Don’t Grab Your Pearls: ACA Exchange Premium Increase in Nevada 6%

Premium Increase Map

Far from it. First, these are REAL numbers, not Trumpian hyperbole about ACA exchange purchased premium increases.  Secondly, increases in insurance premiums whether exchange purchased or privately purchased are going up.  The insurance companies set the premium prices; and if a person used the exchange to buy personal health insurance, and qualifies for a subsidy, then the increase will be felt less than if the insurance isn’t subsidized.

However, this is an excellent argument FOR a PUBLIC OPTION, which would provide competition for the private insurance corporations (and thereby could cause some cost-containment not now built into the system).  We could, for example, allow private citizens who don’t have health insurance provided by their employers to buy into the Medicare system.

Why the increases? Business Insider explained last May:

“However, the most important factors associated with lowest-cost silver plan premiums and premium increases are those defining the contours of competition in the market,” the report concluded. “Rating areas with more competitors had significantly lower premiums and lower rates of increase than those that did not.”

“The paper also found that there was one player that had more of an effect on prices than any other provider.

“Those rating areas with a Medicaid insurer competing in the marketplace also have lower premiums and lower rates of increase than those regions without a Medicaid insurer competing,” Blumberg, Holahan, and Wengle said.

This is an issue as insurance companies evaluate the profitability of the state exchanges. With considerable political pushback against expanding Medicaid, private insurers will have to carry most of the load and provide competition.”

Or, to put it more succinctly – Republican opposition to the expansion of the Medicaid programs helps drive UP health insurance premium costs.  Full. Stop.

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Filed under Health Care, health insurance

Oh Heck, he’s not being very transparent

Heck Trump Hat Representative Joe Heck (R-NV3) candidate for the Nevada Senate seat in this election reveres the secret ballot, and tells constituents it’s nobody’s business who he’ll vote for in the upcoming presidential election. [RGJ]  While this is an honorable position, it doesn’t answer a crucial question. Is Heck supporting Donald J. Trump?

One of the problems for down ballot candidates who are associated with a presidential contender who has insulted 282 people, places, and things during this season, is how to finesse the prospects.  There are several ways and Heck’s about to try them all.

I will vote for the candidate of my party.”  OK, however the fact that you can’t say the name out loud indicates a level of discomfort not usually a function of the  normal campaign process.

I will endorse but I will not support…”  And what on Earth might this mean? Let’s guess it means I begrudgingly offer my official endorsement for my party’s candidate but don’t expect me to defend or explain the candidate’s campaign messages, and for Heaven’s Sake don’t put me on the same stage with him.

“I endorse my party’s candidate fully…” Until he or she does something so egregious I can’t stomach it and the poll numbers are cratering?

“I cannot endorse my party’s candidate…”  Usually announced after the top of the ticket does something egregious and the poll numbers have cratered.

“I won’t tell you who I’m voting for and you can’t find out.”  True. No one will ever know, and you can pray heartily that the candidate never finds out how you voted unless you voted for him, and the candidate’s fervent supporters will never find out you didn’t vote for him, or the candidate’s detractors in your own party never find out either way.  Good luck with that, because when you finally announce how you cast your ballot no one is going to believe you.

And why should they? – you’ve been as ‘transparent’ as Donald Trump’s tax returns.

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Filed under Heck, Nevada news, Nevada politics, Politics

Replace the ACA with What??

Take Two Aspirin

It’s pearl clutching time for the opponents of the Affordable Care Act and Patient’s Bill of Rights.  The premiums are going up.  Yes, and what did a rational person think was going to happen in a system based on private health insurance corporations selling policies?  Further, before swallowing all the hyperbole there needs to be a bit fact checking.

First: This is far from a Nationwide Crisis – calm down – as Think Progress advises

“Although some news outlets are characterizing the news about rising premiums as a “November surprise” that could have a big impact on how Americans feel about the upcoming election, the reality is that these price hikes won’t affect the majority of the country. Most Americans get their insurance either through their employer or through a safety net program like Medicaid. A much smaller portion of the population — about 6 percent — buys private insurance plans on Obamacare’s marketplaces.”

Second:  If the premiums go up so do the subsidies. Again, Think Progress explains —

“Critically, Americans won’t need to shoulder Obamacare’s premium increases on their own. Most people who are insured through Obamacare’s state-level marketplaces don’t pay for the full price of their premiums because they get an assist from the government in the form of subsidies. These federal subsidies to help offset the cost of buying insurance are also going to rise. According to the Obama administration, even with the projected increases, more than 70 percent of people buying insurance on the marketplaces will be able to get a plan for less than $75 a month next year — provided they take advantage of the subsidies available to them and select a low-cost plan with more limited benefits than other options.”

If a person is covered under the terms of an employer’s health insurance plan, Medicare, or private insurance purchased on his or her own – this is not an unexpected increase, nor is the increase in premium costs essentially any more than what other policy premiums will see.  There is no need to grab the pearls, hit the fainting couch, or even to have to take two aspirin.

The Replacement is Worse Than The Current System

If one is inclined to take on headaches, none may be more miserable than what the Republicans have in mind for replacing the Affordable Care Act. If clutching pearls and twisting open the adult-proof cap on the painkillers is desired then by all means – support the Health Savings Account idea.

There is nothing new about this idea, and nothing particularly good about it.

‘A creation of the 2003 Medicare act, HSAs do offer employers the hope of curbing their insurance expense. Under the law, the accounts, which enable workers to set aside pre-tax dollars they can later use toward their out-of-pocket medical expenses, must be offered in tandem with a high-deductible health plan (HDHP).” [cfo]

As originally envisioned the HSA is combined with a high-deductible policy.  Thus for any employee there’s a double whammy.  More money out of the paycheck for the HSA and more money out of pocket for the health insurance plan.  But, doesn’t this make the consumer more cost conscious? Yes, and that isn’t necessarily a good thing.

“Studies have recently confirmed the worst fears about such plans: They can induce beneficiaries to stint on health care that they truly need. According to the Employee Benefit Research Institute study, 35 percent of the people in CDHPs and 31 percent in HDHPs “reported delaying or avoiding care, as opposed to 17 percent of those in comprehensive plans.” [cfo]

Avoiding treatment is NOT a desired outcome of any wellness plan.  If you need more convincing that HSA’s are not the answer, look to Five Reasons Not To Enroll In An HSA —  no drug copays; no immediate financing; high deductibles, 213(d) confusion over what’s covered; and an “education gap” about these products.

Seeking more information about this rather bad idea compliments of the Republican Party and their allies in the corporate insurance and financial markets?  There’s The Truth About HSA’s; Here’s Exactly How Terrible Paul Ryan’s Obamacare Replacement Plan Is; HSAs mostly benefit high income taxpayersGAO study confirms HSAs primarily benefit high income individuals; Making Health Care Worse.

The Health Savings Account is another idea for a nice tax shelter, for young healthy, wealthy people.  It is not an answer for addressing general health care cost containment, especially not if people tend to put off medical treatment until their situation is serious or dire.  In less polite terms, it’s the 0.01% answer to a problem affecting the other 99.99%

Previously in Desert Beacon: All Right Everyone, Gird Your Loins! The GOP’s Coming For Health Insurance Reform Repeal (four years ago)

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Filed under Health Care, health insurance, HSA, Nevada politics, Politics

Early Voting Begins in Nevada, and why it should be expanded

Vote Early And it’s on! Early voting has started in Nevada, and for those not already saturated by campaign information we share the times for voting in at least one of the rural counties (Humboldt):

Monday October 24 through Friday October 28: Early voting can be done at the County Courthouse (Winnemucca) from 8 am to 6:00 pm.  The Clerk’s office will be open from 10 am to 6 pm on Saturday October 29, and Early Voting hours are 8 am to 8 pm from Monday October 31 through Friday November 4.

You know you’re a battleground when POTUS shows up.  The Las Vegas Sun covers his speech on behalf of Hillary Clinton and Catherine Cortez Masto.  The billionaire’s fishwrapper of record gains the dubious distinction of being the only major paper to endorse Donald Trump.  Let’s Talk Nevada has Pictures, and interesting information, well worth the click over to their site.   There’s always at least one willing to douse the enthusiasm for early voting – and this year he doesn’t disappoint.

“There is no good reason – for almost every voter – not to wait until Election Day, so you have the maximum information, including something that could break in the final fortnight. A scandal. A revelation about someone’s character. More information.”  [RGJ]

Here’s what’s fundamentally wrong with this analysis.  First, it promotes one of the worst features of American campaign politics – the last minute unanswerable attack.  This, for many election cycles, has been a campaign scheduling trick designed to attack an opponent with a charge which due to the timing is predicated on the notion that the victim of the ploy doesn’t have time to answer. Thus, all the dirty tricks are withheld until the last possible effective moment – like 24 hours before election day.   So, if I were to employ this artifice I’d have a lovely Photo-Shopped graphic of my opponent embracing a wild-eyed maniac beheading a baby while slaughtering puppies and kittens, all presented in a shiny colorful mailer.   There’s no time to adequately debunk this bit of bluster.  Early voting allows a campaign to avoid this destructive, and definitely uninformative, tactic.

Secondly, the argument is dismissive of any effort to relieve the burden on voting registrars, election officials, and county clerks.  There was a time in which all voting could be done in 24 hours without long delays and attendant problems – but that day has long gone in the face of population increases.

In 1980 Clark County, Nevada had approximately 463,067 residents, the 2014 estimates place it at 2,069,450.  Washoe County had 193,623 residents at the time of the 1980 elections; the 2014 estimate is 436,797.  Mineral County is the only statistical area in which there has been a population decrease since 1980, and others like Nye County have experienced significant growth from 9,408 to 45,456 or Lyon County growing from 13,594 to 53,334 during the same period. [NV Demo]  [WRDC pdf]

The counter, of course, is that as populations increase so do the number of polling sites.  Not really.  An EAC study reported that the number of polling sites increased with some regularity until 2000 at which time the precincts  actually decreased.

Table 13a. Number of Precincts Nationwide, 1980–2004
Number of
Election Year Precincts
2004 185,994
2002 189,900
2000 184,850
1998 185,444
1996 180,834
1994 181,497
1992 177,691
1990 177,101
1988 178,034
1986 176,326
1980 167,037

While it might be tempting to engage in some conspiracy theories at this point – and some voter suppression schemes do tend to reduce polling places in minority and lower income neighborhoods – there’s also a plausible explanation incorporating the notion that polling has become far more expensive with the electronic voting machines required.

Therefore, given the populations increases, the increased cost of election equipment, and the costs of staffing precinct polling sites, combined with the pressure to reduce local government budgets, one has to either accept that elections are going to be more expensive (and budget accordingly) or hope that early voting periods allow a local government to spread overtime and equipment budgets over a longer period of time so that additional costs aren’t incurred.

Third, the argument while traditionalist is also condescending to those who don’t have the luxury of waiting in line for three hours to vote.  Nevada includes time and distance into the allowance of time off to vote on a work day:

NRS 293.463  Employees may absent themselves from employment to vote: Procedure; penalty.
     1.  Any registered voter may be absent from his or her place of employment at a time to be designated by the employer for a sufficient time to vote, if it is impracticable for the voter to vote before or after his or her hours of employment. A sufficient time to vote shall be determined as follows:
     (a) If the distance between the place of such voter’s employment and the polling place where such person votes is 2 miles or less, 1 hour.
     (b) If the distance is more than 2 miles but not more than 10 miles, 2 hours.
     (c) If the distance is more than 10 miles, 3 hours.
     2.  Such voter may not, because of such absence, be discharged, disciplined or penalized, nor shall any deduction be made from his or her usual salary or wages by reason of such absence.
     3.  Application for leave of absence to vote shall be made to the employer or person authorized to grant such leave prior to the day of the election.
     4.  Any employer or person authorized to grant the leave of absence provided for in subsection 1, who denies any registered voter any right granted under this section, or who otherwise violates the provisions of this section, is guilty of a misdemeanor.

If the county can’t spread out the time for voting, then it’s entirely possible a person could be 2 miles from the polling site and have to wait in a two hour line.  And, presumably, the employer could dock paychecks within the reading of the law.

Aside from the practical matter of long lines and tenuous guarantees of permission to take time off to vote, there’s the matter of condescension.  To argue that voting is the ultimate act of civic duty which everyone should embrace no matter the personal cost, is perilously close to the contention that voting is a privilege.  No amount of flag waving, banner hoisting, and parading about, will remove the scent of patronization – those who are really truly patriotic will vote even if it costs them dearly – which is very nice for the boss and those who can take the entire day if they wish, and not so convenient for those who can’t.

Finally, in an election season such as this one – interminable, and more annoying than necessary – early voting gives a citizen a way to say: Whatever someone else may want is fine – just let me get this over with!

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Filed under Vote Suppression, Voting

Who’s Heck Representing? A Look At The Advertising

Heck Trump Hat

A bit of time spent watching local television in the wilds of northern Nevada yields a real bundle of political advertising – much of which comes from the campaign to elect Representative Joe Heck to the U.S. Senate, but the fine print is almost more interesting than the ads themselves.

For example, during one broadcast of one network show, we’re treated to advertising from (1) the National Republican Senate Committee, two ads, (2) the U.S. Chamber of Commerce, (3) the National Rifle Association, (4) two ads from the American Chemistry Council, (5) two ads from the State Leadership Fund, (6) the National Association of Realtors, and 7) one ad from Heck’s campaign.

There’s nothing unusual about the NRSC running ads in a battle ground state, especially this season.  The others raise some questions.  For example, the US Chamber of Commerce isn’t a bit shy of publicizing its policy priorities.

There’s some interesting rhetoric therein, but the translations are fairly simple.  The Chamber wants:

“Regulatory Overreach—Guard against senseless regulations that wrongly attempt to eliminate all risk taking and innovation from the capital formation process. Work with regulators and Congress as they implement the Dodd-Frank Act and other regulations to ensure a more prudent approach to oversight and enforcement.”

Notice that the “risk” part of the equation isn’t clear – whose risk?  In the case of the Dodd Frank Act the idea was to reduce the risk to the American tax payer who was previously on the hook for Wall Street transgressions.  And that “innovation in capital formation” were those very creative, if highly dubious, financial ‘products’ Wall Street created in the run up to the last big collapse.   If we want a more ‘prudent approach’ to oversight then we need to keep to the spirit of the Dodd Frank Act and oppose any efforts on behalf of Wall Street casino operators who wish a return to the bad old days of rampant financialism.  Let’s look at something else the Chamber would like Representative Heck to support:

“Executive Compensation and Corporate Governance—Ensure careful and sensible rulemaking and implementation by the Securities and Exchange Commission (SEC) where needed and preserve the state-based system allowing decisions to be made through directors and shareholders. Reasonable policies must permit pay for performance and promote long-term shareholder value and profitability but not constrain reasonable risk taking and innovation.”

Shorter version:  Let the states with the least corporate regulation set the standards for determining the process for corporate management pay.  Notice the part about promoting “long term shareholder value?”  It’s not too hard to decipher this one.  Let the states with the lowest standards of regulation be the models, and executive compensation should be based on “shareholder value,” – the model which gets us pharmaceutical executives explaining blooming increases in drug prices – and “profitability,” not necessarily corporate investment in research and development.   Even shorter version: Let the corporations do what they want about executive compensation.   Let’s look at another source of support for Representative Heck.

The American Chemistry Council.  The ALEC associated trade organization is worried that Americans will take environmental warnings entirely too seriously.  Like having the Toxic Release Inventory not compiled or reported to the public as often – after all what we don’t know won’t hurt us?

“While promoting the chemical industry as vital to the economic health of the nation the ACC simultaneously lobbied against the Toxics Release Inventory (TRI), a public right-to-know program. Under TRI, the U.S. Environmental Protection Agency annually reports on what industries release into the air, water and land. The ACC “has urged less frequent reporting since 1999.” ACC’s Michael Walls said, “Just because we’re used to doing something doesn’t mean we should accept the inherent high costs or burden of doing it.” The Bush administration supports changing the TRI so that fewer releases are reported, less frequently. EPA officials say they will “likely spend another year weighing the pros and cons” of the proposed changes, after the public comment period ends on December 5. According to federal records, the EPA “previously solicited comments from industry groups.” [SWatch]

In essence, the ACC is telling Nevada voters — “Vote for Joe Heck, and you won’t have to worry about toxic releases into our air and water – because you won’t know about them, and as a bonus, you can keep on using those plastic shopping bags to your heart’s content.”  And now we have the …

National Association of Realtors, who would like to remove:

“Overly stringent lending standards have continued to limit the availability of affordable mortgage financing for credit worthy consumers. Federal policymakers are weighing a number of proposals aimed at creating healthier housing and mortgage markets.”

Remember that time when lending companies were writing mortgages hand over fist over elbow, often to very tenuously credit worthy customers? The NAR would like very much to return to that scenario.   The result was the Housing Bubble, and we don’t need a repetition  of that debacle in Nevada.  We’re barely past the last version of exploding ARMs.

And then there’s the ubiquitous NRA, what more can we say but that any regulation of firearms is anathema to these radicals – even question One in Nevada which merely calls for the implementation of background checks to every gun sale. No, it doesn’t apply if your girl friend want to borrow a gun. No, it doesn’t apply to trading guns with your hunting partner! No, it doesn’t mean you can’t share your arsenal with family members! And, no it doesn’t mean the downfall of the democracy… that’s NRA hyperbole and most Nevadans know it.  The NRA hysteria is costing Americans 30,000+ lives every year, countless injuries, untold tragedy, and more suicides than we’d care to consider.  Who’s NOT in favor of limiting access to firearms to felons, fugitives, the adjudicated mentally ill, domestic abusers, and unsupervised juveniles??

So, the next time there’s a wave of Pro-Heck advertising on the TV screen, read the small print at the end …. Who is supporting Representative Heck and what do they want?

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Filed under financial regulation, Heck, Nevada politics

Another Timely Reminder: Electioneering at NV Polling Sites

NRS 293.740  Soliciting votes and electioneering inside polling place or within certain distance from polling place prohibited; penalty.
1.  Except as otherwise provided in subsection 2, it is unlawful inside a polling place or within 100 feet from the entrance to the building or other structure in which a polling place is located:
(a) For any person to solicit a vote or speak to a voter on the subject of marking the voter’s ballot.
(b) For any person, including an election board officer, to do any electioneering on election day.
Ê The county clerk or registrar of voters shall ensure that, at the outer limits of the area within which electioneering is prohibited, notices are continuously posted on which are printed in large letters “Distance Marker: No electioneering between this point and the entrance to the polling place.”
2.  The provisions of subsection 1 do not apply to the conduct of a person in a private residence or on commercial or residential property that is within 100 feet from the entrance to a building or other structure in which a polling place is located. The provisions of subsection 1 are not intended to prohibit a person from voting solely because he or she is wearing a prohibited political insigne and is reasonably unable to remove the insigne or cover it. In such a case, the election board officer shall take such action as is necessary to allow the voter to vote as expediently as possible and then assist the voter in exiting the polling place as soon as is possible.
3.  Any person who violates any provision of this section is guilty of a gross misdemeanor.
4.  As used in this section, “electioneering” means campaigning for or against a candidate, ballot question or political party by:
(a) Posting signs relating to the support of or opposition to a candidate, ballot question or political party;
(b) Distributing literature relating to the support of or opposition to a candidate, ballot question or political party;
(c) Using loudspeakers to broadcast information relating to the support of or opposition to a candidate, ballot question or political party;
(d) Buying, selling, wearing or displaying any badge, button or other insigne which is designed or tends to aid or promote the success or defeat of any political party or a candidate or ballot question to be voted upon at that election; or
(e) Soliciting signatures to any kind of petition.
(Added to NRS by 1963, 1382; A 1967, 863; 1973, 872; 1977, 464; 1987, 1169; 1989, 2171; 1997, 80; 2011, 2101)

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Filed under Nevada politics, Politics

Timely Reminder: NRS statute on voter intimidation

NRS 293.710  Intimidation of voters.
1.  It is unlawful for any person, in connection with any election, petition or registration of voters, whether acting himself or herself or through another person in his or her behalf, to:
(a) Use or threaten to use any force, intimidation, coercion, violence, restraint or undue influence;
(b) Inflict or threaten to inflict any physical or mental injury, damage, harm or loss upon the person or property of another;
(c) Expose or publish or threaten to expose or publish any fact concerning another in order to induce or compel such other to vote or refrain from voting for any candidate or any question;
(d) Impede or prevent, by abduction, duress or fraudulent contrivance, the free exercise of the franchise by any voter, or thereby to compel, induce or prevail upon any elector to give or refrain from giving his or her vote; or
(e) Discharge or change the place of employment of any employee with the intent to impede or prevent the free exercise of the franchise by such employee.
2.  A person who violates a provision of this section is guilty of a category E felony and shall be punished as provided in NRS 193.130.
(Added to NRS by 1960, 268; A 1993, 2669; 2011, 2100)

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Filed under Nevada politics, Politics