Archive for the ‘#reform’ Tag

ObamaCare House of Cards   Leave a comment

The Congressional Budget Office scored the American Health Care Act and claimed the bill will reduce deficits by $119 billion over the next decade and result in 23 million fewer people being insured by 2026. So clearly, people would be better off if Obamacare were unchanged. This new report from the Department of Health and Human Services dispels that myth.

Reality Bites

The DHHS report shows that premiums in the individual market exchanges increased by 105% in the 39 states using Healthcare.gov from 2013 to 2017. This is equivalent to $244 per month ($2,928 per year) in additional premium payments for people buying insurance through the exchanges. People not eligible for exchange subsidies are fully exposed to these increases, while taxpayers will bear the brunt of subsidies for eligible enrollees.

Despite the promises that Obamacare would “cut the cost of a typical family’s premium by up to $2,500 a year,” average premiums on the exchanges more than doubled over this period. In some states, such as Alabama and Alaska, the average premium more than tripled. Welcome to my world.

B-b-but, Alaska is a small-population state with a huge land mass and people who have to travel long distances to medical care. Surely ….

No, the high average increase is not driven by a few outliers. Twenty-three out of the 39 states included in the analysis experienced premium increases in excess of 105%. Only three states, North Dakota, New Hampshire, and New Jersey, had cumulative premium increases below 50%.

 

As the report acknowledges, the composition of the population enrolling in plans through the exchanges has changed over time due to the adverse selection problems created by the law’s subsidy and regulation frameworks.

Example?

The community rating age bands, which dictate how much more companies can charge older, higher-risk enrollees, were set at 3:1 under Obamacare. A recent study by Milliman estimated that relaxing these age bands to 5:1 would reduce premiums for people aged 20-29 by 15% while increasing premiums for older enrollees.

Lower premiums for younger, healthier people would encourage more of them to enroll through the exchanges instead of foregoing health insurance because it is too expensive for them. Older, less healthy people make up a larger share of the exchange population now than in earlier years, which exacerbates the premium increases on that population.

Due to data limitations, the report does not deal with the population getting plans on the individual market but not through the exchanges. These people accounted for more than a third of the total individual market. They are not eligible for the law’s subsidies, so there is likely less adverse selection for the off-exchange population, but these enrollees have to bear the entirety of the costs of those increases.

Families choosing a plan through the exchanges have seen their premiums more than double since 2013. Alabama and Alaska, which have seen the two highest cumulative premium increases, are both down to only one insurer. In the entire country, only Virginia saw the number of participating insurers increase from 2016 to 2017. Just today, Blue Cross Blue Shield of Kansas City announced it would be exiting the exchange, leaving 25 counties in Missouri without a participating insurer for now.

The trend is absolutely unsustainable.

The lack of choices and competition in a growing number of places makes it unlikely that there will be an end to rapid premium growth without reform. While the CBO estimates will provide some insight into the effects of the bill in its current form, a working group of Senators is crafting a revised bill with major alterations.

Getting the design of replacement legislation right is important, and the CBO score will give the working group more information about which aspects of the bill that passed the House need the most adjustment. Provisions that allow for more competition and choice for people trying to get insurance through the individual market should help bring down annual premium increases.

Safer with Criminals or Lynch Mobs?   Leave a comment

In Wasilla, Alaska, a community about 250 miles south of Fairbanks, a young man fell in with a bad crowd and ended up bludgeoned to death. Five other young men are now accused of his murder.

Image result for image of finger pointingI don’t know anyone involved. I feel compassion for the family that lost their son, who by their account was a good kid … although I would note that he was hanging out with this other kid who is now accused of killing him, which makes me wonder about the nature of this relationship. Generally, teenagers don’t kill one another over baggies of pot. It’s usually something bigger than that.

But I don’t know the details and ultimately, it probably won’t matter to me because I don’t live in Wasilla. Except … the Alaska Dispatch News has a comments section and people are going crazy on the thread, essentially advocating that these young men be executed without a trial and disparaging a recent criminal justice reform bill that Alaska passed. They reached a bridge too far for me when they started talking about “all the other thugs” in the Valley that need to be “dealt with” BEFORE they can commit similar crimes.

I don’t make any secret that I think the criminal justice system in the United States stinks like last week’s fish left out on the counter. Alaska has one of the toughest presumptive sentencing schedules in the country. We needed criminal justice reform for lower level crimes because our jails are overcrowded with a revolving door population. But as soon as something like this happens, people start freaking out about how this or that law needs to be toughened and advocating for the death penalty, insisting that this will reduce crime.

Does it? The statistics say tough-on-crime bills don’t reduce crime as much as armed homeowners do and I know peole in the Valley are armed. What tough on crime legislation basically does it just guarantee prison guards have jobs.

But more … a boy who grows up with a father in prison is twice as likely to go to prison himself.So, we’re not just guaranteeing prison guards jobs today … we’re guaranteeing their children jobs as prison guards in 25 years.

First, we need to realize that human nature isn’t good and so things like this are bound to happen. We used to know that, by the way. The Bible tells us that human beings are all depraved. Some of us are just less depraved than our base nature.

Second, we need to realize that when you lock young people away for decades and then release them, you pretty much guarantee that they’re going to return to a life of crime because they have to feed themselves somehow and most states don’t provide much of anything in the way of re-entry services beyond halfway houses, which have such convoluted rules about curfews and number of hours you’re allowed outside of the facility that it is virtually impossible to maintain any of the few jobs felons can get.

Third, we need to stop putting people in jail for non-violent crimes. It sure doesn’t rehabilitate the incarcerated, but more it does nothing to make the victim (if there is a victim) whole. Whatever happened to the idea that if you broke something, you bought it? If you vandalized the neighbor’s fence, you built them a new fence. My mother’s tribe used to make a man who killed another man responsible for the dead man’s family. He wasn’t allowed to neglect his own family either, so he had a lifetime of hard work ahead of him instead of being dead or sitting on a cot staring at four walls for decades.

Ultimately, though, what we really need to have a serious talk about is the idea that whole classes of people are deemed murderous thugs simply because of the actions of a few. Right now in the Valley, there are people calling for the expulsion of certain people because they are related in one way or another to the five young men who allegedly murdered this young man. “If the police won’t do anything about it, the community must.” I have to wonder how many of the “good” citizens of the Palmer-Wasilla area are harassing the families of the accused. They’re certainly free with their opinions in the Dispatch about how the parents ought to be held responsible too.

From an outsider’s perspective, the “good” people with their violent rhetoric are no better than the “thug” members of their community. When you’re pointing that finger at the “other”, you might want to notice that there are three fingers pointing back at you.

On the thread, someone said this was about keep the community safe and I thought … armed as I am, do I feel safer potentially interacting with criminals or with lynch mobs running around looking for a criminal behind every spruce tree?

I think I’d take my chances with the criminals.

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