before a bill even existed. And a grass-roots campaign was prepared to move health reform center-stage within Democratic congressional districts across the country. Before President Obama took office, congressional leaders and House and Senate staffers were drafting specific legislative language.
Health Care for America Now (HCAN) played a central role in leading that effort. HCAN brought together a wide array of organizations, from AFSCME, AFL-CIO and SEIU to the NAACP, MoveOn, ACORN, the Center for American Progress, the National Council of La Raza, Campaign for America’s Future and more. Even George Soros played a part.
As national campaign manager and chief executive, Richard Kirsch played a key role in founding HCAN. His 2012 book, "Fighting for Our Health: The Epic Battle to Make Health Care a Right in the United States," is an essential reference regarding the grass-roots advocacy behind health reform.
HCAN officially closed up shop on Dec. 31, 2013. I caught up with Kirsch to discuss HCAN’s contributions, as well as to discuss the accomplishments and the many missteps in the passage of health reform. In our conversation, Kirsch expressed pride in health reform. He also wasn’t shy about criticizing Obama, Sen. Max Baucus and others regarding various strategic missteps and the demise of the public option. Below is an edited transcript of our conversation.
Harold Pollack: How and when did HCAN get started, and how did you get involved in it?
Richard Kirsch: I have a history working on health reform going back to 1986, when I started working in New York, along with others around the country, to see if we could get a new movement for national healthcare reform going. We started at the state level. I’m proud to this day that New York State assembly passed the only fully financed single-payer bill in history… .
I then was involved, from New York, in the Clinton health care reform fight. In 2003, I sat down to write a piece that was a history of that fight for organizers who would follow. It was could clear that another fight was brewing over national health reform, which seemed amazing at the time, because people said after ’94, this will never happen again. It was such a disaster; the defeat of the Clinton plan contributed to Gingrich getting elected. Yet the underlying dynamics in the health system continued to escalate. Costs kept increasing, which also meant that more and more people were shut out of coverage. The underlying dynamics were beginning to create renewed movement by 2003.
In writing that history lesson, much to my surprise I also came up with a new policy approach. Rather than again having this divide on the left between single-payer -- which is to say a government health insurance system -- or subsidized private insurance, why don’t we give people a choice of both? That became the public option. It turns out Jacob Hacker at Yale [and some others] had proposed the same thing.
In January 2007, I said to the top staff at USAction, the national group that my organization in NY was affiliated with, that I think we need to start building a new health care campaign. I saw that if a Democrat were elected in 2008, we will have an opening to pass comprehensive reform.
Those discussions led, in mid-2007, to putting together a group of labor unions, community based organizations, constituency groups, online groups and think tanks to build a campaign which became known eventually as Health Care for America Now (HCAN).
It’s hard to remember now, as the Affordable Care Act’s biggest programs come into effect, but many central decisions regarding Obamacare’s structure were made before anyone expected Barack Obama to be president. By the time he was a serious contender, Obama, Hillary Rodham Clinton and John Edwards had all coalesced around strikingly similar health plans that would, in broad outline, become Obamacare.
This prehistory was essential to health reform’s passage. Key constituencies that advocated for health reform negotiated compromises well before a bill even existed. And a grass-roots campaign was prepared to move health reform center-stage within Democratic congressional districts across the country. Before President Obama took office, congressional leaders and House and Senate staffers were drafting specific legislative language.
Health Care for America Now (HCAN) played a central role in leading that effort. HCAN brought together a wide array of organizations, from AFSCME, AFL-CIO and SEIU to the NAACP, MoveOn, ACORN, the Center for American Progress, the National Council of La Raza, Campaign for America’s Future and more. Even George Soros played a part.
As national campaign manager and chief executive, Richard Kirsch played a key role in founding HCAN. His 2012 book, "Fighting for Our Health: The Epic Battle to Make Health Care a Right in the United States," is an essential reference regarding the grass-roots advocacy behind health reform.
HCAN officially closed up shop on Dec. 31, 2013. I caught up with Kirsch to discuss HCAN’s contributions, as well as to discuss the accomplishments and the many missteps in the passage of health reform. In our conversation, Kirsch expressed pride in health reform. He also wasn’t shy about criticizing Obama, Sen. Max Baucus and others regarding various strategic missteps and the demise of the public option. Below is an edited transcript of our conversation.
Harold Pollack: How and when did HCAN get started, and how did you get involved in it?
Richard Kirsch: I have a history working on health reform going back to 1986, when I started working in New York, along with others around the country, to see if we could get a new movement for national healthcare reform going. We started at the state level. I’m proud to this day that New York State assembly passed the only fully financed single-payer bill in history… .
I then was involved, from New York, in the Clinton health care reform fight. In 2003, I sat down to write a piece that was a history of that fight for organizers who would follow. It was could clear that another fight was brewing over national health reform, which seemed amazing at the time, because people said after ’94, this will never happen again. It was such a disaster; the defeat of the Clinton plan contributed to Gingrich getting elected. Yet the underlying dynamics in the health system continued to escalate. Costs kept increasing, which also meant that more and more people were shut out of coverage. The underlying dynamics were beginning to create renewed movement by 2003.
In writing that history lesson, much to my surprise I also came up with a new policy approach. Rather than again having this divide on the left between single-payer -- which is to say a government health insurance system -- or subsidized private insurance, why don’t we give people a choice of both? That became the public option. It turns out Jacob Hacker at Yale [and some others] had proposed the same thing.
In January 2007, I said to the top staff at USAction, the national group that my organization in NY was affiliated with, that I think we need to start building a new health care campaign. I saw that if a Democrat were elected in 2008, we will have an opening to pass comprehensive reform.
Those discussions led, in mid-2007, to putting together a group of labor unions, community based organizations, constituency groups, online groups and think tanks to build a campaign which became known eventually as Health Care for America Now (HCAN).
Can Upward Mobility Cost You Your Health?
By GREGORY E. MILLER, EDITH CHEN and GENE H. BRODY
Americans love a good rags-to-riches story. Even in an age of soaring inequality, we like to think that people can still make it big here if they work hard and stay out of trouble. The socioeconomic reality of most of the last four decades — stagnant wages, soaring income and wealth inequality, and reduced equality of opportunity — have dented, but not destroyed, the appeal of the American dream.
Those who do climb the ladder, against the odds, often pay a little-known price: Success at school and in the workplace can exact a toll on the body that may have long-term repercussions for health.
Among American children there are wide socioeconomic gaps on many dimensions of well-being: school achievement, mental health, drug use, teenage pregnancy and juvenile incarceration, to name just a few. Despite the risks that lower-income children face, we also know that a significant minority beat the odds. They perform admirably in school, avoid drugs and go on to college.
Psychologists refer to these children as resilient, because they achieve positive outcomes in adverse circumstances. They do so in part by cultivating a kind of determined persistence. Often with nurturing from a parent, relative or mentor, they set goals for the future, work diligently toward them, navigate setbacks, stay focused on the long term and resist temptations that might knock them off the ladder to success.
Several years ago, we began studying these resilient young people, trying to find out if their success stories also translated into physical health benefits. We reasoned that, if disadvantaged children were succeeding academically and emotionally, they might also be protected from health problems that were more common in lower-income youth. As it turned out, the exact opposite was true. These young people were achieving success by all conventional markers: doing well academically, staying out of trouble, making friends and developing a positive sense of self. Underneath, however, their physical health was deteriorating.
Our first hints of this pattern came from a study of 489 rural African-American young people in Georgia, whom one of us, Gene Brody, has been tracking for more than 15 years. Most came from families who were working but poor. In 2010, their average family income was about $12,000 a year; about half lived below the poverty line. We found a subgroup of resilient children who, despite these obstacles, were rated, at age 11, by their teachers as being diligent, focused, patient, academically successful and strong in social skills.
Fixing health care system is many baby steps away
Our comparatively shorter, more sickly lives will remain so until there’s a sea change in attitudes.
By Jim Doyle
St. Louis Post-Dispatch
ST. LOUIS — When federal lawmakers agreed in 2010 to pass the Affordable Care Act, they recognized that the U.S. health care system was in desperate straits.
Not only was the cost of health care significantly higher than in other industrialized nations, but Americans were among the unhealthiest populations in the Western world.
Nearly four years later, the system remains in crisis. While the growth of health care spending has slowed, it is still climbing. And despite higher costs, Americans’ health outcomes have not significantly improved.
“Other wealthy nations achieve longer lives, lower infant mortality, better access to care, and higher care quality while spending far less,” states a January 2013 report by the nonpartisan Commonwealth Fund.
The Affordable Care Act was never intended to immediately halt these basic trends; improving health outcomes and quality of life while cutting costs is a tall order. But the nation’s volatile, partisan debate over what is popularly known as Obamacare seems to have missed that point.
The tech-savvy Obama administration was expected to deliver a user-friendly website that would increase Americans’ access to health care by subsidizing insurance coverage. But HealthCare.gov was a bug-ridden disaster. And many consumers have voiced “sticker shock” over the higher monthly premiums and higher deductibles of insurance plans for 2014 both on and off the online marketplaces, also known as health exchanges.
By Jim Doyle
St. Louis Post-Dispatch
St. Louis Post-Dispatch
ST. LOUIS — When federal lawmakers agreed in 2010 to pass the Affordable Care Act, they recognized that the U.S. health care system was in desperate straits.
Not only was the cost of health care significantly higher than in other industrialized nations, but Americans were among the unhealthiest populations in the Western world.
Nearly four years later, the system remains in crisis. While the growth of health care spending has slowed, it is still climbing. And despite higher costs, Americans’ health outcomes have not significantly improved.
“Other wealthy nations achieve longer lives, lower infant mortality, better access to care, and higher care quality while spending far less,” states a January 2013 report by the nonpartisan Commonwealth Fund.
The Affordable Care Act was never intended to immediately halt these basic trends; improving health outcomes and quality of life while cutting costs is a tall order. But the nation’s volatile, partisan debate over what is popularly known as Obamacare seems to have missed that point.
The tech-savvy Obama administration was expected to deliver a user-friendly website that would increase Americans’ access to health care by subsidizing insurance coverage. But HealthCare.gov was a bug-ridden disaster. And many consumers have voiced “sticker shock” over the higher monthly premiums and higher deductibles of insurance plans for 2014 both on and off the online marketplaces, also known as health exchanges.
Why Everyone Seems to Have Cancer
By GEORGE JOHNSON
EVERY New Year when the government publishes its Report to the Nation on the Status of Cancer, it is followed by a familiar lament. We are losing the war againstcancer.
Half a century ago, the story goes, a person was far more likely to die from heart disease. Now cancer is on the verge of overtaking it as the No. 1 cause of death.
Troubling as this sounds, the comparison is unfair. Cancer is, by far, the harder problem — a condition deeply ingrained in the nature of evolution and multicellular life. Given that obstacle, cancer researchers are fighting and even winning smaller battles: reducing the death toll from childhood cancers and preventing — and sometimes curing — cancers that strike people in their prime. But when it comes to diseases of the elderly, there can be no decisive victory. This is, in the end, a zero-sum game.
The rhetoric about the war on cancer implies that with enough money and determination, science might reduce cancer mortality as dramatically as it has with other leading killers — one more notch in medicine’s belt. But what, then, would we die from? Heart disease and cancer are primarily diseases of aging. Fewer people succumbing to one means more people living long enough to die from the other.
The newest cancer report, which came out in mid-December, put the best possible face on things. If one accounts for the advancing age of the population — with the graying of the baby boomers, death itself is on the rise — cancer mortality has actually been decreasing bit by bit in recent decades. But the decline has been modest compared with other threats.
A graph from the Centers for Disease Control and Prevention tells the story. There are two lines representing the age-adjusted mortality rate from heart disease and from cancer. In 1958 when the diagram begins, the line for heart disease is decisively on top. But it plunges by 68 percent while cancer declines so slowly — by only about 10 percent — that the slope appears far less significant.
Measuring from 1990, when tobacco had finished the worst of its damage and cancer deaths were peaking, the difference is somewhat less pronounced: a decline of 44 percent for heart disease and 20 percent for cancer. But as the collision course continues, cancer seems insistent on becoming the one left standing — death’s final resort. (The wild card in the equation is death from complications of Alzheimer’s disease, which has been advancing year after year.)
Though not exactly consoling, the fact that we have reached this standoff is a kind of success. A century ago average life expectancy at birth was in the low to mid-50s. Now it is almost 79, and if you make it to 65 you’re likely to live into your mid-80s. The median age of cancer death is 72. We live long enough for it to get us.
Our View: Obamacare signups starting to meet goals
Despite a slow rollout, the Affordable Care Act has brought insurance to millions already.
By now, we have all heard that the rollout of the Affordable Care Act was a disaster. The federal website was dysfunctional, preventing people who are now mandated to buy insurance from signing up. Millions more received notices that their policies had been discontinued because they were not compliant with the new law’s requirements.
But despite the bad start, real numbers are showing that the law may be working better than we’d heard.
According to the website ACAsignups.net, there have been 2.1 million people signed up for insurance through the online exchanges, including the federal website, which covers Maine and 34 other states. That’s just a fraction of the estimated 40 million Americans without insurance, but it’s not all of the newly insured.
About 4.3 million people have been signed up for federally funded Medicaid in the states that expanded under the ACA. (About 5 million more people, including 70,000 in Maine, would have been eligible if their states had accepted the federal funds.)
And there are the 3.1 million people under the age of 26 who received coverage under their parents’ plans. That brings the total to 9.5 million so far, well within range of the administration’s goal of 10 million signups by the end of March.
It’s far too early to declare victory for the ACA. There are problems with the nation’s health care system that expanding insurance coverage won’t fix. In some cases, it could make things worse.
A study of Oregon’s Medicaid lottery experiment published last week in the journal Science found that expanding Medicaid increased the likelihood that a patient would seek care in an emergency room by 40 percent, even when their ailment is not an emergency.
The response to this data, though, shouldn’t be denying people coverage so they won’t seek help.
Access to primary care at night and on the weekends for people with inflexible work schedules, and public education about knowing when to go somewhere other than an emergency room are also key elements in controlling costs and making insurance premiums affordable. Maine’s experiment with the accountable care organization model could play an important role in getting people the right kind of care.
But even if health care reform in the United States is far from complete, the news so far should be encouraging. Nearly 10 million people who were an illness away from financial ruin now have health insurance. Millions more will join them as other aspects of the law are phased in.
Critics of the Affordable Care Act can still find fault, but their efforts would be best directed at improving coverage, access to care and controling costs. For nearly 10 million Americans and more on the way, there should be no going back.
By now, we have all heard that the rollout of the Affordable Care Act was a disaster. The federal website was dysfunctional, preventing people who are now mandated to buy insurance from signing up. Millions more received notices that their policies had been discontinued because they were not compliant with the new law’s requirements.
But despite the bad start, real numbers are showing that the law may be working better than we’d heard.
According to the website ACAsignups.net, there have been 2.1 million people signed up for insurance through the online exchanges, including the federal website, which covers Maine and 34 other states. That’s just a fraction of the estimated 40 million Americans without insurance, but it’s not all of the newly insured.
About 4.3 million people have been signed up for federally funded Medicaid in the states that expanded under the ACA. (About 5 million more people, including 70,000 in Maine, would have been eligible if their states had accepted the federal funds.)
And there are the 3.1 million people under the age of 26 who received coverage under their parents’ plans. That brings the total to 9.5 million so far, well within range of the administration’s goal of 10 million signups by the end of March.
It’s far too early to declare victory for the ACA. There are problems with the nation’s health care system that expanding insurance coverage won’t fix. In some cases, it could make things worse.
A study of Oregon’s Medicaid lottery experiment published last week in the journal Science found that expanding Medicaid increased the likelihood that a patient would seek care in an emergency room by 40 percent, even when their ailment is not an emergency.
The response to this data, though, shouldn’t be denying people coverage so they won’t seek help.
Access to primary care at night and on the weekends for people with inflexible work schedules, and public education about knowing when to go somewhere other than an emergency room are also key elements in controlling costs and making insurance premiums affordable. Maine’s experiment with the accountable care organization model could play an important role in getting people the right kind of care.
But even if health care reform in the United States is far from complete, the news so far should be encouraging. Nearly 10 million people who were an illness away from financial ruin now have health insurance. Millions more will join them as other aspects of the law are phased in.
Critics of the Affordable Care Act can still find fault, but their efforts would be best directed at improving coverage, access to care and controling costs. For nearly 10 million Americans and more on the way, there should be no going back.
More Medicaid, more ER use. No surprise, and no reason to deny expansion
Predictably, the results of a newly released study on Medicaid expansion ’s effect on emergency room use in Oregon are becoming another flashpoint in the debate over Medicaid expansion, which about half the states are implementing this year under the federal Affordable Care Act.
Now that the Legislature is returning to Augusta, the debate over whether Maine should also participate will only intensify. A public hearing on the latest attempt to extend Medicaid coverage is scheduled for Jan. 15.
The findings throw a wrench — though not an unexpected one — in the oft-repeated talking point of Medicaid expansion proponents that extending public health insurance coverage to more low-income residents helps to keep those residents from seeking care in the emergency room.
In 2008, Oregon carried out a limited expansion of its Medicaid program, extending coverage to 10,000 low-income adults selected by lottery from a waiting list of 90,000. The lottery essentially offered researchers a well designed, randomized experiment to help them compare the effects of Medicaid coverage on those who received it versus a similar socioeconomic group that did not.
In the 18 months following the 2008 lottery, Medicaid recipients visited the emergency rooms of hospitals near Portland, Ore., 40 percent more often than their uninsured counterparts, often for conditions that could have been treated more efficiently elsewhere. Medicaid coverage, after all, offered those low-income adults a tool to pay for care. The study also found Medicaid recipients more often visited primary care doctors. Basically, they used more health care because they had a way to pay for it.
This shouldn’t come as a surprise, and we shouldn’t be surprised this year if hospitals see more emergency room use as more gain coverage through the Affordable Care Act. The increase in visits won’t only come from Medicaid recipients. Uninsured people who purchase private insurance through Obamacare’s online exchanges are also likely to increase their use of health care, both in the emergency room and the doctor’s office. During their time without insurance, they’re likely to have gone without checkups and, potentially, had chronic conditions go undiagnosed.
The prospect that emergency room use could increase following an expansion of Medicaid isn’t a reason for Maine not to extend coverage to more than 70,000 low-income residents, including more than 20,000 who either lost coverage on Jan. 1 or will lose it in the coming months.
Rather, it should strengthen the resolve of policymakers to design a Medicaid program that delivers high-quality care — that keeps people out of the hospital for care that can be provided more efficiently elsewhere — at the lowest possible cost.
Maine has long had a need to confront excessive emergency room use. In 2006, Maine’s overall emergency room use was 30 percent higher than the national average, and Medicaid recipients were more likely than those with private insurance and the uninsured to visit the emergency room for care.
There’s reason to believe the right mix of reforms can ultimately lead to reduced emergency room use among Medicaid recipients. Some of that evidence, in fact, comes from Oregon. In 2012, well after the 2008 Medicaid coverage lottery, the state struck a deal with the federal government, pledging to save the Medicaid program money if the federal government helped the state fill a gaping budget hole.
At the core of the money-saving effort was the formation of 15 coordinated care organizations that are essentially paid to keep their local Medicaid populations — as well as their broader communities — healthy. Now, those organizations are delivering results in the form of reduced emergency room use among Medicaid recipients, lower emergency room spending and fewer hospital admissions.
Obamacare’s expansion of health insurance coverage coupled with the right mix of reforms to the way health care is provided can pay off in the form of improved care, better health and lower costs.
Maine GOP health reform a huge success while Dems rely on more of the same
Posted Jan. 05, 2014, at 11:01 a.m.
One of Maine’s most overlooked news stories in 2013 was the incredible thing that happened to our health insurance market. After several quarters of steady improvement, numbers released by the state’s Bureau of Insurance showed enormous improvements in the premiums for health insurance offered by employers.
The figures reflect the 2011 passage of a health reform law in Maine that allowed insurers to charge young, healthy people less; allowed consumers to buy across state lines; allowed small groups to band together for better coverage; and more. The law, PL 90, was passed by Republican lawmakers who then held the majority in the state Legislature and signed by Gov. Paul LePage. Some Democratic senators signed on as well.
The latest figures on PL 90 from the Bureau of Insurance are astonishing. About eight times as many small groups are seeing rate decreases as compared to before the law’s enactment. Also, those seeing rate increases are seeing much smaller ones. Before PL 90, almost 40 percent of small groups were seeing their premiums rise by more than 20 percent upon renewal. Now, about one-quarter as many are seeing similar premium spikes.
The good news has reached the individual market as well, enabling Anthem to offer $2,000 deductible plans to those 30-34 years old for $254 per month instead of $691. Adult couples in their forties with children are paying about half what they were. A 25-29 year old can get a high deductible plan for $116 per month instead of $333.
However, these are the last pure numbers we’ll ever see on the landmark health insurance reform law passed by Maine Republicans in 2011. Beginning on New Year’s Day 2014, Obamacare kicked in with full force.
Businesses know that the last quarter of 2013 was their last chance to avoid the Obamacare train wreck. That’s why we saw a 35 percent spike in the number of small groups renewing plans before the New Year.
Maine Democrats have centered their health care policy on Obamacare’s medical welfare expansion. For a lesson on why this is misguided, one need only look to past expansions of Medicaid in our state that left us with massive debts, budget shortfalls, and no improvements to physical health outcomes or reduced emergency room usage.
This latest expansion proposal would cover not Maine’s neediest elderly, disabled, or child patients, but about 70,000 able-bodied adults for whom Medicaid was never designed in the first place. It would cost the state $75 million per year and climbing over the long term. That money would have to either be raised in new taxes or slashed out of the budget from education, first responders, infrastructure and other important priorities.
Besides, with all of the broken promises swirling around President Obama’s government health care takeover, how could we trust Congress to pay for its share of the cost of expansion, especially when the feds are sitting on a $17 trillion debt?
Maine GOP health reform a huge success while Dems rely on more of the same
Posted Jan. 05, 2014, at 11:01 a.m.
One of Maine’s most overlooked news stories in 2013 was the incredible thing that happened to our health insurance market. After several quarters of steady improvement, numbers released by the state’s Bureau of Insurance showed enormous improvements in the premiums for health insurance offered by employers.
The figures reflect the 2011 passage of a health reform law in Maine that allowed insurers to charge young, healthy people less; allowed consumers to buy across state lines; allowed small groups to band together for better coverage; and more. The law, PL 90, was passed by Republican lawmakers who then held the majority in the state Legislature and signed by Gov. Paul LePage. Some Democratic senators signed on as well.
The latest figures on PL 90 from the Bureau of Insurance are astonishing. About eight times as many small groups are seeing rate decreases as compared to before the law’s enactment. Also, those seeing rate increases are seeing much smaller ones. Before PL 90, almost 40 percent of small groups were seeing their premiums rise by more than 20 percent upon renewal. Now, about one-quarter as many are seeing similar premium spikes.
The good news has reached the individual market as well, enabling Anthem to offer $2,000 deductible plans to those 30-34 years old for $254 per month instead of $691. Adult couples in their forties with children are paying about half what they were. A 25-29 year old can get a high deductible plan for $116 per month instead of $333.
However, these are the last pure numbers we’ll ever see on the landmark health insurance reform law passed by Maine Republicans in 2011. Beginning on New Year’s Day 2014, Obamacare kicked in with full force.
Businesses know that the last quarter of 2013 was their last chance to avoid the Obamacare train wreck. That’s why we saw a 35 percent spike in the number of small groups renewing plans before the New Year.
Maine Democrats have centered their health care policy on Obamacare’s medical welfare expansion. For a lesson on why this is misguided, one need only look to past expansions of Medicaid in our state that left us with massive debts, budget shortfalls, and no improvements to physical health outcomes or reduced emergency room usage.
This latest expansion proposal would cover not Maine’s neediest elderly, disabled, or child patients, but about 70,000 able-bodied adults for whom Medicaid was never designed in the first place. It would cost the state $75 million per year and climbing over the long term. That money would have to either be raised in new taxes or slashed out of the budget from education, first responders, infrastructure and other important priorities.
Besides, with all of the broken promises swirling around President Obama’s government health care takeover, how could we trust Congress to pay for its share of the cost of expansion, especially when the feds are sitting on a $17 trillion debt?
Maine people are beginning to see through the welfare expansion proposal, too, as indicated by a recent public poll.
Many of the 70,000 people proposed to be put on medical welfare with almost no co-pays and no deductibles can instead find private insurance for as little as $4 per week on the Obamacare exchange. Why should Maine state government be roped into expanding welfare if the feds are willing to subsidize private insurance without the state budget being put at risk?
Health Spending Rises Slowly for Fourth Year in a Row
By ROBERT PEAR
WASHINGTON — National health spending grew slowly for the fourth consecutive year, increasing 3.7 percent in 2012 to $2.8 trillion, or an average of $8,900 a person, the federal government said Monday.
That amounts to 17.2 percent of the economy, little changed from 17.3 percent in 2011, according to the government’s annual report on health spending.
The authors of the report — employees of the Centers for Medicare and Medicaid Services — said that the Affordable Care Act, adopted in March 2010, had only “a minimal impact on overall national health spending growth through 2012.”
So far, they said, the law has not significantly reined in or accelerated the growth of health spending.
“The relatively low rates of growth in health spending in the last four years are consistent with historical trends that we’ve seen in health spending and gross domestic product,” said Aaron C. Catlin, an economist and co-author of the report. “They are consistent with what we have seen in post-recessionary periods in the past.”
Other experts, including the Congressional Budget Office, have reduced their projections of federal health spending, based in part on their belief that pervasive changes in the health care system would endure.
However, the authors of the new report, published in the journal Health Affairs, were more cautious.
“From our perspective,” they wrote, “more historical evidence is needed before concluding that we have observed a structural break in the historical relationship between the health sector and the overall economy.”
Mr. Catlin said that delayed effects of the December 2007 to June 2009 recession — the worst in decades — appeared to be the main reason for relatively low growth of health spending in recent years.
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