The Pardu

Posts Tagged ‘ACA’

CBO Delivers Another ACA Blow To…The (wait) …The GOP?

In ACA, Affordable Care Act on April 14, 2014 at 5:03 PM

The Congressional Budget Office has released a revised estimate of cost associated with the Affordable Care Act. Despite,  right-leaning media reports of the horrors of the ACA and quotes from far right polling authorities like AP/Gfk, data continues to indicate a very different picture. 

Read Complete Document  (pdf, 334 kb)

CBO and the staff of the Joint Committee on Taxation (JCT) have updated their estimates of the budgetary effects of the provisions of the Affordable Care Act (ACA) that relate to health insurance coverage. The new estimates, which are included in CBO’s latest baseline projections, reflect CBO’s most recent economic forecast, account for administrative actions taken and regulations issued through March 2014, and incorporate new data and various modeling updates.

Relative to their previous projections made in February 2014, CBO and JCT now estimate that the ACA’s coverage provisions will result in lower net costs to the federal government: The agencies currently project a net cost of $36 billion for 2014, $5 billion less than the previous projection for the year; and $1,383 billion for the 2015–2024 period, $104 billion less than the previous projections (see the figure below).

Budgetary Effects of the Insurance Coverage Provisions of the Affordable Care Act, 2015 to 2024
The estimates of the net costs for 2014 stem almost entirely from spending for subsidies that are to be provided through insurance exchanges (often called marketplaces) and from an increase in spending for Medicaid. For the 2015–2024 period, the projected net costs consist of the following:
  • Gross costs of $1,839 billion for subsidies and related spending for insurance obtained through the exchanges, Medicaid, the Children’s Health Insurance Program (CHIP), and tax credits for small employers ($165 billion less than the previous projection); and 
  • A partial offset of $456 billion in receipts from penalty payments, additional revenues resulting from the excise tax on high-premium insurance plans, and the effects on income and payroll tax revenues and associated outlays arising from projected changes in employer coverage ($61 billion less than the previous projection).
Those estimates address only the insurance coverage provisions of the ACA; they do not constitute all of the act’s budgetary effects. Many other provisions, on net, are projected to reduce budget deficits. Considering all of the provisions—including the coverage provisions—CBO and JCT estimated in July 2012 (their most recent comprehensive estimates) that the ACA’s overall effect would be to reduce federal deficits.
CBO and JCT have updated their baseline estimates of the budgetary effects of the ACA’s insurance coverage provisions many times since that legislation was enacted in March 2010. As time has passed, the period spanned by the estimates has changed. But a year-by-year comparison shows that CBO and JCT’s estimates of the net budgetary impact of the ACA’s insurance coverage provisions have decreased, on balance, over the past four years (see the figure below). That net downward revision is attributable to many factors, including changes in law, revisions to CBO’s economic projections, judicial decisions, administrative actions, new data, numerous improvements in CBO and JCT’s modeling, and lower projected health care costs for both the federal government and the private sector.
Comparison of CBO and JCT's Estimates of the Net Budgetary Effects of the Coverage Provisions of the Affordable Care Act
Over the past three days I have heard the new GOO Playbook mantra: ACA and “Actuarial (ly) sound.”

Obamacare: Yeah or Nay… Results Will Come (Either "Up" or "Down")

In ACA, Obamacare, ProPublica on April 1, 2014 at 1:15 PM

Re-post from ProPublica on the last day of the ACA open enrollment for 2014.

…as to the title above. At leaset we will have opportunity to assess the good and the bad. There is a political party that would have stayed the course with no efforts to reform health (or insurnace) care.The Pardu

Judging Obamacare: How Do We Know If It’s a Success or Failure?

Sign-ups are supposed to formally end today, and attention is shifting from marketing to measuring whether the law is meetings its goals.

One day very soon, the focus on Obamacare will turn from signing up new enrollees to quantifying the law’s success — or failure.
The six-month open enrollment period, during which consumers sign up for health plans under the Affordable Care Act, is supposed to end today. But the U.S. Department of Health and Human Services, as well as many states running their own marketplaces, are giving some extra time to consumers who’ve had trouble signing up.
It’ll probably all wrap up by April 15. Then, the final numbers will be tallied and the pronouncements will begin. Politicians on both sides of the aisle will use the same data to proclaim that they were right about the law.
Last Thursday, the Obama administration said that more than 6 million people have signed up for coverage on the health insurance exchanges, meeting the projections set out by the Congressional Budget Office. Republicans have countered by questioning how many enrollees have paid their first month’s premium, the final step necessary for coverage to be in effect.
Dr. David Blumenthal of the Commonwealth Fund recently told me that any attempt to review the success of the law must go beyond those who sign up for coverage on the exchanges. It should include those who gained coverage through the expansion of state Medicaid programs for the poor, as well as young adults who are now able to stay on their parents’ health plans because of the law.

Read more after break below

“I think the real success of the law will be judged over 5 years, not six months,” he said. “In fact, this president, President Obama, has until January 2017 to establish it as a fixture in the American social policy firmament.”
That may well be true, but now seems like a reasonable time to take stock. So, how should success — and ultimately the law itself — be judged? Here’s what some experts are saying about which metrics to use and the problems with each.
What percentage of previously uninsured people are finding coverage under the exchanges?
We can’t answer this question yet because we don’t know whether those signing up for coverage were previously uninsured. In fact, some enrollees, perhaps many, had their insurance plans canceled at the end of 2013 because the plans did not meet the requirements set out by the ACA. Obama administration officials have not released any numbers on this.
That said, a recent report from the Leonard Davis Institute of Health Economics at the University of Pennsylvania and the Robert Wood Johnson Foundation compares enrollment data through the end of February (with one month left to go in the official open enrollment period) to the number of eligible uninsured people in each state.
Here’s what the researchers found:
“Overall, more than 4.2 million people have enrolled and picked a plan through the exchanges, about 14.8 percent of all potential eligibles. The enrollment rate varies from state to state, with a high of 54 percent in Vermont to a low of five percent in Massachusetts. We should note that Massachusetts had the lowest rate of uninsurance in the nation since its health reform in 2006; its previous success might mean that the remaining uninsured population could be especially difficult to reach.”
Here’s a graphic from the report showing the states in which the greatest share of uninsured received coverage (through February).
Did states meet estimates from the U.S. Department of Health and Human Services?
MarketWatch had a story last week comparing enrollment in each state to the HHS projections. By that measure, Connecticut led the pack, signing up 218 percent of its projected enrollment through the end of February. It was followed by Rhode Island, New Hampshire, New York and Maine.
Source: MarketWatch
The problem with this approach is that the goals are “in many cases, based on little more than educated guesswork,” writes Charles Gaba, creator of, which has become akin to the Bible for tracking sign-ups under the law.
He noted that CMS’ state-by-state projections were based on 7 million enrollees nationwide, the original projection of the CBO. That projection has since been revised downward to 6 million because of the problems with, the online sign-up portal for 36 states. In addition, some states provided their own figures while CMS simply sliced up the rest to fit the 7 million projection.
He elaborated in an email: “Ten states out of 50 gave their target numbers to CMS, but those numbers were higher than CMS was figuring, so they had to drop the other 40 states down so that the grand total fit the CBO’s 7 [million] total. As a result, you get some absurd numbers — both NY and KY had the same 220K (actually, KY’s was 220K, NY’s was less at 218K) even though NY’s population is much, much higher and so on.”
Gaba suggests an alternate measure more like the one used by the Leonard Davis Institute researchers, which looks at the percentage of eligible enrollees in each state.
What percentage of enrollees are young adults, aka the “young invincibles” who typically are regarded as healthier?
A number of news outlets have focused on the relative dearth of young people choosing plans through the end of February to point out that the insurance companies may not have so-called balanced risk pools, meaning enough young, healthy enrollees to offset the costs of older, sicker ones. The Washington Post noted this month:

“Strong participation by young adults is critical to the program’s success, because they tend to use less medical care. Because they are cheaper to insure, young people offset insurers’ costs of covering the sick, many of whom are eager to sign up for coverage. Under the health-care law, people with preexisting medical conditions can’t be rejected.

Initially, officials had hoped that 40 percent of the sign-ups would be adults under the age of 35, but only about 27 percent of February enrollments were young adults, about the same as in January. On Tuesday, administration officials said they were nevertheless encouraged and predicted more young people would enroll closer to the deadline.”

Drew Altman, president of the Kaiser Family Foundation, is critical of such efforts to equate young enrollees to healthy ones.
“Young people benefit the risk pool because they are healthier, but it’s really the percentage of healthy people that make or break the risk pool,” Altman wrote in a column last week. “Even if enrollment of young adults stays where it is – at about one-quarter instead of 40 percent, which our analysis shows they make up among potential enrollees – premiums would only increase by two to three percent. Though even that isn’t quite right, since many insurers expected this and already built it into their premiums.”
What we really need to know is what percentage of enrollees are healthy vs. sick. That will take time.
What will happen to insurance premiums in 2015?
Some experts are looking beyond this year’s enrollment numbers and are focusing on what the insurance rates will be for those renewing their plans this fall — or selecting plans for the first time. Scott Gottlieb, a resident fellow at the American Enterprise Institute, told me this month that he thinks attention will quickly shift from this year’s enrollment cycle to insurers’ rates for next year.
“The rates are going to come out early spring, so that’s going to be the next big story. And I suspect they’ll go up quite a bit,” he said.
That view was echoed by an anonymous insurance executive who talked to The Hill newspaper.
Dylan Scott at Talking Points Memo isn’t convinced they will uniformly rise. He also notes that insurance rates were increasing before Obamacare and will increase after the law.
“The real data for measuring Obamacare’s success aren’t in yet, but they eventually will be. At the top of the list: What happens with premiums in 2015? Plus: Do insurance companies leave the market or enter it? And the ultimate barometer: Has the number of uninsured Americans dropped significantly?” he wrote last week. “In simpler terms: Did Obamacare, in year one, create a sustainable insurance market for the long term?”
Another problem with looking at rates is that an insurer’s increase for 2015 may mean that it didn’t set the right price for this year, not that medical costs have increased dramatically.
In the end, some hints of the law’s success — or failure — will be available this year, but it will take longer to assess how much it has reduced the number of uninsured and moderated health care costs (the two key metrics of success).
An article Friday in The New York Times suggests that rather than judging the success of the law nationally, it may make more sense to look at it state by state. “A review of state-by-state enrollment data and other research, as well as interviews with patients, advocates, health policy analysts, elected officials, supporters and critics of the Affordable Care Act, suggest that, for consumers at least, the state of health care under the national law depends almost entirely on where a person lives,” the article said.
At the end of his column, Kaiser’s Altman wondered if the American public would wait for the facts to make up its mind: “The problem is that it will take time to learn if the mix of enrollees is healthier or sicker, and how premium increases vary around the country, and how people feel about their coverage,” he wrote. “Meanwhile Republican politicians will lambast the law and Democratic ones will offer lukewarm support and overall popularity of the ACA probably won’t change very much. Anybody willing to wait for a judgment based on the right metrics?”
Have you tried signing up for health care coverage through the new exchanges? Help us cover the Affordable Care Act by sharing your insurance story.

Fox News "Cooks" A HealthCare Chart And GOP Talking-Heads Flourish Like Weeds

In ACA on March 31, 2014 at 4:33 PM

Look closely at how Fox New manipulates its viewers,  Fox New specialists, technicians, developers and managers know that visual charts are developed to show relationships to facilitate comparison and to deliver meaning/information.  Visual Graphics are also not a true tool if the chart has no real opportunity to  provide a relational review.  The chart above is the prefect misleading example.
 IT HAS NO X and Y AXIS indicators.

Now look at how graphic relationships count and render the Fox News manipulation feeble, useless outright ignorant, and ultimately disrespectful to its views. We took an Awesome Screenshot Capture and Annotate image of the chart and added “axis” perspective. Perspective is seriously telling as we consider the level of deceit.

(Excuse “hypothetical” misspell 😉

On the final day of the ACA legislative enrollment date deadline, the GOP is busy with lies, mis-statements, and bubbling-over with talking machine elected officials running “game” like a used car salesman’s (wearing a bow-tie) attempting sell you a car with no front windshield.

UPDATE: Fox comes clean. But think of the viewers who will not see the correction. What a farce is Fox News?

After viewing how the Right-Wing Communications Department (AKA. Fox News) is reporting on March 31 legislative deadline, how a about sitting for a couple of very relevant video segments from, MSNBC’s Jansing & Co. It is unfortunate the segments include GOP members of Congress who are spewing unadulterated bologna regarding the ACA. Sen. John Barrasso, R-Wyoming actually stooped below the level of animal manure via asserting the Administration is “cooking the books.” His remark even drew a very noticeable eye roll and smirk for the generally conservative Chuck Todd. But, first , I must expose you to the GOP’s number one motor-mouth, Rep. Marahs Blackburn (R) TN. 

I have posted the segments as embeds without edit. The full scope of GOP resistance to the ACA should show with full disclosure. It is a true shame a US senator has actually suggested the Obama Admministration has a fabrication team in the deep gallows of the White House.

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Battle of the Year: Hayes Vs Stefano; Who Got Schooled?

In ACA, All In, Fox News, Obama Administration, The Daily Caller on March 28, 2014 at 4:36 PM

Early in the week, the Obama Administration announced an extension for Americans who are in the midst of the ACA enrollment process via an extension to April 15, 2014 (Vs the actual March 31, 2014 deadline).

The deadline extension was reported for people who for whatever reason are immersed in enrolling for the ACA. I have read the deadline change would predominately benefit people who had attempted to enroll in the ACA and may have a record of their efforts. It was reported as not an open extension for all. I frankly suspect however, some will take advantage of the deadline change and start the process. But, I ask, how should the Administration handle people who for various potential reasons failed to compete the sign-up process by this coming Monday?  

Needless to say, right-wing media, conservatives and all who work for the vast Koch brothers network are seething about the deadline extension. Chris Hayes MSNBC, ALL IN, found out the level and scope of angst and ugliness as he invited a regional director from the Koch brothers Americans For Prosperity to sit in discussion.  Discussion did not ensue. 

Hayes sat with Jennifer Stefano and another guest (for the latter portion of the interview).  

Ms. Stefano joined Hayes and seemed to be primed for a classic conservative go-off.  She never answered the question related to why angst from the two week extension, she also failed to discuss any references to GOP refusal to enact Medicaid Expansion.  Since we know MSNBC provides on-air topics to guest (or some form of brief) , we know Stefano was not surprised with Hayes’s questions. The real issue is, why not answer the questions. If she could not provide an answer her employers would find palatable, why not opt out of the interview? Yet, Stefano opted for a sports analogy we have all heard,“…a good offense if the best defense.” 

Since I used a sports analogy above, allow me to say the following is the rightful domain and key responsibility of the show host. The host role: ask the initial question and monitor the segment for accomplishing the focus of the segment. So, let’s say Hayes fired-off the opening and initial “offense” and possibly placing the guest in a defensive posture. It is a basic dynamic of “challenge” TV reporting or questioning when the guest is known to hold opposing views. Unlike many Fox News host/guest interactions resulting from carefully chosen and strategically placed (validating) conservative guest.  

Clip 1. The Question (39 seconds)

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Read more after the break below

According to Yahoo News (and co-signed by Yahoo News), after the initial question Hayes interrupted Stefano several times. (The piece also includes a bit of fact-checking)

The Independent Journal Review and other conservative sites argued that Hayes got “schooled,” and destroyed,” and noted — accurately! — that Hayes interrupted Stefano several times.

After 25 seconds of Stefano never once addressing the question, while issuing a diatribe about being a mother and her children, Hayes performed the first attempt to provide structure to his question and move his show forward. Stefano and Hayes both know the clock is not an ally of the host if the guest can “Gish Gallop” through pre-programmed minutes.

Clip 2. An attempt to shut-off the Gish Gallop with Host redirection
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Over the course of the interview, Stefano actually knocked herself “out.”  The issue of “schooling” is a politically correct way of imparting the ridiculousness of Stefano’s performance and efforts to spew Koch brothers/Rovian talking points. Their was no schooling as Stefano’s misson was to appear and spew Koch talking points. She responded to Hayes’s effort to re-direct to the initial question with her next bag-of-tricks talking-point, “the president lied!” 

From that point Stefano’s performance rivaled some segments of the old Jerry Springer show replete with head-bobbing, finger pointing and Stefano’s wide open oral cavity emanating various forms of “You don’t know me” or “How dare you.”  

The day after the (figurative) “bout”, I posited, “Yes, Stefano we now know you and we know for whom you and we are not surprised.”  

We wonder if Bill O’Reilly took offense to your deploying one of his patented “go-offs.”  Another area of wonderment is why Stefano decided to deploy a “Gish Gallop” (a weak and out of bounds) debate technique.  Since, we know guest on MSNBC are given a heads-up and possibly given briefs on the topics from the show host, we know that Stefano knew exactly what Hayes would ask. Why did she choose to completely avoid answering questions with a preference for attempting a strategy best called: ” the best defense is an offense?” 
Stefano without personal shame avoided Hayes’s questions by providing feed for Breitbart News, The Daily Caller, Fox News and other LIV (Low Information Voters) high-emotion conservative media.  Actually, her ill-fated performance was a live exhibition of what we see in AFP (Koch brothers) television advertisements without the Springer show yelling.  Instead of airing real cases of people who have suffered under the provisions of the ACA, the Kochs and their ad agency professionals broadcast actors speaking from scripts or people speaking half-truths about their (alleged) predicament.

Yahoo News structured their screed around “who got schooled.” Let’s listen to Stefano roll-through a series of points she calls facts. Points that are not being supported as “facts.” Hayes attempts to (rightfully redirect). Why should The Independent Journal Review and Yahoo News expect Hayes to sit back and facilitate a Sean Hannity-like talking- point barrage when the guest was not answering questions about the recent extension?

Clip 3. Marsha Blackburn like rolling talking-points

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At this point in the interview Stefano continues railing like a Jerry Springer prime seat guest, while Hayes attempted to redirect to an answer. Notice Stefano moved to the beginning of a “… don’t know me….”  go-off.  At one point, Hayes actually showed a bit of frustration via a clear eye-roll in response to a Stefano point and her increasing Bill O’Reilly like behavior. After a few more seconds of talking-points based on seemingly inaccurate information (I will not suggest she lied), Hayes managed to fulfill his role as facilitator via as follows.  

Clip 4. Ah ..finally a quiet guest and a redirected effort to secure an answer.


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Now, as Hayes and his guest move towards the end of their time together, notice the seeming pre-planned “offense is the best defense” from a guest who did not answer the question that precipitated her show booking. 

Here we go…. Have you noticed this look on O’Reilly as discussion draws on an inner core of lack of confidence that when cornered generally manifest in anger?

Notice the Ugly and an effort to end the segment with….“You are a good guy otherwise.”  A bit judgmental from a person who just finished showing the deepest level of anger, uncivilized on-air behavior and gauche. Some would say . she showed her ass.” A dynamic loved by Fox News viewers, but held in contempt and disdain by people who tune to current event of news related shows. How about the non-prospect that Hayes had responded, “..well you certainly have not shown signs of being a nice person?”

Clip 5
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And, the interview ends on a civil and intellectual note.

Clip 6

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If there was anything worthwhile from the interview other than a lesson in being prepared for GOP “Gush Gallop,” it could be an opportunity for fact-checking. And, fact checking is taking place. We will report on  claims from Stefano as we find them across the web or on MSNBC. 

Fact-checks from Fox News and CNN will probably not take place for obvious reason. Fox News has no interest in ACA data veracity Vs emotional rants, and CNN is 24/7 occupied with ratings garnering coverage of the Malaysian MH370 tragedy. We should add CNN is doing a good job of covering the recent mountain slide in Washington State.

As we consider Stefano and her conservative performance, we have to suspect her appearance was not only approved by the Kochs, we can assume she would only speak from the confines and pre-approval of a playbook.  Do you think for one second Karl Rove and other operative were not are of her appearance well before she sat to ‘explode?’ It does not happen in the lock-step GOP and RNC.

Kaiser Family Foundation Visualizing Health Policy And The KFF March 2014 Tracking Poll

In ACA, Obamacare on March 26, 2014 at 6:42 PM

Visualizing Health Policy: What Americans Pay for Health Insurance Under the ACA,”

The Henry J. Kaiser Family Foundation, 5.26.2014, [….. ]

The March 2014 Visualizing Health Policy infographic shows examples of what Americans will pay for health insurance under the Affordable Care Act, using different scenarios for 40-year-old individuals living in different parts of the country.
Image not available.

Visualizing Health Policy is a monthly infographic series produced in partnership with the Journal of the American Medical Association (JAMA). The full-size infographic is freely available on JAMA’s website and is published in the print edition of the journal.
For deeper readers Kaiser offers a slideshare of the infograhic with data set numbers. 
What Americans Pay for Health Insurance Under the ACA from KaiserFamilyFoundation

We have linked Kaiser march 2014 Poll results here.  The study is typically Kaiser in detail, thorough and impeccable methodology.  We are posting a couple of key figures from the study. 

Over half report having personal conversations about ACA, but similar share are weary of national debate

   The Henry J. Kaiser Family Foundation, 5.26.2014, [ ]

The ACA was a common topic of personal conversations this month, and the public reports that the tone of those conversations was mostly negative. Just over half the public (55 percent) say they had at least one conversation about the law with friends or family in the past month, up from 31 percent in January 2012 (the last time this question was asked). About half those who say they discussed the law with friends or family (28 percent of the public overall) report hearing mostly bad things about the law in these discussions, while a much smaller share (5 percent of the public overall) say they heard mostly good things and the remainder say it was a mix of the two.

Most Report Hearing Mainly Bad Things About ACA In Conversations With Family/Friends

Figure 9

While personal conversations may be on the rise, many Americans appear to be weary of the national debate about the law. Just over half the public (53 percent) say they’re tired of hearing about the debate over the ACA and want the country to focus more on other issues, while about four in ten (42 percent) say they think it’s important for the country to continue the debate. Democrats and those with a favorable view of the law are more likely to say they’re tired of hearing about the debate, while Republicans and those who view the law unfavorably are more evenly split between those who are tired of hearing about it and those who want the debate to continue. 


Perhaps reflecting this sense that the debate has gone on long enough, more of the public would like to see Congress keep the law in place and work to improve it (49 percent) or keep it as is (10 percent) rather than repeal it and replace it with a Republican-sponsored alternative (11 percent) or repeal it outright (18 percent).

Half Want Congress To Keep Law And Improve It

Figure 11
The previous graph unequivocally shows most Americans do not want repeal of defunding the ACA.
If that is the case, why does Boehner and Cantor continue to enact frivolous repeal ACA votes?  The question is actually rhetorical, we already know the answer. 

The ObamaCare "Death Spilral?"

In ACA, Chris Hayes, MSNBC on March 24, 2014 at 1:49 PM

You are about to view a quick video of Right-wing hope  laden reporting of of the ACA failure. Before, you either get your “hopes up” or “grow anger” based on the last sentence, I remind the sentence includes words such s “right-wing hopes and reporting.” That simply means, you have right-wing media (Fox News) and highly compensated right-wing pundits railing about the demise of ObamaCare, and you can read “HOPE” into their aura and their words.

The following is a prime example; you will see more with the MSNBC segment embed below.

A CBS Executive we expect 
to see on Fox News real soon. 
She left CBS and has commented 
about CBS’s lack of interest in 
pursuing Benghazi, the alleged 
IRS Scandal and other Obama 

Ms. Attkinson calls CBS a bunch of cowards. Now, that depicts a serious disregard of the commonly accepted “Do not bash a former employer” at the very highest level. Obama Derangement Syndrome is, for some chronic. 


We are going to cut to the chase with this piece. As we move closer to the Affordable Care Act 2014 deadline, the political Right, especially right-wing media is boiling over with “poo-poo” comments and rhetoric about how the ACA is failing. 

It appears Right-wing media has been given new “lockstep” mantra for salting the minds of those who either wish the ACA to go away, or for those who are still on the fence regarding its worthiness. The new mantra is: “death spiral.”  
So, the ACA is on a death spiral. We have embed an MSNBC ALL IN piece (below) with a well-developed intro of right-wing talking heads using the new mantra like air spewing air gushing from a balloon pricked with a safety pin. 

First, let’s do what high-information people do; we look at information or data for a true representation of facts. Facts tend to relegate rhetoric and mantra to the level of inane noise. 

Charles Gaba (as he refers to himself) has published and maintains a detailed tracking of the ACA since its October 2013 “flawed” rollout. Gaba’s work is detailed and in spots exhaustive, but for sake or information and facts, his work is exemplary and very appreciated.

  • QHP (Qualified health Plans)
  • Sub26ers (Enrollments under age 26 on family plans)
  • Medicaid/Chip (Meciaid Expansion and Children’s Health Insurance Program (CHIP)
  • Exchanges (state-based system of health insurance exchanges) 
Private QHPs (4.92M – 6.30M
Medicaid/CHIP (4.47M – 6.17M
Sub26ers (2.50M – 3.10M)

Grand Total as of March 22, 2014: (11.9 M – 15.6 M)

Enrollment Period Elapsed: 94.5% 
Est. % of CBO QHP Projection: 78.1% (or 91.1%)

Current 3/31 Exch. QHP Projection (raw numbers): March: 1.96M / Total: 6.20M

Current Exch. QHPs as of 3/22: March: 1.24M / Total: 5.46M

Exchange-based QHPs should hit 5.5 Million sometime Sunday, March 23

The Graph as of 3/19/2014

I do not see a “sprial.”  I see major increases in enrollment as time passes. While unwritten in Gaba’s work, I also see the fact that Republican State govenrors are denying medicaid expansion thus depriving millions of people (constituents)  medical coverage. I also see the denial of ACA Exchanges in many GOP States, again hampering or denying enrollment and coverage to millions.

A closer look at the “spiral. I labored to find an opportunity to edit the following video after the first few minutes: I was not successful. The host and guest discussion after the detail laden intro is typical point-counter-point dialog that we see each and every day.  

March 18, 2014, Chris Hayes, ALL IN, and the “anti-death spiral” hope from the Right.

While the Right seethes and falsely predicts, the ACA moves towards serving the needs of people and towards the betterment of a nation. Remember, conservatives also fought FDR and Social Security and Medicare. We must also never forget the pundits in the video are all highly compensated, and you can rest assured have medical coverage.

Source Information:

Charles Gaba’s blog:

Open Secrets: Waning Influence? Part 1: Tracking the "Unlobbyist"

In ACA, Open Secrets Dot Org on March 23, 2014 at 2:17 PM

We are going to post a series from The Center for Responsive Politics (Open Secrets Dot Org). We realize the following articles are long. If you visit here often, you also know we do not shy away from long pieces. Information feeds brain cells and those cells make educated and informed choices. Those who have aversion to long pieces probably do not visit here, but they must realize their 140 character communication is useful but without full meaning and full scope. Additionally, the alternative to being well informed’ Uninformed gullible voters. Just watch your neighbors and family who spend little time educating themselves or who spend inordinate amounts of time over on Fox News (or AM Radio). Do you see my point?

For some reason Lobbying is failing off as a political tool.  It seems the nation’s uber-wealthy and secretive donors along with Citizens United may have impact well beyond the surface. Something is fueling 51 House votes (
at $81.6 million total cost) to repeal the ACA, when House leadership knows the votes are frivolous with no prospect of defunding the ACA. What could induce (as Einstein was said) “doing the same thing time after time and getting the same result each time.” Einstein spoke about a (his) definition of insanity. Could secretive organizations provide utensils to funnel money to politicians? 

Re-post from The Cneter for Responsive Politics…….licensed under a Creative Commons Attribution-Noncommercial-Share Alike 3.0 United States License by

OpenSecrets Blog

Waning Influence? Part 1: Tracking the “Unlobbyist”



This report is the first in a series examining the years-long decline in both spending on lobbyists and the number of active lobbyists. 

K street.jpg

Beginning in 2010, the Center for Responsive Politics documented a new trend in lobbying: the rise of the “unlobbyist.” The number of federally registered lobbyists who were active in a particular year began dropping in 2008 and has continued every year since. Our report last year showed that 46 percent of those who stopped lobbying in 2012 were actually still employed by the same firm. We argued that many of these ex-lobbyists simply shifted their job responsibilities slightly so as to avoid disclosure requirements and fly “under the radar.” 
Here, we’re extending our previous work. Through extensive research, we tracked the post-lobbying career paths of almost 1,800 registered, previously active lobbyists and found a similar pattern: Nearly half of them continued to work for the same companies — and some even still had job titles like “Director of Government Relations.” From these findings, it seems clear that lobbyists are not fleeing K Street in droves, but rather they are doing similar work for the same companies. Instead of doing it in the public eye, though, they have moved out of sight.  
Where are they now

The number of active lobbyists fell from 12,433 in 2012 to 12,279 in 2013. One possible explanation for this decline is that some have altered their activities just enough to avoid the reporting thresholds despite doing much the same work as they did in previous years. These “unlobbyists” are not uncommon, and there are many examples of prominent former government employees working for — or sometimes running — lobbying firms whose names never appear on lobbying disclosure forms.
For example, former Senate Majority Leader Tom Daschle (D-S.D.) and former House Speaker Newt Gingrich (R-Ga.) both work for major lobbying firms, but neither have ever formally registered as lobbyists. 
To see whether lobbyists are continuing to move “under the radar,” we investigated the professional whereabouts of all lobbyists who were active in 2012 but did not report lobbying in 2013. We refer to these people as having “deactivated.” This is a somewhat different group than those who deregistered,” a term with a specific legal meaning that is harder to measure due to data limitations. 
In 2008, following the passage of the Honest Leadership and Open Government Act of 2007 (HLOGA) — passed in response to the Jack Abramoff scandal — more than 3,400 individuals who had lobbied the year before disappeared from the official rolls. In 2012, there were 1,700 fewer active lobbyists than in 2011, and about the same number — 1,788 — fell away between 2012 and 2013. 
As of early 2014, 45 percent of lobbyists who were active in 2012 but not 2013 were still working for the same employer for whom they lobbied in 2012. In 2013, we performed asimilar analysis of lobbyists who deactivated in 2012 and found that about 46 percent were still with the same employer. The deactivated lobbyists who stayed were again the largest category in 2014. About a third of deactivated lobbyists moved to a different organization, with 14 percent staying in a similar industry and 19 percent going to a different industry. A small handful exited the job market altogether, either through retirement or death. We were unable to find information on 14 percent of the lobbyists who deactivated during 2013.
There are many reasons why someone might cease reporting lobbying activity. The most basic explanation is that he or she no longer lobbies: the individual may have been promoted into a job that no longer requires active lobbying, her contract with a lobbying client might have ended, or she might be nearing retirement and therefore cutting back on her duties. Our interviews with some of the “unlobbyists” confirmed these assumptions.
“It was just circumstances,” said Donald Gatlin of the Raben Group, a lobbying shop whose website says it also does “coalition building” and “strategic communications,” among other things. “‘Clients turn over. We have a lot of change here…I really don’t think it’s that unusual.” Gatlin added that there was no emphasis on reducing his or the group’s lobbying, and he was doing other work in 2013. 

Read more after the break

Dan Gilchrist of the University of Minnesota told us he “took a new, non-lobbying position” as of June 2012. Ellen Garrison of the American Psychological Association also said she changed jobs within her organization, as did several others who asked not to be named.
We also uncovered numerous examples of individuals who are no longer actively lobbying but whose job titles imply they are still involved in government affairs. About 14 percent of the nearly 1,800 lobbyists who deactivated in 2013 and 20 percent of those who are still working at the same place held titles that included phrases like “government,” “legislative,” “public policy,”  “regulatory,”  “congressional,” “federal,” “advocacy” or even “lobbyist.”
In roughly equal numbers, deactivating lobbyists hailed from organizations lobbying on their own behalf and lobbying firms for hire. That suggests the decline applies broadly to the entire influence industry, rather than to just K Street professionals — at least according to this measure.
The vast majority of lobbyists who deactivated in 2013 have multiple years of experience. Only 203 of them had never reported actively lobbying prior to 2012. Those who only lobbied in 2012 were likely doing a one-time job for a client.  
About 10 percent of those who deactivated in 2012, or 166 individuals, returned to active lobbying in 2013. Nearly three-quarters of them came back to lobby for the same organization they were with previously.
For an Excel spreadsheet of lobbyists who were registered in 2012, deactivated in 2013 but were still with the same employer, click here.
Sector trends 
Ever since the number of active lobbyists peaked at 14,837 in 2007, nearly every sector has experienced a significant decline. Most sectors did not, however, see quite as precipitous a decline in spending. In fact, spending increased in many areas.
But only one sector, labor, gained lobbyists during that period, increasing its lobbying force by 8 percent in 2013. On average, the 13 sectors tracked by CRP reported 23 percent fewer lobbyists in 2013 than in 2007, while at the same time they reported spending 7 percent more.
   Our previous research has found that both HLOGA and, to a lesser extent, executive branch hiring restrictions put in place by President Obama contributed to lobbyists ceasing to register even though they continue  to spend significant time on what most would consider lobbying activities
While most sectors have reported increases in spending since 2007, many also show a steep decline after 2009, when expenditures peaked. Since then, overall lobbying spending has dropped every year, reaching a low of $3.2 billion last year. Still, even though most sectors have seen declines in both the number of lobbyists and spending levels since 2009, in 11 of the 13 sectors the decrease in lobbyists outpaces the drop in spending.
The losses seem to be spread across all sectors of the economy. Among CRP’s sector categories, only Labor, Finance/Insurance/Real Estate (FIRE), Communications/Electronics and Agribusiness spent more in 2012 than they did in 2009, with the rest dropping by an average of 15 percent.  All but one sector reported fewer active lobbyists. Labor was alone in also hiring more lobbyists and is also reported to be mounting a political comeback after being somewhat less involved during the last few elections.
The biggest disparities between changes in spending versus changes in the number of active lobbyists were in the Communications/Electronics and Defense sectors. 
The overall disparity is not as striking as what we found for the longer period since 2007. Nevertheless, it indicates that money is still being spent to contact government officials and, by implication, that lobbyists and their staffs are still doing the work — but fewer are disclosing their activity to the public. 
Most industries, which are subgroups of a sector, followed a similar pattern, unsurprisingly. The Computers and Internet industry, which has seen several companies like Google and Facebook storm into the lobbying arena in recent years, spent $20 million more in 2013 than in 2007 but reported 553 fewer lobbyists. 

Issues and Bills
Lobbying reports are organized by issue area, using a preset list of about 80 issues such as TaxesWelfareLaborHomeland Security, or Education. Within each issue area, filers must report the agencies they contacted, lobbyists who worked on the issue and a more specific description of topics on which they lobbied.
The Center tallied up how many total lobbyists worked in each issue area as well as how many of the deactivating lobbyists had reported working on them and found that every single issue area lost at least three lobbyists due to deactivation. Three issue areas — Federal Budget & AppropriationsHealth Issues or Taxes — lost more than 275 lobbyists apiece in 2013. However, those are also the top three issues in terms of total number of lobbyists. 
By comparing the ratio of lobbyists who became inactive to total lobbyists listing each issue, we see that issues that attract less lobbying activity overall suffered the biggest losses by percentage. That could be because the exit of a few major organizations or the slimming down of a lobbying operation after a major fight over a big issue can have a larger impact, proportionally. Those with the biggest disparities were Religion, Welfare and Hazardous Waste; less than 1.5 percent of all active lobbyists report working on those issues, but they accounted for more than 10 percent of the deactivating lobbyists in 2013.
However, the issues most frequently lobbied (those having more than 1,000 reported lobbyists in 2012) saw a comparatively small number of deactivated lobbyists. About one-third of all lobbyists reported working on matters related to Budget, Taxes or Health issues in 2012, for instance, but only 7.7 percent, 6.4 percent and 8 percent, respectively, of the those lobbyists deactivated in 2013.
Similarly, the bills targeted by the highest number of deactivated lobbyists were also the most popular bills overall. However, nearly a third of the lobbyists who reported trying to influence two bills that were not as widely lobbied in 2012, the SOPA and PIPA Internet security and privacy legislation, left the active lobbying rolls. Companies and organizations interested in influencing or stopping the bills may have added staff with specific policy or even technical knowledge to lobby Congress. In addition, specific clients would have required more attention during the fight. Some personnel who usually slip under the reporting thresholds by spreading their activity across several clients might have found themselves working much more on this one issue. 
While there are a number of explanations for the decline in officially disclosed lobbying activity, it is clear that at least some of the activity has not stopped at all but has instead gone underground. Nearly half of the lobbyists who stopped reporting in 2013 are still working at the same employer and many are doing that work under a title that indicates they are still involved in influencing government policy.
Whether we look at what industry these “unlobbyists” lobbied for or what issues they worked on, the same basic pattern emerges: Lobbyists are becoming inactive at a higher rate than spending decreases would seem to predict, and in some cases in spite of increased spending.
Definitions and methodology
CRP matches individual lobbyists to their previous records every quarter as data is made available by the Senate Office of Public Records. Using these matches we found individuals who “deactivated,” or reported lobbying activity in 2012 but did not do so in 2013. What we have chosen to call deactivation differs in meaningful ways from the term deregistration, which has a specific technical meaning. To deregister, a lobbyist must be listed on the “deregistration” line of reports filed by every client she represented; alternatively, she could be listed on termination reports for all of these clients. Conceptually, not lobbying (as in, not appearing on any reports for a year) is just as meaningful as technically deregistering, thus we chose to study deactivation instead of deregistration. 
CRP then attempted to determine where these “former” lobbyists were working today. We were unable to find current information for 242, or 14 percent, of the lobbyists who deactivated in 2013.
Read more about our methodology for processing lobbying data. Lobbyists must register with the government if they are paid to lobby on behalf of a client, make at least two contacts with covered government officials and spend at least 20 percent of their time working for that client. All three conditions must be met to trigger the filing requirement.

Reporting interns Robbie Feinberg and Emily Kopp contributed to this report.

Connect The Dots USA OBamaCare Myths: Part II, The 6th Myth

In ACA, Connect The Dots USA, RIck santorum on March 15, 2014 at 9:33 AM

Connect The Dots USA OBamaCare Myths.  The 6th Myth….

“Myths” 1 – 5 Linked, here.

Connect The Dots USA

Debunking #6: “I Don’t Want To Pay To Cover Contraception Or Maternity Care.”

If Viagra is covered, then covering contraception only seems fair.

The Daily Show’s Samantha Bee exposes the millions of dollars of taxpayer Medicare money that goes to fund penis pumps (at $360 each):

Why is it when it comes to covering medications/treatments that men want in Rick Santorum’s “sexual realm,” it’s covered without discussion, but there’s a double-standard when it comes to women?

And pregnancy does not occur by immaculate conception — somewhere along the line there was a dude involved. Men need to pay into that insurance pool, too. And thanks to the ACA, older folks are getting even more subsidized by younger folks — rates can vary no more than 3:1 for oldest adult:youngest adult instead of the previous 5:1 or 8:1. So older adults can at least help subsidize younger folks’ maternity coverage. It’s all about cross-subsidies and community-rating to help make everything affordable for everyone. You get some, you give some. Not a perfect system but seems fair.

Insurance policies have never been written a la carte for a particular person at a particular time. Lots of coverages will never apply to you (e.g. women never need prostate exams).

See Michael Hiltzik, “Yes, men should pay for pregnancy coverage, and here’s why.”

6 Obama Care Criticisms ( Myths)!

In ACA, Connect The Dots USA, Obamacare on March 11, 2014 at 6:48 PM

the act of expressing disapproval and of noting the problems or faults of a person or thing : the act of criticizing someone or something
  a traditional but unfounded story that gives the reason for a current custom, belief, or fact of nature


to make a statement one knows to be untrue

 to deceive, win over, or induce to do something by artful coaxing and wheedling or shrewd trickery

The Koch brothers have spent one half a billion dollars working to repeal ObamaCare. The US House of Representatives has wasted $80 million dollars on frivolous and subservient (to money backers) repeal votes. House leadership has indicated a 51st vote in the coming weeks. Do you think the silliness will stop when the gauge hits $100 million?  Did I hear someone say, the tea party is against big government and is for cost cutting?  
In addition to phony “I cannot accept the ACA” panels on Fox News and internet and actor developed television commercials against the ACA. The Fox broadcast and expensive Koch brothers ads center around a few (bundled) ACA lies. We will defer to Connect The Dots USA use of the word “criticism” as we present what follows.
Later tonight plan to post a video segment related to the Koch ad campaign. You already know the site has many postings related to the Koch paradigm for the nation. We ask, why do such wealthy people literally hate the middle and lower income Americans? It is impossible to avoid use of the word “hate”, as we can find no other reason for spending over $500 million dollars to kill law that benefits so many people.

The ACA is good for people and good for the nation! 
Connect The Dots USA

Let’s debunk the Top 6 ObamaCare Criticisms.

First, we have all those purported ObamaCare horror stories offered up by the right-wing propaganda machine and even elected officials. Once an investigative reporter actually scratches beneath the surface, however, every one of these stories has turned on to be phony. You’d think if ObamaCare was so awful, the right-wing would be tripping all over legitimate tales of woe.

On the contrary, reporters like Michael Hiltzik and Kevin Drum “wonder whether there’s a single genuine Obamacare horror story out there, given that virtually every yarn promoted by Republicans or conservatives about people hurt by the Affordable Care Act has deflated like a pricked balloon on the merest examination.

Read the rest of this entry »

Connect The Dots USA Paid Us A Visit: The ACA Moves Forward

In ACA, Connect The Dots USA on March 10, 2014 at 4:06 PM

Liked · March 7 · Edited 

As of January 1st, 2014, one of the biggest game-changing benefits of the Affordable Care Act went into effect: NO MORE DISCRIMINATION BASED ON PRE-EXISTING CONDITIONS. It deserves an all-caps treatment because it is the headline that keeps getting buried in all the silliness. This discrimination ban has been a feature of most employer-based group plans, but until recently it has eluded the individual insurance market.
REAL Health Insurance Freedom is not the freedom to continue to buy junk insurance or the freedom to free-ride by going without insurance until you get sick. No, REAL Health Insurance Freedom means…
1) …No longer being denied or charged more due to a pre-existing condition (or gender). Such discrimination has been a huge roadblock to coverage in the individual (non-group) insurance market. Now it’s gone, along with its evil and onerous step-child — medical underwriting. 
2) …Having the option to switch insurance plans every year during open enrollment. Think about it — every year, you can ditch your insurance company and pick a different plan that suits you better: You are no longer held hostage because of a pre-existing condition. So if you’re still fretting about which plan to pick this year, don’t agonize too much. Just choose something that fits your needs now and especially make sure it covers you from catastrophic costs. If you later decide you don’t like your selection or you discover a doctor that is not in-network, you can easily change to another plan for 2015. Your choice is no longer a lifetime commitment.
3) …Consulting your doctor without fear it will ding your permanent record. Good-bye underwriting! Patients would actually refrain from sharing medical concerns with their doctor for fear of establishing a pre-existing condition. That had a chilling effect and impeded optimal medical care. How crazy was that? Gone! 
4) …Finally being able to quit your corporate job to start your own business or retire early. No more job lock because of health benefits. That’s the labor market effect the recent Congressional Budget Report was referring to, not that the ACA would kill demand for jobs.
Remember: Open enrollment ends March 31st for 2014 coverage: If you enroll and pay by Saturday, March 15th, your coverage will start April 1st. If you enroll and pay by Monday, March 31st, your coverage will start May 1st. After that, you’ll have to wait for 2015 open enrollment, which starts Nov 15th, 2014. If during the year, you have a qualifying life event such as losing your job-based coverage, having a child, moving out of the coverage area, or getting married/divorced, you’ll get a special enrollment period to purchase insurance.
Happy shopping. Enjoy the FREEDOM!

UPDATE: Huffington Post is reporting the uninsured rate has dropped for the first time since President Obama took office, and Gallup is attributing the drop to ObamaCare.