Amodei, Amadavat, and Affordable Health Care

Things beginning with A-M:  Amodei (R-NV2) and Amadavat.  The latter being an Asian weaverbird often kept caged for its pleasant singing.   The former known for his ability to pleasantly sing the Republican Party Anthem no matter what new variations are put on the basic incantations.   Representative Amodei’s reaction to the Supreme Court’s declaration that the Affordable Care Act is, in fact, constitutional, perches him solidly in the Amadavat Chorus of GOP Talking Points du jour.

“Advocates for Washington-based management of health care and unprecedented tax increases on the middle class won today. However, I will continue to work for patient-centered solutions, reductions in health care costs, and improving health care access for all Nevadans.” [Amodei]

Oh, the horror! “Unprecedented tax increases on the middle class?”  So, how does any of the taxation in the Affordable Care Act stack up compared to the Reagan Tax Increase of 1982?  One more glance at the chart of tax increases in recent memory:

And, what, pray tell, is a “patient centered solution?”  Let’s guess that the phrase “market based solution” isn’t going over so well in the Luntz focus groups these days after the revelations about Barclay’s diddling with the LIBOR and the “mis-selling” of interest rate swaps to small business owners.  Americans also seem a bit put off by the fumbling explanation of “off shoring/outsourcing” from the Romney camp.  By deftly swapping Patient Centered for Market Based, we now have a New Idea…except it isn’t new, it’s the same old YOYO.  (You’re on Your Own)  The Really Big GOP New Idea? Promote the sale of individual health insurance plans by giving tax deductions for them, and for allowing tax free HSAs to be used for paying health care insurance premiums.  There’s no limit to what the health insurance corporation could charge you for one of their plans, nor is there any provision for requiring that the insurance corporation actually spend most your premium dollars on health care — as opposed to CEO compensation, advertising, etc.

“I look forward to the opportunity to vote the week of July 9 for full repeal of this harmful government intrusion into health care. Congress created this mess and it’s our responsibility to clean it up. We owe it to the middle class to give them specific, well-thought out options focusing on portability of insurance across state lines and affordability, while not interfering with the patient-doctor relationship.”  [Amodei]

The underlined phrases highlight the basic Amadavat Song.  Government + Intrusion = Really Bad.  But wait, what’s harmful?  How many Americans are harmed by having the government require that health insurance corporations not discriminate against women? Or, refuse to offer coverage to those with a pre-existing medical condition? Or, abuse rescission clauses to dump coverage after a person becomes ill or injured? Or, refuse to offer basic childhood vaccinations as part of basic coverage?

How many Nevadans are harmed by requiring basic coverage insurance plans to include mammograms, prostate cancer screenings?  Diabetes and heart disease screenings?  Autism screening for toddlers?

Yes, Nevadans — and all other Americans — are owed “specific, well thought out options,” BUT portability is a euphemism for a race to the bottom in health insurance coverage.  Representative Amodei is now full throatedly singing The Insurance Corporation Anthem.  For years now the insurance industry has attempted to bypass consumer protections at the state level by getting “portability,”  by getting federal permission to offer only that coverage which is included in the least restrictive state.

“Doctor- Patient” relationship?  Please.  As noted earlier today:

“Thanks to the Affordable Care Act, all Americans joining new insurance plans have the freedom to choose from any primary care provider, OB-GYN, or pediatrician in their health plan’s network, or emergency care outside of the plan’s network, without a referral.” [HHS]

That, not the restrictions of the health insurance conglomerates, is NOT interfering in a doctor- patient relationship.

“This 2,700-page monster offends seniors, veterans, middle class families and employers. I will continue to take every opportunity to repeal and address this mess for Nevadans in a practical way without picking political winners and losers.”  [Amodei]

Please, the Word Salad Random Talking Point Generator needn’t be in over-drive.   How are any of the groups “offended?”  How are seniors offended by closing the infamous Medicare Part D do-nut hole?  How are veterans affected by the bill?  Other than say, getting preventative health care access for those not qualified for VA administered programs?   How are middle class families “offended” by a statute which requires insurance corporations to offer coverage without artificial life-time limits or other forms of junk insurance plans?

“Without picking winners and losers?”  Did Representative Amodei get his anti-alternative energy statement mixed up with his anti-affordable health care message?  This is not a chocolate + peanut butter combo accident.  Who are the winners? The losers?  Don’t Nevadans win when their health insurance plans must cover a person without regard to gender?  Don’t Nevadans win when pre-natal care must be offered as part of basic health insurance policies?

After cranking up his GOP Random Talking Point Generator, and singing from his gilded Insurance Corporation Cage, Representative Amodei must sound truly pleasant to the CEOs of Big Insurance and their other amadavats in the Republican Party.

Monday Charts and Graphs

** It’s Monday Morning And Obamacare Is The Biggest Tax Increase Since The First Dynasty of Ukhaimir!  Or. Not.   The following chart from the Washington Post is instructive:

** Poor Grover (Norquist), “Grover Norquist of Americans for Tax Reform, for example, stated, “it’s now clear that ‘Obamacare’ is all about taxes and it hits everybody, not just rich people.” [CBPP] There’s a chart for this bit of hysteria too:

** In case you missed it, “Middle-income and low-income Nevadans would pay somewhat more in taxes under the Congressional Republicans’ approach to extending the Bush tax cuts than they would under President Obama’s approach, while high-income Nevadans would pay far less under the Republican approach, according to a new analysis from the Institute on Taxation and Economic Policy (ITEP) and Citizens for Tax Justice (CTJ).  National figures show the same pattern.”  [PLAN] (emphasis added)   There’s a chart for that too:

The full report from which this chart is reproduced is here. (pdf)

** The Sin City Siren covers the little dust devil the Heller Campaign would like to kick up about Rep. Shelley Berkley’s (D-NV1) efforts to save the kidney transplant center at UMC (Las Vegas).    OK, her husband is a surgeon.  Does this obviate the need to have kidney transplant services in southern Nevada?  No.  Kidney disease is the 9th highest cause of death in Nevada (2009), for which the Silver State gets a ranking of 12th in the nation. [CDC] The Heller campaign’s attempt to equate Berkley’s so-called conflict of interest falls neatly into the Ignoratio Elenchi category of catch-all fallacies of irrelevance.

** We can do better.  Las Vegas, NV was number 1 in the nation in African American unemployment as of 2011.  The 2011 rate was 22.6%.  [EPI] Things could be better for manufacturing employment nationally:

Remember when the Senate Republicans filibustered S.3816 on September 28, 2010? The Creating American Jobs and Ending Offshoring Act failed to get the 60 votes necessary to break the filibuster, the cloture vote was 53-45. [Roll Call 242, 111th Congress]

Heck covers Nugent (No, not THAT Nugent) with H.R. 5951

Representative Joe Heck (R-NV3) introduced a plan to “save taxpayers money” by allowing members of Congress to forgo benefits from the Federal Employees Retirement System. [LVSun] Congressman Heck’s office is pleased to announce that “Congressman Joe Heck (NV-03) has introduced legislation that could potentially save taxpayers millions of dollars by allowing Members of the House of Representatives to opt-out of the Federal Employees’ Retirement System (FERS).  Since 1984, Members of Congress have been automatically enrolled under FERS, but could choose to opt out of the program. ” (H.R. 5951)   Wait a moment please.  This tune is sounding familiar.

Congressman Joe Heck may have introduced legislation on this subject, but it’s not like he’s the first one with the idea.  A very similar bill, H. 981, was introduced by Representative Richard Nugent (R-FL5) on March 9, 2011.  [GovTrack] Congressman Nugent’s bill garnered three co-sponsors and still sits in the House Administration Committee.   The House Administration Committee has not yet scheduled a hearing, much less a mark up session, on H.R. 981, [Thomas] which tends to imply that H.R. 5951 will meet a similar fate.  There is no Congressional Budget Office scoring of H.R. 981, so those “savings” remain securely in the “potential” category.

If Representative Heck wanted to score points bashing public employee retirement programs — such as the one from which his Democratic opponent draws his pension after 20 years of service as a firefighter — then some symbolic bill like H.R. 981/H.R. 5951 might be appropriate.  As serious legislation, the idea hasn’t even secured enough support to make it to a committee hearing in the 112th Congress since March, 2011.

Congressman Heck may also want to dim the spotlight on public employee benefits since his own record has a bit of a blip.  His Democratic opponent, John Oceguera, points out that when Heck went to Congress he dissolved his company, putting his wife out of work — the Heck’s then reported unemployment benefits for his wife, thus supplementing the family income.  [Oceguera]

Skirmishes such as this leave Rep. Heck within the confines of Dunsinane Castle — with a bill that “struts and frets his hour upon the stage And then is heard no more: it is a tale Told by an idiot, full of sound and fury, Signifying nothing.”  (MacBeth Act V)

From The Needy To The Greedy: NV GOP Reps. Support Ryan Plan

On March 29, 2012 the House of Representatives voted 228 to 191 on H. Con. Res. 112 “Establishing the budget for the United States Government for fiscal year 2013 and setting forth appropriate budgetary levels for fiscal years 2014 through 2022.”  That would be the Ryan Budget, and both Representative Mark Amodei (R-NV2) and Representative Joe Heck (R-NV3) voted with the Republican majority.  [roll call 151]

To the Greedy. Since the numbers don’t add up in the Ryan/Romney budget plan, the entire scheme depends upon the support of those who believe in Tax Cuts for the Rich, and austerity for the remaining 99%.   For those who would like an illustration of precisely what Amodei, Heck, Romney, and Ryan are proposing there’s a chart for that:

So, if you are a median income earner in Nevada ($53,082) under the Ryan/Amodei/Heck/Romney proposal you could reasonably expect a 1.9% after tax income gain.  This might be a good time to note that the annual inflation rate for 2011 was 3.2%.  [USinflat] However, if you are earning more than a cool million, then your after tax income gain should be about 12.5% under the GOP plan.

The Tax Policy Center (Urban Institute & Brookings Institution) ran the numbers and concluded that the Republican plan takes care of the Greedy very well, thank you very much.

The Christian Science Monitor concluded:

“TPC looked only at the tax reductions in Ryan’s plan, which also included offsetting–but unidentified–cuts in tax credits, exclusions, and deductions. TPC found that in 2015, relative to today’s tax system, those making $1 million or more would enjoy an average tax cut of $265,000 and see their after-tax income increase by 12.5 percent. By contrast, half of those making between $20,000 and $30,000 would get no tax cut at all. On average, people in that income group would get a tax reduction of $129. Ryan would raise their after-tax income by 0.5 percent.”

But, but, but… sputters the GOP talking point, “46% of the people don’t pay any income tax.”  Curious, the Republicans are publicizing the fact that a significant portion of American income earners aren’t making enough money every year to be considered liable for federal income taxation.   What the 99% do pay are payroll taxes — which they pay in higher proportions than the 1%’ers, and sales taxes — which are the most regressive form of taxation imaginable.  In short the GOP budget, which Representatives Heck and Amodei were pleased to support attends solely to the tax concerns of the economic elite.

From the Needy.  So, how do the Republicans intend to “reduce the deficit” by practicing austerity on the remaining 99% of the U.S. population?  Here’s part of the problem:

“Because Romney promises to protect current Social Security and Medicare recipients from cuts, he cannot get much savings from those programs by 2016. Combined, they are projected to make up about 44 percent of the budget that year. Interest costs, which cannot be touched, would make up an additional 9 percent of the budget, while Romney promises to add almost $100 billion to the Pentagon budget that year, based on his pledge that military spending reach 4 percent of GDP.”  [full article Salon Taylor]

So, what remains on the chopping block?  Ans: Programs designed and implemented to assist low and moderate income Americans, those same median income earners who aren’t going to see after tax income gains that are likely to exceed the rate of inflation.

Medicaid:  As of 2009 there were a total of 62,458,000 Medicaid recipients in this country. 5,433,000 of the recipients were in general hospitals, another 115,000 were receiving care in mental hospitals.  101,000 were mentally disabled.  1,644,000 were in nursing homes.  [SSA stats]    The simplistic “Gee Whiz” formula for reducing expenditures relies on assuming a reduction in the number of recipients and/or reducing the funding available for the program.

This is where the ideology is at variance with the reality:

“The rate of increase in Medicaid expenditures also declined over the last decade. A major contributor to Medicaid expenditure growth has been increases in enrollment caused by the two economic recessions experienced in the past decade and continued growth, almost 3 percent per year, in the disabled population. Medicaid spending growth on a per enrollee basis in the past decade was below 3 percent per year. Part of this relatively low growth rate is due to the changing composition of Medicaid enrollees— the number of lower cost adults and children grew faster than the aged and disabled. But states have also been very aggressive in cost containment efforts because they face declining revenues and have many competing priorities.”  [UrbanInst. pdf]

After the Little Wizards of Wall Street (aka Financialists) lost approximately $10.2 trillion in our national wealth in the wake of their Housing Bubble and CDO Bonanza circa 2008, [BusInsider] we’d expect to see a rising number of individuals eligible for Medicaid.   And, while the states were struggling to cope with the consequent declining revenues they were also trying to assist a growing number of “low cost” adults and children.   Perhaps a little sparkly anti-deficit dust sprinkled over the spreadsheets would work a bit of magic? Like Block Grants?

What if Medicaid funding came in the form of block grants to states?  Then the states could be “creative and flexible.”  Yes, and they could also look forward to being creative and flexible with continually declining revenues.

Ask local officials who deal with HUD block grants how “creative and flexible” they are being as they look at 12% cuts, and a Congress which shaved about $390 million from their revenues?  [Governing] A local official in Connecticut summed up the situation:

“CDBGs, Rodriguez said, have been under constant threat of federal budget cuts. He said at one point former President George W. Bush ’68 called for an end to the entire program until he faced overwhelming resistance from cities.

“The Block Grants is one of those grants that we always worry about because the federal government is always cutting it,” Rodriguez said. “It may actually go away, depending on what happens to Congress [in the 2012 elections].” [YaleDN]

The simplest way to think of the GOP proposal for health care services for the poorest among us is to note that of all the formats for federal funding the block grant is the easiest  to cut.

From what other sources might the Romney and his Republican cohorts make budget cuts in order to finance the extension of the Bush Tax Cuts for the top 1% and other tax breaks?

Former Governor Romney has “promised” 5% cuts in non-defense budget categories, so what would that include?  “At issue are these programs, just to name a few: health research; NASA; transportation; homeland security; education; food inspection; housing and heating subsidies for the poor; food aid for pregnant women; the FBI; grants to local governments; national parks; and veterans’ health care.” [Salon]

Somehow the “Support the Troops” Republicans managed to draft a budget proposal for the consideration of the House of Representatives without using the word: Veteran.   So, when we have about 45,000 members of our military services coping with wounds and injuries sustained in Iraq and Afghanistan, we have a Republican Party suggesting a cut of $11 billion from veterans care programs.  [VV] As Andrew Taylor opines in his Salon article, if the Romney campaign and other Republicans eschew cuts to VA programs, then the remaining federal functions would face deeper cuts.

Public Health and Safety.   Food – the amount of  regulated goods have increased by 200% in the last decade, but as of today we only inspect about 2% of food imports.  We import about 80% of our seafood from China and Thailand, countries with less stringent food safety laws that our own.   And now the GOP proposes to cut from 5% to 20% of the food inspection budget?  [News21] As one commenter put it, “You can’t fight bioterrorism with a tank.”  [The Hill]

Police and law enforcement – Senator Harkin was justifiably disappointed to note that the Republican version of a budget cut $118 million from federal funds to support local and state law enforcement. [Harkin] In FY 2011 the BJA processed 56 state and 1,348 law enforcement funding applications, and in FY 2012 made $295.58 million available to local and state officials for improvements in policing, and for other programs like the sex-offender registry and the Adam Walsh Child Protection and Safety Act. [BJA pdf]    However, in the interest of the 1% the GOP is willing to cut from 5% to 20% from the BJA programs which, “…. provides  states, tribes, and local governments with critical funding necessary to support a range of program areas including law enforcement, prosecution and court, prevention and education, corrections and community corrections, drug treatment and enforcement, planning, evaluation, and technology improvement, and crime victim and witness initiatives.” [BJA pdf]

Perhaps the most cynical, and assuredly the most economically irrational, of the GOP cuts would be to programs like food stamps (SNAP) and WIC.   Chad Stone explains:

“The $8 billion in SNAP cuts over the next year would do more damage to economic growth and job creation than any stimulus that the $46 billion in tax cuts could generate, according to standard “multiplier” or “bang-for-the-buck” estimates like those from the Congressional Budget Office (CBO) and Moody’s Analytics.

CBO ranks policies like SNAP and unemployment insurance (UI) as among the most effective ways to boost economic growth and job creation in a weak economy — and business tax cuts like those in the House bill as among the least effective.  That’s because SNAP and UI benefits go to low-income and struggling Americans who will spend virtually every additional dollar they get to pay bills and buy necessities, while the main problem businesses face is that too few customers are spending too little money — and that won’t be fixed by giving the businesses themselves a tax cut. “

Especially not effective if the tax cuts are designed to benefit those “small” businesses like hedge funds and lobby shops that are already doing well and yielding income to their owners and partners sufficient to put them in the +$1 million annual salary category.  Exactly how the House GOP explains a $46 billion reduction in the SNAP program as a “job creator” requires more imagination and intellectual gymnastics than a Cirque Du Soliel production.

But, never fear — protecting the tax breaks for millionaires and billionaires is, by Republican lights, ever so much more important that preserving Medicare as we know it, or preserving the health care services for the elderly, the children, or the disabled in poverty, or sustaining programs for Veterans, or enhancing public safety by supporting our local sheriffs, or making sure our food imports are inspected, or insuring our bridges are safe…

The Republican focus, as adopted by Rep. Ryan, and supported by Representatives Heck, Amodei, and by presidential candidate Romney is singularly narrow, and illustrates with astounding clarity how eager they are to sacrifice the needy for the noteworthy benefit of the greedy.

>On the House Docket

>In addition to the usual plethora of post office naming bills and commemorations, there are some rather more substantive bills coming to the House floor on which Nevada’s congressional delegation will be voting. Representatives Berkley (D-NV1), Porter(R-NV3), and Heller (R-NV2) will be asked to consider:

Tuesday, May 15th

HR 1700 “COPS Improvements Act of 2007″ to amend the Omnibus Crime Control and Safe Streets Act of 1968 to enhance the COPS on the Beat Program. The program would award grants to hire school resource officers and to establish partnerships between local law enforcement agencies and local school systems to combat crime, gang activity, drug distribution, and other problems in and around elementary and secondary schools. The bill also calls for programs to train ex-military personnel in law enforcement careers, and assist the Community Prosecutors Program to address counter-terrorism, violent crime, gang activities, and anti-drug enforcement. A technologies grant would allow local communities to modernize their criminal record technology and forensic departments.

HR 1773 “Safe American Roads Act of 2007″ This bill would limit the authority of the Secretary of Transportation to grant motor carriers domiciled in Mexico to operate beyond U.S. municipalities and commercial zones on the U.S.-Mexican border.

Wednesday, May 16th

HR 1585 “National Defense Authorization Act for FY 2008″

HR 1427 “Federal Housing Finance Reform Act of 2007″