ObamaCare: How can states ‘lose’ what they never had?

So, your boss promises to give you a raise next year, prompting you to make plans for how to spend that windfall. In the meantime, that boss is fired and replaced with a new boss, who nixes the raise. That means you “lost” money, right?

That’s how it works in Washington-speak.

According to Modern Healthcare, “Two nonpartisan analyses of the Graham-Cassidy bill show that many states represented by Republican senators would lose billions of dollars in federal healthcare funding through 2026 and far larger amounts after that.”

The morning paper says Nevada would lose $2 billion from 2020 to 2026.

Nevada Republican Gov. Brian Sandoval was one of 10 governors signing a letter opposing Graham-Cassidy, while Nevada Republican Sen. Dean Heller is a sponsor of the bill.

According to The Wall Street Journal, Graham-Cassidy would address the huge inequities in ObamaCare Medicaid funding between the states.

“According to the proposal’s authors, Washington in 2016 sent states anywhere from about $400 (Mississippi) to over $10,000 (Massachusetts) per beneficiary whose annual income was between 50% and 138% of the federal poverty level,” the paper reports. “In contrast, the size of the Graham-Cassidy block grant would not depend on whether a state chose to expand its Medicaid program. Thus, it would equalize the base per-person amount the federal government gives states. In 2026 it would be about $4,400 for each qualified beneficiary. The bill then adjusts these payments to compensate for factors such as demographic differences and various levels of illness among the states.”

So, some states will lose all ill-gotten windfall from ObamaCare.

Sen. Bill Cassidy at a health-care news conference in Washington earlier this month. (Getty Images via WSJ)

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Editorial: A day worthy of celebrating: Constitution Day

This Sunday, Sept. 17, marks the anniversary of one of the most propitious days in the history of this country. On that day in 1787, the representatives at the Constitutional Convention in Philadelphia signed the Constitution. It was ratified by the states and went into effect on March 4, 1789.

You remember the Constitution don’t you?

That’s the document that says the president “shall take Care that the Laws be faithfully executed …” Not waive, delay or ignore parts of laws the president doesn’t like, such as immigration laws, which the Constitution says: “The Congress shall have Power To … establish an uniform Rule of Naturalization …”

The Constitution also says, “All Bills for raising Revenue shall originate in the House of Representatives …”

But when it came to ObamaCare, which is replete with a panoply of revenue generating taxes to offset its expenses, the Senate grabbed an unrelated bill that had passed the House, cut the existing language and substituted the ObamaCare verbiage. The bill number was the only thing that originated in the House.

Yes, it’s those four-handwritten pages that give Congress the power “To regulate Commerce with foreign Nations, and among the several States …” Not to force people to engage in commerce by buying health insurance or pay a fine or a tax for not doing so.

That Commerce Clause also has been stretched to prohibit a farmer from growing grain to feed his own cattle because that affected demand for grain on the interstate market. The same rationale allows Congress to set minimum wages for jobs that have nothing to do with interstate commerce.

It also gave Congress the power to “declare War, grant Letters of Marque and Reprisal, and make Rules concerning Captures on Land and Water.” Some wars get declared, while others are just military exercises.

The instrument also says the “President shall have Power to fill up all Vacancies that may happen during the Recess of the Senate, by granting Commissions which shall expire at the End of their next Session.” Not decide for himself when the Senate is in session. At least the judiciary slapped Obama’s wrist on that one.

During ratification the Founders added the Bill of Rights, including the First Amendment that says Congress “shall make no law respecting an establishment of religion, or prohibiting the free exercise thereof …” That probably means Congress can’t order a religion to pay for contraceptions, abortifacients and sterilization against its beliefs.

We’re pretty sure the document did not envision a president’s administration creating by regulation laws the Congress refused to pass — think immigration enforcement and rules promulgated by the EPA, FEC, HHS, HUD or USDA without the consent of Congress.

Another clause gives Congress the power “to make all Laws which shall be necessary and proper for carrying into Execution the foregoing Powers, and all other Powers vested by this Constitution in the Government of the United States …” though the foregoing powers and powers vested by the Constitution part is largely ignored.

The Constitution also gave Congress the power “To exercise exclusive Legislation in all Cases whatsoever … to exercise like Authority over all Places purchased by the Consent of the Legislature of the State in which the Same shall be, for the Erection of Forts, Magazines, Arsenals, dock-Yards, and other needful Buildings …” And just when did Congress purchase and the state Legislature consent to turning over 85 percent of Nevada’s land mass to the federal government?

As James Madison said, “I believe there are more instances of the abridgement of the freedom of the people by gradual and silent encroachments of those in power than by violent and sudden usurpations …”

Happy Constitution Day, while it lasts.

A version of this editorial appeared this week in some of the Battle Born Media newspapers — The Ely Times, the Mesquite Local News, the Mineral County Independent-News, the Eureka Sentinel,  Sparks Tribune and the Lincoln County Record.

Editorial: Bill continues giving veterans health care choice

Trump signs VA Choice bill. (AP pix)

With a deadline rapidly approaching, two weeks ago President Trump signed a bill sponsored by Nevada Sen. Dean Heller that appropriates $2.1 billion to extend a program that provides veterans with an opportunity to seek health care outside the backlogged, and too often distant, Department of Veterans Affairs hospitals.

Senate Bill 114, VA Choice and Quality Employment Act of 2017, passed both the Senate and the House without a single nay vote.

Trump said at the bill signing ceremony, “This bill will ensure that veterans continue to have the ability to see the doctor of their choice — so important — and don’t have to wait or travel long distances for care. And during the campaign, I kept talking about it. People — these great, incredible veterans — our finest — they’re waiting in line for seven days, nine days, fourteen days, for ailments that could be fixed quickly, and they end up dying of things that could be taken care of very, very routinely.”

The president used the occasion to personally praise Heller, Sen. Johnny Isakson of Georgia and Congressman Phil Roe of Tennessee for shepherding the bill through a passage.

Trump also noted that the bill authorizes new community-based outpatient clinics and improves the VA’s ability to hire quality employees through improved recruitment and training.

Sen. Heller noted that the funding for the Choice Program will continue to give the 300,000 veterans living in Nevada access to services that the VA cannot provide – such as chemotherapy and certain life-saving surgeries.

“I applaud the president for signing my bill to ensure Nevada’s veterans can continue using the Veterans Choice program,” said Heller. “Nevada’s warriors have fought and served their country selflessly, and they should not be forced to jump through hoops when it comes to accessing the care and benefits they’ve earned.”

He cited as examples a Navy veteran from Lovelock named Wendell, who used the Choice Program to get a neck surgery so that he could still walk and an Air Force pilot from Battle Mountain named John who had cancer removed from his neck.

“The program also allows veterans living in rural areas to receive care near their homes,” Heller said. “Without funding for the program, rural veterans, like those in Ely, Elko, Winnemucca, and Tonopah, would have to drive hundreds of miles to get care. The Choice program allowed an Army veteran from Ely to access mental health services nearby as opposed to traveling over 200 miles to Salt Lake City, Utah, or forgoing the care entirely.”

We applaud this modest step toward privatization of our veterans’ health care.

A version of this editorial appeared this week in some of the Battle Born Media newspapers — The Ely Times, the Mesquite Local News, the Mineral County Independent-News, the Eureka Sentinel,  Sparks Tribune and the Lincoln County Record.

Editorial: Congress needs to delay or repeal health insurance tax

You might not have said anything when they announced that ObamaCare-compliant health insurance premiums are going up nearly 40 percent next year, because you get your insurance elsewhere.

You might not have said anything when they announced there will be no ObamaCare-compliant health insurance policies available in 14 Nevada counties, because you get your insurance elsewhere.

You may have just shrugged about the tax on so-called Cadillac health insurance, because that is not your insurance.

You may not have spoken out when Congress failed to pass the “skinny repeal” that would have dropped the penalties for those who don’t buy health insurance, including 90,000 Nevadans, because you have health insurance.

Now they are coming for you.

If Congress fails to act soon, everyone who pays for health insurance will get hammered with a new tax in 2018. In 2015 Congress declared a one-year moratorium on the ObamaCare provision that imposes a health insurance tax of almost 3 percent — dubbed appropriately enough with the acronym HIT — in 2017, but that expires at the end of the year.

In 2016 the HIT tax cost insured Americans $11.3 billion, but that is to increase by 26 percent if reimposed in 2018.

If not delayed or repealed, HIT is expected to tap American wallets for $14.3 billion next year, and the hardest hit will be average Americans. One analysis of the tax estimates that fully half the tax will be paid by those earning between $10,000 and $50,000 a year.

A study by Oliver Wyman broke down the cost by state and found that in Nevada those with small group family insurance would pay $453 in HIT tax. Those with large group family policies would pay $519. Even Medicare Advantage users would have to pony up an additional $271, and Medicaid users would also be hit with $120 in taxes.

Grover Norquist, president of Americans for Tax Reform, has noted, “The health insurance tax directly impacts as many as 1.7 million small businesses, 11 million households that purchase through the individual insurance market, and 23 million households covered through their jobs. The National Federation of Independent Business estimates the tax could cost up to 286,000 in new jobs and cost small businesses $33 billion in lost sales by 2023.”

This is in addition to a tax on employer provided care, a tax on innovative medicines and treatments, a tax for failing to buy insurance, a tax on medical devices and taxes on health savings accounts, Norquist says.

“The trillion dollars in higher taxes have restricted health care choice, increased costs, made saving more difficult, and granted government more control over care at the expense of individual control,” the tax reform guru argues. “The passage of these taxes also broke President Obama’s promise not to increase any form of tax on any middle class family.”

Additionally, the higher cost is expected to result in people dropping their health insurance, resulting in an increase in the uninsured.

President Obama promised that his healthcare law would decrease premiums by $2,500 a year. Instead, it increased premiums by nearly $5,000. Still Congress has not been able to repeal it.

So, the very least Congress can do is repeal or delay the costly tax on health insurance premiums. And we do mean the least.

A version of this editorial appeared this week in some of the Battle Born Media newspapers — The Ely Times, the Mesquite Local News, the Mineral County Independent-News, the Eureka Sentinel,  Sparks Tribune and the Lincoln County Record.

That’s why Heller voted for the ‘skinny’ ObamaCare repeal

Now there’s a figure we haven’t seen before.

When the topic of ObamaCare comes up in Nevada media there is invariably a reference to the number of Nevadans who gained health insurance coverage under the law. That number usually ranges from 200,000 to 400,000, but is probably really closer to 220,000.

But down in the penultimate paragraph of a front page story in the Las Vegas newspaper Sen. Dean Heller explains why he voted for the “skinny” repeal of ObamaCare, the bill that would have ended the penalties for individuals who don’t buy health insurance and companies that don’t offer health insurance as a benefit. The bill, unlike a previous one that Heller voted against, did not touch the expanded Medicaid roles that Gov. Brian Sandoval approved.

“Heller said he voted to repeal the Obamacare individual mandate because 90,000 people in Nevada are paying the tax penalty because they can’t afford insurance,” the story reports.

Heller’s only declared Democratic opponent in the 2018 election, Rep. Jacky Rosen, has lambasted that “skinny” vote and Sen. Catherine Cortez Masto voted to continue those penalties on 90,000 Nevadans.

According to a published report, those penalties will still apply in the 14 counties that in 2018 will have no ObamaCare eligible insurance providers, unless Congress changes that.

Video falsely claims Heller changed his vote:

A guide to political language in the ObamaCare debate

In our age there is no such thing as “keeping out of politics.” All issues are political issues, and politics itself is a mass of lies, evasions, folly, hatred, and schizophrenia. — George Orwell

The political dictionary turns words and thoughts on their heads. Coercion is virtuous. Ending extortion is thievery.

This week the Senate voted 48-51 against the so-called “skinny” ObamaCare repeal. The bill would have ended the mandate that everyone must purchase health care insurance or pay a stiff penalty. The “skinny” bill lowered the penalty to $0. It also ended the requirement that employers with 50 or more employees provide a specific amount of health insurance or pay a penalty.

Nevada Republican Sen. Dean Heller voted for taking the gun away from the heads of Americans and let them decide for themselves whether to purchase health insurance.

Nevada Democratic Sen. Catherine Cortez Masto voted against the repeal and is quoted in the morning paper as saying:

“In the dead of night, Senate Republicans tried and failed to rip away the health care of hundreds of thousands of Nevadans and millions of Americans. Their failed attempt is the result of overwhelming public opposition – your calls, letters, protests and tweets put Republicans on notice.

“The Affordable Care Act has provided lifesaving, affordable health care coverage to millions. …”

Las Vegas Democratic Rep. Jacky Rosen, who has said she will seek to unseat Heller, was quoted as saying that Heller had promised he wouldn’t vote for a bill that takes health care from hundreds of thousands of Nevadans, but, “Last night he voted to do just that.” (The quote is in the print edition, but not the online version.)

See. Ending extortion is theft.

But this is nothing new when it comes to discussing ObamaCare. Antonin Scalia’s dissent in the Supreme Court decision upholding ObamaCare points out the newspeak and doublethink required:

The somersaults of statutory interpretation they have performed (“penalty” means tax, “further [Medicaid] payments to the State” means only incremental Medicaid payments to the State, “established by the State” means not established by the State) will be cited by litigants endlessly, to the confusion of honest jurisprudence. And the cases will publish forever the discouraging truth that the Supreme Court of the United States favors some laws over others, and is prepared to do whatever it takes to uphold and assist its favorites.

 

Catherine Cortez Masto at UMC. (KSNV pix)

 

 

Editorial: Repeal ObamaCare and let states handle health insurance

The bad news for those who live in Clark, Carson City and Nye counties is that companies offering ObamaCare-compliant health insurance policies have requested 38 percent premium increases in 2018. The good news for those in the rest of Nevada is that their ObamaCare premiums will not be going up because there are no companies offering such policies.

In pulling out of those counties Anthem stated the “individual market remains volatile” and “planning and pricing for ACA (Affordable Care Act)-compliant health plans has become increasingly difficult due to a shrinking and deteriorating individual market …”

As libertarian economist F.A. Hayek warned years ago, central planning, such as ObamaCare, which dictates to private companies to whom they must sell their services and at what price, cannot possibly work. There are too many abstract factors that only a free market can account for. Witness the lack of willing ObamaCare insurance sellers in 14 Nevada counties.

Congressman Mark Amodei, who represents six of the counties without an ObamaCare option, said, “Sadly, this news isn’t shocking. It represents another symptom of the sickness that is killing America’s health care system. While there are plenty of arguments on how to fix this, regardless of your political views, it’s clear the status quo isn’t working and is in need of serious repair. Once again, I’m left wondering, when is Congress going to put the issue ahead of the politics? I will continue to focus on the facts and the policy options to be applied in Nevada. As always, my goal is to ensure that any reform package increases Americans’ access to quality and affordable care, while paying respect to rural communities like ours that are being hit the hardest.”

The House version of ObamaCare repeal and replace is currently stalled in the Senate, where Nevada Sen. Dean Heller is balking at supporting it due to the potential reduction in Medicaid funds for Nevada. Gov. Brian Sandoval opted to expend Medicaid under ObamaCare, and Heller is reluctant to retrench.

Apparently Nevadans are of two minds when it comes to deciding what to do about ObamaCare.

According to a recent American Medical Association survey, when asked straightforward whether ObamaCare was a good or bad idea, fully 45 percent of Nevadans say it was a good idea, while 37 percent say it was a bad idea.

But when you get down to whether Congress should change that law, the opinions are more varied. When asked, “As you may be aware, in order for the health care legislation passed by the House to become law, the United States Senate must review and pass the legislation. Do you think the U.S. Senate should …”

Seven percent said pass the House legislation as is; 23 percent said make minor changes to it and pass it; 27 percent said make major changes to it and pass it; 33 percent said Congress should not pass any part of the House legislation, thus leaving ObamaCare in place

So, 33 percent say leave it as is, while 57 percent call for some changes.

But when asked about specific changes being proposed, the Nevadans surveyed largely opposed those changes.

They opposed dropping the mandate to buy health insurance. They opposed dropping various federal subsidies and eliminating the ObamaCare requirement that all health plans sold must provide a standard set of government-established benefits, including mental health services, addiction treatment, maternity care and preventive health services with no out-of-pocket costs.

Nevadans favor providing federal funding for states to cover people with pre-existing conditions, the survey says.

Frankly, Congress should repeal ObamaCare and turn over policing of health insurance to the states, which under the 10th Amendment is the proper jurisdiction for wielding power in this arena. Congress should merely exercise the power of the Commerce Clause to assure health insurance can be sold across states lines.

Leaving the status quo in place is not an option, as rising premiums and deductibles and a lack of willing sellers attests.

A version of this editorial appeared this week in some of the Battle Born Media newspapers — The Ely Times, the Mesquite Local News, the Mineral County Independent-News, the Eureka Sentinel,  Sparks Tribune and the Lincoln County Record.

Nate Beeler cartoon