Balloon Juice Survival Bunker Standoff Watch: Day 1 (Updated at 12:45 AM)

I know Anne Laurie is working up a new post from checking the dashboard, but since we’ve got two aging posts and breaking news, this’ll do for both an open thread and a discussion of ongoing events until she finishes and hits publish.

Ammon Bundy, his brother Ryan, another unnamed Bundy brother, Ryan Payne, and a number of other militia folks have now occupied the Malheur National Wildlife Refuge headquarters buildings. The Bundys have stated that they are prepared to stay there for years and that they are prepared to use violence if any attempt is made to remove them. So we now have breaking and entering into a Federal facility, criminal trespass, and terroristic threats. (h/t Paul W and Kelly in comments).

Here’s the link to Oregon Live’s update. They’ve just updated at 9:15 PM local time with the following statement from the local sheriff:

Statement from Harney County Sheriff Dave Ward: ‘After the peaceful rally was completed today, a group of outside militants drove to the Malheur Wildlife Refuge, where they seized and occupied the refuge headquarters. A collective effort from multiple agencies is currently working on a solution. For the time being please stay away from that area. More information will be provided as it becomes available. Please maintain a peaceful and united front and allow us to work through this situation.'”

Here’s the link to what the Feds had to say about what the Hammonds were actually accused, tried, and convicted of.

Here’s John Ritzheimer’s Youtube video (h/t LGF commenter Backwoods Sleuth):



Fat bottomed tails make the world go round

Holy mother of god, the  catch-up care in the co-ops was worse than I thought, and I thought it was already really bad:

At Arches, only 200 people—or 0.3% of its 63,000 members—accounted for 50% of its claims. Oncology care and organ transplants, in particular, hit Arches and many co-ops hard. Green said there was a lot of pent-up demand from people who previously could not access affordable policies or pay for the care out of pocket.

“The risk was a lot worse than anybody had expected,” Greene said during the call.

Arches, a PPACA co-op start-up that closed this fall due to the lack of risk corridor money, was probably expecting between 2,500 and 3,300 people to drive 50% of their claims expense, not 200 people.  This is why PPACA originally had the 3-Rs, specifically why it had the risk corridors as non-revenue neutral.  No one knew how bad or how good the risk pool was.  And the risk pool was far worse than projected.  Part of that was the lack of Medicaid expansion as Medicaid would have picked up quite a few people, and part of it our cost control mechanism in the past was based on ability to pay.  Services don’t cost a thing if they aren’t consumed because they are too expensive.

But holy mother of god, that is a hideous risk pool.  And it is one hell of a good illustration of why consumer directed health care and high deductible plans are limited in their actual system transformation method.  Those 200 people blew through any deductible limit by Valentine’s Day.



The Razor Cuts Deep

Hanlon’s Razor states that you should “Never attribute to malice that which can adequately be explained by stupidity.”  Maybe then I’m drastically overthinking why rural Kentucky voted Matt Bevin as governor.

The 66 percent of Owsley County that gets health coverage through Medicaid now must reconcile itself with the 70 percent that voted for Republican Governor-elect Matt Bevin, who pledged to cut the state’s Medicaid program and close the state-run Kynect health insurance exchange.

Lisa Botner, 36, belongs to both camps. A Kynector — a state agent representing Kynect in the field — recently helped Botner sign up for a Wellcare Medicaid card for herself and her 7-year-old son. Without that, Botner said, she couldn’t afford the regular doctor’s visits and blood tests needed to keep her hyperthyroidism in check.

“If anything changed with our insurance to make it more expensive for us, that would be a big problem,” Botner, a community college student, said Friday at the Owsley County Public Library, where she works. “Just with the blood tests, you’re talking maybe $1,000 a year without insurance.”

Yet two weeks earlier, despite his much-discussed plans to repeal Kynect and toughen eligibility requirements for Medicaid, she voted for Bevin.

I’m just a die-hard Republican,” she said.

Bu there’s more to it than that.

The trend seemed to hold across the state. At Transylvania University, political scientist Andrea Malji said she has crunched state data and found a “99 percent confidence level” between the counties’ Medicaid enrollment levels and their gubernatorial choices. The larger the Medicaid numbers, the more likely they were to back Bevin, she said. The lower the Medicaid numbers, the more likely they were to favor the Democratic nominee, Attorney General Jack Conway.

So Bevin — who said during the campaign that “the fact that we have one out of four people in this state on Medicaid is unsustainable” — racked up votes in rural, mostly poor counties where far more of the local population than that holds a Medicaid card. This was true even in traditional Democratic Party strongholds, such as Pike and Breathitt counties.

Malji, who is from Pulaski County, where Bevin captured 72 percent of the vote, said she heard people back home denounce “Obamacare” while thousands rushed to sign up with Kynect. They didn’t seem to realize that Kynect, Kentucky’s response to the federal Patient Protection and Affordable Care Act, is the same thing as Obamacare, she said.

There’s either voter disconnect here, where the people weren’t thinking about or weren’t aware of Bevin’s stance on health care, or these counties just have higher levels of social conservatives who thought it was more important to vote on social issues,” Malji said.

I don’t buy the former because of the correlation.  Bevin made it very, very clear what his stance was and made it clear for six months.  He went to town halls in these counties and straight up told them that he would get rid of Kynect and Medicaid expansion. His ads made it clear that he thought Kynect was going to bankrupt the state.  What I do buy is that maybe they decided that they could stick it to the party of the ni-CLANG! president, and that Bevin wouldn’t take my Medicaid, just take it from those people.

Governor-elect Bevin of course has other ideas.

I do not intend to re-enroll people at the same level going forward,” Bevin told reporters several days after his election. “There is not going to be a continuation of enrolling people at 138 percent of the poverty level. That is not going to happen.”

Perhaps we should call it Bevin’s Law:  white people will vote overwhelmingly against their own self-interest if it means it hurts those people too.


Trans-Plutocratic Plunder

Have you read the Trans-Pacific Partnership trade deal yet? You can read it right here, as no less a personage than President Obama himself informed me via email the other day. I’ve only made it to Chapter 2 so far (there are 30 chapters). It kicks insomnia’s ass.

As CP Pierce points out, Columbia economist Jeffrey Sachs says it’s a lousy deal that should be voted down. According to Sachs, TPP’s provisions “enshrine the power of corporate capital above all other parts of society, including labor and even governments,” and while it gives lip service to social fairness and sustainability goals, “the agreements are thin, unenforceable, and generally unimaginative.”

Climate change isn’t even mentioned, according to Sachs. Senator Warren also gives the proposal a frowny face.

Pierce concludes that this deal, along with education policy, “is going to be one of the only acts of [Obama’s] presidency with which the president justifies the criticisms levelled at him from the left.” Sounds about right.

If these analyses are accurate, I’m glad the Democratic candidates are fleeing the TPP like workers running toward daylight from a collapsing mine. But if the pessimists among us are to be believed, some version of a shitty deal is inevitable because Global Economy.

Maybe President Obama is among those pessimists and that’s why he supports this particular shitty deal. I’ve quoted my old co-blogger StrangeAppar8us on this topic before because he was so right about the declining influence of national sovereignty and rising power of multinational corporations:

In truth, nations have been obsolete as sovereign organizational units for some time. There are sovereign corporations and sovereign piles of capital, but nations are basically accounting entries associated with a particular profile of a) indigenous resources, b) comparative labor costs, c) relative social stability, d) relative currency strength and e) relative weakness of business taxation and regulatory controls. Local military power still matters, and some nations still command a certain reflexive residual deference to their post-WWII/Cold War primacy. However, in an age of cheap intercontinental shipping and wire transfers, nations are basically cultural theme parks competing for ticket sales.

One of my cousins once played “Goofy” at Disney World, wearing a hot, stuffy costume in the 90-degree heat for minimum wage while toddlers kicked him in the shins and older children whacked him in the nuts with replica light sabers. Welcome to the New Economy, fellow characters.



Kynecting the elections to policy

And now that officially sucks.

Tue Nov 03, 2015 at 5:22 PM PT (David Jarman): To recap, Republican Matt Bevin (whom you might remember from losing his tea-flavored primary challenge to Mitch McConnell in 2014) has won a surprising (to the extent that no poll had given him the lead) victory in Kentucky’s gubernatorial race.

Bevin (R-Sociopath) had run on a promise to repeal as much of PPACA as he could.  That means shutting down Kynect, the Kentucky exchange and turning down the very successful Medicaid expansion.  As Charles Gaba noted, he was promising to take away health insurance from 9% of the state.  And he looks like he won going away and with coattails.

There are two major health policy implications of a Bevins win.  The first is the switch from Kynect to Healthcare.gov.  This is not that big of a deal in and of itself.  It is a different portal and a different set of branding but subsidies flow to people who buy insurance from healthcare.gov after the King case.  The biggest downside is if Kentucky wanted to go the Wyden Waiver route, having their own exchange makes plumbing a Wyden Waiver, even a very conservative Wyden Waiver a whole lot easier.

The big policy change is Medicaid expansion.  Medicaid expansion covered approximately 420,000 Kentuckians as of this morning or 9% of the state. Bevin ran against expansion.  The best case scenario is the hospital groups march into  Bevin’s chief of staff office tomorrow and tell him flat out that their books don’t balance without expansion of some sort and they’ll lay covering fire for an extremely punitive waiver application.  That is the best case scenario and I’ll give it a 10% chance of happening.  The probable case scenario is 420,000 people are fucked as of February 1, 2016 and most of Appalachian Kentucky has medical care and medical financing resembling Third Wold nations again.

Kentucky, a red state, is highly likely to return to being a purple state on the New York TimeUpshot map of uninsurance rates:

NYTIMES Uninsurance Rate

It was a good two years of actually connecting people to health insurance without the death defying worry that a toothache could either be immediately fatal or financially destroying.

 



Many Bothans Died To Bring Us These Tax Cuts

The practical upshot from the chaos in the House GOP with Orange Julius now gone and Paul Ryan now Speaker of the House is that the Austerity Death Star will soon be fully operational.

The Wisconsin Republican who claimed the gavel last week is one of Congress’ preeminent tax experts, an ardent advocate of rewriting the code with lots of ideas on how to do it. Over the years, he’s gone further than most lawmakers in pushing politically fraught changes that have gone nowhere, such as wiping out a major tax break for employer-provided health plans and making it harder for the wealthy to claim the hugely popular mortgage-interest deduction.

But now Ryan has far more power to put the issue on Washington’s agenda — and the latest budget deal between congressional leaders and the White House should give him ample room to launch his speakership without being distracted by constant battles over funding the government and raising the debt limit. So some advocates are recalibrating the odds of a long-elusive tax overhaul that they say could spur new jobs and bring corporate money back from overseas.

Sweeping tax change won’t happen this year, supporters say, with lawmakers still staring at a stack of unfinished business — or next year, when the 2016 election will loom even larger. But they say it’s suddenly a lot more likely in the early years of the next presidency, especially if the Republicans win the White House.

It certainly comes as close to guaranteeing it as possible,” said a top Republican staffer. “It’s his No. 1 priority — it’s what he cares about most.”

The sort of ambitious reform Ryan has in mind, which would be the first since 1986, promises to cut both individual and corporate tax rates in exchange for junking scores of credits, deductions and other special provisions. Any rewrite would be hugely controversial, with an array of powerful interest groups sure to line up to defend their favorite provisions, not to mention many Democrats who’ve long complained that Ryan’s plans amount to a giveaway to the rich.

In a speech to the House just before his swearing-in Thursday, Ryan named tax reform as one of his top priorities.

It was bad enough when the Ryan Austerity Budget was a club used to get sequestration into play in 2013.  But as Speaker, Ryan now has significant power as far as bringing his austerity monster to life.  If you still had questions as to what’s at stake a year from now, better hope the GOP doesn’t have the keys to both Congress and the White House when Congress gets called into session in January 2017.

Otherwise, the Austerity Death Star is going to do a pretty good job of blowing America up.



Buyer’s Remorse From Topeka To Salina

Turns out GOP Gov. Sam Brownback’s ridiculous austerity program is incredibly unpopular in Kansas a year after being re-elected on a platform of massive tax cuts magically creating revenues.  Hoocoodanode, right?

A new poll from the Docking Institute of Public Affairs at Fort Hays State University shows only 18 percent of Kansans are satisfied with Gov. Sam Brownback’s performance in office, and most (61 percent) think his signature tax policies have either been a “failure” or a “tremendous failure.”

The Fall 2015 “Kansas Speaks” survey also showed a large majority (61 percent) favor expanding Medicaid. Another 84 percent oppose requiring colleges and universities to allow firearms on campus, and 82 percent are skeptical that voter fraud is a significant problem in Kansas.

The survey of 638 Kansas adults was conducted Sept. 14 through Oct. 5, with a margin of error of 3.9 percent.

The survey asked respondents to indicate whether they were very satisfied, somewhat satisfied, neutral, somewhat dissatisfied or very dissatisfied with a list of elected officials. Overall, only 18 percent said they were either somewhat or very satisfied with Brownback.

That question is slightly different from the standard polling question, which asks people whether they “approve” or “disapprove” of a person’s performance in office. It wasn’t immediately clear how much impact that subtle difference in wording may have had on the results. One thing that was clear, though: Brownback’s “satisfaction rating” among Kansans was 10 points lower than President Barack Obama’s.

Brownback is losing to Obama in a blood red state.  That’s how bad his austerity regime has been for Kansans, and in fact his platform planks of opposing Medicaid expansion, putting guns on university campuses, and voter suppression laws have been complete losers for the guy.

I’d argue that Brownback has actually replaced Jindal as the most hated governor in the US right now, especially with Jindal’s term up in January.  Kansas on the other hand has three more years of Brownbackonomics to go, and I’m pretty sure his massive tax hike on cigarettes and beer in order to make up for his ever-deepening budget hole may put him in single digits by this time next year.

But once again, Kansas, you brought this on yourself.  You knew exactly what Brownback was going to do, he followed through, and you’re all surprised now that your state is a hellhole?

How about “stop voting Republican” guys?