James Richard Verone of North Carolina spent his whole life playing by the rules and staying out of trouble. Having worked as a delivery man for Coca Cola for 17 years, Verone was known as a hard worker and honest man.

Yet when he was laid off from Coca Cola three years ago, Verone was desperate to find work. He eventually found employment as a convenience clerk, yet he began to notice a protrusion in his chest. He developed arthritis and carpal tunnel syndrome, and soon the pain became too much for him to bear. He filed for disability, but he was denied any sort of coverage by the federal government.

So earlier this month, as the Gaston Gazette reports Verone drove to a local RBC Bank and told the teller he was robbing them for a dollar. He said he wanted to rob the bank in order to go to jail and get medical coverage:

Verone didn’t want to scare anyone. He executed the robbery the most passive way he knew how. He handed the teller a note demanding one dollar, and medical attention. “I didn’t have any fears,” said Verone. “I told the teller that I would sit over here and wait for police.” [...]

Verone says he’s not a political man. But he has a lot to say on the subject of socialized medical care. He suspects he wouldn’t be talking to a reporter through a metal screen wearing an orange jumpsuit if such an option were available in the U.S. “If you don’t have your health you don’t have anything,” said Verone. The man has high hopes with his recent incarceration. He has seen several nurses and has an appointment with a doctor Friday.The ideal scenario would include back and foot surgery and a diagnosis and treatment of the protrusion on his chest, he said.

Verone told the local press he would like to serve in prison long enough to be able to get out in time to collect Social Security benefits that he paid into his entire life. He also hopes to be able to retire along a beach some day. Verone says that he doesn’t regret landing behind bars and that he had no choice. Between continuing a life in pain and choosing prison, he is happy with his decision. “If I had not exercised all the alternatives I would be sitting here saying, ‘Man I feel bad about it,’” he said. “I picked jail.” The United States is the only wealthy country that does not offer comprehensive universal health care to every citizen; in no other rich country would anyone be faced with such a choice.

McKinsey has just released the methodology for its highly contested and controversial survey of the effects of the Affordable Care Act on employers. The report, which Republicans have been using to argue that American’s won’t be able to keep the coverage they have even if they like it, found that up to 30 percent of employers would stop offering insurance. But in the methodology summary just released, McKinsey stresses that the report “was not intended as a predictive economic analysis of the impact of the Affordable Care Act. Rather, it captured the attitudes of employers and provided an understanding of the factors that could influence decision making related to employee health benefits”:

As such, our survey results are not comparable to the health care research and analysis conducted by others such as the Congressional Budget Office, RAND and the Urban Institute. Each of those studies employed economic modeling, not opinion surveys, and focused on the impact of healthcare reform on individuals, not employer attitudes.

Comparing the McKinsey survey to economic estimates, such as the CBO’s, is comparing apples to oranges. While the McKinsey Quarterly article about the survey cited CBO estimates, any comparison is not apt. We understand how the language in the article could lead the reader to think the research was a prediction, but it is not.

So it’s worth reiterating that all other studies of employer responses have found significantly less coverage erosion. After the first 10 years, the Congressional Budget Office estimates that “the number of people obtaining coverage through their employer would be about 3 million lower in 2019 under the legislation.” Actuaries at CMS estimated that just 1.4 million would move out of employer coverage. As the very resent survey of employer surveys from Avalere concludes, “the ESI Market will be fairly stable after 2014 when key ACA coverage provisions go into effect.”

Greg Sargent has more on the growing fall-out from McKinsey “employers will drop health care coverage” study. He points to this comprehensive review of employer surveys from Avalere, which came to the exact opposite conclusion:

Overall, our analysis suggests that the ESI market will be fairly stable after 2014 when key ACA coverage provisions go into effect. The microsimulation models estimates from RAND, the Urban Institute, the Lewin Group and the Congressional Budget Office (CBO) show net changes to ESI ranging from –0.3 percent to + 8.4 percent compared to baseline projections without ACA implementation – not major changes in the market (Figure 1).1 Similarly, large-scale employer surveys and analyses conducted by benefits consultants, investor groups, and other consulting firms also confirm that most employers will remain committed to providing coverage. Stability in ESI is driven by expectations that large firms, whose policies cover more people than small- and medium-firm policies combined, will continue offering health benefits.2 Moreover, small businesses that will benefit from new economies of scale in the small business exchanges are likely to offer coverage for their employees through the exchange and possibly newly offer coverage if they previously did not.

Look:

Significantly, Avalere also calls out the GOP’s favorite economist, former CBO head Douglas Holtz-Eakin, for conducting a “simplistic” analysis of the effects of the Affordable Care Act on employer-based coverage (the study predicted that a significant number of employers will stop offering insurance). “Holtz-Eakin conducts a simple calculation of whether or not dropping coverage and paying the employer penalty in ACA would be more financially beneficial to both employers and employees (if the latter’s wages are increased by a commensurate amount) than continuing to offer coverage,” the study notes. “However, when benefits consultants conducted similar analyses – taking into account a number of additional factors that employers will undoubtedly consider – they come to the opposite conclusion. They determined that employers, on average, would spend $1,000 more per employee if they dropped coverage.”

Avalere offers three reasons for why employers will continue providing insurance: 1) to recruit and retain employees, 2) historically there has been no viable alternative for employees to obtain comprehensive coverage on their own, and 3) boost worker productivity.

Republicans argue that states are the “laboratories of democracy” that should be charged with developing new, innovative ways for delivering quality health care more efficiently. But that point is far harder to make in the face of Gov. Scott Walker’s (R-WI) effort to shut the public out of a debate about Medicaid cuts and shield legislators from having to weigh in on cutting benefits and services for the neediest Americans:

The new state budget bill grants broader power to Gov. Scott Walker’s administration to remake BadgerCare Plus and other state health programs with little legislative oversight, a situation that worries advocates for the roughly 1 million people covered by those programs.

The major question: how the governor’s Department of Health Services will use that authority as it cuts a projected $466 million in costs from the programs over the next two years.

“We don’t know exactly what will be coming down the pike,” said Bob Jacobson, a spokesman for the Wisconsin Council on Children & Families. “And we don’t know how we can have a voice in those decisions when the Legislature has been taken out of the picture.” [...]

The budget-repair bill passed earlier this year gave the Department of Health Services the authority to make changes in the programs without legislative approval but required the department to hold public hearings.

The budget bill passed last week dropped the public hearing requirement. The exemption would remain in effect throughout the governor’s term.

The pending changes in the programs could range from new rules on eligibility and cost sharing to managing care for people with severe mental illnesses.

This also doesn’t bode well for the GOP’s push to block grant the Medicaid program. After all, if states like Wisconsin — or any other Republican state that isn’t very invested in maintaining government-sponsored health care programs — are already demonstrating that they’re more interested in slashing enrollment rolls than developing any truly revolutionary health delivery models, you can easily predict how they would react to a block grant that does not keep up with projected health care costs.

On Saturday, ThinkProgress Health caught up with Jared Bernstein — Vice President Joe Biden’s former economic adviser and currently a senior fellow at the Center on Budget and Policy Priorities (CBPP) — at Netroots Nation in Minneapolis, MN and asked him for his take on McKinsey’s recent report about employers dropping coverage as a result of the Affordable Care Act. Bernstein questioned the study’s increasingly suspect methodology and reiterated that the law would actually lower health care spending for employers:

BERNSTEIN: The health care cost burden on employers has been a uniquely American damper on hiring for a long time. And one of the things you have to recognize about the 1990s…because health care costs that employers faced fell sharply pretty quickly, you could see an employment boom that was quite significant. One of the things I like most about the Affordable Care Act is that it starts to take this burden of health care costs off of the employers. Remember, small businesses are exempt 50 workers or more, there are considerable subsidies in the system, you got the system with a functionality to lower costs over time, you’ve got the exchanges, so there are a number of mechanisms that are going to lower employer costs, that’s going to be good for business.

Watch it:

Bernstein added that he expected large employers to continue offering group coverage, but said that small employers could see some much needed relief in terms of lower health care costs. All of this is relatively difficult to predict, but broadly speaking small businesses — many of whom could be eligible for tax credits — will be purchasing coverage with lower administrative costs and through exchanges where the additional competition between health care plans would reduce average premiums. Consumers will be encouraged to enroll in lower-cost plans and and the plans themselves will have to to keep their premiums low to attract enrollees. A Congressional Budget Office (CBO) report from November 2009 estimated that on average, families will save hundreds of dollars in the new markets by 2016.

Rick Ungar asks why McKinsey would be willing to put its reputation on the line by producing a very questionable study that predicts a much larger number of employers would drop coverage as a result of the Affordable Care Act — more than anyone else has predicted. The group has refused to release its methodology, even as several McKinsey employees are telling reporters that the “survey is not a good tool for prediction.”

Ungar explains McKinsey is not a right-wing ideology shop, and speculates that they’re simply interested in generating greater business for the firm:

Ask yourself this question – What does McKinsey & Company do for a living?

They consult and advise large corporations on how to solve business problems and properly innovate and organize their future.

If a major shift in – or the termination of – a corporations’ long-standing employee health care benefits program is not a major business issue requiring the greatest of care in the planning and execution, then I don’t know what is.

Who will these companies turn to in order to get advice on the benefits of unraveling their complicated and extensive employee benefit plans and for assistance in executing any new plans for the same?

McKinsey & Company.

What we have in the McKinsey survey is little more than a company “pitch piece” designed to drive customers to their door.

There are, after all, endless hours to be billed for conducting reviews of corporate employee benefit plans to better assess the impact of the new health care law and even more to be banked should McKinsey conclude that a revision and revamp of a benefits plan is in order as McKinsey will be performing that revision and revamp- for a fee.

If this is the case, then McKinsey misread the political climate and greatly underestimated the willingness of reform opponents to use any possible piece of data to discredit health care reform as a whole — and the media’s willingness to cover that fight. Certainly the controversy this generated cannot be worth any new business the report brought in.

Late last week, Senate Finance Committee Charmain Max Baucus (D-MT) sent a letter to McKinsey “calling on the company to answer more than 30 questions about its clients and the study itself. The company has already agreed to allow representatives to meet with staffers from the Senate Finance Committee.”