Friday, October 26, 2012
Foreign business execs prefer Obama
Tuesday, July 17, 2012
Obama, the tax-break president
From Obama, the Tax Cut Nobody Heard Of
By MICHAEL COOPER
New York Times
October 18, 2010 LINK
Monday, February 20, 2012
Contraceptives mandate already mandated
New contraceptives mandate doesn’t change much for DePaul
By Rima Thompson and Rachel Metea
Published: Monday, February 13, 2012 LINK
The Catholic Church is scrutinizing the Obama administration's new mandate requiring religious-based institutions to provide contraception for their employees, despite a new compromise announced Friday.
The Obama administration's mandate ignited a religious debate, with many Catholic institutions crying out that the new mandate was a breach of their religious freedom. With the mandate's new changes, religious organizations will not have to pay for or directly provide contraceptive services, President Obama announced Friday.
Along with several other Catholic universities, DePaul University, which is the nation's largest Catholic university, already offers contraceptives in both its fully insured HMO plan and its self-insured PPO plan.
"The heart of it is pretty simple," DePaul University President Father Dennis Holtschneider said in an email to The DePaulia. "DePaul fully supports the bishops' stance, but has offered [contraceptive] benefits ever since both Illinois and the Federal government required us to do so several years ago."
Catholic and other religious-based institutions across Illinois have historically been able to avoid a state mandate requirement to include contraception in employees' health benefits.
The United States Conference of Catholic Bishops released a statement late Friday expressing their opposition to the new compromise. The Bishops oppose the new mandate saying that the rule forces private health plans to cover sterilization and contraception at "the stroke of a bureaucrat's pen". The Bishops argue that mandated preventative services should not include birth control and contraceptives because pregnancy is not a disease.
The mandate would have forced religiously affiliated institutions—such as DePaul University—to provide access to birth control for women employees unless they can show reason for qualifying for the exemption, they must comply with the new law by August 2013. Doctors who do not agree with contraceptives will not be forced to prescribe birth control. Both the new and old mandates exclude churches and only include religiously affiliated institutions.
"Under the rule, women will still have access to free preventive care that includes contraceptives … no matter where they work, so that core principle remains," Obama said in his announcement. "But, if a women's place of work is a charity or a hospital that has a religious objection to provide contraceptive services as part of their health plan, the insurance company, not the hospital, not the charity, will be required to reach out and offer the woman contraceptive care free of charge, without co-pays and without hassles."
Twelve years ago, the U.S. Equal Employment Opportunity Commission (EEOC) ruled that the exclusion of contraceptives from health insurance coverage is discrimination under Title VII of the Civil Rights Act of 1964. Several years later, DePaul University added birth control to its health insurance coverage after complaints from the EEOC.
DePaul University's official statement expressed disappointment in the Obama administration's decision not to include religious educational institutions under the exemption umbrella.
"The University's position on this issue is fully aligned with that of the Catholic Health Association, which recently expressed its disappointment ‘that the definition of a religious employer was not broadened' to encompass Catholic educational and other institutions in the new federal regulations for health insurance plans," said RobinFlorzak, DePaul's interim assistant vice president of public relations and communications.
DePaul University released a new statement after the Friday amendment saying, "DePaul is encouraged by the administration's willingness to forge a compromise, but it would be premature to discuss it further until the university has had time to fully review the administration's new approach."
Nearly half of Americans said religiously affiliated colleges and hospitals should be required to provide their employees with contraceptives or birth control through health care plans at no cost, according to a survey released last week by the Public Religion Research Institute. According to the survey, 52 percent of Catholics say religiously affiliated colleges and hospitals should have to provide coverage that includes contraception.
According to a study released last April by the Guttmacher Institute, 99 percent of women have used a contraceptive method other than family planning. Similarly, 98 percent of sexually active Catholic women have used contraceptive methods.
The announcement made Jan. 20 by Department of Health and Human Services Secretary, Kathleen Sibelius, has sent media personnel from Catholic and other religious-based institutions behind closed doors scrambling to generate a politically correct statement for the press.
Contraception was already partially covered through health plans of religiously affiliated institutions in 28 states. Obama's health care law changes that coverage from partial to full.
Annie Hughes, Loyola University of Chicago's marketing and communications associate wrote a statement about the original ruling and said: "Loyola University Chicago joins the United States Conference of Catholic Bishops, the Association of Catholic Colleges and Universities … in expressing our profound disappointment in the recently announced Department of Health and Human Services ruling. The ruling narrowly defines the "religious employer" exemption and therefore requires all faith-based hospitals, universities, and social service agencies to cover contraceptive, sterilization, and abortifacient products and services in their employee and student-health plans that are contrary to the religious commitments of our institutions."
Many of these religious officials, who oppose the new health care law, believe that their organizations should have the freedom to follow their beliefs, and that it is wrong for the Obama administration to mandate a law that goes against those beliefs.
"The key ruling that we take issue with is that the mandate, without a broader religious employer exception, constitutes an unprecedented attack on the religious liberty of Catholic and other religious institutions who have served the common good of our country since its founding, a founding based upon the very notion of religious freedom now at stake," said Hughes.
Many Catholic universities such as Georgetown, Loyola University Chicago and Fordham University will provide contraceptives for medical reasons and not for birth control.
But, the facts presented by the Obama administration based on the Institute of Medicine's recommendation leaves little hope that such an exemption will be granted to these institutions. According to the Institute of Medicine, one in two pregnancies are unplanned and four in 10 of those pregnancies may lead to abortions.
Still, Catholic and other religious institutions continue to argue that birth control goes against the core of their principles.
"The mandate rests upon an excessively narrow definition of "religious employer" that excludes religious hospitals, social service agencies, and universities from its definition. It undermines our ability to do our shared work with the requisite religious freedom protected by law," Hughes said.
Obama officials have maintained that the objective of the law is not to offend or infringe upon anyone's religious beliefs. It is intended to protect the rights of female employees who work for religious affiliated institutions.
As the debate continues, some religious leaders are encouraging their parishioners to voice their opinions to their lawmakers, while others are putting their trust in the decisions of their institutions.
"I respect very much faith-based institutions' right to make decisions based upon their identities," said the DePaul University CDM and law school chaplain, Tom Judge. "I also respect DePaul's right to discern what is most consistent with our mission, as well."
"This misguided decision on the part of the Department of Health and Human Services would force our institution to violate well-known, well-established, and, until now, well-protected moral commitments," Hughes said. "In good conscience, we cannot abide by such a law as it stands. We are currently in conversation with our colleagues to plan further action toward correcting this erroneous decision."
"The employee health insurance plans include a prescription contraceptive benefit, in compliance with state and federal law," Florzak said. "An optional insurance plan that covers such benefits is available to students, also due to previously established state and federal requirements."
According to Holtschneider, there are no conversations inside the university about changing DePaul's health coverage with regards to contraceptives. "Illinois law remains Illinois law," he said.
Sunday, February 19, 2012
Socialists wish Obama was a socialist
Why Obama's the Least Socialistic President in Modern History (And That's a Shame)By Richard (RJ) Eskow, AlterNet |
Sunday, February 5, 2012
Reaganomics: Appropriate in early 80s, but not now
Why the GOP should stop invoking Reaganomics
Bruce Bartlettfor The Washington Post LINK
In their debates, ads and speeches, the candidates for the Republican presidential nomination are vying for the label of most Reagan-esque.
On taxes, “I take the Reagan approach,” former senator Rick Santorum said at a recent Florida debate.
On the economy, “under Ronald Reagan, we had . . . the right laws, the right regulators, the right leadership,” former House speaker Newt Gingrich said in a debate before his South Carolina primary victory.
Judging from the candidates’ tax proposals, they seem to believe that the most Reagan-like candidate is the one with the biggest tax cut. But, as the person who drafted the 1981 Reagan tax cut, I think Republicans misunderstand the premises upon which Reagan’s economic policies were based, and why those policies can’t — and shouldn’t — be replicated today.
I was the staff economist for Rep. Jack Kemp (R-N.Y.) in 1977, and it was my job to draft what came to be the Kemp-Roth tax bill, which Reagan endorsed in 1980 and enacted the following year. Kemp and Sen. Bill Roth (R-Del.) proposed cutting tax rates across the board by about a third, lowering the top rate from 70 percent to 50 percent and reducing the bottom rate from 20 percent to 8 percent. (Though when the Reagan tax cut was enacted in 1981, the bottom rate was reduced to 11 percent.)
While our aim was to increase growth and employment, we were intent on doing so in a way that did not exacerbate inflation, which was the nation’s top problem at that time.
After all, growth was not particularly sluggish in the late 1970s — the economy grew at 5.4 percent in 1976, 4.6 percent in 1977 and 5.6 percent in 1978. (We haven’t seen three consecutive years as good since.) But people didn’t feel very prosperous because inflation and unemployment were high. The unemployment rate was around 7 percent during those three years, and inflation accelerated, going from 4.9 percent in 1976 to an astonishing 13.3 percent in 1979.
We believed that inflation contributed to unemployment because when workers got cost-of-living pay increases, they were pushed into higher tax brackets. In turn, this required them to ask for bigger pay increases to try to maintain their after-tax income. This cycle increased the cost of employment for businesses and discouraged them from hiring more workers.
According to the Tax Policy Center, the total federal tax rate (including both the employer and employee share of the payroll tax) for a four-personfamily earning the median national income more than doubled between 1965 and 1979, from 11.5 percent to 23.1 percent. The marginal tax rate — the tax on each additional dollar earned — rose from 17 percent to more than 36 percent. This “tax wedge” — the difference between a business’s cost of employment and the employee’s after-tax reward — also explained why unemployment was high despite robust growth.
Keynesian economics, which was the dominant theory at the time, said that higher taxes would curb inflation by reducing people’s disposable income and spending, and that any tax cut would exacerbate inflation. Our thinking, by contrast, was that lower taxes would increase the incentive to work, save and invest; if that led to an increase in the supply of goods and services, then the impact would be anti-inflationary.
Mainstream economists also argued that the cost of bringing down inflation, even a little bit, would be extraordinarily high. In a May 1978 paper, Brookings Institution economist Arthur Okun calculated that bringing the inflation rate down by just one percentage point would cost 10 percent of a year’s gross national product.
If Keynesian theory was correct, the 1981 Reagan tax cut, which reduced revenue by close to 3 percent of GDP per year, should have been massively inflationary. But in fact, inflation dropped like a rock, from 12.5 percent in 1980 to 8.9 percent in 1981 and 3.8 percent in 1982, where it basically stayed for the rest of the 1980s.
Of course, the Federal Reserve’s tight money policy did the heavy lifting on reducing inflation. But if Okun’s estimate had been even remotely correct, we should have gone through another Great Depression. Although the 1981-82 recession was painful, it was brief and not very deep. Real GDP fell 1.9 percent in 1982 but bounced back nicely, rising 4.5 percent in 1983 and 7.2 percent in 1984.
Republicans like to say that massive growth followed the Reagan tax cut. But average real GDP growth during Reagan’s eight years in the White House was only slightly above the rate of the previous eight years: 3.4 percent per year vs. 2.9 percent.The average unemployment rate was actually higher under Reagan than it was during the previous eight years: 7.5 percent vs. 6.6 percent.
Liberals argue that the real economic effects of Reagan’s policies show that they failed. However, I believe that these critics overlook the enormous importance of breaking the back of inflation at a relatively small economic cost — certainly far less than any economist would have thought possible in 1981. Reagan’s results should be measured against the (incorrect) expectation that a far more severe economic downturn would be needed to reduce inflation. On that basis, his policies were overwhelmingly successful.
When comparing Reagan’s policies with Republican proposals today, several things stand out. Inflation is low now. We are not looking at “bracket creep” or sharply rising taxes, as we were in the late 1970s. The top income tax rate is 35 percent, half the rate Reagan inherited. And federal revenue is at a 60-year low of about 15 percent of GDP, compared with a post-World War II average of about 18.5 percent.
These differences are essential to understanding why Reagan’s policies worked when they did — and why they are not appropriate today.
All of the evidence tells us that the economy’s fundamental problem today is not on the supply side but the demand side. According to a recent study by Credit Suisse, two-thirds of the difference in growth at this point in the business cycle, compared with previous cycles, is due to slower consumer spending. And low inflation — as well as widespread unemployment, vast stocks of unsold houses, empty factories and other indicators — tells us that money is tight, not loose, as was the case in the late 1970s.
“Low interest rates are generally a sign that money has been tight,” economist Milton Friedman wrote in 1997. Yet, absurdly, Republicans continually berate the Federal Reserve for being too easy; some even insist, insanely, that the United States should return to the gold standard, even though it was a key cause of the Great Depression.
Because inflation and interest rates are low, Fed policy is constrained today in ways it was not in the early 1980s. Back then, the Fed could bring down the federal funds rate to a little less than the inflation rate and create negative real rates, thus stimulating borrowing, investment and consumption. It can’t do that now because it can’t reduce market interest rates below zero.
Economic conditions are entirely different today than they were in Reagan’s era, and different conditions demand different policies. Those who say otherwise are simply engaging in cookie-cutter economics — proposing whatever was popular and seemed to work once, without regard to changing circumstances.
Bruce Bartlett was a domestic policy adviser to President Ronald Reagan and a Treasury official during the George H.W. Bush administration. His latest book is “The Benefit and the Burden: Tax Reform — Why We Need It and What It Will Take.”
Sunday, January 22, 2012
George Washington and and first congress first mandated health insurance
"In 1790, the first Congress, which was packed with framers, required all ship owners to provide medical insurance for seamen; in 1798, Congress also required seamen to buy hospital insurance for themselves. In 1792, Congress enacted a law mandating that all able-bodied citizens obtain a firearm."
Einer Elhauge on Thursday, January 5th, 2012 in a commentary in the New England Journal of Medicine
Harvard Law professor says early Congress mandated health insurance for seamen and gun ownership for most men
Share this story:
One complaint about President Obama’s Affordable Care Act is that it forces uninsured people to purchase health insurance or pay a penalty -- an argument the Supreme Court will consider when it takes up challenges to the health-care law in oral arguments March 27 and 28. If the court upholds the act, critics argue, what's to stop Congress from forcing us to buy, say broccoli.
Harvard Law School professor Einer Elhauge focused on that issue in a Jan. 5, 2012, commentary in the New England Journal of Medicine titled "The Irrelevance of the Broccoli Argument against the Insurance Mandate."
Some people, he said, "argue that the Constitution's framers could not possibly have envisioned a congressional power to force purchases. However, in 1790, the first Congress, which was packed with framers, required all ship owners to provide medical insurance for seamen; in 1798, Congress also required seamen to buy hospital insurance for themselves.
"In 1792, Congress enacted a law mandating that all able-bodied citizens obtain a firearm. This history negates any claim that forcing the purchase of insurance or other products is unprecedented or contrary to any possible intention of the framers."
We wondered whether those early Congresses -- some of whose members helped draft the Constitution -- did indeed mandate health insurance and gun purchases.
First, we wanted to see whether that first Congress was actually "packed with framers."
Fifty-five men are considered the framers. During the first Congress in 1790, only 20 of the 91 senators and representatives were framers. That's not exactly packing them in.
Then we contacted Elhauge about the other parts of his claim. He referred us to three pieces of legislation.
First was the 1790 law, passed by that first Congress, which applied to any U.S. ship that was at least 150 tons or with a crew of at least 10. It required the master or commander to either have a supply of on-board medicines (with instructions) or provide "all such advice, medicine, or attendance of physicians, as any of the crew shall stand in need of in case of sickness" and do it "without any deduction from the wages of such sick seaman or mariner."
Sounds like mandatory health care to us.
Then, in 1792, a Congress that included 17 framers passed a law requiring nearly every "free able-bodied white male citizen" age 18 to 44, within six months, "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," along with balls and gunpowder. A rifle could be substituted. The purpose was to establish a uniform militia.
Again, that sounds like a mandated purchase to us.
Finally, in 1798, a Congress that included five framers expanded the health coverage mandate, requiring every ship owner or master coming into a port to pay 20 cents per seaman for every month each worker had been employed.
The funds, which could be withheld from the seamen, were used "to provide for the temporary relief and maintenance of sick or disabled seamen, in the hospitals or other proper institutions now established" in the port. Leftover funds were used to create hospitals for those mariners.
How did the framers vote on these laws?
There was no roll call for the House and Senate bills requiring health care for seamen. But on the proposal mandating the purchase of musket, firelock or rifle as part of the larger bill to establish a uniform militia, 10 of the 14 framers whose votes were recorded endorsed the measure.
One side note: In November 1792, an attempt was made in the House to reconsider the weapon requirement in the militia bill because some people were complaining that it was too onerous, an argument that echoes complaints from critics of the new health-care law. The proposal was defeated 6 to 50. The vote among framers was 1 to 6.
It should also be noted that the president who signed the first two of these laws was our Founding Father-in-Chief, George Washington.
Elhauge, in an e-mail, stood by his characterization that the first Congress was "packed" with framers, saying, "20 framers sounds pretty packed to me. There were only 55 delegates who attended the Constitutional Convention, so 20 is around 40 percent of all the framers present in that Congress."
We disagree. The issue is not how many framers went to Congress, but how many members of Congress were framers. And you can't pack a meeting when you only account for 22 percent of the representatives.
More importantly, he said, "I don’t think anyone objected to any of these laws on constitutional grounds, which presumably someone would have if it was obvious that the original understanding was that such an obligation would be unconstitutional."
Our ruling
Harvard Law professor Einer Elhauge said that early Congresses, particularly the first Congress, had no qualms about forcing purchases.
Our research confirmed that. Congress required merchant ship owners to purchase medicines or provide health care for their workers. Seamen were later taxed to pay for what might be regarded today as an 18th-century health maintenance organization to provide for hospital care. And most able-bodied men were required to purchase weaponry for their service in the militia.
Although he correctly characterized the laws, to say that the framers of the Constitution "packed" that first Congress is too much of a stretch. "Packed" means at least a majority; 22 percent is not a majority.
For that reason, we rule his statement Mostly True.
(An earlier version of this item incorrectly reported that Washington signed all three bills. John Adams, a founding father who was not a framer because he was in Europe when the U.S. Constitution was written, signed the 1798 legislation.)
(Get updates from PolitiFactRI on Twitter. To comment or offer your ruling, visit us on our PolitiFact Rhode Island Facebook page.)
Sunday, December 18, 2011
Insuring kids nice, but too expensive, Rick?
By Scott Keyes on Dec 15, 2011
Link
http://thinkprogress.org/health/2011/12/15/389859/santorum-rejects-obamacares-success-at-pro-life-event/
At a pro-life event in Iowa yesterday, former Pennsylvania Senator Rick Santorum (R) spoke out against new data showing that 2.5 million young adults now have health coverage as a result of the Affordable Care Act. Ignoring the good news, Santorum insisted that health care reform had “failed miserably” by not doing more to bring down costs and said that insurance was “too expensive” to cover young adults.
Asked if he saw any contradiction between attending an event that celebrated life and criticizing the health law for extending health coverage to living people, Santorum replied that he didn’t:
KEYES: Could we get your reaction to the new study that the Affordable Care Act extended coverage to 2.5 million young adults in this country?
SANTORUM: How about the same reaction that’s also caused a dramatic increase in the price of health insurance? In fact, a substantial increase in the cost of health insurance to millions of Americans. It has failed miserably in the one area the president suggested it would have the most impact, which is decreasing the cost of health care in the country. [...]
KEYES: But if we’re at an event though celebrating life, shouldn’t we be pushing to cover more young adults like the Affordable Care Act is doing?
SANTORUM: No. Again, if government had unlimited amounts of money we could cover everybody with all the coverage in the world, but of course we don’t. The objective President Obama sold to the American public was that this would reduce health care costs, make it more affordable, save the government and people money, and thereby expand insurance. It is not doing it in that fashion. It is simply spending more money and wasting more money.
KEYES: So it’s just too expensive to cover the kids?
SANTORUM: It’s too expensive, number one. Number two, it’s the wrong approach in solving health care, which is government-run, top-down and that’s why it’s wasteful and inexpensive.
Despite Santorum’s claims, the government is not financing the coverage expansion; the ACA allows families to keep young adults on their existing health plans until they turn 26. The provision has added more young people to health care risk pools and has had a negligible effect on premiums.
The fact that Santorum dismissed this achievement at a pro-life event demonstrates just how much Republicans are willing to let their dislike for President Obama’s policies shade their judgment of policy outcomes. For years, the Republican Party has fought the perception that they care more about pre-birth fetuses than post-birth humans who are struggling to make ends meet. Santorum’s remarks Wednesday did little to shed that reputation.
Tuesday, December 6, 2011
HCR coming through for breast cancer victims
Op-Ed
'Obamacare' to the rescue
A woman who felt President Obama had let the middle class down has changed her mind.
By Spike Dolomite Ward
LA Times LINK
December 6, 2011
I want to apologize to President Obama. But first, some background.
I found out three weeks ago I have cancer. I'm 49 years old, have been married for almost 20 years and have two kids. My husband has his own small computer business, and I run a small nonprofit in the San Fernando Valley. I am also an artist. Money is tight, and we don't spend it frivolously. We're just ordinary, middle-class people, making an honest living, raising great kids and participating in our community, the kids' schools and church.
We're good people, and we work hard. But we haven't been able to afford health insurance for more than two years. And now I have third-stage breast cancer and am facing months of expensive treatment.
To understand how such a thing could happen to a family like ours, I need to take you back nine years to when my husband got laid off from the entertainment company where he'd worked for 10 years. Until then, we had been insured through his work, with a first-rate plan. After he got laid off, we got to keep that health insurance for 18 months through COBRA, by paying $1,300 a month, which was a huge burden on an unemployed father and his family.
By the time the COBRA ran out, my husband had decided to go into business for himself, so we had to purchase our own insurance. That was fine for a while. Every year his business grew. But insurance premiums were steadily rising too. More than once, we switched carriers for a lower rate, only to have them raise rates significantly after a few months.
With the recession, both of our businesses took a huge hit — my husband's income was cut in half, and the foundations that had supported my small nonprofit were going through their own tough times. We had to start using a home equity line of credit to pay for our health insurance premiums (which by that point cost as much as our monthly mortgage). When the bank capped our home equity line, we were forced to cash in my husband's IRA. The time finally came when we had to make a choice between paying our mortgage or paying for health insurance. We chose to keep our house. We made a nerve-racking gamble, and we lost.
Not having insurance amplifies cancer stress. After the diagnosis, instead of focusing all of my energy on getting well, I was panicked about how we were going to pay for everything. I felt guilty and embarrassed about not being insured. When I went to the diagnostic center to pick up my first reports, I was sent to the financial department, where a woman sat me down to talk about resources for "cash patients" (a polite way of saying "uninsured").
"I'm not a deadbeat," I blurted out. "I'm a good person. I have two kids and a house!" The clerk was sympathetic, telling me how even though she worked in the healthcare field, she could barely afford insurance herself.
Although there have been a few people who judged us harshly, most people have been understanding about how this could happen to us. That's given me the courage to "out" myself and my family in hopes that it will educate people who are still lucky enough to have health insurance and view people like my family as irresponsible. We're not. What I want people to understand is that, if this could happen to us, it could happen to anybody.
If you are fortunate enough to still be employed and have insurance through your employers, you may feel insulated from the sufferings of people like me right now. But things can change abruptly. If you still have a good job with insurance, that doesn't mean that you're better than me, more deserving than me or smarter than me. It just means that you are luckier. And access to healthcare shouldn't depend on luck.
Fortunately for me, I've been saved by the federal government's Pre-existing Condition Insurance Plan, something I had never heard of before needing it. It's part of President Obama's healthcare plan, one of the things that has already kicked in, and it guarantees access to insurance for U.S. citizens with preexisting conditions who have been uninsured for at least six months. The application was short, the premiums are affordable, and I have found the people who work in the administration office to be quite compassionate (nothing like the people I have dealt with over the years at other insurance companies.) It's not perfect, of course, and it still leaves many people in need out in the cold. But it's a start, and for me it's been a lifesaver — perhaps literally.
Which brings me to my apology. I was pretty mad at Obama before I learned about this new insurance plan. I had changed my registration from Democrat to Independent, and I had blacked out the top of the "h" on my Obama bumper sticker, so that it read, "Got nope" instead of "got hope." I felt like he had let down the struggling middle class. My son and I had campaigned for him, but since he took office, we felt he had let us down.
So this is my public apology. I'm sorry I didn't do enough of my own research to find out what promises the president has made good on. I'm sorry I didn't realize that he really has stood up for me and my family, and for so many others like us. I'm getting a new bumper sticker to cover the one that says "Got nope." It will say "ObamaCares."
Spike Dolomite Ward is the founder and executive director of Arts in Education Aid Council, a nonprofit organization that is restoring the arts to public schools in the San Fernando Valley. http://www.aieac.org
Copyright © 2011, Los Angeles Times
Sunday, November 27, 2011
HCR coming through for senors
AP Newsbreak: Medicare's drug coverage gap shrinks
The "doughnut hole," an anxiety-inducing catch in an otherwise popular benefit, will shrink about 40 percent for those unlucky enough to land in it, according to new Medicare figures provided in response to a request from The Associated Press.
The average beneficiary who falls into the coverage gap would have spent $1,504 this year on prescriptions. But thanks to discounts and other provisions in President Barack Obama's health care overhaul law, that cost fell to $901, according to Medicare's Office of the Actuary, which handles economic estimates.
A 50 percent discount that the law secured from pharmaceutical companies on brand name drugs yielded an average savings of $581. Medicare also picked up more of the cost of generic drugs, saving an additional $22.
The estimates are averages, so some Medicare recipients may do worse and others better. Also, it's still unclear if the discounts will start to overcome seniors' deep unease about the law.
Concern over cutting Medicare to expand coverage for the uninsured helped push older voters toward Republicans in the 2010 congressional elections. Obama and the Democrats have been trying to woo them back ever since.
"For people with high drug expenditures, the 50 percent discount offers real savings," said Tricia Neuman, director of Medicare policy for the nonpartisan Kaiser Family Foundation. "It's certainly more helpful than no coverage at all, which is what they had previously."
More than 2 million beneficiaries already have gotten some help, discounts that have gone largely to middle-class seniors, because the poor are covered in the gap at taxpayer expense.
For retired elementary school teacher Carolyn Friedman, it meant she didn't need a loan to pay for drugs that keep her epilepsy under control.
"What a change for the better," said Friedman, 71, of Sunrise, Fla. "This year it was easier to pay my bills, whereas last year I had to borrow money to pay for my medications when I was in the doughnut hole."
One of her brand-name anti-seizure drugs cost about $370 in the gap last year, and the other about $270. This year Friedman paid about $150 and $130, respectively, for a month's supply.
Medicare covers about 47 million older and disabled people, and about 9 in 10 have some kind of prescription plan. Most rely on the drug benefit, also known as Part D, which is delivered through private insurance plans.
Beneficiaries have until Dec. 7 to change their drug plans for 2012. Consumer advocates recommend that seniors check their coverage during open enrollment to see if their current choice remains the best for next year. Many families start the process around the Thanksgiving holiday.
The coverage gap, a money-saving idea from a previous Congress, never has been popular.
It starts after an individual beneficiary and his or her drug plan have spent a total of $2,840 on medications for the year. Seniors are then on their own for the next $3,600.
Once total spending reaches about $6,440, Medicare's catastrophic coverage kicks in and beneficiaries pay only a token amount. Most people do not spend enough in the doughnut hole to qualify for catastrophic coverage.
Although few private insurance plans still cap the amount they spend on medications, Medicare's hole-in-the-middle approach is highly unusual.
The Republican-led Congress that passed the drug benefit under President George W. Bush was trying to balance coverage and costs, as many conservatives fretted about creating a new unfunded entitlement.
Supporters wanted all beneficiaries to get some initial benefit from the program, and they wanted to protect those with overwhelmingly high costs. The resulting compromise led to the doughnut hole.
Under Obama's health care law, the gap will be gradually phased down by 2020.
This year, the law provides a 50 percent discount on brand name drugs and 7 percent break on generics. Next year the discount on generics rises to 14 percent. When the changes are fully phased in, beneficiaries will still be responsible for their annual deductible and 25 percent of the cost of their medications until they reach catastrophic coverage.
If Republicans succeed in repealing what they dismiss as "Obamacare," the discounts would be wiped out as well.
Joan Gibbs thought her pharmacy had made a mistake. Her total cost for a brand-name painkiller in the doughnut hole came out lower than her co-payment earlier in the year, at a time her plan was picking up most of the tab.
"I reluctantly called the insurance company," said Gibbs, 54, who lives near Cleveland. "If they had made a mistake, I knew they would catch it sooner or later. I was very surprised that it turned out to be such a good discount."
Gibbs is on Medicare because of an auto-immune disorder and other medical problems that left her unable to work.
Other beneficiaries say it's still a struggle, even with the discounts.
John Robinson of Bel Air, Md., has diabetes and heart problems. A retired director of patient accounts for a hospital, Robinson said he runs up his credit card balance to pay for insulin, other medications and diabetic supplies in the doughnut hole.
"Thank God for credit cards," said Robinson, 71. "I thought it was better this year, but it still cost me more money than I had."
___
Online:
Medicare plan finder: http://tinyurl.com/2c6o5fh