BluntPolitics.com

By Ric Joyner

Folks,

Enjoyed my day meeting with my representatives. The first was Senator Feingold’s aid…Andrew S. Our mission was not to talk about ideology but how flex plans will be affected in health care.

Since the Dems are using reconciliation the process stops until the senate finishes. But the problem is that that House has to pass the Senate version (which has the two negative impacts on flex in it. Capping the health FSA and eliminating the over the counter medicine deduction in FSA, HRA and HSA.

We explained that our software vendor provided data on all their participants which provides about 1.2 million cdh account holders. The average dollar amount put into the FSA for health expenses was $1,563.17. I then explained that the problem with this that it is average numbers and singles put in much less than families so this numbers for actual participation with families is much higher and we were there to let the Senators know that our participants asked us to pass along to the representatives that this is a hidden tax. Same thing with over the counter meds.

Interesting fact, we waited in their lobbies and the phone rang off the hook with people calling to protest the health care bill. Finally one of the aids blew a gasket literally and started to argue with the constituent that health care did need overhauling. As we left, there were other folks from other associations that were lecturing the representatives staff on big government etc. and for them not to support this bill. But by and large the calls were steady in all the offices and they were overwhelmingly against this bill (there officially is no bill but just pieces and they will be cobbled together. But do watch the senate version and the house must pass this bill). The staffers said their job was take down and pass along the information to the member but that it was tiring!

There was genuine concern by staffers they could lose the house. They don’t think they will lose the Senate. They talked about Mass election catching them all by surprise.

The Senate Aides said they have the 50 votes (the VP adds 1) to pass the bill in the Senate but in the house it is unraveling. (This was told to us by Democratic Aides). One said she had been working so hard and long hours on a bill that she would be severely depressed if it didn’t happen.

Again we didn’t talk politics just asked the senators and representative to please work together to take out this hidden tax. We received positive comments that they would. (I have known most of them for years)

BTW we ended up lost below the Capital and we took a  ride on the Senator’s subway train which I guess is a not allowed. A guard stopped us and asked if we were staff and we said no…just lost. He told us we weren’t supposed to be on the train and asked how we got there and we told  him we came down the stairs and got on. He told us to come to his desk and he checked our IDs and gave us “official business Visitor” badges.

Oh boy that was cool. We got into a ton of places (and trains) we probably shouldn’t have.  One staffer asked how we got the badges and we said it was fun riding the senators train and appreciated the nice officer that gave them to us. She said “Great, that is why I feel so safe in Washington” and rolled her eyes.

Ferdacripesake it is fun to be from Wisconsin! 

One guy from NE was wearing a giant corn cob hat to represent the cornhusker pay off!

Per a White House official:

Tomorrow afternoon at the White House, the President will deliver remarks about moving forward into the final stage of the health insurance reform debate. He’ll reiterate why reform is so crucial and what it will mean for American families and businesses: they’ll have more control over their own health care, they’ll see lower costs , and they’ll see an end to insurance company abuses. He’ll note that his proposal includes the best ideas from both parties, and he’ll restate his preference for a comprehensive bill that will reduce premiums and end discrimination against people with pre-existing conditions. He’ll urge Congress to move swiftly toward votes on this legislation.
More on the event:
– The President will speak at 1:45 pm in the East Room
– He will be joined by health care professionals from around the country
– Secretary Sebelius will attend as well
– The remarks will be open press

Politico…retrieved at 1.49am Eastern http://wbx.me/l/?u=http%3A%2F%2Fwww.politico.com%2Flivepulse%2F0310%2FPresident_will_unveil_his_way_forward_at_145_pm_tomorrow_.html

By Ric Joyner, CEBS, CFCI

The House has just released their version of HCR. The Senate posted theirs recently. The two bills must be approved in each chamber to move to “conference”. Conferencing allows the bills to be blended into one final bill. Next, both chambers vote to approve a final bill, and then on to the President’s desk for signing into law. Due to the issues some representatives have with government run health care, called the public option, which is included in each bill, there is a tough fight in both chambers to pass respective bills into one.

Here is a synopsis from our friends at Kilpatrick Stockton.

Summary: http://www.screencast.com/t/xlAkiUKAA

From the KS Health and Welfare Team:

Not to be outdone by the Senate action on consolidating its two outstanding health care reform bills, the House of Representatives released its revised health care reform bill today.  Apparently, the House is attempting to break the record on how many different existing statutes it can amend with one bill.  I say this because the revised bill drops in at 1,990 pages - almost 1/3 more than the previous bill.  I have attached a summary produced by the House (only 11 pages).  The actual bill is linked below.

http://docs.house.gov/rules/health/111_ahcaa.pdf

Mark L. Stember
Kilpatrick Stockton LLP
Suite 900
607 14th Street, NW
Washington, DC 20005-2018
t 202 508 5802
f 202 585 0018

Ric Joyner, CEBS, CFCI

Joe Lieberman an independent  Senator from Connecticut which usually votes with the democrats, has just announced he will side with the Republicans on a filibuster of the Senate version of health care reform. Olympia Snowe a Senator from Maine also will side with the Republicans against the bill. Unless a compromise can be reached soon the bill is effectively “dead” in the Senate! The result is that the bill is prevented from moving out of the Senate to be joined with a House version. Both Senators are citing the public option (government take over of 20% of the economy), as their reason for not backing the bill. This news is  a blow to democrats who want a government take over of 20% of the economy. We are for fixing the people who do not have coverage, but this bill according to the Congressional Budget Office  (CBO) will not cover enough of the uninsured, potentially cost trillions of dollars and millions of jobs.

Current healthcare system unsustainable: CLHIA

September 22, 2009 | Mark Noble

The president of the Canadian Life and Health Insurance Association says Canadian healthcare system is headed for a crisis, unless serious reforms are made.

Speaking before the Economic Club of Toronto, Frank Swedlove warned the current Canadian healthcare system is not sustainable.

Swedlove said too many people believe there are just two healthcare options available—a private system like the one in America, or a fully-funded public system. He argued there’s a way to preserve the integrity of Canada’s universal public coverage, while offloading some expenses to private care providers.

"We’re in the midst of an aging population and there are newer and more expensive treatments. If the trend continues, in ten years many provinces will spend 70 cents out of every budget dollar on healthcare, with little remaining for education, infrastructure, and innovation," Swedlove said.

This figure suggests it’s virtually impossible to have a world-class healthcare system under the current model.

Successful private partnerships in certain medical services can reduce the funding burden of the government, Swedlove said. There are homegrown examples of private-treatment offerings—sometimes covered by insurance—that don’t undermine the public healthcare system in Canada.

"A 2006 Conference board of Canada study, comparing 24 leading OECD countries, ranked Canada 11th in terms of overall health. There are more recent studies that rank us even lower," Swedlove noted. "There are plenty of countries for us to learn from. Home-grown success stories can also be studied and built on. For instance, there is the Shouldice Clinic here in Toronto—a leader in privately delivered hernia surgery — and similarly the Calgary-based Gimbel Eye Centre—the first out-of-hospital institution in Canada to offer small-incision cataract surgery."

In fact, Canada actually has an above-average participation of privately covered healthcare versus the global average.

"The average public healthcare spending by partner nations is 73%. Canada’s public spending ranks lower at 70%. The rest comes from private sources, a mixture of private health care providers and directly from your pocket," Swedlove said.

Skyrocketing drug costs account for part of the growing healthcare costs. According to a white paper released by the CLHIA in June, Canada ranks second in total per capita spending on drugs, both prescribed and non-prescribed, out of the 20 leading OECD countries. Total drug spending in Canada reached $26.9 billion in 2007, representing an annual growth rate of 7.2% over 2006. Spending on prescribed drugs grew faster than spending on non-prescribed drugs and reached 84% of total drug costs in 2007.

The cost of drugs is staggering for those who don’t have private drug coverage. Even, generic drugs in Canada are much more expensive than they are in other developed nations.

"Healthcare may be a universal benefit of living in Canada, but it isn’t the same reality when it comes to affordable drugs. Consumers continue to face prescription drug costs that can be staggering. Supplementary insurance provides some drug assistance but not all Canadians have such insurance," Swedlove said. "Our paper calls for catastrophic drug coverage for all Canadians, equitable drug pricing across public and private programs, and a competitive generic drug regime."

Incentives for LTC

Currently, Canadian insurers cover about 220,000 Canadians for long-term health care (LTC). And the number of Canadians needing LTC is growing dramatically, according to CLHIA, and the public system will be unable to support LTC claims as the number of elderly Canadians drastically increases over the coming decades.

The CLHIA white paper says many Canadians hold a "mistaken belief" that all of their long-term care needs are met by the government. The CLHIA says the responsibility to pay for such care remains largely with them. With the number of seniors expected to balloon to 9.8 million by 2036, (according to Statistics Canada), there will be a significant cost burden to Canadians fighting for an LTC spot.

According to Swedlove the CLHIA would like to see the government introduce tax incentives through an RSP-equivalent vehicle such as a Medical Spending Account to allow Canadians to fund LTC.

"Governments need to ensure that people living with a chronic illness receive health care services that are integrated across the primary care system and coordinated by family doctors or clinics," he added. "Tax and financial incentives for Canadians would also help them take greater responsibility for the care of aging or ill family members at home through the purchase of private insurance."

(09/22/09)

Part of the 47 million (which is proven to not be true) are people who are young or don’t wish to purchase insurance. These people according to the Obama administration are irresponsible and  thus must be penalized. This is a direct assault on individual freedoms. And may be unconstitutional. If you are concerned it is now time to let the www.senate.gov and www.house.gov know your opinion for or against this plan.

http://www.foxnews.com/politics/2009/09/26/baucus-mandate-penalty-lead-prison-congressional-analysts-say/

This weekend on the pundit shows (except FOX) President Obama pitched the same spiel on health care reform which is chalk full of inaccuracies. For example, a revenue neutral bill. How can you give 30-50 million people health insurance or health care without it costing money? The neutral part comes in taxes or mandates.  A tax is defined as: noun

–verb (used with object)

http://dictionary.reference.com/browse/tax

Thus, forcing people to purchase insurance is a tax. These type of taxes are referred to as mandates. Mandates are the same as forcing someone to purchase insurance and thus is a tax.

On Sunday George Stephanopolus ask President Obama about forcing people who  don’t want to buy insurance if they were being taxed. The President was caught off guard and in typical socialistic fashion debated whether this was a tax or not!!! When you force people to pay for something they don’t choose it is a tax.

Huge middle-class tax increase:

http://www.youtube.com/watch?v=lgBzmoo9izw

How can we trust this president?

By Ric Joyner

This is great news. And helps put pressure on the President.

www.dailykos.com

The Baucus Debacle

by mcjoan

Wed Sep 16, 2009 at 10:50:21 AM PDT

It’s finally here, set to go to mark-up next Tuesday. The famous "bipartisan" effort that so far has the support of absolutely no Republicans, including President Sen. Snowe.

You can read the Chairman’s mark here [pdf]. In Finance tradition, the bill is written in narrative form, rather than legislative form. All amendments will also be offered in plain English, and then the plain English mark turned into legislative form.

Start reading, and chronicle the debacle in the comments. Let’s start with this one, on page 2 (page 5 of the pdf), where it establishes that older people could be charged 5 times as much as younger people. You’re reading that right: 

Under the Baucus legislation, private insurers could also charge older individuals up to five times more for coverage. "You’re just using age as a proxy for health status," Uwe Reinhardt, an economics professor at Princeton University told the New York Times. Reinhardt estimates that "Senator Baucus’s age-rating plan would allow insurers to cover roughly 70 percent of the additional risk they’d take on by being required to accept all comers, regardless of health."

Affordability questions remain paramount throughout the mark, not just for older Americans (over 55, not yet eligble for Medicare). Marcy is doing a fantastic job of breaking down the costs for middle America, and the very real possibility that this bill would make American workers captive to their employers:

The individual definition of affordable uses 10% of Adjusted Gross Income. Whereas the employer’s definition of affordable uses 13% of (apparently) total income.

Now, it’s a good thing (sort of) that the affordability rate for individuals is 10% of AGI. That means a family would be able to opt out if there were no health care available at even a lower rate than I thought (for example, it might mean a middle class family could opt out if health insurance cost them $6,000 a year, as opposed to $8,000 a year). It’s a bad thing, though, because it means MaxTax would be far from universal–a lot of middle class families will pretty much have to opt out because they can’t afford coverage.

But if your employer offers health care–even if it covers just 65% of costs–then you can’t opt-out unless you’re paying out of pocket 13% of your total income!! Oh, and to opt-out you have to go to your manager and tell him or her that you’re opting out, which means the employer will be fined; how many people do you think will be fired rather than opt-out?

So far the Baucus debacle is very good for Wal-Mart, very good for AHIP, and not so great for the rest of us. Note as well, there is no employer mandate to provide coverage to workers in this bill. But what happens when you don’t obtain insurance (page 29):

Excise Tax. The consequence for not maintaining insurance would be an excise tax. If a taxpayer‘s MAGI [Adjusted Gross Income] is between 100-300 percent of FPL [Federal Poverty Level], the excise tax for failing to obtain coverage for an individual in a taxpayer unit (either as a taxpayer or an individual claimed as a dependent) is $750 per year. However, the maximum penalty for the taxpayer unit is $1,500. If a taxpayer‘s MAGI is above 300 percent of FPL the penalty for failing to obtain coverage for an individual in a taxpayer unit (either as a taxpayer or as an individual claimed as a dependent) is $950 year. However, the maximum penalty amount a family above 300 percent of FPL would pay is $3,800.

Right, that’ll bring us to universal coverage. You can either spend your money by getting trapped in a crappy, expensive insurance policy, or pay the fine. In general, mandates are a key component of reaching universal coverage, but the mandates have to be accompanied by an affordable, sustainable option. Which we don’t get in the Baucus debacle. We get co-ops, that "must not be sponsored by a State, county, or local government, or any government instrumentality."

The Baucus debacle: as bad as we thought it would be. And this is just scratching the surface. There’s plenty more to be had. Read it yourself, and add your thoughts in the comments.

By Ric Joyner, MBA, CEBS, CFCI

Initial analysis:

http://finance.senate.gov/sitepages/leg/LEG 2009/091609 Americas_Healthy_Future_Act.pdf

Here is an  impact chart from the bill that our Senator Kohl’s Staff sent us. A must read.

http://www.screencast.com/t/spifjWNyY92

Some good news in this for the future is imposing a tax on costly benefits will help to drive higher deductible plans which promotes healthier lifestyles. Imposition of some the caps and taxes don’t start for a few years which is odd. But the impact on FSAs will start 12-31-10.

The bad angels are the reporting requirements, the high taxes and loss of some benefit offerings. This bill, if left intact will fundamentally change how employee benefits are delivered.

Apparently, the GOP (republicans) are not on board with this bill. Conclusion: It is not bi-partisan which is a goal of the Presidents. But my prediction has been and still remains that the Democrats will likely go this alone. They have control.

Remember this is a bill that will need to go into “mark  up” which will change after it is debated.

It appears the President will have a tough fight for this bill. Employers are not going to appreciate the added burden of reporting and the potential for taxes.

I am working as well as others on analyzing the bill which I will post on www.benefitblog.com

Here is an excerpt from the bill that should concern most practitioners and employers. Another burden is the amount of reporting that will be required and the excise taxes imposed.

The amount subject to the excise tax on high cost employer-sponsored coverage for each employee is the sum of the aggregate premiums for health insurance coverage, the amount of any salary reduction contributions to a Health FSA for the taxable year, and the dollar amount of employer contributions to an HSA, minus the dollar amount of the threshold. The aggregate premiums for health insurance coverage include all employer-sponsored health coverage including coverage for major medical, dental, vision and other supplementary health insurance coverage. The applicable premium for health coverage provided through an HRA is also included in this aggregate amount.

Under a separate provision (described below), an employer is required to disclose the aggregate premiums for health insurance coverage for each employee on his or her annual Form W-2.

Under the Mark, the excise tax is allocated pro rata among the insurers, with each insurer responsible for payment of the excise tax on an amount equal to the amount subject to the total excise tax multiplied by a fraction, the numerator of which is the amount of employer-sponsored health insurance coverage provided by that insurer to the employee and the denominator of which is the aggregate value of all employer-sponsored health insurance coverage provided to the employee. In the case of a self-insured group health plan, a Health FSA, an HRA or employer contributions to an HSA, the excise tax is allocated to the plan administrator. The employer is responsible for calculating the amount subject to the excise tax allocable to each insurer and plan administrator and for reporting these amounts to each insurer, plan administrator and the Secretary, in such form and at such time as the Secretary may prescribe. Each insurer and plan administrator is then responsible for calculating, reporting and paying the excise tax to the IRS on such forms and at such time as the Secretary may prescribe.

For example, for an employee who elects family coverage under a fully-insured health care policy covering major medical and dental with a value of $28,000, the amount subject to the excise tax is $7,000 ($28,000 less the threshold of $21,000). The employer reports $7,000 as taxable to the insurer, which calculates and remits the excise tax to the IRS.

Alternatively, an employee who elects family coverage under a fully-insured major medical policy with a value of $23,000 and a separate fully-insured dental policy with a value of $2,000 and who contributes $3,000 to a Health FSA has an aggregate health insurance coverage value of $28,000. The amount subject to the excise tax is $7,000 ($28,000 less the threshold of $21,000). 201

The employer reports $5,750 ($7,000 x $23,000/$28,000) as taxable to the major medical insurer and $500 ($7,000 x $2,000/$28,000) as taxable to the dental insurer, each of which then calculates and remits the excise tax to the IRS. If the employer uses a third-party administrator for the Health FSA, the employer reports $750 ($7,000 x $3,000/$28,000) to the administrator and the administrator calculates and remits the excise tax to the IRS. (If the employer is acting as the plan administrator of the Health FSA, the employer is responsible for calculating and remitting the excise tax on the $750 to the IRS).

Technorati Tags: barack obama,spying on americans,whitehouse,collecting americans data on social network sites

(Folks this is an amazing article)

EXCLUSIVE:

Audrey Hudson (Contact)

EXCLUSIVE:

The White House is collecting and storing comments and videos placed on its social-networking sites such as Facebook, Twitter and YouTube without notifying or asking the consent of the site users, a failure that appears to run counter to President Obama’s promise of a transparent government and his pledge to protect privacy on the Internet.

Marc Rotenberg, president of the Electronic Privacy Information Center, said the White House signaled that it would insist on open dealings with Internet users and, in fact, should feel obliged to disclose that it is collecting such information.

“The White House has not been adequately transparent, particularly on how it makes use of new social media techniques, such as this example,” he said.

Defenders of the White House actions said the Presidential Records Act requires that the administration gather the information and that it was justified in taking the additional step of asking a private contractor to “crawl and archive” all such material. Nicholas Shapiro, a White House spokesman, declined to say when the practice began or how much the new contract would cost.

Susan Cooper, a spokeswoman for National Archives and Records Administration, said the presidential records law applies to “social media” and to public comments “received by the president or immediate staff.”

Mr. Obama signed a memo in January stating that his efforts to maintain an open government would be “unprecedented” and “ensure the public trust and establish a system of transparency, public participation and collaboration.”

An Obama campaign document on technology pledged that, as president, Mr. Obama “will strengthen privacy protections for the digital age and will harness the power of technology to hold government and business accountable for violations of personal privacy.”

In a June 5, 2008, article in PC Magazine, Mr. Obama said, “The open information platforms of the 21st century can also tempt institutions to violate the privacy of citizens. We need sensible safeguards that protect privacy in this dynamic new world.”

The National Legal and Policy Center, a government ethics watchdog, said archiving the sites would have a “chilling effect” on Web site users who might wish to leave comments critical of the administration.

Ken Boehm, a lawyer and chairman of the center, also disputed that the presidential records law applies, because the comments are pasted onto a third-party Web page and not official correspondence with the president.

“If the White House has nothing to hide, why is this cloaked in secrecy? Why won’t they make the dollar amount this is going to cost public?” Mr. Boehm asked. “I don’t think there is an expectation that this is being captured by the government and saved.”

But Patrice McDermott, director of OpenTheGovernment.org, called the proposal “a positive development because it demonstrates a commitment from the Obama administration to meet its obligations under the Presidential Records Act.”

“Additionally, I am encouraged to see the administration recognizing that it must find a way to handle the ever-expanding amount of data generated electronically. I hope the rest of the executive branch will learn from the president’s leadership on this issue,” Ms. McDermott said.

Shahid Buttar, executive director of the Bill of Rights Defense Committee, called for congressional oversight of the practice of collecting data.

“Given the administration’s disappointing secrecy in other contexts, the Bill of Rights Defense Committee encourages Congress to conduct oversight to ensure compliance with the law, maximize transparency and protect individual privacy,” Mr. Buttar said.

According to the law, the term “presidential records” means documentary materials “created or received by the president, his immediate staff or a unit or individual of the Executive Office of the President whose function is to advise and assist the president, in the course of conducting activities which relate to or have an effect upon the carrying out of the constitutional, statutory, or other official or ceremonial duties of the President.”

“It includes any documentary materials relating to the political activities of the president or members of his staff, but only if such activities relate to or have a direct effect upon the carrying out of constitutional, statutory, or other official or ceremonial duties of the President,” the law says.

David Almacy, who served as President George W. Bush’s Internet director, said the Bush administration did not use the then-fledgling social-networking sites in the same manner as the Obama White House, except to upload presidential speeches onto iTunes. The White House, however, did archive comments posted to its official Web site.

The proposal issued Aug. 21 calls for a contractor to “crawl and archive” social-networking Web sites where the White House maintains an official presence on seven networks: Facebook, Twitter, MySpace, Flickr, YouTube, Vimeo and Slideshare.

The collection will include the comments, tags, graphics, audio and video posted by users who don’t work for the White House.

The White House has more than 333,000 fans on Facebook, and posts updates several times a day that draw hundreds of thousands of comments, both positive and negative. The White House has more than 1 million followers on Twitter and more than 87,000 subscribers on YouTube, where more than 400 videos of the president and White House briefings are posted.