ACHA review

Here are a few lowlights of the AHCA Congressional Budget Office score. I’ll try to keep this non-technical.

  • Medicaid is still getting changed from an entitlement that is responsive to changing needs to a block grant
  • 23 million people will lose coverage compared to current law projections
  • The MacArthur/Upton waivers are expected to destroy the individual markets that cover 15% of the country
  • Most of the premium decreases are due to older and sicker people being priced out of the market
    • Real easy to have low premiums when you don’t cover anyone who is likely to need services
  • Pre-existing condition protection is effectively destroyed by splitting the risk pool.

Relevant tweets below the fold:
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Thursday Morning Open Thread: The Great War Is Here

Paul Ryan and Mick Mulvaney are gonna get matching Blood for the Blood God tattoos…

Released Wednesday, the CBO’s scoring of the new bill finds that a few cosmetic tweaks don’t change the fact that the AHCA remains a breathtakingly cruel bill…

The AHCA is cruel. There is no other word for it. If the law is enacted, people will die because of it.

Given recent headlines, Democrats naturally have been focused on ties between Donald Trump’s campaign and Russia and his related actions as president. But Democrats have to make the AHCA central to their plans for 2018 and beyond. In recent polling by the Kaiser Family Foundation, only 24 percent of Trump voters want him to decrease Medicaid spending, and 42 percent say that the program is somewhat or very important to them. Independents and Democrats are overwhelmingly against the bill. And for the vast majority of Americans, health care is a visceral issue, something that affects their everyday lives. We’ve seen this reflected in the sharp confrontations between GOP members of Congress and their constituents, who are furious at their representatives’ support for a bill that voters do not want. For moral — not just political — reasons, Republicans must be made to regret their AHCA vote.

Jeanne Lambrew, in the NYTimes, “Republicans, Get Ready for the Trumpcare Headlines”:

If the Senate makes this flawed bill law, Republicans will have the chance to watch, all the way up to the midterm elections, as Americans pay higher premiums and lose coverage. By the time the bill’s full changes went into effect in 2020, many of those who voted for it could be long gone…

President Trump has repeatedly said that Obamacare should be blamed for any problems in the individual market this year and next. Yet many of the predicted premium increases are actually a reaction to the attempts to repeal Obamacare, an attempt on the part of insurance companies to protect themselves from the uncertainty induced by the congressional debate and President Trump’s executive actions. And poll after poll shows a majority of Americans dislike the Republican approach and will hold Republicans responsible for any future problems.

So Republicans citing Obamacare headlines should take a moment to imagine the likely Trumpcare headlines and what they will mean for their job security.

Since Mormons aren’t supposed to ‘disfigure their bodies’ with tattoos, the First Rat Off the GOP House Ship is feeling pretty good about his latest career choice…

Apart from that freighted discussion, what’s on the agenda for the day?



On The Road

Good Morning All,

This weekday feature is for Balloon Juicers who are on the road, travelling, etc. and wish to share notes, links, pictures, stories, etc. from their escapades. As the US mainland begins the end of the Earth day as we measure it, many of us rise to read about our friends and their transient locales.

So, please, speak up and share some of your adventures, observations, and sights as you explore, no matter where you are. By concentrating travel updates here, it’s easier for all to keep up-to-date on the adventures of our fellow Commentariat. And it makes finding some travel tips or ideas from 6 months ago so much easier to find…

Have at ’em, and have a safe day of travels!

Should you have any pictures (tasteful, relevant, etc….) you can email them to picstopost@balloon-juice.com or just use this nifty link to start an email: Start an Email to send a Picture to Post on Balloon Juice

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News Dump of the Day: Part the 3rd

According to CNN, Attorney General Jeff Sessions failed to disclose his contacts with Ambassador Kislyak on his Security Form (SF) 86.

Attorney General Jeff Sessions did not disclose meetings he had last year with Russian officials when he applied for his security clearance, the Justice Department told CNN Wednesday.

Sessions, who met with Russian Ambassador Sergey Kislyak at least two times last year, didn’t note those interactions on the form, which requires him to list “any contact” he or his family had with a “foreign government” or its “representatives” over the past seven years, officials said.
Sessions initially listed a year’s worth of meetings with foreign officials on the security clearance form, according to Justice Department spokeswoman Sarah Isgur Flores. But she says he and his staff were then told by an FBI employee who assisted in filling out the form, known as the SF-86, that he didn’t need to list dozens of meetings with foreign ambassadors that happened in his capacity as a senator.
After CNN’s story published, a spokesman responded to the reporting with a statement, saying that Sessions was instructed not to list meetings like the ones with Kislyak on his form.
“As a United States Senator, the Attorney General met hundreds — if not thousands — of foreign dignitaries and their staff,” spokesman Ian Prior said. “In filling out the SF-86 form, the Attorney General’s staff consulted with those familiar with the process, as well as the FBI investigator handling the background check, and was instructed not to list meetings with foreign dignitaries and their staff connected with his Senate activities.”

Here’s a link to a blank SF 86 below the fold/after the jump. Here’s what the bottom of page 121 looks like:

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Don’t boss him, don’t cross him, he’s wild in his sorrow

Holy shit. The piece of shit Republican, Greg Gianforte, who is running in tomorrow’s special election in Montana attacked a reporter for politely asking questions about TrumpCare.

He’s going to be that much more upset when he loses tomorrow.








Blabbermouth Trump Blabs Out More Classified Info

Remember a long time ago when blabbermouth Trump invited the Russians who jacked our election into the Oval Office and blabbed about “code-word” intel? Yeah, that was last week.

Then this week, he made matters worse by confirming that the source of the intel was Israel while scolding the media about saying he said it was Israel, which they had not said. God, what a dumbass.

As a result, Israeli officials are allegedly changing the way they share classified info with the US. They say their cooperation with the US is “unprecedented,” but they would say that since we dump bales of cash on them every year. But common sense says they’ll give blabbermouth less to blab about if they don’t want more sources torched.

Now US sources — probably via Trump and his entourage again, because we know he’s a blabbermouth — caught UK officials by surprise by prematurely releasing info on the Manchester bombing. Via the Guardian:

American officials in Washington briefed US journalists early on Tuesday about the number of dead, confirming that it was a suicide bombing and – hours later – the name of the killer. The UK had not been planning to release the name on Tuesday.

The UK’s reluctance to identify the assailant was evident because it took hours after his name was circulating in the US media before Greater Manchester police confirmed it.

One of the basic tenets of intelligence sharing is that other agencies do not disclose it. The problem is that those intelligence agencies, whether American or French, pass it up to their presidents, prime ministers and departmental ministers. In the past, that secrecy was respected.

After the leaks, it could be tempting for UK police and intelligence services to stop sharing sensitive information, although Britain relies heavily on the US sharing its intelligence and benefits from intelligence, especially on counter-terrorism, from European colleagues such as France and Germany.

And now someone from the Filipino government at the Trump White House* released a transcript of a call between Trump and Philippines President Rodrigo Duterte, a nutcase who ordered the extrajudicial killing of thousands of Filipinos in that country’s “war on drugs” [NYT]. And guess what? Not only does Trump squee like a prepubescent girl at a Bieber concert about Duterte’s bloodthirsty antics, he reveals yet more classified information! Excerpts from the transcript:

TRUMP: l just wanted to congratulate you because I am hearing of the unbelievable job on the drug problem. Many countries have the problem, we have a problem, but what a great job you are doing and I just wanted to call and tell you that.

DUTERTE: Thank you, Mr President. This is the scourge of my nation now and have to do something to preserve the Filipino nation.

TRUMP: I understand that and fully understand that and I think we had a previous president who did not understand that, but I understand that and we have spoken about this before.

DUTERTE: Yes, I know that. Thank you. Yes.

Does Trump really admire Duterte’s murderous war on drugs? I doubt it. I’d bet money Trump has shoveled thousands of dollars up his own nostrils. But Duterte treated President Obama disrespectfully, so Trump thinks he’s a swell guy.

Now, on to the part where Trump spilled more secrets:

TRUMP: So how is everyone doing, how is the Philippines doing? [Jesus God! — Ed.]

DUTERTE: We are doing fine, Mr. President, but in the ASEAN summit, every member state was really nervous about the situation in the Korean peninsula, but we would like to tell you that we support you and keep on the pressure because as long as those rockets and warheads are in the hands of Kim Jong Un we will never be safe, as there’s no telling what will happen next.

TRUMP: What’s your opinion of (Kim), Rodrigo? Are we dealing with someone who is stable or not stable?

DUTERTE: He is not stable, Mr. President, as he keeps on smiling when he explodes a rocket. He even has gone against China, which is the last country he should rebuke. But it seems from his face — he is laughing always and there is a dangerous toy in his hands which could create so much agony and suffering for all mankind.

TRUMP: Well, he has got the powder but he doesn’t have the delivery system. All his rockets are crashing. That’s the good news. But eventually when he gets that delivery system… What do you think about China? Does China have power over him?

DUTERTE: Yes, at the end of the day, the last card, the ace has to be with China. It’s only China. He is playing with his bombs, his toys and from the looks of it, his mind is not working well and he might just go crazy one moment. China should make a last ditch effort to tell him to lay off. China will play a very important role there.

TRUMP: We have a lot of firepower over there. We have two submarines — the best in the world — not that we want to use them at all. I’ve never seen anything like they are but we don’t have to use this but he could be crazy so we will see what happens.

So basically, two lunatics are discussing the stability of a third lunatic, but only one of the lunatics is blabbing state secrets such as the location of submarines, and he’s our dumb fucking President Lunatic.

Can you imagine this buffoon keeping an operation like the bin Laden raid under wraps? Trump’s big fat mouth is going to get a lot of people killed. It’s only a matter of time.

*Thanks to all three dozen who emailed about this correction!



Wednesday Evening Open Thread: Class Tells, When There Is No Class


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Old Esquire tag line: Why is this man smiling?
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News Dump Comes Early Today

This is going to be a quick post. Between noticing earlier that some of my cactuses are in bloom

and heading up to Los Alamos tonight to meet Ray Monk, who has written a biography of J. Robert Oppenheimer, I want to post some early questions about the revelation that the FBI had a possibly fraudulent document, possibly Russian, that caused James Comey to make his July announcement last year. I have the feeling that I am missing some things and have many questions. Some are unlikely to be answered any time soon, but others may be due to my confusion and hurry. Read more



CBO on the AHCA

This will be a running and updated post on the cost estimates of the AHCA by the Congressional Budget Office (CBO) and Joint Committee on Taxation (JCT)

17:20 TLDR It is about the same bill that got scored in March with marginal changes. CBO does not think MacArthur/Upton will have large net effects

16:22 The JCT estimates the bill that passed the House has a $662 billion dollar tax cut over the scoring window.

16:30 The March 23, 2017 CBO score is here. This was the managers amendment leading into the week of the first vote window which got pulled. It does not include everything that was in the bill before it got pulled.

The baseline is -24 million incrementally not insured for a total 52 million people without insurance and $150 billion in total deficit reduction.

16:33 Here it is

16:34$120 billion in deficit reduction, donut plans will be purchased, slightly more people covered

In addition, the agencies expect that some people would use the tax credits authorized by the
act to purchase policies that would not cover major medical risks and that are not counted
as insurance in this cost estimate.

1635 Read more








Incentives from caps in Medicaid

I was on a webinar this afternoon listening to analysis and “analysis” of the Medicaid proposals in the AHCA. One of the things that I wish they brought up was the incentives that a cap structure gives state Medicaid directors to severely limit care that patients with outlying care requirements can receive. Let’s assume that the incentives for state Medicaid directors is to do as much good for as many people as they can given the state budget constraint with a weaker objective of minimizing how many times and how loudly they get yelled at.

Let’s take the $12,000,000 member in Iowa and assume s/he is on Medicaid instead of an Exchange plan.

Currently, if s/he receives an additional dollar of Medicaid spending to finance care, the state pays $0.42 and the Federal government pays $0.58 if s/he is Legacy qualified or the state pays a nickel and the feds pay $0.95. There is a very loose constraint on spending based on Iowa’s state budget but the spending is leveraged through the federal match rate.

Under a cap system, an extreme outlier does not bring in any additional federal funding. Any incremental dollars spent on an individual with extremely costly needs will be originating from only state level funds. Outlier funding is tough as it would be explicitly moving money from dozens or hundreds or thousands of people to spend it on one or two extremely expensive to care for people.

The state director’s incentive is to severely limit outlier spending. That could be done by eliminating coverage of certain classes of care. It could be done by instituting annual or life time caps. In both cases the societal response is to either let people bankrupt themselves and die or shift the cost of care to the hospital and doctors in the form of noncollectable debt instead of spreading the costs to society in the form of taxes.

In each major eligibility category, there is a spread of spending. Some people in the Aged&Disabled category are far more expensive to cover than others even if the absolute average spending is high. Some kids are more expensive than others to cover. The incentive under a capped system of funding where all outlier costs are borne by the state government is to aggressively reduce outlier costs even if those costs are efficient, effective and medically necessary.








Fox News Trifecta? (Open Thread)

As you’ve probably heard, Trump toady Sean Hannity has been shamelessly exploiting the tragic death of DNC staffer Seth Rich to distract folks from the RussiaGate scandal that is engulfing Trump’s administration. Fox News went along for a while. But as it became increasingly clear that the story is an absurd conspiracy theory propagated by disreputable louts, even Fox News retracted it:

On May 16, a story was posted on the Fox News website on the investigation into the 2016 murder of DNC Staffer Seth Rich. The article was not initially subjected to the high degree of editorial scrutiny we require for all our reporting. Upon appropriate review, the article was found not to meet those standards and has since been removed.

We will continue to investigate this story and will provide updates as warranted.

Hannity kept beating the drum on his show, despite the Rich family’s direct appeal to his producer to stop exploiting their dead son. Last night, Hannity was supposed to reveal “game-changing” information from known fraudster Kim Dotcom. He even teased it by retweeting this deeply idiotic cartoon tweeted by the fraudster himself:

But according to the WaPo story linked above, Kim Dotcom tried to access the late Mr. Rich’s Gmail account to plant fake evidence this week but was rebuffed. So, no big reveal on the Hannity show. Instead, Hannity pretended to grow a conscience and drop the matter “out of respect for the family’s wishes.” But to satisfy his mouth-breather audience, he hinted on Twitter that he’s still pursuing the story:

My guess is that, in addition to the Dotcom bust, the network’s lawyers told him to STFU. Right now, #FireHannity is trending on Twitter, and Hannity is bellowing like a ruptured bull about his persecution by Soros-Hillary-Satan:

MediaMatters has a handy list of Hannity’s advertisers here. I don’t know if Hannity is in any real danger. He’s probably screaming at the top of his lungs about being silenced to save face after being taken in by a known bullshit artist. But it would be cool if he got shit-canned right after O’Reilly was kicked to the curb and Ailes croaked.

Anyhoo. Open thread!



Open Thread for All Purpose Assholery

Stay out of the fucking thread below.








Help Me With My Music Library

I spent the last month importing every single CD I own. I imported it all to a LaCie external drive.

I opened Itunes today, and it “organized” my external hd and 90% of my music is gone. Here is what I need besides a hockey puck sized sedative and a box of kleenex.

All I fucking want is to import all of my music in .aiff to my LaCie external hd. Then, once it is all there, I want to be able to make sure it can not be deleted, and I can create playlists for my iphone.

That is it. That is all I want. I am reformatting my LaCie, I am deleting everything with my MusicMonkey Pro and doing a fresh install, and I am doing the same with itunes. I am on a Windows PC running Win10 64 bit, and I have a macbook pro as well.

I want point by point instructions. If I need another application, let me know. I will give you my god damned phone number so you can walk me through this. I am ready to fucking break shit.

*** Update ***

Also, I am in a pretty fucking volatile mood right about now so if you have nothing to offer other than “that sucks” or “buy a radio” this is not the goddamned cocksucking thread for you or your shitfuckery.








Advice From A Former President

This is excellent.

Open thread!








Open Thread

Looks like time for a new thread.

Have at it!

ETA: I wish I was still living in Colorado. I’d have taken off today and gone to setup a campsite for a few days and then head back home for the night with fresh trout for dinner.  We would drive the hour after work, and this would have been our Friday evening view (minus the pop-up, I use tent and cots for back reasons). And crawdads so tasty, those mountain lakes deliver!