RUTHFULLY YOURS

Senate conservatives wish the health-care bill was more ambitious on deregulation, and so do we, though the benefits of its state waiver feature are underappreciated and worth more explanation. This booster shot of federalism could become the greatest devolution of federal power to the states in the modern era.

One of ObamaCare’s most destructive legacies is a vast expansion of federal control over insurance and medicine—industries that did not exactly lack supervision before 2010. This included annexing powers that traditionally belonged to states. The Obama Administration then used regulation to standardize insurers as public utilities and accelerate a wave of provider consolidation that has created hospital and physician oligopolies across the country.

Once in command, the federal government rarely eases off or returns control, but the Senate bill does. The Affordable Care Act included a process in which states could apply for permission to be exempted from some rules, but conditions are so onerous that these 1332 waivers have been mostly notional. The Senate Republican draft bill makes this process quicker, more flexible and broader, which could launch a burst of state innovation.

The Senate bill is broader than the House’s Meadows-MacArthur waivers that only apply to a few so-called Title I regulations. Creative Governors could use the 1332 exemptions to explore a wider variety of reforms to repair their individual insurance markets, lower premiums and increase access to care.

Introducing many competing health-care models across the country would be healthy. California and South Carolina don’t—and shouldn’t—have to follow one uniform prototype designed in Washington, and even a state as large as California doesn’t have the same needs from region to region.

If nothing else the repeal and replace debate has shown that liberals, conservatives and centrists have different health-care priorities, and allowing different approaches and experimentation would be politically therapeutic. The more innovative can become examples to those that stay heavily regulated.

Some conservatives in the Senate and the House are despondent because neither bill repeals the federal rules related to pre-existing conditions known as guaranteed issue and community rating. They’re right that these mandates are destructive. Community rating, which limits how much premiums can vary among people with different health status and risks, tends to blow up insurance markets, as ObamaCare is now showing.

But at least for now, conservatives have lost this political debate. There’s no Senate majority for catching the pre-existing conditions grenade, Governors aren’t hot on the idea either, and even insurers don’t want to return to the days of medical underwriting.

The Senate bet is that the 1332 waivers can help create enough of a recovery in insurance markets to overcome the distortions of these rules and bring down rates. The bill also relaxes ObamaCare’s age bands to a 5 to 1 ratio from a 3 to 1 ratio, meaning insurance for the oldest beneficiaries can be priced five times as high as for the youngest. Since age is a proxy for health risks and expenses, and a 5 to 1 ratio is close to the true actuarial cost of care, the policy result in practice is a wash.

Former President Barack Obama is joining the demagogic slugfest against the GOP’s latest bill to repeal and replace Obamacare. He claims the bill would “ruin Medicaid.”

Not so fast, Obama. Your health care law ruined Medicaid. Now, about half of all women who give birth in the United States are on Medicaid, a staggering figure.
The Republican bill, awaiting Senate action, will reform Medicaid, restoring its original mission and ensuring its future.

Medicaid was created in 1965 as a safety net for the poor. But Obamacare distorted it, edging the U.S. closer to a Medicaid-for-all or single-payer system. Swelling the Medicaid rolls — not making private insurance affordable — is the main way Obamacare dealt with the uninsured.

Almost 75 million people are now enrolled, 20 million more than in Medicare, the program for the elderly. If the repeal bill doesn’t pass, Medicaid enrollment will soar to 86 million by 2026, according to a Congressional Budget Office analysis released Monday.

Who’s picking up the tab for this vast Medicaid expansion? You. Worse, you pay twice — once as a taxpayer, and then again as an insurance consumer. Families with private insurance pay $1,500 to $2,000 or more in added premiums yearly already to keep Medicaid afloat. The more Medicaid expands, the higher their premiums will go. That’s because Medicaid shortchanges hospitals and doctors, paying less than the actual cost of care. They make up for it by shifting the costs onto privately insured patients. Ouch.

That cost shifting only works until Medicaid enrollment grows too large. The Mayo Clinic warned three months ago that Medicaid enrollment has reached the tipping point. The renowned clinic announced it will have to turn away some Medicaid patients or put them at the back of the line, behind patients with commercial insurance.

Years earlier, when Obamacare was still being debated in Congress, the dean and CEO of Johns Hopkins Medicine, Dr. Edward Miller, issued a similar warning: Allowing a vast expansion of Medicaid could have “catastrophic effects” at places like Hopkins.

His dire prediction came true. Obamacare loosened Medicaid eligibility rules and urged states to enroll as many people as possible, with Uncle Sam paying 100 percent of the tab until 2016 and 90 percent or more thereafter.

Medicaid enrollment spiked in many states, including New York, where it skyrocketed up by a third to 6.3 million. Blame the incentive to rake in federal dollars.

And waste money. Roughly 10.5 percent of Medicaid payments are in error. Any company with that record would be out of business.

Incoming elected administrations, especially the Obama transition team of 2008 in the case of Russia and Iran, seek contacts with foreign diplomats before formally entering office.https://amgreatness.com/2017/06/28/late-great-russian-collusion-myth/

Most presidential campaigns are staffed by at least a few free-lancing opportunists who see their candidate as a nexus for profiteering. There is no need for a reminder of the lucrative careers of Bill Clinton from 2009-2012, or of Hillary Clinton’s brother, or of the nature of some of John Podesta’s investments. And foreign governments, our own included as in the case of the Obama Administration’s entrance into the Israeli elections, are frequently accused of trying to sway or indeed interfere with another nation’s campaign cycles.

Yet what is strange about the charges of collusion between the Trump campaign and the Russian government is that those landscapes were concocted into something supposedly criminal and uniquely applicable to Donald Trump’s election and presidency. Indeed, one of the strangest events in recent political history was the post-election false news narrative that Trump and the “Russians” had colluded during the campaign to rob Hillary Clinton of a sure victory.

The discredited concoction lingers to this day, despite the fact that former FBI Director James Comey on three occasions told Trump that he was not the subject of any investigation about collusion with the Russians.

Both the former Director of National Intelligence James Clapper and former CIA Director John Brennan (both foes of Trump) at various times admitted that there was no intelligence, to their knowledge, that implicated Trump as a colluder with Vladimir Putin to gain advantage over Clinton. Former Homeland Security Secretary Jeh Johnson seconded that consensus by conceding there was no evidence of any Trump campaign effort to persuade the Russian to alter the elections. In a more general sense, Barack Obama (who had intelligence reports of Russian election-cycle hacking) three weeks before the election, and the assumed certain victory of Hillary Clinton, had dismissed entirely the idea that any party could taint a U.S. election. Obama went on to accuse Trump of whining for even suggesting that the impending election might be questioned by impropriety.

Even news producers at CNN, the chief engine that drove the collusion fairy tale, were caught on camera admitting that the entire story was mostly “bulls—t”. And one producer added, “And so I think the president is probably right to say, ‘Look, you are witch hunting me.’” Recently, three staffers, including a reporter and an executive editor, resigned from CNN in disgrace for peddling more fake news accounts of collusion between Trump and the Russians.

Who Really Blew the Election?

Here’s my problem: I’m a Bill of Rights guy in what’s become a Second Bill of Rights country. That’s why I can’t work up much of a pulse over the intramural healthcare debate among Senate Republicans.https://amgreatness.com/2017/06/27/progressive-washingtons-obamacare-train-wreck/

The Democrats, the party of Obamacare and the dream of socialized medicine, has for Trump-deranged reasons become the Party of No on the matter of addressing the catastrophe they have wrought. So, the Senate debate, like the GOP-controlled House debate before it, is a family fight. The family is splitting up, though. The dynamic that led to Donald Trump’s election tells us why. The party no longer stands for what it has long purported to stand for: freedom, self-determination, and limited government. Nothing better illustrates this than its Janus-faced approach to Obamacare.

Republicans, of course, have campaigned full-throatedly on the imperative to “repeal and replace” Obamacare for seven years. They’ve never been serious about it for a moment.

To be trendily trite, I’m old enough to remember when “repeal and replace” was deceptive because it understated the party establishment’s commitment to the GOP’s conservative base. In the beginning, Republicans boldly beat their chests and bellowed that they’d repeal Obamacare root-and-branch. “Repeal and replace” was actually the first moving of the goalpost, the first implicit admission that, in principle, they were all for a government-managed health-insurance system. If you really want to move to the free market, you repeal statism. When you’re talking “and replace,” you’re just haggling over the price.

In a few short years, “repeal and replace” has gone from a subtle understatement of what Republicans conned voters into believing they’d do, to a gross overstatement of what they’re willing to try. No one who has been paying attention can be surprised by this regression.

Obamacare has always been sleight-of-hand, on both sides. From the beginning, Democrats lied about its feasibility: “Like your doctor, keep your doctor,” “like your plan, keep your plan,” plunging premiums, lower costs, etc. All the while, they knew it was unworkable. That was not a flaw, it was the design. The plan was to orchestrate a collapse of the private insurance market, blame the private insurers rather than the death-spiral regulations, and gradually inure people to the need for a complete government takeover—the panacea of “single payer.”

Equally patent is that, at most, Republicans wanted to slow the train down, not stop it. Many of them, after all, have been on it from the get-go. “Repeal!” and, then, “repeal and replace” made for great fundraising and electoral wedge issues. But when it got down to brass tacks, it was always “Maybe the Supreme Court will strike it down,” or “Maybe we can sue Obama over these waivers,” or “Maybe it will collapse of its own weight.”

Republicans have controlled the House, where all spending originates, since 2010, and the Senate since 2014. Not a dime for Obamacare could have been spent had they not approved it. Never did they use the power of the purse as the Framers intended: Congress’s decisive check against ruinous policy.

Every year, the federal government pays $125 billion in tax dollars for federal pensions. In spite of this being such a large amount of money, there is a remarkable lack of transparency surrounding these funds.

Taxpayers deserve to know the details of the lucrative pensions of career bureaucrats and members of Congress. Basic questions deserve answers: How many years were worked, how much money was paid-in and by whom, how quickly did they break-even on their own contributions, and just how much did the taxpayers finance?

Releasing data on federal pensions will require an act of Congress, and we are leading the way. The Taxpayer Funded Pension Disclosure Act will empower citizens with the data and technologies to hold their government accountable like never before.

Today, pension data is not merely opaque; it is literally hidden in an undergroundcomplex in Pennsylvania. Federal employees hand-calculate federal pensions in a process that has not changed since the Cold War era. How many mistakes has the government made in that cavernous complex? No one knows because we’re all in the dark.

The case for greater federal pension transparency can easily be made by looking at the fraud that has already been exposed by non-profit organizations like Open The Books at the state level. In the 32 states that have pension transparency – including California, Illinois, New York and Oregon – citizens have exposed significant amounts of waste and mismanagement.

Auditors at Open the Books uncovered a pair of union bosses in Illinois who taught as substitutes for one day in public schools and then retired, in order to collect a pension that will amount to $1 million dollars over their lifetime.

At the Port Authority of New York and New Jersey, data shows that a police lieutenant with a final salary of $129,000 received a starting pension of $172,000. An assistant airport operations manager retired with a final salary of $89,000, but soon began collecting a $103,000 pension. An electrician quit with a base salary of $76,000 and collected a pension of $79,000.

With relatively little transparency, we’ve found numerous examples of waste and abuse across the country. Consider what we’d find if we could see more at the federal level.

For instance, former IRS chief Lois Lerner used her authority to infringe the rights of American citizens and consistently obstructed congressional investigations. Wouldn’t it be nice to see her pension information? Her pension is estimated to equal nearly $2 million in lifetime payout.

According to the Office of Personnel Management, in 2012, 21,000 retired federal employees were collecting pensions exceeding $100,000. Since then, the number has likely doubled or tripled. Moody’s estimates federal employee pensions have a $3.5 trillion-dollar unfunded liability, with taxpayers on the hook to guarantee it all. All of this information should be posted online in real time.