Nonsense from the Far Right

Fortunately, the discerning Iowan can find the facts about the federal budget by looking for them, and not buying into Dick Morris’ spin.

Political consultant Dick Morris slipped into Iowa last week, and the Spin-O-Meter was in overdrive.

Now, rather than repeat Mr. Morris’ misinformation, here is a link to a Des Moines Register story about his appearance at a rally orchestrated by the national right-wing organization Americans for Prosperity.

What Iowans need to know is that (1) Morris is wrong about what is driving the federal budget deficits, and (2) the causes are clear: You can’t cut taxes and fight two wars at the same time without digging a big budget hole.

Center on Budget and Policy Priorities graph
Center on Budget and Policy Priorities

As shown in the graph at right from the Center on Budget and Policy Priorities, the economic downturn, President Bush’s tax cuts and the wars in Afghanistan and Iraq explain the vast majority of the deficit through 2019. One thing folks must recognize is that deficits caused by those factors cause more debt down the road, because we have to keep paying interest. Even after the Iraq war ended, we have to keep paying for it.

As we deal with these self-inflicted budget problems, we must maintain the fundamental and long-accepted responsibilities of our nation — to care for the most vulnerable and put them on their feet to get work and succeed in our economy.

Dick Morris has a big megaphone to try to instill something other than a factual presentation about what’s causing our deficits and debt. Fortunately, the discerning Iowan can find the facts by looking for them, and not buying into the conventional spin he delivers in his traveling medicine show.

Posted by Mike Owen, Assistant Director

Wellmark’s ‘uncertainty’ should not affect Iowa’s exchange

In a strong, consumer-oriented exchange, small businesses, individuals and families will want to participate. Why would Wellmark not want a share of that playing field?

Andrew Cannon photo
Andrew Cannon

Any business worth its salt can find a way to make a buck in a market with sufficient consumer demand.

Wellmark’s reported uncertainty in its ability to “break even” in the health reform-created insurance marketplace would seem puzzling for a company with 70 percent of the Iowa market.

According to an Aug. 31 Des Moines Register report (“Wellmark undecided on insurance exchange,” by Tony Leys), Iowa’s largest insurer is unsure it will participate in the health insurance marketplace created by the health reform law, citing concerns about its ability to “break even.”

This marketplace could be the place where as many as 156,000 Iowans* seek to purchase health insurance. Those with household income below 400 percent of the federal poverty line (about $89,000 for a family of four) will receive tax credits from the federal government to help cover the premium cost. And small businesses, which will also be eligible to purchase insurance in the exchange, will receive tax credits if they cover at least half of their employees’ premiums.

The stars are aligned to create consumer demand in the new insurance marketplace. Wellmark’s concern about breaking even probably should not be lawmakers’ first concern. The point of the exchange is to enhance the marketplace, not keep it restricted.

Rather, as we have repeatedly stressed, policy makers need to be focused on how to assure that lawmakers create an Iowa exchange that is fair and consumer-oriented.

Two groups heretofore are woefully underserved by the current health insurance market — individuals and families who don’t receive health insurance benefits at work, and Iowa’s small businesses. The exchange’s structure and governance should assure that Iowa individuals, families and small businesses can find affordable health insurance options.

In a strong, consumer-oriented exchange, small businesses, individuals and families will want to participate. Why would Wellmark not want a share of that playing field?

*Note: Data comes from the 2009 American Communities Survey (ACS), analyzed online using the University of Minnesota’s Integrated Public Use Microdata Series (IPUMS-USA). The ACS is conducted on an ongoing basis by the Census Bureau. Those 156,000 Iowans have household income in excess of 133 percent of the federal poverty level – the cut off point for Medicaid eligibility under health reform.

Posted by Andrew Cannon, Research Associate
Tweet

Health reform turns 1

Despite heated rhetoric, health reform will help thousands in Iowa receive better and more affordable coverage, and better protect their rights as patients.

Andrew Cannon photo
Andrew Cannon

A year after it was signed into law, confusion about the health reform law remains high. With the heated rhetoric and widespread misinformation about the law, citizens can hardly be blamed for not yet understanding the Affordable Care Act.

Over the course of this week, the Iowa Fiscal Partnership — a joint project of the Iowa Policy Project and the Child and Family Policy Center — has tried to combat some of that confusion and outright misinformation. In a series of five “issue snapshots,” we have succinctly explained how certain groups of Iowans will be impacted by the health law.

On Monday, our brief snapshot described some features of the law designed to help small businesses, which provide insurance to employees in far lower numbers than larger firms. Small businesses may qualify for tax credits if the provide coverage to employees now, and will have access to a new health insurance marketplace beginning in 2014.

Our Tuesday release focused on how senior citizens will be impacted by the new law. Gaps in Medicare prescription drug coverage will gradually be phased out and Medicare enrollees need no longer worry about co-pays for approved preventive treatments.

On the actual anniversary of health reform becoming the law of the land, our Wednesday snapshot explored some of the consumer protections featured in the law. Patients’ need no longer worry about bumping against a benefits ceiling; lifetime benefit limits are eliminated and annual benefits limits will be phased out. The law enshrines the right of patients to choose their own provider; that choice may not be dictated by insurance carriers or the government.

Our Thursday snapshot focused on the law’s impact on Iowa women. Many women are only one family tragedy away from losing their coverage. Just 28 percent of Iowa women have their health coverage through their own job.  In 2014, Iowa women, along with all Iowans, will have a host of new health coverage options. Medicaid eligibility will be raised and lower- and middle-income families will be eligible for premium assistance from the government to purchase insurance coverage in the new state-based marketplaces.

Today, our snapshot details some of the law’s benefits for Iowa’s youth — from infants up to 25-year old young adults. The 51,300 Iowa children with a pre-existing condition will never be denied coverage for that reason; insurers are prohibited from denying children health coverage due to pre-existing conditions. Young adults through age 25 may also remain on their parents’ insurance plans, regardless of whether they are in school or just starting a career.

In spite of some of the heated rhetoric that continues against health reform, it will help thousands of Iowans receive better and more affordable health coverage, as well as protecting their rights as patients.

Posted by Andrew Cannon, Research Associate

But what have you done for me lately?

An astounding number of people have no idea what their government does for them — even as they benefit from government programs.

Source: Suzanne Mettler, "Reconstituting the Submerged State: The Challenges of Social Policy Reform in the Obama Era," via Sara Robinson, Campaign for America's Future

This NYTimes blog post is interesting enough, but what really caught my attention was a table from a recent academic political science paper that has made its way from liberal bloggers to a former Reagan economic advisor.

An astounding number of people have no idea what their government does for them, even as they benefit from government programs.

 

Posted by Andrew Cannon, Research Associate

Implementing Health Reform: Early Successeses

A number of health-reform provisions already have taken effect, and are showing results.

Andrew Cannon, research associate
Andrew Cannon

The new health reform law is already helping thousands of Iowans and small businesses.

Though the major provisions of the health reform law won’t be implemented until 2014, a number of provisions have already gone into effect.

The new law provides tax credits to small businesses that offer health insurance to their employees. The rapid growth of premiums over the past decade have made insurance provision extremely difficult for small businesses. According to the Agency for Healthcare Quality and Research’s Medical Expenditure Survey, In Iowa, just 28 percent of firms with 10 or fewer offered insurance to employees, compared to 92 percent of firms with 100 or more employees.

The Wall Street Journal‘s Janet Adamy reported Tuesday that the percentage of small businesses with three to nine employees offering health insurance to employees has increased significantly over the past year — from 46 percent to 59 percent. Researchers at Bernstein Research attribute that growth to the health reform law’s small business tax credits.

In addition to small businesses, health reform is helping Iowa prepare for full implementation of the law and helping Iowa’s seniors. The state received a $1 million grant to plan for a Health Insurance Exchange, one of the key components of the overhaul.

Though Medicare recipients gained prescription drug coverage through Medicare Part D in 2003, the law had a $2,000 gap in coverage — often called the “donut hole.” Early implementation of health reform lessens that gap, by providing a $250 tax-free rebate to Medicare recipients. In Iowa, 17,774 Medicare beneficiaries have received the rebate.

Posted by Andrew Cannon, Research Associate

Medicare ‘Advantage’? Private carve-outs cost more

Private carve-outs such as Medicare Advantage drive up costs.

Bad policy should be bad politics.

Nevertheless, a group of members of Congress recently persisted in promoting a wasteful private-sector subsidy that undermines the highly successful Medicare program.

The Iowa Hospital Association, in a recent Twitter post, noted the letter from 58 House members against President Obama’s nomination of Dr. Donald Berwick to head the Center for Medicaid and Medicare Services. The letter claims that health reform could jeopardize so-called “Medicare Advantage” programs.

Public vs pvt insuranceWe can only hope.

As shown in the graph at right, public-sector health insurance provides better bang for the buck than private  insurance.

Moreover, specifically with regard to Medicare Advantage, substantial evidence and expert analysis has demonstrated the parasitic effects of such programs on traditional Medicare.

See an excellent primer that breaks down the problems with Medicare Advantage plans and why it is that these private carve-outs from Medicare drive up costs and make it more difficult to serve Americans who depend on Medicare.

Posted by Mike Owen, Assistant Director