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

Newspaper column: Senate candidates are on opposite ends of political spectrum

Catherine Cortez Masto debates Joe Heck in Senate race faceoff recently. (R-J photo via AP)

Catherine Cortez Masto debates Joe Heck in Senate race faceoff recently. (R-J photo via AP)

The race to fill the U.S. Senate seat of retiring Sen. Harry Reid offers voters a marked contrast in candidates, especially rural voters.

Reid has handpicked former Nevada Attorney General Catherine Cortez Masto to be his Democratic heir apparent, while Republicans have nominated Congressman Joe Heck, an emergency room physician by profession and a brigadier general in the Army Reserve.

The issue of what to do about federal public lands alone finds the two candidates pegged on opposite ends of the political spectrum.

Rep. Heck argues that far too much of Nevada — more than 86 percent — is controlled by federal government land agencies, which restrict productive uses.

“I believe that the best stewards of our precious lands are the people closest to it, who understand Nevada’s Western way of life, not bureaucrats in Washington,” Heck says on his website. “I opposed the president’s recent unilateral, executive land grab designating the Basin and Range Monument because it went well beyond the intention of the Antiquities Act and it did not have the support of local residents. I also cosponsored legislation called the Nevada Land Sovereignty Act of 2015, which prevents the president from taking executive action designating or expanding national monuments without Congressional approval or local support.”

In Congress, Heck boasts that he has fought to stop the listing of the greater sage grouse as an endangered species because of how it would harm the state’s economy.

“As your Senator, I will fight to transfer more of our public lands back to our state so that Nevadans can decide how to best utilize the land,” the congressman says.

In sharp contrast, Cortez Masto is cut from the same cloth as Reid, who applauded the president’s unilateral designation of Basin and Range Monument and has generally opposed handing over greater control of public lands to the state.

She has said on her website, “I will fight to ensure that future generations are able to experience the incredible natural resources Nevada has to offer, just like I did,” meaning leaving it in the hands of federal bureaucrats who have failed to manage the range to prevent wildfire and have failed to control the overpopulation of feral horses that are starving from overgrazing and jeopardizing other wildlife as well.

She also embraces Reid’s blind allegiance to the not-ready-for-free-market green energy acolytes.

“As U.S. senator, I will work to ensure we are fully utilizing Nevada’s abundance of wind, solar, and geothermal energy resources and increase investments in renewable energy technology to create green jobs here in Nevada,” she says. “I will also work to preserve and protect Nevada’s incredible public lands — a unique, valuable resource in Nevada that creates thousands of jobs and brings in millions of dollars into our state’s economy every year. We must safeguard our natural resources and stop big oil from receiving unnecessary tax subsidies” — unlike subsidies for green energy?

When it comes to ObamaCare and its skyrocketing premiums and deductibles and disappearing providers, Heck has already worked to pass legislation that would exempt residents of counties that have only one ObamaCare provider from the requirement to pay a tax penalty if they fail to maintain minimum health coverage under the so-called Affordable Care Act. Ten rural Nevada counties this next year will have only one provider.

“As an emergency department physician, one of the reasons I ran for Congress was the passage of the disastrous Affordable Care Act,” Heck says “The law has failed to meet its stated goals of increasing access to healthcare and reducing costs. Recent events suggest the law is having the opposite effect. Major insurers are leaving the exchanges and others are predicting significant premium hikes for their customers, making it anything but affordable.”

For her part, as attorney general, Cortez Masto refused then-Gov. Jim Gibbons’ directive to file suit to challenge the ObamaCare law, even though she was required to do so by state law — a dereliction of duty.

Heck recently voted to delay an Obama administration Labor Department rule that would vastly increase the number of workers who would have to be paid overtime and thus cripple many small businesses and result in job losses.

Meanwhile, Cortez Masto is advocating that Congress should raise the minimum wage, another job crushing move.

When it comes to the Second Amendment, Heck has an “A” rating from the National Rifle Association, while the NRA has spent $1 million on ads opposing Cortez Masto.

A version of this column appeared this week in many of the Battle Born Media newspapers — The Ely Times, the Mesquite Local News, the Mineral County Independent-News, the Eureka Sentinel and the Lincoln County Record — and the Elko Daily Free Press.

Nevada ObamaCare 2017 premium increase less than half of national average

Perhaps you’ve heard, ObamaCare premiums are going up 25 percent on average next year for the most common coverage. It was in all the papers.

But in Nevada the rates are only going up 8 percent — which was not in all the papers. That’s good news, better news and bad news. It is good for those purchasing insurance on Nevada’s health insurance exchange that the rates aren’t up as much as the national average and nowhere close to Arizona’s skyrocketing 145 percent. The better news for the vast majority of ObamaCare customers is that the out-of-pocket expense is increasing by zero percent. The bad news is that the taxpayer is picking up the increase.

The Kaiser Family Foundation used the second-lowest silver premium for a 40-year-old non-smoker to analyze the changes state by state. Here is the chart:

aca-by-state

Actually, the Nevada health insurance exchange reported the likely insurance rate changes back in August.

Health Plan of Nevada (UnitedHealthcare’s HMO) is increasing rates in 2017 by 10.4 percent increase for its 50,000 members. Prominence (formerly Saint Mary’s HealthFirst) is going up 17.51 percent increase for its 11,000 members. Anthem (HMO Colorado/HMO Nevada), which is the only plan available in 10 rural Nevada counties is going up 8.58 percent for its nearly 10,000 members. Anthem (PPO, also called Rocky Mountain Hospital and Medical Service) is increasing 13.8 percent for 19,000 members.

The overall weighted average proposed rate increase for the entire individual market in Nevada (including the exchange carriers) works out to 15.02 percent for 2017, which is higher than the 9.58 percent hike in 2016.

 

No one is yet reporting, so far as I can find, the total hit the taxpayers will be absorbing for the premium increases.

AP noted that the spike in premiums generally does not affect the employer-provided plans that cover most workers and their families.

According to a recent editorial, ObamaCare is particularly affecting rural Nevadans.

(AP photo via WSJ)

(AP photo via WSJ)

Instead of addressing state’s problems lawmakers give us diversion

Football is, appropriately enough, a gladiatorial sport.

Nevada public school graduates scored worst in the nation on ACT tests, which measure college preparedness.

The state Supreme Court ruled the education savings accounts law, which would help students escape failing public schools, funding method was unconstitutional, but it was not urgent enough to consider in a special session of the Legislature.

Wild horses overpopulate the range and are running ranchers out of business.

Federal public land restrictions are hampering mining, ranching, oil and gas exploration and other economic uses.

Ten counties face monopolies and higher premiums and deductibles when it comes to access to ObamaCare.

Nevada needs to improve its transportation infrastructure and is asking voters in each county to allow fuel taxes to be indexed to inflation.

Nevada faces more than $40 billion in unfunded liabilities for public employee pensions.

The next biennium budget faces a $400 million shortfall in revenue even though lawmakers in 2015 raised taxes $1.5 billion, the highest increase ever.

So what do the governor and the state lawmakers do during this past week’s special session? They agree to spend $750 million in tax money to help build a football stadium for a billionaire casino owner and a billionaire NFL team owner.

On top of that the Nevada Department of Transportation says $900 million in road projects will be needed to be accelerated to accommodate the stadium traffic, which means $900 million in roadwork elsewhere will be delayed.

Instead of addressing the public service needs, they give us bread and circuses — without the bread.

Editorial: Rural residents being harmed by health care changes

From the beginning under ObamaCare rural residents throughout the nation have had fewer choices for health care coverage and have been charged considerably higher premiums than those in urban areas.

As insurers flee the ObamaCare market there is even less competition and still higher rates.

It has reached the point that in 2017 a majority of Nevada counties — Esmeralda, Mineral, Humboldt, Pershing, Churchill, Lincoln, White Pine, Eureka, Lander, and Elko — will have only one firm offering coverage under the ObamaCare program.

To ameliorate the blow to residents of single-provider counties nationwide, Nevada Republican Reps. Joe Heck, Mark Amodei and Cresent Hardy a couple of weeks ago introduced a bill that amends the Internal Revenue Code to exempt those residents from the requirement to pay a tax penalty if they fail to maintain minimum health coverage under ObamaCare, or as it is laughably titled, the Affordable Care Act.

Heck is running for the Senate seat being vacated by the retirement of Harry Reid, who rammed through ObamaCare — using deals such as the Cornhusker Kickback and the Louisiana Purchase — without obtaining the vote of a single Republican.

The bill is called Protection from Insurance Exchange Monopolies Act, H.R. 6049. It has been referred to the House Ways and Means Committee.

In the coming year there will be only three companies offering ObamaCare coverage in Nevada — Anthem, Health Plan of Nevada, and Prominence Health Plan (formerly St. Mary’s). In the 10 counties listed above the only carrier option is Anthem.

All three congressmen commented on the necessity of their bill in a press release.

“The better way to solve rural Nevada’s access to health care is to replace Obamacare with a fairer and more patient-centered approach,” Hardy said. “But as long as ObamaCare is the law, Nevadans shouldn’t be forced to pay a tax on a monopoly caused by a government mandate that forced out other competition. All Nevadans, and particularly those in our rural communities, deserve access to more health care choices and lower health care costs.”

“The Affordable Care Act promised Nevadans more healthcare choices and lower costs but, as expected, we now know those promises were empty” Heck said. “Nevadans in 10 counties will be living under an ObamaCare insurance monopoly in 2017 and it is unfair to inflict a penalty tax on residents in counties with only one carrier option. This is yet another example of the failures of the ACA and highlights the urgent need to replace the broken parts of the law with healthcare reforms that actually expand access to quality, affordable care.”

“President Obama promised his healthcare law would bring Americans ‘more choice’, ‘more competition’, and ‘real health care security,’” Amodei said.  “Despite the president’s assurances, ObamaCare has delivered nothing more than higher premiums and less choices – with millions of Americans having even fewer choices in 2017. In Nevada, ObamaCare will soon be leaving residents in 10 counties with only one choice – choose what Washington says is right for them – or pay the penalty. By allowing people who reside in areas with less than two provider options to be exempt from the individual mandate, our bill provides much needed relief to those who have been left with no alternative.”

Repealing ObamaCare is the preferred solution, but this is a worthy patch in the meantime.

Adding further problems for rural communities, in January the Centers for Medicare and Medicaid Services changed the reimbursement process for medical suppliers. CMS is now using bids from metro areas to start cutting reimbursement rates in rural areas.

But providing care in rural areas can be more expensive due to distances between patients and providers and the time and expense it takes to cover those distances. The Medicare reimbursement rate has been cut by more than 50 percent for many items.

Health care providers are hoping Congress remedies the devastating cuts to Medicare reimbursement rates that are impacting medical suppliers throughout the country. Many providers are cutting services or refusing to take new patients. Some are even closing their doors.

Congress needs to act on both of these problems for rural America.

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.

Where is the nearest doctor?

Where is the nearest doctor?

Imagine what the ad would say if she abdicated her duty?

The political columnist in the morning paper spent his customary column inches customarily defending a Democratic candidate — Catherine Cortez Masto in this case — against attacks from conservatives.

Catherine Cortez Masto (AP photo via USA Today)

The columnist goes on at considerable length to say Masto did not take quid from the taxi industry in order to wage quo against Uber, the ride sharing app. This claim is in an ad reportedly funded by the Koch brothers’ Freedom Partners Action Fund.

The columnist concludes she was just doing her job and a judge agreed with her, but he closed with this: “If she’d ignored the issue, she could have been accused of abdicating her duty. And can you imagine that attack ad?”

Does he mean like the time she abdicated her legal duty to sue to block ObamaCare when directed to do so by the governor?

NRS 228 states unequivocally:

“Whenever the Governor directs or when, in the opinion of the Attorney General, to protect and secure the interest of the State it is necessary that a suit be commenced or defended in any federal or state court, the Attorney General shall commence the action or make the defense.” (Emphasis added.)

The governor directed. If she believed such action was frivolous, she could have sought the advice of the courts. Instead, the state’s top lawyer simply ignored the law.

Another section of NRS 228 that might apply in such a situation:

“If the Attorney General neglects or refuses to perform any of the duties required of him or her bylaw, the Attorney General is guilty of a misdemeanor or is subject to removal from office.” (Again, emphasis added.)

Waiting for the ad.

By the way, though the columnist fails to mention it, Cortez Masto is running for Harry Reid’s senate seat against Republican Rep. Joe Heck and has been endorsed by uber-Democrat Reid.

 

 

All the news that fits … again

There is a fine editorial in today’s newspaper pointing out the lackadaisical attitude of the people who spend our money.

It seems The Associated Press reported a couple of days ago that the Silver State Health Insurance Exchange has spent $368,000 with nine organizations over six months for “outreach” to try to sign up additional customers for ObamaCare. But there was an abysmal lack of oversight by the government agency to make sure any outreach actually took place.

The AP said an audit found the agency was billed for 17,900 staff hours, but could only confirm outreach took place at events for about 3,000 of those hours, or 17 percent, and two of those were for belly dancing and lingerie.

“Six of the nine navigator organizations offered explanations for the time they weren’t at events, saying they were working on social media posts, emails, training or helping with walk-in customers, but auditors said it was still unclear whether those paid hours were spent on exchange-related activities,” the AP story relates.

The executive director of the exchange defended the outreach program as successful but conceded the agency needs to appropriately manage expenses, while offering the excuse that it is a small agency with limited resources.

The editorial suggests there needs to be a bit more oversight when spending our tax dollars.

Please pardon the alert reader who finds this to be a surprise, because, so far as I can find, the morning newspaper has never run said AP story. The Sun ran online a mere five paragraphs of the story with none of the salient details. The Eureka Sentinel bannered the story this week.

Well, the morning paper readers got the gist of the tale from the editorial page today.

All the news that fits … in Eureka.

sentinel