Tag Archives: Rep. Mark Amodei

Caveats and The Unspoken Big Lie

So, we have two sources telling us that approximately 24 to 26 million people will lose their health care insurance if the Republicans are successful in jamming through their tax shift proposal masquerading as a ‘replacement’ for the Affordable Care Act.  Therefore, it’s now time for a new ‘talking point’ from the GOP, especially since some Republicans like Rep. Mark Amodei are on record saying:

When asked what his plan for a change to Obamacare would be, Heller said, “If you like your health care, you can keep it,” a statement that echoes a promise from Obama that later ended up being false.  Amodei said he would not vote for any plan that resulted in reduced coverage for anyone.  “No, I don’t think you can say forget it, we’re going to let them be uninsured because as a practical solution, that’s not an answer and somebody ends up paying in the end anyhow,” Amodei said. [RGJ 2/22/17]

Well, now we know with some certainty that the GOP replacement bill will result in reduced coverage, and some people and families will be uninsured.  How to escape this trap? A new talking point!

“No one will lose their coverage.” 

The HHS Secretary Tom Price, whose replacement would have cost some 18 million their insurance, opined:

“Success, it’s important to look at that,” he said. “It means more people covered than are covered right now at an average cost that is less. I believe that we can firmly do that with the plan that we’ve laid out there.”  Not exactly.

Then, there was Pete Sessions, a Republican from Dallas, telling his listeners:

“Nobody is going to lose their coverage,” Sessions, chairman of the House Rules Committee, told CNN. “You’ll be able to keep your same doctor, you’ll be able to keep your same plan.”

A spokeswoman for the congressman later explained that Sessions meant Americans will have the choice whether to obtain or maintain coverage — not that the GOP bill would take coverage away. The American Health Care Act would nix the ACA mandates requiring Americans to have health insurance.” [DMN]

And, there it is, the Big Caveat, which makes taking health insurance away from working American all AOK.  You can “choose” to keep your health insurance! IF and ONLY IF you can afford it. ?

However, even IF you can afford it, the policy you can purchase may not be truly comprehensive. A young person may have to get additional insurance if he or she marries and there is a pregnancy in the plans. More cost. A plan may not cover preventative care? Or mandatory coverage for cancer screenings?  More cost.  It doesn’t take too long to add up the extras until what has been basic coverage becomes optional coverage. Then the risk pool is reduced and the premiums go up. That is how insurance works. The larger the risk pool the lower the premium costs.

Thus, “you can keep your health insurance” IF:

  • You can afford it in the first place, not likely if you are among the low wage workers in this country.
  • You can afford it and are willing to accept lower levels of coverage, and you don’t mind having to pay for additional services for additional  premiums.
  • You are willing to shop for insurance coverage every time the circumstances of your life changes; as in pregnancies, pre-natal care, caring for a special needs child, a family member needs rehabilitation or mental health care.
  • You are willing to see your local, and especially rural, hospitals see higher levels of uncompensated care.
  • You are willing to accept that your doctors and other health care professionals will see less reimbursement for services rendered.
  • You are willing to forego coverage for preventative screening and treatment for medical conditions.

Access to health insurance isn’t the same as having health care insurance.  As the now commonplace tweet has it: “I have access to a Mercedes Benz dealership — that doesn’t mean I can afford to buy something of their lot.”

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Amodei: Not So Mr. Moderate?

Amodei 3Now this is some turn-around!  On April 28, in the year of our Lord 2014, Representative Mark Amodei (R-NV2) was “chiding” Senate Majority Leader Harry Reid (D-NV) for his position on the Bundy Brigands:

The Republican says he disagrees with Senate Majority Leader Harry Reid’s branding of them as “domestic terrorists” and doesn’t think Heller’s labeling of them as “patriots” helps to resolve the dispute over Bundy’s cattle.  Amodei says the issue is the “culture” of U.S. Bureau of Land Management law-enforcement operations in the West. [KOLO]

But wait! On the same day Representative Amodei was heaping praise on the BLM decision to stand down and refuse to offer the ersatz ‘patriots’ a chance to turn the situation in Bunkerville into their own Ruby Ridge, Waco, whatever other fantasy-land re-enactment they’d imagined for themselves.  Those inclined to accept Representative Amodei’s quick-whip-around talking points as evidence of moderation, should look to his recent voting record.

Exhibit One:  The House GOP budget proposal which leaves Pentagon spending unscathed but slashes funding for the Indian Health Service by 18%.  Also under the GOP meat axe, funding for fire fighting on federal lands, again cut by 18%. [HuffPo]  Not only does Rep. Amodei’s district contain a lengthy list of Reservations, but it’s also been known as the site of several recent, and truly large, wild land fires.  Rep. Amodei is fond of referring to his concern for ranchers in the 2nd District, but is apparently not quite so alarmed at the prospect of range fires destroying their grazing lands.

Nor should we miss the fact that the latest incarnation of the House GOP budget included the “Coupon Care” proposal which would eliminate Medicare as we know it, and substitute a voucher plan in its stead. [CBPP]

In case there are any consumers in the 2nd Congressional District, it should be noted that the Ryan Plan would eliminate the provisions of the Dodd Frank Act which requires that Big Banks have a plan in place to wind down operations, and that the FDIC can require the bankers to establish the plans to PREVENT future bailouts.  The ‘plan’ would also put the future of the Consumer Finance Protection Bureau under the guillotine of future Congressional budget cuts. [Hill]

When H.Con. Res. 96 (Ryan Budget) came to a vote on the House floor on April 10, 2014 — Representative Amodei supported it. [Roll Call 177]

Exhibit Two:  Once upon a time there was a mid-level IRS employee in a regional office who was accused of targeting conservative groups by not allowing political organizations to pass themselves off as social welfare institutions.  Truth be told, Lois Lerner acceded to a plan to look for key terms, like “political,” or “party,” on a watch list of sorts to cull the political from the social.  The ultra-right when ballistic.  “Conservatives were Targets of the IRS!”  Not. So. Fast.  Also on the list were terms like “Blue” and “Green Energy” and “occupied territory” organizations. [Wire]

However, this didn’t stop Government Affairs Committee Chr. Issa from claiming that the IRS ultimately “intended” to target more conservative groups, even as it was actually looking for ACORN successor organizations.

Failing to find any solid evidence of IRS targeting, or even of IRS ‘intent’ to increase scrutiny of conservative applicants, the Republican lead House voted anyway to recommend that Lerner be held in ‘contempt of Congress’ for citing her 5th Amendment rights.

This sort of thing happened on Capitol Hill before during the McCarthy Witch Hunt Era.  Lerner joins 10 Hollywood writers, producers, and directors who were voted “in contempt of Congress” for not cooperating with the infamous HUAC.  [Hist]  Rep. Issa may be missing the point that short term theatrical political gains can easily become long term memories of political infamy.

Who joined in the vote to find Lerner in contempt of Congress? None other than Rep. Mark Amodei (R-NV2), and Rep. Joe Heck (R-NV3).  [Roll Call 203]

Aligning oneself with the likes of Hamilton Fish III, Martin Dies, Jr., is not the way to convince most people that you are a proponent of moderation.

 

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Glitches, Gremlins, and the Affordable Care Act in Nevada

DoctorThere are a couple of ways to read the LVRJ’s write up on the Silver State Health Insurance Exchange.   Republicans will ‘rejoice’ that the glitches in the web portal for the exchange have generated a log jam — as if being happy that people haven’t been able to purchase affordable private health insurance plans is something to be applauded.

Democrats will argue the glitches can be fixed, and may argue the proposed extension of the enrollment period will alleviate some issues for those who can demonstrate they attempted to buy an insurance policy before March 31.  Setting aside the initial technical issues for just a moment  (inadequately staffed call center, and software gremlins) it’s important to remember that these health insurance exchanges aren’t a Big Government operation — they are in the business of selling PRIVATE health insurance for major corporations.

Once more — the Silver State Health Insurance Exchange, and other state exchanges throughout the nation, are facilitating the sale of private insurance to people who do not have health insurance subsidized by their employers, and who do not qualify for Medicare.

“Sign-ups kicked off Oct. 1, but technical issues and an understaffed call center hampered enrollments to well below expectations. About 21,000 Nevadans had bought and paid for coverage as of Saturday.” [LVRJ]

Now back to those technical issues.  In short, the good news is that 21,000 Nevadans now have a health insurance plan, the bad news is that there are people having to wait an inordinate amount of time to get one.   Let’s assume for a minute that capitalism works.  If there is a demand for a product there will be sales.  There is obviously a demand for health insurance plans to cover people who are not getting their coverage subsidized by their employers and who do not qualify for Medicare.  We literally have people waiting in line.  The bottom line is the bottom line — there are more people who want to buy private health insurance policies than the current distribution system can manage.

Note, this is NOT an issue involving whether or not people want to buy policies.  It is NOT an issue involving insurance corporations not wanting to sell their policies.  It is a ‘distribution’ issue.  In basic economic terms ‘distribution’ is how producers get their products to consumers.

Anyone who’s run a small business for at least five minutes knows about distribution, and channel or distribution partners.   Most business advisers will inform their clients that having a distribution partner will (1) help increase sales, (2) assist with physical distribution, and (3) add value to the product by providing services to the end-user. [MMDept]  If we are speaking in this context, then the Silver State Health Insurance Exchange is, in essence,  functioning as a Distribution Partner to the health insurance corporations.  It just isn’t functioning very well at the moment.

The fact that there is a Distribution Partner component to the Affordable Care Act should be a giant flapping  flag to free market advocates that the ACA is NOT a government take over of the health insurance sector.  If individuals were to sign up as they do for Medicare, then the government itself acts as the distributing partner for its own product.  Ah, but that would have been “single payer!”

Political Angles

The possibility that the only real problem with the Affordable Care Act lies in perfectly ‘fixable’ distribution issues may be part of the reason we see Representative Joe Heck (R-NV3) all over the map on the associated political issues:

“Obamacare is not going anywhere,” Heck says. “There are parts I agree with and parts that I don’t agree with. I think we need to start concentrating on fixing the things that are wrong with it, as opposed to passing a budget to get $1.4 trillion in deficit reduction by repealing a law that we know we’re not going to be able to repeal.” So why vote for repeal? “That’s the position I ran on, and I will continue down that path as long as I can,” he says.” [NatlJournal]

And then there was the session with a constituent small business owner  told the Representative last August that the ACA was actually helping his profitability.  Crooks and Liars has the video in which Heck, for all intents and purposes, tosses small business owners under the bus while decrying the problems of employers with more than 50 employees.

Meanwhile Representative Mark Amodei (R-NV2) is still peddling horror stories — as per the instructions of the RNC, etc:

“Prior to the ACA they had affordable coverage they liked, noting that they never had a claim rejected. Now, thanks to the ACA, they pay a higher monthly premium and saw their deductible increase from $400 to $5,000 a year. They are in good health and have rarely spent $5,000 a year on medical care, so essentially their future costs will be out of pocket. They were also notified that their coverage will no longer be offered by the end of 2014. Does this sound like health care reform to you? The ACA has made matters worse,” said Amodei.”

Let me guess. Now why would an insurance company pull a policy after the enacting of the Affordable Care Act? [CNN] There were some very common practices which helped insurance corporations sell policies that were not very customer friendly, let’s look at three general examples:

(1) The Carve Out Policy:  Some corporations offered “comprehensive policies” which were anything but comprehensive, and did not cover a broad range of medical procedures or even offer some essential ones.   These were cheap, but they a policy holder couldn’t be assured they’d cover mammograms, prostate exams, and other basic preventative care.

(2) The Cost Limit Policy:  One classic example of these kinds of policies were the Mini-Meds plans.  Some of these had annual limits of $1,000 per year for out-patient services and $2,000 per year for hospitalization. [CR]  Now, compare this to the average cost for breaking a leg which is about $2,500 or more for a fracture requiring a cast. [HCH]  So, one healthy kid in the family breaks one otherwise fabulous fibula and the insurance runs out for the rest of the family for the entire year.  Cheap but not exactly why people buy insurance. Not even close.

(3) The Fixed Benefit Indemnity Policy:  These plans had an upper limit for medical services, after which the YOYO element kicked in. Once the fixed benefit was set the policy holder paid premiums, some in the $450 per month range for $100 apiece for five trips to a doctor, $50 per year for screening tests, and commonly $30,000 worth of hospitalization at $1,000 per day.  [CR] The average cost per day in a Nevada hospital is about $1,856. [KFF]  Again, these policies might have had cheaper premiums — but that was because they had limited coverage and often coverage well below what would be reasonable in terms of what they paid for.

Little wonder these policies were pulled out of the market. NRS 482.351 forbids me from selling you a motor vehicle using “bait and switch,” or deceptive advertising about the condition of the vehicle or its component parts.  I should also not be allowed to sell ‘defective’ insurance or insurance policies which don’t cover basic and essential services.

Thus our Couple In District 2 is now allegedly paying $416 per month for insurance which must now be comprehensive.  What were average families in the United States paying in health insurance premiums per month in 2011? $414.00. And, the average deductible was $3,879.00. [eIns]  Somehow this doesn’t sound as horrific when put in some context.

And so we have Representative Heck voting to repeal the Affordable Care Act — what is it now 50 times? — just because he said he would, not necessarily because it makes any sense; and, Representative Amodei trying to dig up Scarey Stories of people who bought junk insurance and don’t want to pay for the real thing.

Meanwhile … we have a distribution issue.  We can fix that.

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Filed under Economy, Health Care, health insurance, Politics

Amodei, Heck, Right Face, Left Face, Backwards, March

Joe HeckRepublican members of the Nevada Congressional delegation Joe Heck (R-NV3) and Mark Amodei (R-NV2) are following the Tea Party script in the ever evolving rationale for the impasse created when the House passed a Continuing Resolution (defunding the implementation of the Affordable Care Act).  The Senate received the CR, stripped out the defunding section, voted on the clean version, and sent it back to the House.  The House has yet to vote on this measure.

Remember when, not so long ago that the House version of the CR was all about repealing “Obamacare?”  That horrible no good terrible job killing freedom smashing liberty restricting socialist communist anti business law of the land to allow people to buy private health insurance policies in a competitive marketplace?  Well, no longer — NOW the House refusal to bring a clean CR up for a vote is all about — The Debt and The Deficit.

Representative Heck tells the Las Vegas Sun his views on a clean Continuing Resolution:

“It would have to be a bill, and I don’t comment on hypothetical bills,” Heck said when the Sun asked if he might consider signing on.

But in theory, Heck is not on board.

“What is there associated with the clean (budget resolution)?” he asked. “How are we going to address our debt and our deficit?”

How are the debt and deficit to be addressed in the Senate version of the Continuing Resolution?  How about like this?

Clean CR Senate

What we have here is another instance of the Republicans refusing to take “YES” for an answer.  The Clean CR is $217 billion less than the Obama Administration’s proposed budget.  It is $109 billion less than the previous incarnation of the Ryan Budget.  The Senate CR is $80 billion less than the 2011 Budget deal, and only $19 billion more than the proposed 2014 Ryan Budget.  Is Representative Heck saying that he’s in favor of allowing the federal government to go into default for $19 billion?   Just to put that number into perspective, the blundering F-35 program has cost the U.S. taxpayers some $400 billion since 2001, [Time] a number which comes down to about $30.76 billion per year.

Amodei 3Nevada District 2 Representative Mark Amodei, has also changed the marching tune, offering this variation:

“We ain’t repealing Obamacare, we ain’t defunding Obamacare, we get that,” Amodei said. “It’s not just health care. It’s $2 trillion more in debt. If you get policy concessions in order for having more debt, what’s the matter with that? What’s the evil in that?”

Amodei may not have as purple a district as Heck, whom, he surmised, has “gotta be mindful of who his folks are.”  [Las Vegas Sun]

Herein, Representative Amodei engages in a bit of obfuscation.  Where did that $2 trillion more in debt come from? It may be the total of all federal debt.  It might be the number being bandied about in right wing circles for the national debt, or it might refer to the number the Congressional Budget Office projected as necessary to begin reducing the national debt in relation to the Gross National Product to 31% (below the 40 yr. average.) [Reuters] However, no matter the origin of the number, it represents long term budgetary goals and figures — and only tangentially relates to the Continuing Resolution to keep the government floating for the time remaining until the next GOP tantrum.

Bottom Line: IT, if by IT Representative Amodei means the Senate’s version of the Continuing Resolution, doesn’t add $2 trillion to the national debt.

Evidently, NOW the dismantling of the Affordable Care Act is reduced in GOP parlance to the status of a “policy concession.”

For the sake of clarity in this squabble, which threatens to take the United States of America into a default, let’s review some basic points:

(1) The raising of the debt ceiling has NOTHING to do with increasing the national debt.   President Obama isn’t the first President to ask for a “clean CR,” President Reagan wanted one in a 1986 battle with a Democratically controlled Congress in 1986. [NYT]  What President Obama understands now, and President Reagan understood then, is that a Continuing Resolution merely authorizes the Treasury to pay bills we have already incurred.  It doesn’t increase the amount of future appropriations.  Representative Amodei’s and Representative Heck’s concerns notwithstanding — the CR doesn’t add to the debt — it authorizes the payment of current debts.

(2) The Senate version of the Continuing Resolution IS a compromise between the Administration’s budget proposal, the Senate budget, and the House budget.  In a normal environment, after the two versions of the budget were passed by the respective houses in March, a conference committee would have been appointed to work through the differences and to bring a compromise budget to the original houses.  Senate Budget Chair Senator Patty Murray (D-WA) has asked 19 times for the Senate to appoint conferees to a budget compromise conference committee and has been rebuffed by Republicans each time.  The House has not appointed any of its members as conferees to such a committee.

(3) We have been on a trajectory to significantly reduce the federal debt.   IF we accept that $4 trillion target for budget reductions over the next ten years, then the Obama Administration has been remarkably well focused.  There’s good news and bad news with this target, summarized as follows concerning the President’s budget:

“Cutting an additional $1.5 trillion would indeed stabilize the debt, leaving it growing at about the same rate as the broader economy for the rest of the decade, the CBO said. However, the debt would remain above 73 percent of gross domestic product — the highest level in U.S. history except for the period after World War II. [WaPo]

However, someone needs to ask the question: Is debt reduction an appropriate focus during a recessionary period or exceptionally slow recovery?  It’s important to notice at this point that Austerians focus on cutting government spending — even though government spending is part of the GDP formula — to the exclusion of consideration of the possibility of tax increases, and the increased revenues available when wages and salaries are also increasing.  This position is analogous to expecting a camp stool to balance on only one of its three legs.

Meanwhile back in the real world, Governor Sandoval is already feeling the bind:

“… the consequences have already started. In a meeting with his cabinet, Sandoval warned that Nevada would soon run out of money to process unemployment benefits or cover food stamps, and that National Guard vehicles had already been grounded because of a lack of funds to pay for basics, such as gas.”  [LVSun]

So, Representatives Heck and Amodei continue their forward, backward, left face, right face, backwards march in step with the Tea Party leaders in the U.S. House of Representatives, while the Nevada National Guard isn’t going anywhere…

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