This Week’s Primary: “Indiana Is Weird”

Times like this, I really miss Doghouse Riley. Imagine what he would’ve done with the newest ways the state GOP is embarrassing itself — as Jim Newell describes it, “Indiana Gov. Mike Pence Thinks Donald Trump is Perfect! (He Also Endorses Ted Cruz.)”

And here’s Craig Fehrman explaining at FiveThirtyEight “why Abe Lincoln’s dad would be a Trump voter”:

… I’ve lived in Indiana my whole life, outside of a few years passed on the East Coast in grad school, and I have to say: All the attention has been nice. It’s nice to be noticed, however fleetingly, for something other than hosting sporting events and being a part of Abraham Lincoln’s formative years.

The Lincoln who’s most relevant in the upcoming primary, though, is Abe’s father, Thomas. For more than a decade, Thomas and his family lived in Indiana, and as I’ve watched the politicians and pundits try to figure Indiana out I’ve thought a lot about Thomas. Indiana, which is 86 percent white, may seem demographically similar to nearby states like Ohio (83 percent white) and Wisconsin (88 percent white). But, in truth, Indiana is a much stranger place than it’s given credit for, with a history and heritage that divide it from other Midwestern states. The Hoosier State was settled from the south and isolated from cultural change, and you can still see the effects of that today. In fact, that’s why it’s actually pretty hard to predict how Indiana will vote in its primary. That’s why, if you really want to understand Indiana, you need to go back to the time of Thomas Lincoln.
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Brave New Worlds

ETA: Sorry about the bigfoot (proof, once again, that the front-pagers really don’t collude). But I’ve got to run, so I’m just going to leave this here on the theory that this community can handle more than one topic at a time.

You may have caught this news, but today Nature published a report on the discovery of three earth-scale planets in orbit around just about the least impressive star it’s possible to be.

Edvard_Munch_-_Starry_Night_(1922–24)

What’s most intriguing is that the dimness of that parent star — now known as TRAPPIST-1, after the instrument at the heart of this discovery — makes it just possible (if you squint just right) to glimpse a possible opening for life on its planets.

It’s tricky, because the two better-characterized planets are terribly close to their sun, with orbits of 1.5 and 2.4 days.  But TRAPPIST-1 is what’s called an “ultracool dwarf” — and even at that distances, the two planets would have equilibrium temperatures that are pretty damn hot.  But — if everything broke just right, there would be some locations that could be cool enough to support liquid water on the surface.

That’s one of the big pre-conditions exobiology researchers/dreamers imagine would be valuable/necessary for the emergence of life beyond earth.  Given how many ways we can imagine (and all the ways we can’t) that those circumstances might not pan out, I wouldn’t hold my breath waiting for a signal from our new friends on a distant world.

But the real juice behind this finding comes from the fact that these planets are decent candidates for transmission spectroscopic analysis of their atmospheres (if they have them) during their transits across the face of their star.  All it will take is the next generation of large, infrared-capable telescopes:  the James Webb Space Telescope, scheduled to launch in 2018, and instruments like the Giant Magellan Telescope, the European Extremely Large Telescope, both now starting construction in Chile, and the Thirty-Meter-Telescope, now stalled in Hawaii.

I write more about this over at The Atlantic. It’s a fun tale — a small team pursuing a hunch that has led to a significant (or at least enticing and delicious) advance in our grasp of the possible out there.

So — if you’re tired of terrestrial politics, have some fun contemplating possible home worlds for the Lectroid going by the name of Cruz.

Image:  Edvard Munch, Starry Night, 1922-24








Pissing It All Away

The Sanders campaign is pissing everything they accomplished all away:

Bernie Sanders predicted Sunday that Hillary Clinton would not win enough pledged delegates to claim the nomination ahead of the Democratic convention in Philadelphia, and he delivered his most forceful call yet for superdelegates in states he’s won to consider throwing their support to him.

Speaking at the National Press Club in Washington, D.C., the Vermont senator argued that Clinton “will need superdelegates to take her over the top at the convention in Philadelphia. In other words, it will be a contested convention.”

Sanders said that in the states where he handily defeated Clinton, superdelegates who aren’t supporting him should reconsider aligning themselves with the will of voters of those states.

“In the state of Washington, we won that caucus with almost 73 percent of the vote there — 73 percent of the vote. In anybody’s opinion, that is a massive landslide. But at this point Secretary Clinton has 10 superdelegates from the state of Washington, we have zero,” Sanders said, offering an example of a state where he won the popular vote but did not collect any superdelegates. “I would ask the superdelegates from the state of Washington to respect the wishes from the people in their state and the votes they have cast.”

Sanders’ comments came just ahead of Tuesday’s Indiana primary, as his path to the nomination has become even more narrow due to recent defeats. The campaign recently laid off a large number of staff members in states that have voted.

Caucuses, we must note, are less democratic than even closed primaries. Yet there he goes. Kthug cuts to the chase:

What we’re getting instead is an epic descent into whining. He dismissed Clinton victories driven by black voters as products of the conservative Deep South; he suggested that his defeat in New York was unfair because it was a closed primary (you can argue this case either way, but requiring that you identify as a Democrat to choose the Democratic nominee is hardly voter suppression — arguably caucuses are much further from a democratic process); then, with the big loss in the mid-Atlantic primaries,he has turned to a sort of fact-free complaint that any process under which Bernie Sanders loses is ipso facto unfair, and superdelegates should choose him despite a 3 million vote deficit.

At this point it’s as if Sanders is determined to validate everything liberal skeptics have been saying all along about his unwillingness to face reality — and all of it for, maybe, a few weeks of additional fundraising, at the expense of any future credibility and goodwill. Isn’t there anyone who can tell him to stop before it’s too late?

FWIW, Nader Be Sirens is an anagram of Bernie Sanders.



Hell’s Trapdoor (Open Thread)

In this video, right after Carly Fiorina says, “Your next President of the United States, Ted Cruz,” she disappears:

It is reported that she fell off the stage and was uninjured. Maybe. But who’s to say the devil himself didn’t just open a trapdoor to hell after she told that big fat lie?

Satan is allegedly the “Father of Lies,” so why would a standard bit of campaign mendacity provoke his wrath? Maybe the devil hates that miserable son of a bitch Cruz as much as everyone else does.

Open thread!



Woodworkers and assignment flexibility

Charles Gaba notes today that Pennsylvania’s  Medicaid Expansion has seen more people sign up for it than were projected to be eligible for it.  Michigan had the same pattern.

Officials expected that up to 600K would be eligible, and as of last summer 439,000 had already signed up. By December it was up to 500K.

Well, one year after standard expansion went live, the state of Pennsylvania is reporting that:

As of April 2016, the expansion had reached 625,970 newly eligible Pennsylvanians, ages 18 to 64.

Yup, that’s 26,000 more people enrolled than anyone had even thought were eligible for the program.

I think a few things could be going on here. The first is that our system of counting the poor and near poor and the high income variance might not be as good as we thought it was.

Secondly, I think the woodworker situation should be examined. Woodworkers is a wonk term for people who were eligible for Legacy Medicaid but did not sign up for it. However there has been a three year consciousness raising outreach on the importance of getting health insurance as well as increased connectors to assistance combined with fewer administrative barriers to signing up for Medicaid (both Legacy and Expansion flavors of Medicaid).  So a lot of people who were Legacy Medicaid eligible came out of the “woodwork” and signed up for Medicaid during one of the open enrollments.

My question on this is on the sub-population of Medicaid woodworkers who through a variety of circumstances could qualify for both Legacy Medicaid and income based Medicaid expansion.  I know in states with a 1115 waiver such as Arkansas, these individuals are moved to the Legacy Medicaid pool but I am not sure how this works in states with a straight-up expansion.

Legacy Medicaid is split funded.  The Federal government pays through the FMAP between 50% and 74.3% of Legacy Medicaid medical costs.  The state picks up the remainder.  Administrative costs are split a bit differently.  Expansion Medicaid is currently single source funded.  It is, until the end of this year, a 100% Federal program.  Going forward it will eventually be a 90%-10% Federal/State split.

This is important from a state Medicaid administration point of view.  An individual who is categorized as a Medicaid Expansion member is far cheaper (currently free) to the state government than someone who is on the books as a Legacy Medicaid member.  From an individual beneficiary point of view, there is minimal difference besides different codes on their ID card, but this is a big deal at the administrative level.  The states have every incentive to move as many people who could conceivably be qualified as Expansion eligible and Legacy eligible to Expansion.

My question for Pennsylvania, Michigan and other states with high Medicaid expansion enrollment is what percentage of those individuals are unique new individuals to Medicaid who would not have qualified under Legacy rules when they applied?  If that number is low, then the shifting of membership to FMAP optimization categories would be low.  If that number is high, then there is significant optimization happening.








Only The Government Deserves Privacy

This is disturbing:

The government hacking into phones and seizing computers remotely? It’s not the plot of a dystopian blockbuster summer movie. It’s a proposal from an obscure committee that proposes changes to court procedures—and if we do nothing, it will go into effect in December.

The proposal comes from the advisory committee on criminal rules for the Judicial Conference of the United States. The amendment would update Rule 41 of the Federal Rules of Criminal Procedure, creating a sweeping expansion of law enforcement’s ability to engage in hacking and surveillance. The Supreme Court just passed the proposal to Congress, which has until December 1 to disavow the change or it becomes the rule governing every federal court across the country. This is part of a statutory process through which federal courts may create new procedural rules, after giving public notice and allowing time for comment, under a “rules enabling act.”1

The Federal Rules of Criminal Procedure set the ground rules for federal criminal prosecutions. The rules cover everything from correcting clerical errors in a judgment to which holidays a court will be closed on—all the day-to-day procedural details that come with running a judicial system.

The key word here is “procedural.” By law, the rules and proposals are supposed to be procedural and must not change substantive rights.

But the amendment to Rule 41 isn’t procedural at all. It creates new avenues for government hacking that were never approved by Congress.

The proposal would grant a judge the ability to issue a warrant to remotely access, search, seize, or copy data when “the district where the media or information is located has been concealed through technological means” or when the media are on protected computers that have been “damaged without authorization and are located in five or more districts.” It would grant this authority to any judge in any district where activities related to the crime may have occurred.

This is not how this is supposed to work. Using a VPN does not make someone a criminal, and certainly shouldn’t void one’s constitutional rights.








Everyone Hates Ted

humansuits

This headline over the weekend cracked me up:

headline

Here’s the deets:

Even as Donald J. Trump trounced him from New Hampshire to Florida to Arizona, Senator Ted Cruz could reassure himself with one crucial advantage: He was beating Mr. Trump in the obscure, internecine delegate fights that could end up deciding the Republican nomination for president.

“This is how elections are won in America,” Mr. Cruz gloated after walking away with the most delegates in Wyoming.

But it turns out that delegates — like ordinary voters — are susceptible to shifts in public opinion. And as the gravitational pull of Mr. Trump’s recent primary landslides draws more Republicans toward him, Mr. Cruz’s support among the party’s 2,472 convention delegates is softening, threatening his hopes of preventing Mr. Trump’s nomination by overtaking him in a floor fight.

With each delegate Mr. Trump claims, he gets closer to the 1,237 he needs to clinch the nomination outright, and Mr. Cruz’s chances of stopping him — even if he pulls out a victory in Tuesday’s Indiana primary — shrink.

Before Mr. Trump’s crushing victory in Pennsylvania last week, Mr. Cruz’s campaign boasted that it had 69 people devoted to acquiring as many as possible of the state’s 54 unbound delegates — who are free to vote as they please on the first ballot, making them potentially decisive players in a contested convention.

Mr. Cruz won only three.

The more they know about him, the less they like him.








True Belief Rewarded

Sorry I didn’t post last week. There was some travel, some allergies, and some heavy searching for morel mushrooms. (Zero found to date despite ongoing Talmudic scrutiny of this map and related documents.)

But I’ve also been bummed about the Bernie campaign implosion. It happened fast and furious, and the fact that it happened in the wake of massive voting irregularities in his/my home, New York City, didn’t help.

It was depressing, but I’m doing my best to take solace from the fact that Bernie’s campaign (which succeeded beyond all reasonable expectations, considering where it began) is of a piece with Occupy, Arab Spring, Black Lives Matter, the many campus movements currently underway, and a zillion other indicators. (Including the rise of Obama himself, btw.) We seem to be on the cusp of a new progressive era fueled by technology-enabled people power, while our enemies have fulfilled our version of Voltaire’s prayer and made themselves ridiculous.

So, in the matters of both morels and mores (a stretch, I know!) I remain toujours hopeful.

Anyway, sometimes success comes at you sideways. Yesterday, I found a bazillion ramps on a nearby hill. I harvested a few, from which “we” (Royal We) made a heavenly, megagarlicky pesto from this recipe, using vegan parmesan instead of pecorino.

And last week, I found years of faith in another realm amply rewarded:

I imagine some Juicers will be crying tears of ecstatic joy at this while the rest will all be wtf…

PS – “I’m going to roll away the Hamm.” LOLLLLLLLLLLLLLLLLL



Variance, risk adjustment and targeting

Risk adjustment is the process by which insurers with sicker than average populations get money from insurers with healthier than average populations. One of the  goals is to make cherry picking an inherently not particularly profitable activity. Some companies, like Centene/Ambetter, will deliberately seek out to insure a reasonably healthy population while accepting that they’ll have a massive cash outflow.  Risk adjustment occurs by the calculation of relative health/risk scores where individuals with certain diagnosises are scored in different manners.   The score will (roughly) reflect the average incremental cost multiplier for people who have a condition compared to the general population where everything else is held equal.

These risk scores are very rough guesses.  They are averages with wide error bands.  In Medicare, in 2015, an individual with Type 2 Diabetes was assumed to cost 15% more than the average Medicare beneficiary.  However there is wide variance in individual costs for people who have the same risk score.

And that is an area of an interesting possibility of an exchange hack.  Some Exchange insurers have started to issue condition specific policies.  There are several plans on Exchange that are actively recruiting individuals with diabetes.  This is odd and a clear signal of the transformation of the individual market.  Insurers are actively seeking to take on risk.

There are two reasons why insurers would want to do this.  The first is that risk adjustment is accurately pricing the incremental cost of treatment on average.  These insurers offering specific condition policies may have come up with either a better treatment regimen or they are merely paying their providers very little so the same treatment regime costs less than the risk adjustment bump payment.  This is a straightforward change that will put some downward pressure on pricing.

The other thing that could be going on is that insurers are skimming the low cost variance of the diabetes population.  This could be done by benefit design, it could be done by marketing these plans at gyms and nutritionist offices which would be attractive to people who are already mostly compliant with their treatment plans.  It could be done in a half dozen ways.  If these specific condition plans are primarily a risk selection play for low actual but high designated transfer payment individuals than it is a cost shift as the remaining diabetic population is being covered by other insurers who are not getting sufficiently large transfer payments to cover the incremental cost.








Monday Morning Open Thread: Everything Is Political

break thru the glass ceiling cornered

(Mike Baldwin via GoComics.com)
.

Because “The history of the world, my sweet… is who gets eaten and who gets to eat”.

Does it still matter that the inventor of Bitcoin may have been discovered?

What else is on the agenda as we start another week?



Late Night Open Thread: Revenge of the Girl Grind

If not for that last bit — and for all the young girls who’ll finally see a President who looks like them — I’m not sure how I’d make it through till November.



Open thread

For talking about anything other than what every GoT fan is talking about right now.

Poll time! Do you still have that dream once in a while where you need one last test to get your high school diploma and you realize that it’s eighty pages long and you didn’t study? I want to know how common that is.








GoT thread

Watch Game of Thrones? Use this space to talk about what just happened. And god(s) help those of you who click through hoping to avoid spoilers.








Long (Hate) Read: “The Selling of Obama”

This showed up online well in advance of last night’s WHCD, as part of Politico‘s “Media Issue,” as a story about how the President failed to uphold the Media Village Idiots’ prescriptions:

President Barack Obama insists he does not obsess about “the narrative,” the everyday media play-by-play of political Washington. He urges his team to tune out “the noise,” “the echo chamber,” the Beltway obsession with who’s up and who’s down. But in the fall of 2014, he got sick of the narrative of gloom hovering over his White House. Unemployment was dropping and troops were coming home, yet only one in four Americans thought the nation was on the right track—and Democrats worried about the midterm elections were sprinting away from him. He wanted to break through the noise… [I]in a speech at Northwestern University, he tried to reshape his narrative. If the presidential bully pulpit couldn’t drown out the echo chamber, he figured nothing could.

The facts were that America had put more people back to work than the rest of the world’s advanced economies combined. High school graduation rates were at an all-time high, while oil imports, the deficit, and the uninsured rate had plunged. The professor-turned-president was even more insistent than usual that he was merely relying on “logic and reason and facts and data,” challenging his critics to do the same. “Those are the facts. It’s not conjecture. It’s not opinion. It’s not partisan rhetoric. I laid out facts.”

The Northwestern speech did reshape the narrative, but not in the way Obama intended. The only line that made news came near the end of his 54-minute address, an observation that while he wouldn’t be on the ballot in the fall midterms, “these policies are on the ballot—every single one of them.” When Obama boarded Air Force One after his speech, his speechwriter, Cody Keenan, told him the Internet had already flagged that line as an idiotic political gaffe… Obama’s words couldn’t change the narrative of his unpopularity; they just gave Republicans a new opening to exploit it. They quickly became a staple of campaign ads and stump speeches tying Democrats ball-and-chain to their leader. “Republicans couldn’t have written a better script,” declared The Fix, the Washington Post’s column for political junkies. Even Axelrod called it “a mistake” on Meet the Press. The substance of the speech was ignored, and Keenan still blames himself for letting one off-message phrase eclipse a story of revival, a prelude to the second Republican midterm landslide of the Obama era. “I’m still pissed off about that,” Keenan told me. “Everything he said was true and important, and that one line got turned against him.”

Obama was hailed as a new Great Communicator during his yes-we-can 2008 campaign, but he’s often had a real failure to communicate in office. The narrative began spinning out of his control in the turbulent opening days of his presidency, and he’s never totally recaptured it. His tenure has often felt like an endless series of media frenzies over messaging snafus—from the fizzled “Recovery Summer” to “you didn’t build that” to the Benghazi furor, which is mostly a furor about talking points…
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May Day!

Happy International Workers Day!

That’s one incarnation of a classic — and here’s another, with a lovely story to frame it.

So, to channel my inner President Obama talking to Senator Sanders last night, “this is the time and place” in which I wish all my comrades a happy, peaceful, easeful international labor day.  We may all Tikkun Olam again tomorrow.

The thread it is open.