Coburn: Medicaid Recipients Should Pay More For Health Care To Help Lower The Deficit

By Igor Volsky on Dec 14, 2010 at 8:10 pm

The Hill’s Julian Pecquet reports that in light of Judge Henry Hudson’s ruling to invalidate the individual mandate in the Affordable Care Act, Sen. Tom Coburn (R-OK) is passing around an old Congressional Budget Office (CBO) report touting the deficit savings of eliminating the requirement. The report estimates that the change could “bring in $202 billion from its 2014 start date to 2019,” while causing “the number of uninsured people to increase by 16 million — to 39 million — over the same time period”:

The penalty itself — $695, or 2.5 percent of income, whichever is greater, starting in 2016 — would bring in about $17 billion from 2010-2019, CBO’s scoring window. But that would be more than offset by savings from the millions of people who would choose not to take advantage of federal health programs and subsidies.

According to the CBO, repealing the mandate would reduce the number of people on Medicaid and the Children’s Health Insurance Program by 6 million to 7 million people; reduce those with individual coverage by 5 million; and reduce those who choose employer-sponsored coverage by 4 million to 5 million people.

The savings to Medicaid would amount to about $113 billion, according to CBO, while the government would save another $39 billion in uncollected subsidies and about $60 billion in increased tax revenues linked to the reduction in employer coverage.

First, it’s refreshing to see the Republicans citing the CBO again, an agency they had previously maligned as a group of hardworking geeks who simply do what they’re told and thus produce analysis that is grounded on flawed assumptions that can’t be trusted. Secondly, it’s telling that Coburn is simply dismissing the increase in the uninsured and ignoring the fact that if you eliminate the mandate and remove any incentive for young people to purchase coverage, you’re dramatically increasing the costs for those individuals who need insurance. From the CBO’s analysis:

This adverse selection would increase premiums for new non-group policies (purchased either in the exchanges or directly from insurers in the non-group market) by an estimated 15 to 20 percent relative to current law. Without the mandate, Medicaid enrollees would also have higher expected health spending, on average, than those enrolled under current law.

Coburn’s suggestion that we should lower the deficit by asking the poorest Americans to pay more for health insurance coverage is troubling, no? I would just point out that 18% of Oklahomans live in poverty and 20% rely on Medicaid for coverage. But, at least they’ll be doing their part to pay off the national debt.

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Economy

HAMP’s Flop Continues As 21 Percent Of ‘Permanent’ Mortgage Modifications Fail

By Pat Garofalo on Dec 14, 2010 at 7:10 pm

When last we visited the Home Affordable Modification Program (HAMP) — which is the Obama administration’s signature foreclosure prevention program — it was badly sputtering, spending little of the money allocated to it. More borrowers were being booted from the program mid-stream than were receiving permanent mortgage modifications.

The Congressional Oversight Panel released a report today that doesn’t make the picture any prettier. To date, HAMP has processed about 500,000 permanent loan modifications, out of 1.4 million trial modifications that have been initiated. And the redefault rate (meaning the number of borrowers who again fall behind on their mortgages, post-modification) is an ugly 21 percent:

Figure 19 shows that although only around 1 percent of permanent modifications are 90+ days delinquent within their first three months, the number jumps to 5.5 percent by month six and 11 percent by month nine; within a year, 21 percent of HAMP permanent modifications are 90 or more days delinquent, at which point they are disqualified from the program.

As Naked Capitalism’s Yves Smith noted, “HAMP should have done much better by virtue of putting borrowers through a trial mod, plus offering deeper payment reductions than typical private mods. How much better is an open question, but a 21% first year redefault rate says the program will fall far short of Treasury’s goal that the program would show only 40% defaults over the five year ‘permanent’ mod time frame.” Indeed, by just about any measure, HAMP has underwhelmed.

At this point, the Congressional Budget Office estimates that just $12 billion of the $50 billion dedicated to foreclosure prevention will be spent, which brought Mike Konczal to note that some members of Congress explicitly voted to release the second tranche of TARP funds because it included help for homeowners that has yet to materialize:

In exchange for getting the second half of TARP, the Obama administration promised publicly to dedicate at least $50 billion for foreclosure relief and to push for mortgage modification…People took votes, politically difficult and unpopular votes, because of these promises, and they have failed to be delivered.

HAMP has suffered from a nasty confluence of bank intransigence, design trouble, and lack of concern over its poor performance. While Congress and the administration grapple with just how big a tax cut to give to the richest estates in the country, a few moments dedicated toward fixing this fundamentally flawed program are certainly in order. Here are a few suggestions.

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Politics

Birther Army Doc Who Refused To Serve Pleads Guilty, Faces Up To Three Years In Prison

By Ben Armbruster on Dec 14, 2010 at 6:35 pm

Earlier this year, Lt. Col. Terrence Lakin, an 17-year Army veteran, refused to report for duty at Fort Campbell, KY because he said his orders emanated from an illegal President who is not a natural born U.S. citizen. As such, Lakin said he had “no choice” but to disobey the orders and that he would “gladly deploy” if Obama released his birth certificate.

In September, a military judge ruled that Obama’s birth certificate was irrelevant in Lakin’s case, thus he was not able to raise the issue in a military court today where he pleaded guilty to two charges related to the case:

An Army doctor who disobeyed orders to deploy to Afghanistan because he questions President Barack Obama’s citizenship pleaded guilty Tuesday to one of two charges against him.

Lt. Col. Terrence Lakin of Greeley, Colo., pleaded guilty in a military court to a charge that included not meeting with a superior when ordered to do so and not reporting to duty at Fort Campbell.

Lakin faces up to 18 months in prison and dismissal from the Army. He pleaded not guilty to a second charge of missing a flight he was required to be on, and the court-martial proceeding continued on that count.

Stars and Stripes reports that a group of about 30 birthers attended Lakin’s hearing, carrying signs that read “usurper” and “ineligible.” For his part, Lakin still believes Obama was born outside the U.S.:

At the hearing, Lakin told the court that he still believes that questions surround Obama’s presidency but that he should not have refused to meet with his superiors and report to Fort Campbell, Ky., while making his protest.

“I was praying and soul searching,” he said. “I believed there was a question that needs to be answered to ensure a valid chain of command. But I had asked every question, done everything else I could short of disobeying orders, without success.”

During a heated interview with Lakin back in May, CNN’s Anderson Cooper lambasted him for singling out Obama. “He has taken orders for years from people, probably thousands of orders, countless orders. He has never questioned the legitimacy of the people he has taken orders from…or all he knows, General Casey could be a foreign-born, a — not an American citizen.”

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Climate Progress

Still Bjorn: Now that his movie has bombed, Lomborg is back to telling folks “Go Ahead and Guzzle”

By Joe Romm on Dec 14, 2010 at 6:20 pm

Bjorn Lomborg’s effort at mass miscommunication, Cool It, looks like it will go down as one of the great box office bombs in history.

According to Box Office Mojo, in its first month (from 11/12 to 12/12), the movie made a whopping $61,967. Last Sunday, for instance, the movie played in 10 theaters and made a total of $279. Ouch! You don’t have to be a statistician like the Danish delayer himself to figure out that nobody is watching and somebody has lost a bundle of money. We’re talking Heaven’s Gate, The Adventures of Pluto Nash and Gigli territory.

Lomborg has no natural audience because conservatives don’t like the fact that he pretends to believe in global warming science and progressives don’t like the fact that he doesn’t actually want to do anything about global warming except diss the people who do.

The movie is just a clever loss leader for Lomborg’s bad ideas, as I noted (see Climate Science Rapid Response Team debunks Bjorn Lomborg’s Washington Post op-ed). A film is a ticket to widespread media attention, far more than even a new book provides. For instance, the movie means that credulous reviewers who don’t follow the energy and climate debate closely will write columns that millions will read (see “Cool It and plausible deniability“), compared to the, uhh, hundreds that are flocking to the film.

Lomborg continues to spread disinformation, this time in Slate, with another laughable effort to disempower the masses, “Go Ahead and Guzzle. Face it: There’s not much any one person can do about climate change.” It is rather pathetic that Slate doesn’t fact-check its pieces and just lets Lomborg make up head-exploding crap like this:

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Yglesias

Endgame

By Matthew Yglesias on Dec 14, 2010 at 6:16 pm

Follow my lead:

— I’m amused by the quantity of “legal analysis” out there over the ACA case, as if the ultimate decision will come down to anything other than Justice Kennedy’s personal preferences.

— Suburbs left behind as downtown office rents rise.

— Smart editorial on DC transportation policy.

— Charting stereotypes.

— “The Supreme Court and the Attitudinal Model Revisited”.

— Better web-metrics needed.

The Thermals “Never Listen to Me”.

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Security

Right Panics As START To Start Tomorrow – Get Ready For Process Whining

By Max Bergmann on Dec 14, 2010 at 6:15 pm

In a last gasp, Frank Gaffney and others on the extreme right held a press conference on Capitol Hill yesterday to urge Senate Republicans to oppose the New START treaty. Their efforts look doomed. Despite throwing gobs of money into an anti-START campaign and having an incredibly favorable political climate, the far right has failed to hold its moderates. There are now enough votes to ratify the treaty regardless of what Senator Jon Kyl (R-AZ) thinks.

Majority Leader Harry Reid (D-NV) is therefore indicating he will bring the treaty to the floor of the Senate tomorrow. On almost every other piece of legislation the GOP can block legislation through filibuster without actually voting against the specific piece legislation. We saw this on Don’t Ask Don’t Tell last week where Sens. Scott Brown (R-MA), Olympia Snowe (R-ME), Lisa Murkowski (R-AK) all claimed to support DADT, but then proceeded to vote to filibuster because of a ridiculous process complaint. Thus GOP moderates have been able to adopt moderate positions without having to vote for them. But the GOP cannot do this on a treaty, because it only takes 50 votes to begin debate. Therefore on START moderate Republican Senators will actually have to vote up or down on the treaty.

This makes the START treaty a real test of the craziness of the Republican party. Tellingly very few Republicans want to align with Frank Gaffney and oppose the treaty on its merits and now a real split has emerged within the Republican caucus over the treaty. Few Republicans want to oppose a treaty that is unanimously backed by the US military and almost the entire foreign policy establishment of both parties. That’s why for those just looking to deny President Obama a “victory” the easiest course is to gin up some complaint over process to push for a delay.

This now looks like it is already being set in motion with news that START will come to the floor. Thus far the only GOP talking point during the lame duck session against the treaty has been a process complaint that there wasn’t enough time or that the lame duck period was not an appropriate time to do the treaty. These complaints are completely absurd.

First, there is no reason why the treaty needs to take a long time. Kyl has been demanding “two weeks” of floor time. That is absolutely absurd. The original START treaty, which was introducing a brand new monitoring and verification regime, took just five days. The Strategic Offensive Reductions Treaty (SORT) under George W. Bush took just two days. There is zero reason New START should take more than two or three days considering that its reductions are modest and entail no change to nuclear force posture and that it simply updates and extends a verification regime already in place. In other words, this isn’t a brand new treaty that is changing the status quo – this treaty simply maintains the status quo.

Second, nothing about this process has been rushed or jammed through. To accommodate Republicans, the process had already been delayed repeatedly over the last nine months. In fact, Democratic Senators have been too accommodating of the GOP’s process whining, postponing a committee vote in August and delaying a floor vote in the fall. The treaty was delayed due to GOP complaints.

Finally, this is the appropriate Senate to address the treaty. The 111th Congress is the one that has been involved in the negotiations – it sent Senators from both parties to consult with negotiators in Geneva last year, it has reviewed the treaty for the last nine months, that has held more than 20 hearings, and submitted 1000 questions to the administration.

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Yglesias

Third Parties

By Matthew Yglesias on Dec 14, 2010 at 5:31 pm

After reading Matt Bai on Michael Bloomberg’s prospects as a third party presidential candidate along with various recent commentary about the idea of a from-the-left challenger to Barack Obama, I’m coming to the view that too much of this kind of talk focuses on the actual viability (or lack thereof) of possible third party runs. What’s more interesting to me is all the ways that non-viable candidates can make a difference.

After all, it’s reasonably common in recent years for an incumbent or quasi-incumbent center-left party leader to succeed in capturing the median voter and nonetheless lose power in the face of many people voting for further-left candidates. That’s how Al Gore lost, that’s how Paul Martin lost power in Canada, that’s how Gerhard Schöder lost power in Germany, and it’s arguably the reason Lionel Jospin couldn’t beat Jacques Chirac for the Presidency of France. In all these cases, I think the Nader/NDP/Linke/Trotskyite voters were being short-sighted and counterproductive. But the point is that these things happen. A lot of people all around the developed world are basically pacifists and fundamentally don’t accept the neoliberal economic consensus. And there’s basically no way for a center-left movement to win without getting the votes of that constituency, even though few mainstream center-left political leaders (and certainly not Barack Obama) actually espouse those views.

The resulting problem of coalition management is both big and quite difficult. It’s something worth paying attention to even though the idea of a third party candidate winning the presidency or of a primary opponent beating Obama is silly.

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LGBT

Reid Pledges To Hold Senate In Session Until January 4th To Finish DADT, Other Priorities

By Igor Volsky on Dec 14, 2010 at 5:28 pm

Speaking to reporters this afternoon, Majority Leader Harry Reid (D-NV) practically guaranteed that he would bring Don’t Ask, Don’t Tell to a vote before Congress adjourns, suggesting that the Senate would take up the measure once it passes in the House. Reid warned Republicans that he was prepared to stay in session until the new Congress is sworn in on January 4th “to complete the work we have to do here”:

REID: We have other things to do that are extremely important. We have to make sure we complete work on the DREAM Act….If the House completes work on Don’t Ask, Don’t Tell, we’ll have to work on that….We are going to complete the work we have to do here. I want to get out of here just as soon as we can, but we’re not going to walk away from any of the work we have to do. Christmas is a week from Saturday, I understand that, but I hope the Republicans understand that also. Because we are going to complete our work no matter how long it takes in this Congress. We have to do the work of the American people…You know, there is still Congress after Christmas. So if the Republicans think that because they can stall and stall and stall that we take a break we’re through, we’re not through. Congress ends on January 4th. So we’re going to continue working on this stuff until we get it done.

Watch it:

The majority leader did not say precisely when he’ll bring the DADT measure to the floor — which, according to Lieberman has more than 60 votes — but said that it would be after the Senate ratifies the New START treaty, which could move as early as this evening.

His comments about the House voting first are also significant. House Speaker Nancy Pelosi (D-CA) has promised to hold a vote on the House version of the stand-alone DADT tomorrow, which under one optimistic scenario, could send the bill to the Senate sometime this evening. Senate aides have indicated that the plan is to then send the bill to the upper chamber as a message that holds privileged status. Reid will be able to call up the measure without voting on a motion to proceed, saving some 30 hours of debate in the Senate, and will have to hold firm against Republican efforts to filibuster or attach amendments to the legislation. Under this scenario, the Senate bill would have to be identical to the House version or else it would have to return to the House for another vote.

The tactic is not without its problems. While Sens. Lisa Murkowski (R-AK) and Scott Brown (R-MA) are expected to vote for the bill, as Sam Stein points out, “Reid may have to fill the tree with amendments — thereby setting in stone how the debate process plays out. But if he does this without accommodating Republican requests, it could give senators the cover they need to oppose the measure on procedural grounds.”

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Politics

Cuccinelli’s Anti-Health Reform Argument Has A George Washington Problem

By Ian Millhiser on Dec 14, 2010 at 5:00 pm

In an interview with CBS News today, Virginia Attorney General Ken Cuccinelli (R) claimed that the Affordable Care Act must be unconstitutional for the same reason that Congress could not require people to buy guns:

Never before in our history has the federal government ordered Americans to buy a product under the guise of regulating commerce. Imagine, Bob, if this bill were that in order to protect our communities and homeland security, every American had to buy a gun. Can you image the reaction across the country to that? Well, the truth of the matter is, the same legal power is at stake in ordering us to buy health insurance.

Cuccinelli’s comparison between health care and guns is unfortunate, since it reveals his utter ignorance of American legal history. Indeed, rather than trying to “imagine” what the reaction to such a hypothetical law might be, Cuccinelli could learn exactly what America’s reaction was to an actual law simply by picking up a history book. As it turns out, President George Washington signed a law that was almost identical to the one Cuccinelli railed against on CBS:

[E]very citizen, so enrolled and notified, shall, within six months thereafter, provide himself with a good musket or firelock, a sufficient bayonet and belt, two spare flints, and a knapsack, a pouch, with a box therein, to contain not less than twenty four cartridges, suited to the bore of his musket or firelock, each cartridge to contain a proper quantity of powder and ball; or with a good rifle, knapsack, shot-pouch, and powder-horn, twenty balls suited to the bore of his rifle, and a quarter of a pound of powder; and shall appear so armed, accoutred and provided, when called out to exercise or into service, except, that when called out on company days to exercise only, he may appear without a knapsack.

Sadly, this failure to familiarize himself with an important historical fact is par for the course for Ken Cuccinelli. Cuccinelli’s original legal brief challenging the Affordable Care Act was riddled with legal errors, including an embarrassing claim that the Boston Tea Party somehow renders health reform unconstitutional. Likewise, Cuccinelli still refuses to drop a witchhunt against a leading climate-change scientist despite the fact that his office’s own incompetence already got him tossed out of court once.

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Climate Progress

Daily Caller’s Amanda Carey Argues Coal Pollution Keeps Poor People Warm

By Brad Johnson on Dec 14, 2010 at 4:38 pm

Amanda Carey

In a blatant piece of coal-industry propaganda, the Daily Caller claimed limits on global warming pollution “will drastically increase costs for the majority of Americans who get their heat generated from coal.” The Daily Caller’s Amanda Carey rewrote a press release from the National Center for Public Policy Research (NCPPR), a polluter front group, that tried to shift blame for the struggles of millions of Americans to keep warm this winter onto the Environmental Protection Agency:

“With millions of Americans unemployed and struggling to keep their homes warm, the need for government assistance will only increase,” said Deneen Borelli of the National Center for Public Policy’s Project21. “Heavy demand and higher prices due to the Obama Administration’s assault on the fossil fuels we rely upon are going to stretch charities to their limits and beyond,” she said in a press release. Borelli went on to say that “By having the EPA regulate carbon emissions, [EPA Administrator] Lisa Jackson is laying the foundation for the 2010 version of bread lines by supporting efforts that will raise energy costs.”

“Environmental Protection Agency regulations could make it difficult for Americans to stay warm this winter,” Carey writes. In fact, EPA rules on greenhouse pollution aren’t scheduled to be implemented until 2012, and rules limiting pollution can actually lead to lower utility bills. Somehow, Carey and Borelli fail to mention the real reason that most Americans are now suffering while the super-rich take home record profits: the deregulatory Bush economy that has rewarded Wall Street speculators, rapacious bankers, and fossil fuel polluters at the expense of everyone else. Meanwhile, Republicans filibustered tax cuts for the middle class, tried to slash funding for the Low Income Home Energy Assistance Program, and have successfully stalled the Cash for Caulkers program to make homes more energy efficient.

Carey ties the NCPPR defense of coal pollution to “reports predicting brutally-cold weather to envelop much of the U.S. in the coming weeks.” It is absolutely true that winters can be cold, and that global warming has increased the frequency of extremes. Overall, winters in the United States have become milder, but with more extreme storms and temperature swings. Even as parts of the United States are seeing record cold, the Southwest is experiencing record-breaking heat. The Daily Caller unjustifiably raised the question of the potential costs of limiting coal pollution without considering the costs of the pollution itself. Traditional coal pollution already kills about 10,000 Americans a year — disproportionately the young, elderly, and poor. As global warming accelerates, the deaths and damages from our degraded climate will only compound that suffering.