Age based subsidies and geographic disparities

I am reading through the leaked Republican Reconciliation bill at Politico.  

P.66 has the replacement subsidies that are determined solely by age and do not reflect either income or local cost of coverage:

  • 18 to 29 — $2,000 year
  • 30-39 — $2,500 year
  • 40-49 — $3,000 year (note mid-40s is when the cost curve which is incresing from a 3:1 band to a 5:1 band starts getting expensive)
  • 50-59 — $3,500 year
  • 60+ — $4,000 year

There are major distributional impacts that will kick the Republican base voters in the teeth.  Most notably the increase of the age premium band from 3:1 to 5:1 will make insurance much more expensive for older insured individuals.  The subsidy band is only 2:1.

In Pittsburgh under the 3:1 band, a 29 year old can buy a catastrophic policy today for less than their monthly subsidy. A Bronze plan would cost $20 out of pocket every month and a Silver plan $47 per month.  Under the same banding, a 64 year old with their $333 non-income adjusted subsidy will be able to buy a catastrophic policy for $89 per month, a Bronze plan for $152 per month and a Silver plan for $211 per month.  This is a favorable set of assumptions for the 64 year old as the age banding is 3:1 instead of 5:1.  Less favorable assumptions would make the Silver policy cost $600 or more after subsidy for a 64 year old.  The only person who will buy that policy is someone who is already getting extremely expensive treatment in the hospital.

That appeals to liberal moral interest and a bit of schradenfreude.  A more useful angle of attack is to look at what that 29 year old and 64 year old can buy after the subsidy in Alaska (zip code 99501).  There a 64 year old under 3:1 band would see a Bronze plan cost them $1,300 a month and a Silver plan cost them $1,700 a month after the flat age based subsidy is applied.  These numbers will get even larger once a 5:1 premium band is applied.  This will death spiral the individual market.

Apply the same analysis to Arizona which also has two Republican Senators that count on an older supporting voter base and there are stories to tell which will inflict significant political risk to Republican Senators.



Time to call Congress

You know what to do.

Call Congress. If your Senator is a firm No vote to Puzder, thank them and their staff.

If they are a firm Yes vote, tell them they are wrong.

If they are mushy, encourage them to vote no.

Burn those phone lines up.

And let’s see if we can get another minor win.

UPDATE 1

UPDATE 1

Puzder is withdrawing.

 



Government, Meet Bathtub

It’s easy to run a government that does (next to) nothing.

Here’s where Trumpism — or really Pence-ism, or really, exactly what the GOP has been promising (threatening) will have its most immediate, and quite possibly its most damaging impact:

Staffers for the Trump transition team have been meeting with career staff at the White House ahead of Friday’s presidential inauguration to outline their plans for shrinking the federal bureaucracy, The Hill has learned.

The departments of Commerce and Energy would see major reductions in funding, with programs under their jurisdiction either being eliminated or transferred to other agencies. The departments of Transportation, Justice and State would see significant cuts and program eliminations.

The Corporation for Public Broadcasting would be privatized, while the National Endowment for the Arts and National Endowment for the Humanities would be eliminated entirely.

Overall, the blueprint being used by Trump’s team would reduce federal spending by $10.5 trillion over 10 years.

The NEH and NEA cuts are at once symbolic — the GOP is killing stuff liberals like, which is reward enough in those quarters — and, I think, intended to distract from other hugely reckless choices:

The Heritage blueprint used as a basis for Trump’s proposed cuts calls for eliminating several programs that conservatives label corporate welfare programs: the Minority Business Development Agency, the Economic Development Administration, the International Trade Administration and the Manufacturing Extension Partnership. The total savings from cutting these four programs would amount to nearly $900 million in 2017.

At the Department of Justice, the blueprint calls for eliminating the Office of Community Oriented Policing Services, Violence Against Women Grants and the Legal Services Corporation and for reducing funding for its Civil Rights and its Environment and Natural Resources divisions.

At the Department of Energy, it would roll back funding for nuclear physics and advanced scientific computing research to 2008 levels, eliminate the Office of Electricity, eliminate the Office of Energy Efficiency and Renewable Energy and scrap the Office of Fossil Energy, which focuses on technologies to reduce carbon dioxide emissions.

Under the State Department’s jurisdiction, funding for the Overseas Private Investment Corporation, the Paris Climate Change Agreement and the United Nations’ Intergovernmental Panel on Climate Change are candidates for elimination.

The single most important point I can make is that this is the Kansas-ification of America.  This isn’t a Trump policy choice.  This is Mike Pence shepherding plans the Republican Party has been trying to implement for years, decades even.  I doubt it will all get through, but much of it will, I’d guess, and when it does we will need to hang every shitty outcome and terrible choice around the neck of every Republican officeholder.

This is what they want. This is what they told us they wanted. They’re likely going to get it, to some approximation.  And they’re going to have to own it, so that once again, Democrats can come in and fix the serial catastrophes we’re going to witness very damn soon.

Also, too — who wants to bet all the pieties about the deficit and restoring balance to the budget will fall to the tax cuts to come?

Fuck it.  I’m heading back to the seventeenth century.

Image: Francesco de Rossi, Bathesheba at her Bath1552-1554.



Congratulations, West Virginia

You screwed yourself good this time:

But that drop, it turns out, is even more pronounced among poor whites. Gallup-Healthways tells me that among whites without a college degree who have household incomes of under $36,000, the uninsured rate has dropped from 25 percent in 2013 to 15 percent now — a drop of 10 percentage points. It’s often noted that the law has disproportionately expanded coverage among African Americans and Latinos. That is correct, but it has also disproportionately expanded coverage among poor white people.

Now, it’s hard to know how many people we’re talking about here. But other evidence supports the idea that a lot of red state voters have gained coverage from the law. In some parts of rural Kentucky, the Medicaid expansion has greatly expanded coverage. And CBS News recently reported that even some Republican officials in the GOP-led states that expanded Medicaid are not prepared to see that evaporate. Gallup-Healthways numbers also show that the drop in the uninsured rate has outpaced the national average in some red states that have expanded Medicaid, like Kentucky, Arkansas, and West Virginia.

Did people benefiting from Obamacare who voted for Trump really expect repeal to happen? I think we need more reporting on this question. Yes, Trump did repeatedly say he would repeal Obamacare. But he also said he would replace it with “something terrific.” And he explicitly went out of his way to create the impression that he does not agree ideologically with Republicans who are hostile to government efforts to supply health care to those who can’t afford it.

Now, it’s always possible that many voters backed Trump in the full knowledge that their Obamacare might be repealed, for other reasons — because, for instance, he’ll supposedly bring manufacturing and coal jobs roaring back. Before long, those voters will learn whether their bet was a well-placed one. It’s also possible that Trump will surprise us all and insist on some kind of replacement that somehow preserves much of Obamacare’s coverage expansion. And a kick-the-can-down-the-road scenario which keeps deferring the harshest fallout from repeal is also a possibility.

About those jobs:

After campaigning as a champion of coal miners, Donald Trump is reportedly close to choosing for commerce secretary a New York billionaire who owned a West Virginia mine where a dozen miners were killed in 2006. Trump’s favored candidate, Wilbur Ross, also engineered buyouts that cost workers their benefits and their jobs. It’s a striking choice, considering Trump’s promises to improve the lives of coal miners and other working-class Americans.

Ross made his money collecting “distressed assets”—failing steel and textile mills in the Midwest and South, and coal mines in Appalachia. Dubbed the “the King of Bankruptcy,” Ross cut jobs, wages, pensions, and health benefits at the companies he acquired, and reaped the profits. In the early 2000s, Ross’s foray into the steel industry netted him a $267 million personal windfall, but stripped health-care benefits from more than 150,000 retired steelworkers. Then he moved on to the coal industry, at one point controlling as much as $1.2 billion in coal assets through his company, the International Coal Group.

I’m sure he has miners best interests at heart. Oh, about those miners:

Again and again, President-elect Donald Trump presented himself as the coal miners’ candidate. During the campaign, he promised to bring coal back into the economy, and jobs back into struggling Appalachian towns.

But now some in coal country are worried that instead of helping, Trump’s first actions will deprive miners — and their widows and children — of the compensation they can receive if they are disabled by respiratory problems linked to breathing coal mine dust.

That’s because buried in the Affordable Care Act are three sentences that made it much easier to access these benefits. If Trump repeals Obamacare — as he vowed to do before the election — and does not keep that section on the books, the miners will be back to where they were in 2009, when it was exceedingly difficult to be awarded compensation for “black lung” disease.

And just how many people fucked themselves? Kthug runs the numbers:

As Greg Sargent points out, the choice of Tom Price for HHS probably means the death of Obamacare. Never mind the supposed replacement; it will be a bust. So here’s the question: how many people just shot themselves in the face?
My first pass answer is, between 3.5 and 4 million. But someone who’s better at trawling through Census data can no doubt do better.

Here’s my calculation: we start with the Census-measured decline in uninsurance among non-Hispanic whites, which was 6 million between 2013 and 2015. Essentially all of those gains will be lost if Price gets his way.

How many of those white insurance-losers voted for Trump? Whites in general gave him 57 percent of their votes. Whites without a college degree — much more likely to have been uninsured pre-Obama — gave him 66 percent. Apportioning the insurance-losers using these numbers gives us 3.42 million if we use the overall vote share, or 3.96 million if we use the non-college vote share.

There are various ways this calculation could be off, in either direction. Also, maybe we should add a million Latinos who, if we believe the exit polls, also voted to lose coverage. But it’s likely to be in the ballpark. And it’s pretty awesome.

Just give dad some robitussin and a Make America Great Again hat, you stupid, stupid people. I mean I feel horrible, but they voted for it. Not just for Trump. All of Appalachia is red, red, red and they’ve been voting this way for a while. There are no Democrats save Joe Manchin left to blame.

And they are still coming for you social security, you stupid bastards.

disabilitymap

1. West Virginia
> Pct. of working age population with benefits: 9.0%
> Pct. with recurring neck and back pain: 39.0% (the highest)
> 2011 labor force participation rate: 54.1% (the lowest)
> 2011 unemployment rate: 7.8% (23rd lowest)

No state had a higher percentage of working age people receiving SSDI benefits than West Virginia. In addition, the benefits received from by the federal government were more generous compared to most states. The average monthly benefit of more than $1,140 in 2011 was the 10th highest of all states. Almost 21% of recipients received monthly benefits of at least $1,600, a higher percentage than all but three states. Like most states on this list, West Virginia is among the less-educated states in the country. Just 18.5% of the adult population had a bachelor’s degree, the lowest percentage of all states. Also, few residents in the state had jobs. Just 54.1% of residents were considered part of the labor force in 2011, by far the lowest percentage of any state in the nation.

And those who aren’t on disability are just plain elderly and receiving social security benefits:

elderly

On top of all of this, some lady had some idea about revitalizing the region:

Hillary Clinton is committed to meeting the climate change challenge as President and making the United States a clean energy superpower. At the same time, she will not allow coal communities to be left behind—or left out of our economic future. That’s why Clinton announced a $30 billion plan to ensure that coal miners and their families get the benefits they’ve earned and respect they deserve, to invest in economic diversification and job creation, and to make coal communities an engine of US economic growth in the 21st century as they have been for generations.

She also had some thoughts about social security and medicare you can read about here:

Defend Social Security against Republican attacks. Republicans are using scare tactics about the future and effectiveness of Social Security to push through policies that would jeopardize it. The real threat is Republican attempts to undermine the bedrock of the system. Hillary believes that Social Security must remain what it has always been: a rock-solid benefit that seniors can always count on—not subject to the budget whims of Congress or to the fluctuations of the stock market. She fought Republican efforts to undermine Social Security when she was a senator and throughout her career, and she will fight them as president.

As president, Hillary will:

Fight Republican attempts to repeal the Affordable Care Act. The Affordable Care Act made preventive care available and affordable for an estimated 39 million people with Medicare and saved more than 9 million people with Medicare thousands of dollars in prescription drug expenses. Read more here.

Fight back against Republican plans to privatize or “phase out” Medicare as we know it. Republicans have called for privatizing or even “phasing out” Medicare and shifting millions more seniors into private plans that would dramatically raise costs. Hillary will stand against these attempts to weaken the program. Read more here.

You stupid, stupid, stupid people. And there honestly is no real way to stop this. You’ve given them majority rule over EVERYTHING. All Democrats can do is scream. I don’t know if there is even any real point to calling Manchin. He won’t get in the way of any nominees https://www.washingtonpost.com/blogs/plum-line/wp/2016/11/29/obamacare-is-probably-toast-and-a-lot-of-poor-white-trump-voters-will-get-hurt/?utm_term=.cba0274e91fe. Hell, he’ll probably vote to confirm Sessions and Price, then they will gut medicare, and the WV voters in their infinite wisdom will vote for his Republican opponent in 2018 because they will punish incumbents because they are angry and we’ll have a completely red delegation who will just give them more of the same. It’s sad and hysterical at the same time.

You can lead a horse to water but you can’t keep them from pissing in it and then drowning themselves in the urine.



Distributional Impacts of Price Plan (Reprise)

Now that we know Rep. Tom Price (R-GA) will be the next Secretary of Health and Human Services, it would be a good idea to look at the mechanics of his Obamacare Repeal and Replace bill. We did this in 2015 for HR2300 and I am reprinting the post on distributional impacts below. The mechanics of the plan are described in this post:

TLDR: The plan is good if you are healthy and wealthy as there are a ton of tax breaks and tax shelter expansions through HSA expansions. If you are chronically ill or poor, you are significantly worse off. And now for the moldy oldie:
Read more



Where There’s a Will, There’s a Way to Screw the American People

monopoly1

Donald Trump, the GOP, and his wealthy backers had a real problem. On December 1st, an Obama administration rule that would expand by multiple millions of people the number of those who were eligible to receive overtime pay up to those who earn $47,500 a year was set to start:

In 2014, President Obama directed the Secretary of Labor to update the overtime regulations to reflect the original intent of the Fair Labor Standards Act, and to simplify and modernize the rules so they’re easier for workers and businesses to understand and apply. The department has issued a final rule that will put more money in the pockets of middle class workers – or give them more free time.

The final rule will:

– Raise the salary threshold indicating eligibility from $455/week to $913 ($47,476 per year), ensuring protections to 4.2 million workers.

– Automatically update the salary threshold every three years, based on wage growth over time, increasing predictability.

– Strengthen overtime protections for salaried workers already entitled to overtime.

– Provide greater clarity for workers and employers.

The final rule will become effective on December 1, 2016, giving employers more than six months to prepare. The final rule does not make any changes to the duties test for executive, administrative and professional employees.

The Republicans did not want this to go into effect, because if it did, they would find it difficult to repeal on 20 January, because even the American people are not dumb enough to notice their overtime being cut just two months after they started to receive it.

Fortunately for the Republicans, this just happened:

A Texas judge blocked President Obama’s bid to expand overtime pay protections to millions of Americans on Tuesday, thwarting a key presidential priority just days before it was set to take effect.

The Labor Department rule would have doubled the salary level at which hourly workers must be paid extra for overtime pay, from $23,660 to $47,476. Siding with business groups including the U.S. Chamber of Commerce, Texas District Judge Amos L. Mazzant III halted it.

The rule, finalized in May, represented the first such change in more than a decade and was hailed at the time as the most consequential action the Obama administration could take for middle-class workers without congressional involvement.

And with that, a significant payraise to millions of voters, economically anxious and otherwise, was strangled in the crib, and no fingerprints were left behind. Come January 20, Trump, Paul Ryan, and the coterie of wealthy industrialists and banksters who run this nation will quietly rescind the rule change, and no one will even know it ever existed.

America, fuck yeah!



Gimme Brains for Breakfast Baby

Jump

Holy shit, Senator Elizabeth Warren apparently murdered a bankster in the Senate today:

I’m honest to goodness physically aroused.