Tag Archives: Cadillac Tax

Obamacare’s Biggest Legacy? More Welfare Beneficiaries.


Once upon a time, in the darkest, most putrid bowels of the White House, the diabolical creators of the worst piece of health legislation in American history connived to completely uproot one-sixth of the economy by convincing the populace this was first, necessary, and second, a boon to the country.

The Obamacare architects knew that there weren’t that many Americans truly locked out of health insurance, and certainly not in the numbers that would justify such a massive overhaul. Yet they, with the help of the lapdog media, touted completely bogus numbers of 45 MILLION!, 47 MILLION!, and 50 MILLION! (depending on the source) to get your attention.

It worked, didn’t it? And we all felt bad to learn this, didn’t we? Half of the country was covered by company plans and we thought it was unconscionable that people hoping to purchase their own health insurance couldn’t afford to.

We were told in 2010, by Jonathan Gruber’s CBO, that the Obamacare insurance exchanges would cover 22 million more Americans by this year (which is, you’ll note, less than half of the purported 50 million uninsured. Some “universal coverage” plan!).

We were also told that insuring these long-suffering individuals would actually save us money!

“$2500 per family per year!”

Employers “would see premiums fall by as much as three-thousand percent, which means they could give you a raise!

Eureka, Big Daddy Government will deliver us from ever-increasing health care costs!!! We’re on board!

Now, of course, we realize that the middle-class is taking this law directly on the chin. Workers with health insurance benefits are seeing their out-of-pocket costs skyrocket — while many in the individual market have decided to take their chances as they abandon expensive Obamacare policies with unreachable deductibles. 

Meanwhile, as the Congressional Budget Office churns its new Obamacare numbers, we find that the 2009-2010 CBO — Jonathan Gruber’s CBO — was remarkably off-base in its projections. In short, this year’s CBO report shows that the enrollment numbers are roughly half the 21-22 million 2016 exchange customers CBO had consistently forecast in years past, even as recently as March 2015. 

 

Get this: For all the sacrifice
the American people are making,
only 10 million people
are expected to be enrolled
in the exchanges by year’s end.

 

So what happened? 

Well, what happened was that an unexpectedly large number of Americans were folded into Medicaid, the worst coverage in the entire country, instead of signing up for Obamacare plans.

As the Weekly Standard’s Jeffrey Anderson points out, “In 2013, the CBO projected that, in the absence of Obamacare … 34 million people would have been on Medicaid or CHIP” in 2016.

What are the Medicaid/CHIP numbers now? 

Sixty-eight million. 

That’s right. Sixty-eight million American human beings are now on (lousy) Medicaid. Let that sink in.

Even better news for Progressives: CBO also believes that slower wage growth in the future will qualify even more Americans for the welfare programs.

What’s ironic for Obamacare proponents is that increased Medicaid enrollment also poses an existential threat to the exchanges. Take it from CBO itself, which projects that “as more people become eligible for Medicaid coverage, enrollment in coverage through the marketplaces will decline.”

Dentons, a global legal firm, maintains that this is already happening:

“Medicaid and the Children’s Health Insurance Program (CHIP) cover 17 million more people in 2016 than projected, while private insurance through the non-group market, including exchanges … covers 10 million fewer people. Millions of young, healthy people are enrolled in Medicaid and CHIP, rather than in private insurance offered through the exchanges.”

Before a 2012 Supreme Court ruling made Medicaid expansion optional for the states, CBO assumed all Americans with incomes at or below 138 percent of the federal poverty level (FPL) would receive Medicaid. Nineteen states are currently opting not to expand, so a smaller pool of Americans are Medicaid-eligible.

Still, as Dentons notes, “in the past six years Medicaid and CHIP enrollment has nearly doubled from the 2010 baseline.

We’ve repeatedly been told that state legislatures opting not to expand their Medicaid programs are “greedy, selfish and uncaring.” Yet it is in Medicaid expansion states that Obamacare enrollment and risk pools suffer the most.

In non-expansion states, low-income, young, able-bodied Americans can purchase highly-subsidized exchange policies and help to balance out the costs of older, sicker enrollees. In expansion states, those same young, able-bodied Americans at or below 138 percent FPL are FORCED into Medicaid — as in:

“Sorry, you can’t have a real insurance policy.
You’re too poor.”

In the nation as a whole, insurers need about 40 percent of Obamacare enrollees to be 18- to 34-year-olds. Meanwhile, over at healthcare.gov, only “26 percent of the individuals who selected, or were automatically reenrolled in, a 2016 Marketplace plan are ages 18 to 34.” 

Where’d they go?
Medicaid, anyone??

The Wall Street Journal reports the reason the young and healthy are needed in the exchanges: to “hold down premium rates by balancing out the greater medical spending of older enrollees.” Insurers are already dismayed over the greater-than-expected costs of their current Obamacare populations and are threatening to raise 2017 premiums by double digits. As a result, reports of adverse risk selection and death spirals are proliferating.

It wasn’t enough that Progressives like Harry Reid, Chuck Schumer, and Nancy Pelosi put the exchanges at risk by insisting on a Cadillac Tax delay — which thus postpones the incentive for employers to dump workers in the Obamacare “exchanges, whether they like it or not.

Now we see that their failed Medicaid policies have doubled down on the damage.

The Obamacare exchanges are doomed,
and Progressives have only themselves to blame.

Ezra Klein, Please Don’t Fire Sarah Kliff

For months, Vox’s Sarah Kliff has complained about the declining value of workers’ health insurance coverage and in particular rising deductibles

Kliff has also written about Obamacare’s Cadillac Tax.

And we called her out on her failure to connect the two. Twice

“Three articles on increased worker cost-sharing 
and yet NO mention of the Cadillac Tax?” 

So did The Tax Foundation.

It appears that Sarah has now awakened to the fact that the Cadillac Tax is driving down the value of company plans — and increasing employee costs — and her discovery has not made her happy.

NOW she’s skeptical. NOW she wonders if workers will really experience pay hikes as their health plans lose value. It took a long time and some hard cogitating to get Kliff to this point, but we congratulate her for discovering what we revealed in June.

One may wonder how her enlightenment is sitting with Vox boss and alleged wunderkind and intellectual giant Ezra Klein. Klein was a HUGE fan of the Cadillac Tax when disgraced Obamacare architect Jonathan Gruber promoted it in 2009 and 2010. In fact, Klein and Gruber had a mutual Cadillac Tax love-fest, and Klein frequently wrote in support of the tax and its wage growth promise.

In 2009:

Earlier in the day, I’d been talking to MIT economist Jon Gruber about this issue. “There are a few things economists believe in our souls so strongly that we have a hard time actually explaining them,” he said. “One is that free trade is good and another is that health-care costs come out of wages.” To put it another way: Economists are pretty united on this point. A firm’s compensation for its workers is pretty static, and if relatively more goes to health-care costs, relatively less will go to wages, and vice-versa. But this isn’t just a matter of theory. 

In 2010:

Unions will respond by “rebalancing compensation away from expensive insurance plans and towards higher wages, which is exactly what the tax is supposed to.”

And again:

[T]he excise tax is small change. It won’t hurt many people. It won’t hurt folks badly. 

But should workers suffer, Klein was all in:

When a policy bumps up against the tax, a couple of different things could happen. One is that the employer just passes along the tax, either increasing premiums for the employee or taking it out of wages. The other is that the employer chooses a plan that’s beneath the threshold. That plan might have a higher deductible, or more co-pays, or tighter networks, or less coverage for brand-name drugs. It will, in other words, be more like the managed care of the 1990s, which brought down spending and didn’t hurt health outcomes, but which people really didn’t like. “Managed care worked,” says Gruber, “but workers didn’t know it. They didn’t see the benefit. We’ve got to make them feel the pain of not reforming and enjoy the benefits of reforming.” In this case, the pain will be the excise tax.

In what can only be called economic incest, Gruber used a chart Klein created from Gruber’s numbers as evidence that his premises were valid. 

The available evidence clearly illustrates that there is essentially a one to one offset between employer insurance spending and wages. There are a number of economics studies that support this conclusion. But it is perhaps most vividly illustrated by simply comparing the growth rate of health insurance costs to the growth rate of wages, a task recently undertaken by Ezra Klein…when health care costs moderate, wages rise.” 

In other words, Gruber fed Klein his numbers, Klein sold them to America, and Gruber quoted Klein as evidence for his wage growth hypothesis. 

So Kliff now concludes that “the evidence is thinthat Klein’s Cadillac Tax sales job was honorable.

Let’s hope he doesn’t punish her for actually thinking this through herself, even as it took her years.

UPDATE: Who could have anticipated this? Klein admits Gruber’s “wage growth” hypothesis was bogus all along.

You have some ‘splaining to do, Mr. Klein.

Sarah Kliff Unloads Yet Another Awful Voxplanation

Is “awful” too harsh an adjective for Vox.com, the faux-educational ‘splainer site run by alleged wunderkind and intellectual giant Ezra Klein? One Twitter user, after reading our last piece on health beat reporter Sarah Kliff, didn’t think so.

Vox has also been called “terrible” and “a joke.” The staff has been referred to as “complete idiots” and likened to “sleazy mob lawyers.”  David Harsanyi of The Federalist writes that “Vox makes us stupid.”

Let’s agree to call them awful. Because they really are. Say it like Donald Trump would. 

NEW YORK, NY - MARCH 09:  Donald Trump and Melania Knauss-Trump attend the Comedy Central Roast Of Donald Trump at the Hammerstein Ballroom on March 9, 2011 in New York City.  (Photo by Andrew H. Walker/Getty Images)   Original Filename: GYI0063876060.jpg

“Vox is awwwwwwful!”

In her latest awful health care ‘splainer, Kliff tells us “Why your health bills are getting higher, in one chart.” And Kliff, who is now rather famous for producing pieces that cover only part of the story, once again fails to disappoint her reader(s)!

Let’s be clear: she really doesn’t explain “Why your health bills are getting higher, in one chart.” She only informs the reader that one component — the deductible — is on the rise. As if we hadn’t noticed.

She must believe Americans open bills from their doctors or hospitals and think, “Whaa?? How did this happen to me? I sure hope Sarah Kliff can ‘splain this!”

But see, she doesn’t. She just calmly ’splains that “This is your new deductible. On steroids.”

Actually, middle-class Americans already realize that Obamacare has made everything related to health care — not just deductibles — awfully expensive. Copayments and coinsurance are rapidly increasing. So are pharmaceutical and medical device costs, narrow networks (“if you have a doctor you like, you will be able to keep your doctor”) and insurers’ “medical necessity” audits and preauthorization requirements.

Why, oh why, is this happening, dear Sarah?

She’ll never admit this, of course, but it’s by design, courtesy of Obamacare architects like Jonathan Gruber, Zeke Emanuel, John Kerry, and The Won. You’re supposed to embrace this financial pain. It’s supposed to be awfully good for you. It’ll force you to reconsider scheduling that physician visit (as if you relished such appointments before) and filling your prescription order.

Never mind that it’s causing people to avoid care. (Shush!)

And never mind that you weren’t told of this plan before you voted in 2010 and beyond.

Kliff would have you believe these cost increases are occurring because “bosses are mean and stingy.” That is her implication in this, the latest of three articles in which she’s complained about deductibles and NOT mentioned the source of this pain: Obamacare’s Cadillac Tax on company health plans. 

(You can read all about the forty percent excise tax here and here.)

Kliff is merely taking a page from her progressive elders’ script: blaming company owners — for rising health care expenses and dropped policies — was the plan all along. 

Emanuel advanced this move in an interview with FOX news anchor Chris Wallace:

The president — look, the law does not say “Sears, drop coverage.” Sears decides what’s good for Sears… When the private companies decide that they’re going to drop people or put them in the exchange, you blame President Obama. He is not responsible for that.

Yeah, that’s right. The Preezy didn’t write an executive order commanding Sears to trim or drop company plans. He and his fellow Obamacare masterminds just made it a whole lot harder for Sears to keep its doors open. Paying a forty percent excise tax on health policies would put many firms out of business; employers simply have no choice but to skimp on or terminate company insurance.

We’re not alone in noticing Kliff’s awful omissions. The Tax Foundation also offered commentary on her latest skewed article:

Vox today covered the issue of rising deductibles in the U.S. health care market. As with their past coverage of the issue, there is a curious omission from the piece: the Cadillac tax…A number of outlets have linked this industry trend of higher deductibles to the Cadillac Tax. If Vox is to live up to its tagline and “explain the news,” it should perhaps give some consideration to the possible explanation offered by reports from Kaiser Family Foundation and Mercer, both of which link the Cadillac Tax to higher cost-sharing or consumer-directed health plans (CDHPs). This explanation for the news, for example, was considered by journalists at Bloomberg, the New York Times, the Wall Street Journal, and the Los Angeles Times, in today’s papers alone. It may behoove Vox to give it a look.

Kliff has a documented history of recycling information, but this is getting ridiculous — and, yes, awful! — for a former Washington Post writer.

Three articles on increased worker cost-sharing and yet NO mention of the Cadillac Tax? 

While some may have previously believed Sarah Kliff was just goofy, inattentive, and lazy, there’s no reason to think she wants her reader(s) to be anything but ignorant.

Shame on you, Sarah Kliff. Like your boss, you’re nothing but a progressive propagandist.

How awful of you!

H/T Citizen researcher Kathy in Alabama

Kliff’s Clunker Coverage of the Cadillac Tax

There’s no doubt about it: the faux-educational website Vox had a very unfortunate week.

First, alleged wunderkind and intellectual giant Ezra Klein nixed an essay an editor commissioned because the topic might challenge its reader(s) to think different thoughts. “The concern is that people will misinterpret it as implying opposition to abortion rights and birth control.”  Can’t have free discussion of ideas, huh?

Steven Hayward eviscerated Klein, concluding that he is a “a petty and small-souled human being.” 

Ouch.

Then someone at the outlet, apparently thinking the National Rifle Association produced chocolate products, confused the organization’s image with FDR’s National Recovery Administration. Twitchy, T. Becket Adams, and The Daily Caller ridiculed the site until Vox deleted the tweet and the image

Finally, our favorite Vox writer, Sarah Kliffafter more than a month of teasing us — offered her ‘splainer of Obamacare’s Cadillac Tax, the excise tax on employer plans designed to deliver a sucker punch to workers. 

First let’s note that Kliff wrote two previous articles complaining that those nasty little business owners are offering “crummier” insurance plans.

In neither article did she mention the Cadillac Tax as the reason. And it IS the reason. 

In her piece on the excise tax, Kliff only tells part of the story. Worse yet, she implies Republicans support it (this is not true).

She first admits this:

The point of the Cadillac tax isn’t to tax health insurance. It’s to change health insurance.

Do you remember being told you could keep your health insurance? Kliff fails to mention the 2013 Lie of the Year.

And do you remember this pie chart

Oh, yes, during all the outrage over cancelled plans in late 2013, Jonathan Gruber, who helped design the Cadillac Tax, claimed that worker plans wouldn’t be touched. And then someone made a pie chart for us.

Go ahead and peek at it. That big blue area representing the “unaffected” 80 percent of Americans?

“Largely people who keep their current employer plan.” 

Kliff apparently doesn’t remember any of this when she confesses that your job-based insurance is, after all, required to change. 

She is correct when she says people of all political stripes hate what’s called “the tax exclusion” allowing workers to receive benefits tax-free. But as Duke University research scholar Chris Conover points out, there’s a BIG difference between limiting the exclusion, as various policy analysts have suggested, and wiping it out through the highly regressive Cadillac Tax:

In short, whereas capping the tax exclusion even-handedly eliminates the tax subsidy for all workers above a certain premium dollar threshold, the Cadillac tax is far more pernicious–imposing a far heavier burden on low-wage workers than high-wage workers. That is, instead of merely reducing the low-wage worker’s tax subsidy to zero, the Cadillac tax goes overboard by using the tax code to actually penalize the provision of employer-provided health benefits to low wage workers. In contrast, while it obviously reduces the magnitude of the subsidy for high wage workers, it nevertheless leaves in place a net taxpayer subsidy for the identical health coverage for which a low-wage worker would face a tax penalty! Leave aside fairness: does that make any policy sense to you?

So when Jon McDonough told her the Cadillac Tax is “working just as Republicans wanted,” he either lied or is wildly uninformed about the law he helped write. 

And Kliff swallowed it whole.

Furthermore, Kliff writes that Economists think the Cadillac tax will give Americans a raise. Let’s put aside the proposition that A TAX can increase your take-home pay and proclaim that this is almost true. 

Some economists — like Gruber — have maintained for years that Americans are going to see pay raises as the tax forces companies to dilute the value of health plans they offer. (See Obamacare’s Wage Growth Hoax for more detail.) But other economists, health policy experts and even some Congress members find this doubtful. 

Linking to only one study, Kliff writes, “There’s a vast body of economics research that shows workers bear the cost of more expensive health plans with lower wages. These papers suggest there’s a lump sum amount that companies spend compensating workers. It goes into either wages or benefits.”

A lump sum, huh? Employers have no other options for savings they reap? What about distributing dividends or cutting the price of products they market? What about hiring more workers, say in Human Relations, to comply with Obamacare reporting requirements?

Have Gruber or Kliff ever run a business?

Keep in mind that at the time the tax was being debated, Megan McArdle demonstrated that she’d actually put some thought into the proposition:

What if employers just cut their costs and don’t raise their employees wages? What if employers just cut their costs and don’t raise their employees wages, because they’re in a dying unionized industry? What if they shift workers to other forms of tax-deferred compensation, like 401(k) matching or HSAs?

Indeed. What if this doesn’t work? What if employees suffer both higher health care costs and no pay raises?

After reading Kliff’s article, Gruber researcher Rich Weinstein tweeted:

And he’s right. Here’s what she omitted:

  • In his ’08 campaign the President swore his health reform plan wouldn’t tax worker benefits. He spent $100 million hammering John McCain for proposing a cap on the employer exclusion. 
  • And because they all understood the tax would be a political nightmare, John Kerry, to quote Gruber, “had a very clever idea. He said, ‘Let’s call it instead a tax on insurance companies and not a tax on insurance plans.’…Now, you and I know, economists know, that that will just get passed on in the price of insurance.”
  • Three days later, Obama said this to his Shaker Heights, Ohio, audience:

First of all, in terms of taxing benefits, I said I oppose the taxing of health care benefits that people are already receiving, so that’s not a proposal that I’m supportive of…But what I said and I’ve taken off the table would be the idea that you just described, which would be that you would actually provide — you would eliminate the tax deduction that employers get for providing you with health insurance, because, frankly, a lot of employers then would stop providing health care, and we’d probably see more people lose their health insurance than currently have it. And that’s not, obviously, our objective in reform. OK?

But that was the objective. Bye-bye, employer-sponsored coverage. “Everybody, into the exchanges!” As analyst Patrick Garry writes:

Obamacare was sold as supporting the employer-based system, not eroding it. But at its core, Obamacare is designed to do precisely that: to eventually force every American with employer-based coverage onto the Obamacare exchanges, whether they like it or not.

So there’s your ‘splainer, Vox. You’re welcome. Feel free to update your article with this material. 

We would have made corrections in your comments section instead of writing a long and embarrassing blog post, but you don’t allow comments on your articles.

And it’s pretty clear why.

Obamacare’s “Wage Growth” Hoax

Families across the country are facing escalating out-of-pocket health care costs and, as a result, less disposable income, thanks to Obamacare’s Cadillac Tax. A major funding mechanism for the law, the 40 percent excise tax forces employers to cut back on health benefits, leaving workers increasingly subject to higher deductibles and copayments.

(Note: See here, here, and here for more details on the Cadillac Tax.)

The drive-by media originally maintained the Cadillac Tax was merely a justified penalty on unusually expensive gold-plated plans — such as those owned by Goldman-Sachs executives — that theoretically encourage over-utilization of medical care. 

However, we now know that the tax was designed to eventually target every employer-sponsored insurance (ESI) plan. We’re talking about 158 million Americans.

Since employers have already begun reducing the generosity of their plans to prepare for the tax’s 2018 implementation, even the drive-by media has had to pay attention to a flurry of reports — from sources like Forbes, The Los Angeles Times, Bloomberg, the Institute for Policy Innovation, The Wall Street Journal, and more — on soaring employee cost-sharing.

Completely blindsided by these revelations, Progressives are now referring to copayment and deductible victims as “underinsured” and calling for action, including government requirements that insurers lower deductibles. Some are even demanding a repeal of the Cadillac Tax.

This situation shouldn’t have been a surprise to anyone. This is, as they say, a feature, not a bug, of the law; the Cadillac Tax was always intended to discourage patients from consuming health care. This is Obamacare’s promised “cost control.”

Law professor (and big-time Cadillac Tax fan) Edward Zelinsky explains:

 “Those who drafted the Cadillac Tax presumed that this tax…would be passed on to the employer and that the employer, in turn, would transfer this additional cost to its employees. In this indirect fashion, the Cadillac Tax should sensitize employees to the high costs of their health care coverage.”

Steve Wojcik of the National Business Group on Health described the policy’s intention:

“If employees have more cost sharing…then they’re more mindful when they access health care to choose a more efficient provider or say, ‘You know, I don’t need to go to the doctor every time I have a cough.’” 

America, you were conned from the very start. Not only did politicians lie — including Obama, dozens of times — in maintaining we could keep our plans, period, but so did Progressive reporters, who insisted that job-based coverage would be untouched.

Young Jonathan Cohn explained that for most of those with employer-sponsored insurance, Medicare, or Medicaid, 

“Very little about their health plans are changing because of the law,
at least outwardly.”
 

America’s alleged wunderkind and intellectual giant Ezra Klein told us

“For most companies, the Affordable Care Act won’t bring much change at all.” 

And Ryan Lizza  assured readers that:

“About eighty percent of Americans are more or less left alone by the health-care act—largely people who have health insurance through their employers.” 

To prove that most people wouldn’t be affected by Obamacare, the liberals even paraded a pie chart, because apparently, in their view, “stupid” Americans understand colorful pictures more clearly than words. 

Even now, in the midst of this massive shift to higher employee cost-sharing, at least one of the law’s engineers is still perpetrating the fable that Obamacare isn’t affecting company plans.

Why did Obamacare’s designers aim to abuse American workers this way? Why was it necessary that Americans lose their policies to make Obamacare work?

To rake in more federal money, of course. The tax was devised to undercut the IRS provision that allows workers to receive tax-free company benefits. Policy experts estimate the government is robbed of $250 billion per year through this arrangement. 

And Progressive lawmakers rationalized that as employers scaled back or eliminated tax-free plans, they’d offset the loss with pay raises — in other words, taxable wages.

Here’s then-Senate Finance Committee chair Max Baucus explaining your raise.

Progressive politicians — backed by the Congressional Budget Office (CBO) — predicted that the excise tax itself would raise relatively little, since companies would have no choice but to bring plan costs below the tax’s threshold. Obamacare crafter Jonathan Gruber is quoted to say, “I would be surprised if [the IRS] even collect[s].’” 

Most of the $201.4 billion revenue over 2013-2019 was predicted to result from payroll and income taxation of, yes, your raises.

Are you following? America’s gonna get a raise, any day now.  There’s even an econo-wonk term for this phenomenon — the “Wage Growth” effect.

So what about this “Wage Growth?” And who was the genius predicting with absolute certainty how companies would react to any savings on benefit costs?

Let’s flip the calendar back to 1993-94, when Hillary Clinton and Friends were busily at work trying to accomplish a very similar government takeover of America’s health care sector. 

“Wage Growth” was a major assumption in the Clinton bill: employers were expected to “shift to wages” any savings or costs they experienced due to the employer mandate to offer insurance. Those offering ESI for the first time were predicted to offset costs by reducing wages; companies that had previously offered ESI would receive government subsidies and were expected to pass along those savings to employees. 

The proponent of the Wage Growth hypothesis was 28-year-old Jonathan Gruber — yes, that Jonathan Gruber — who explained it to a health reform group in December 1993, and in testimony before a House committee five days later. When testifying before a Senate committee in July 1994, he again maintained the legitimacy of his unproven assumption.

Gruber was successful in persuading the 1994 CBO to accept the same premise: “employers facing an increase in their premiums would probably shift most of the added cost to their workers by reducing cash wages” and “employees of firms that would pay less would receive higher wages.” CBO’s evidence? Two research papers (one of which was still “forthcoming”) written by Jonathan Gruber.

Fifteen years later, in the midst of the Obamacare battle, Gruber was again peddling Wage Growth, offering professional papers and articles attempting to prove that Wage Growth would materialize with Obama’s reform package as well. Gruber, then more heavily involved with the CBO, influenced the body to repeatedly make the same Wage Growth assumption with Obamacare. (That’s for a subsequent post.)

For now, remember that it was critical that CBO find that Obamacare would pay for itself, as Obama promised and demanded a reform package that didn’t increase the deficit by a dime. Also remember that CBO analysis killed HillaryCare when it found the proposal increased the deficit by $74 billion

Obama and his Progressive Senate buddies couldn’t endure such an outcome. And government control of one-sixth of the economy couldn’t wait. 

So Jonathan Gruber rode in to save Obama by convincing just about everyone who mattered that the plan was deficit-friendly. Gruber then effectively went “on tour” to sell his claim to the American people, citing the support of the “independent CBO” — that’s right, the CBO that relied upon his Wage Growth hypothesis. 

Why is this important now, six years later? Because a wage increase has not occurred, despite ever-increasing benefit cuts, and was known to be improbable before Obamacare was passed. In a December 2009 Mercer employer survey, only 16 percent of respondents said they’d convert any cost savings into pay raises. In Towers Perrin’s September 2009 survey, a paltry nine percent said they’d increase wages.

It’s less than clear that even Jonathan Gruber believed in the Wage Growth hypothesis, since he appears to have solely relied on his analysis of wage and health insurance trends in the late-90s. And he doesn’t appear entirely convinced he hadn’t overlooked some confounding variables.

Gruber told The New York Times in January 2010, “‘There are many academic studies showing that when health costs rise, wages fall,’ he said. ‘In the mid- and late-1990s, when we got health costs under control, wages rose nicely.’ But he added that other factors could have also lifted wages during that period.” (More on that later, too.)

Additionally, liberal economist Lawrence Mishel, a critic of Gruber’s Wage Growth hypothesis, wrote on January 12, 2010, that ”Gruber clearly overreached with the argument about health care driving wage trends and has acknowledged that to me privately (yesterday).

Given this, one must wonder: would Obamacare have passed if not for the false narrative of deficit reduction? Even in Gruber’s 2011 comic book, he admits this about the law:

“There are risks.  But we have the benefit of
the independent projections of the CBO
…to suggest that this should work out.”
 

Now we’re discovering that those CBO projections were not very “independent” and instead were biased by Gruber’s assumptions.

Stay tuned. A subsequent post will explain how Jonathan Gruber manipulated economic research to advance his Wage Growth hoax.

Obamacare Scorecard: Takers Taking, Makers Breaking

When market research company J.D. Power released its 2015 Health Insurance Marketplace Exchange Shopper and Re-Enrollment (HIX) Study last Thursday, progressive health care reporters rushed to their laptops to declare Obama’s remarkable achievement:

Wowie!
Obamacare customers
are more satisfied
than people with job-based plans!

Vox’s Sarah Kliff offered her ‘splainer of the study, which was based on data collected from December 9, 2014, through February 24, 2015. 

People who had coverage through Obamacare had an average satisfaction score of 696 in 2014, thinking back to their last year of coverage. During that same year, people in mostly employer-based plans had a satisfaction rating of 679 — 17 points lower.

So did Sarah Ferris at The Hill:

People who bought coverage through ObamaCare are generally more satisfied than those with other types of insurance, according to a new national survey. ObamaCare customers rated their satisfaction over the last year as 696 out of 1,000, compared to the 679-point rating by customers with employer-based plans, according to a large survey by the consumer research firm J.D. Power.

And let’s not forget young Jonathan Cohn, who wrote a Huffington Post piece titled Obamacare News That Should Make Conservatives Happy, But Won’t:

J.D. Power uses a numerical index, from zero (low) to 1,000 (high), to measure consumer satisfaction. The figure for Affordable Care Act consumers was 696. To put that in perspective, the figure for people with employer-sponsored insurance — the source of coverage for most working-age Americans — was 670 [sic].

Here’s a question for Kliff, Ferris, and Cohn:

Are you really surprised that getting free stuff is popular?

…especially since J.D. Power found that “cost is the most influential attribute driving satisfaction among Marketplace plan members?”

Reporters of all stripes ought to know why Obamacare customers are happier than those in employer plans.

  • Obamacare enrollees enjoy the taxpayer’s helping hand with their premiums: in 2014, 90 percent received premium subsidies, and 69 percent paid $100 or less per month. 
  • Those in job-based plans are being increasingly hammered by rising out-of-pocket costs, as employers reduce benefits to avoid Obamacare’s Cadillac Tax. 

The New York Times provides one example of the excise tax’s impact on workers.

Starting this year, they have a combined deductible of $2,300, compared with just $500 before. And while she was eligible for a $1,400 hospital contribution to a savings account linked to the plan, the couple is now responsible for $6,600 a year in medical expenses, in contrast to a $3,000 limit on medical bills and $2,000 limit on pharmacy costs last year. She has had to drop out of school and take on additional jobs to pay for her husband’s medicine.

Remember: Obamacare enrollees don’t have to pay the Cadillac Tax; only those with company plans suffer that burden.

The real story in the J.D. Power release, though, is not found in comparisons of people with different types of coverage: it’s found when one examines the insurance satisfaction index over time.

In 2009, the year before Obamacare was passed, that number was 712 out of 1000. In 2010, it plummeted to 701. And now, for those with employer-provided insurance, that number is 679 — and 696 for those in the individual market.

In their reports, the research firm (strangely) never mentions the sampling errors and confidence intervals that would allow for meaningful year-by-year comparisons. However, they do say they consider a ten-point change to be significant.

So overall, Americans are vastly less satisfied with their health insurance since Obamacare started monkeying around with it. That’s the story.

But our progressive health care journos didn’t write about that tidbit, did they? 

Instead, they put a happy face on the numbers, gleefully announcing that those getting freebies are happy with their free provisions, and those subsidizing those freebies are much less so. 

Duh. They must think their readers were educated at the Jonathan Gruber School of Stupid.

[Sigh] It’s all fun and games until we “run out of other people’s money.”

How Obama Learned To Stop Worrying And Love The Obamacare Bomb

Last fall Duke University research scholar Chris Conover wrote a powerful piece titled “Obamacare’s Three-Legged Stool of Deception,” in which he explained the covert way Obamacare crafters aimed to eliminate job-based health insurance through the Cadillac Tax.

  • The first leg is that the Cadillac tax is paid by insurance companies, when in reality it is paid by employees. 
  • The second leg is that the Cadillac tax is aimed at “lavish” high cost plans, when in reality it is designed to eventually hit virtually every employer health plan (even those with lower-than-average costs). 
  • The third leg is that the Cadillac tax is functionally equivalent to a reform long championed by conservatives: a cap on the tax exclusion for employer-sponsored health insurance. 

Dr. Conover hit a home run in detailing the duplicitousness of the law’s architects, and his piece is probably the best exposé of the Cadillac Tax you’ll find.

But who designed the Cadillac Tax, and how did Obama come to love it?

In his first presidential campaign, Obama repeatedly maintained that he was dead-set against taxation of health insurance benefits. He even chastened his opponent, Senator McCain, for proposing that Americans receive tax credits instead of tax-free insurance benefits.

“This is your plan, John: for the first time in history,
you will be taxing people’s health care benefits.”

Ezekiel Emanuel, special advisor for health policy during the law’s creation, gives us important insights into how, in the summer of 2009, Obama decided campaign promises weren’t as important as was more money in the federal coffers.

Zeke describes a “hot Friday July afternoon” in the White House when he says the “core health team” was working on Obamacare. After about an hour, he recalls, the president walked in, “in his shirt sleeves with his cuffs rolled up. He was there to give us a sort of uplift.” After pleasantries were exchanged,

“I raised with the President one of the issues that had been burning up the staff — the issue of something called the Tax Exclusion.”

In both videos linked above, Zeke describes the issues he and others had with tax-free employee benefits: 

“The big argument we were having was, people on what was called the economic part of the health team…we wanted to do something about the tax exclusion because it’s inflationary, it’s regressive, it’s a lot of money.”

One obstacle? Obama wasn’t clear on his stance: 

“We got into some weeds, and he would say, ‘What did we say about that? What was my position on that? ‘Cos the people should know I stand by my position.’” 

And since David Axelrod, his senior advisor, pointed out that he’d spent $100 million running ads against McCain’s position, the Campaigner-in-Chief stalled, worried that he’d be contradicting his promises.

“David Axelrod, as part of this debate internally, created a montage of all the ads that President Obama had run against John McCain attacking McCain’s proposal — which was basically to get rid of the tax exclusion and give people a tax credit instead to buy health insurance.”

Eventually the economic team won Obama’s heart by showing him how much power and money ($250 billion per year) the Cadillac Tax would grant him.

“I said, you know, Mr. President, as President, you can control a lot related to the public provision of health care insurance — Medicare, Medicaid, CHIP, veterans health benefits — but you don’t have a lot of power over the private side. And that, after all, is the bigger side. It’s most of the money, covers half the American population.” 

That “hot Friday” was July 17, 2009, when the Washington, D.C., temperature soared to 90.9º.

“(O)ver the course of the next few days, this was Friday, then Monday and Tuesday we had meetings around this, the idea began to hold that we should do something about it, we shouldn’t roll it back, but we should modify it.”

The following Monday and Tuesday were July 20 and July 21, 2009. White House visitor logs show an “Economics Team” indeed met the morning of the 20th. (White House visitor logs also indicate that the beloved Jonathan Gruber was in attendance!)

So why did THIS happen, on Thursday, July 23, 2009, in Shaker Heights, Ohio?

“First of all, in terms of taxing benefits, I said I oppose the taxing of health care benefits that people are already receiving, so that’s not a proposal that I’m supportive of…But what I said and I’ve taken off the table would be the idea that you just described, which would be that you would actually provide — you would eliminate the tax deduction that employers get for providing you with health insurance, because, frankly, a lot of employers then would stop providing health care, and we’d probably see more people lose their health insurance than currently have it.”

Dear President Obama, wasn’t that exactly the goal? That we lose our plans and have to join your lousy exchanges?

It’s very odd that Obama repeatedly characterizes his views using terms like “what I’ve said is,” rather than “what I believe is.” 

But it’s more than disappointing to learn that Obama lied to his Shaker Heights audience — and America — mere days after he fell in love with the bomb that will blow up job-based insurance.

H/T Citizen researcher Kathy in Alabama

April Fools’ Bracket: Who Wins? The Cannon or The Gruber?

Financial services company Sun Life is again hosting its Wake Up Summit. Its last webinar explored the effect of Obamacare on the nation, and Jonathan Gruber, MIT economist and Obamacare architect, was a speaker in the keynote address and a contributor to one panel discussion (registration required to view). 

The conference could have been described as boringly collegial.

This year’s webinar occurs on April Fools’ Day and may prove more provocative. Wake Up Summit 2015 will again feature Jonathan Gruber, but this time alongside Michael Cannon, the Cato Institute’s director of health policy studies and, with legal scholar Jonathan Adler, one of the masterminds of the so-called Obamacare “subsidies cases.” The informed reader will recall King v. Burwell as the case most recently heard at the Supreme Court.

If you’re free at 2:00 p.m. on Wednesday, you can register to watch it live here. Click the RSVP button on the right side of the page.

You can also make the event more lively. Sun Life is inviting questions before the event. 

You may have a variety of questions of your own for Mr. Gruber. But you could also pose questions like these, for either participant:

1. Everyone’s heard that “if you like your plan, you can keep your plan.” Would you please explain how the ACA affects those who receive health insurance from their employers?”
2. When Senator Obama ran for office he promised not to eliminate the tax exclusion for job-based insurance. But doesn’t the Cadillac Tax achieve the same goal over an extended time frame?

3. Don’t you think the Cadillac Tax is mislabeled since it appears to eventually impact most if not all job-based plans?
4. Why does the Cadillac Tax cap grow at CPI or CPI +1? Won’t that assure that most if not all plans become Cadillac Tax plans?
5. What do you think of S&P Capitals’ recent prediction that by 2020 90% of those with job-based coverage will be shifted to the ACA exchanges?
6. Do you agree with Medicare chief actuary Richard Foster’s prediction that “essentially all Americans” will over time get their private coverage through ACA exchanges?
7. Exactly how does the ACA cause “wage growth” for workers?
8. The CBO scores the ACA as improving the deficit more in the out years than in the first ten years. Why is that?
9. Do you think the ACA is more like Romneycare or Hillarycare?
10. If states do not establish their own exchanges, what role do states really have with regard to the ACA?
11. Is a “single payer“ health system more likely if the ACA fails or if the ACA succeeds?

Of course, you’re also free to ask not-so-serious questions of either Mr. Gruber or Mr. Cannon, questions like these:

1. Why aren’t you, Mr. Gruber, still hiding under a rock?
2. Are you, Mr. Gruber, capable of feeling shame?

3. Mr. Gruber, would you like to clarify your “falling off a building” prediction for workers losing job-based insurance?
4. Mr. Gruber, why were your Obamacare models so wrong?
5. Have you, Mr. Gruber, apologized to your family for publicly humiliating them?
6. Has MIT placed any sanctions on you, Mr. Gruber, given your damaging effects on its reputation?
7. Mr. Gruber, when will you turn over your “research assistants’” records?
8. Mr. Cannon, how did you become so flipping awesome?

Feel free to offer your questions in the comments section below. But it’s far more important that you send them to Sun Life.

Of course, as Mr. Cannon points out, Mr. Gruber may not show up at all. 

John Kerry Is No More Trustworthy Than The Disgraced Jonathan Gruber

In summer of 2009, as Obamacare crafters were assembling their plan to destroy the U.S. health care industry, they faced several problems, and most of them involved financing.

Over twenty years ago, Mrs. Clinton’s health reform plan died when the Congressional Budget Office (CBO) determined it would cost too much. 

Learning from her failure, White House officials knew they had to create a plan the CBO could score as budget-neutral. But where, oh, where, would they find the money to not only subsidize insurance purchases but also fund an “unknowable” number of new agencies, boards, commissions, and task forces? 

It was at that point in late-July that Obama’s economic team advocated that the plan eliminate the tax exemption for job-based insurance. What was later dubbed the Cadillac Tax would result in an estimated federal tax grab of $250 billion per year. 

But, as Jonathan Gruber told a Boston audience, any plan that ended the tax exclusion would have been a political hot potato. “Economists have called for 40 years to get rid of the regressive, inefficient and expensive tax subsidy provided for employer provider health insurance…It turns out politically it’s really hard to get rid of.”

That’s where then-Senator John Kerry became Gruber’s “Massachusetts hero” by introducing a scheme to trick Americans. “No, no,” Gruber quotes Kerry, “we’re not going to tax your health insurance. We’re going to tax those evil insurance companies!” 

 When we all know it’s a tax on people who hold those insurance plans.

An ordinary person responsible for such duplicity might have experienced regret, even shame. But not Kerry, who, like Gruber, aimed to exploit Americans’ “lack of basic economic understanding.”

Less than six months later, Kerry doubled down on his deceit, penning a January 2010 Huffington Post piece explaining his support for the Cadillac Tax.

It will help control future health care costs without — I repeat without — directly taxing employees.

Notice the word “directly?” By this he means the tax on insurance companies will be borne by the worker, but certainly not clearly or directly. It was intended that Americans blame insurance companies and employers for jacking up premiums, deductibles, and copayments. (In fact, Harvard faculty members are already blaming the university for out-of-pocket cost increases.) Later, they hope, we will curse our bosses for eliminating job-based insurance altogether.

The excise tax included in the Senate-passed health care bill will affect only a small portion of the very highest cost health plans.

Not according to the American Health Policy Institute, who projects the tax will “hit 17 percent of all American businesses, and 38 percent of large employers” in 2018. And as Gruber explained, the method establishing the yearly tax threshold means that eventually all plans will be subject to the Cadillac Tax. 

For the small sub-set of plans that are affected, the likely impact will be to increase workers’ wages. MIT economist Jon Gruber recently found that the excise tax included in the Senate bill would lead employers to raise wages by $223 billion between 2010 and 2019. In 2019, wages for those affected by the provision will be higher by about $660 per household. I repeat — raise wages.

Did anyone think to ask Kerry how a tax on insurance companies naturally produces higher pay for America’s workers? That’s a curious connection, isn’t it?

Well, you see, Secretary Kerry conveniently omitted the “Employers-Kill-Your-Health-Plan” factor in his analysis. What he failed to mention is his apparent belief that, as employers shrink insurance benefits or dump employees in Obamacare exchanges, they’ll compensate them with higher wages. 

(By the way, this is an assumption based on Gruber modeling, the same model predicting that our health insurance premiums would fall under Obamacare.) 

Finally,

After spending years and years hearing from workers tired of seeing their unions forced to spend all of their energy at the bargaining table just to hold on to health care instead of negotiating for better wages, we now have a way to help increase wages and improve health care simultaneously.

If Kerry believed union workers would gleefully skip off to the Obamacare exchanges, he was wildly uninformed.

Let’s not forget: this is the same John Kerry currently negotiating a nuclear agreement with Iran. 

More than likely, Iran’s mullahs will fare better than Americans have with Obamacare. 

But they may have to sign the deal to find out what’s in the deal.

Jonathan Gruber Cutely Likens Obamacare Victims to Those “Falling Off A Building”

When the “Gruber-gate” story broke last fall, TIME’s Kate Pickert explained that the scandal represented no more than a “flash of candor.” 

Both sides lied, she said. 

Supporters of the law did, in fact, do their best to obscure unpopular provisions—like new taxes. But Republican opponents were just as deceptive in their efforts to exaggerate the law’s potential negative effects.

Journalists, she claimed, “focused more on the politics of the bill than its policies,” and therefore didn’t explain Obamacare well enough. 

And that’s why Americans weren’t aware that the law aimed — through the Cadillac tax — to eliminate 156 million workers’ job-based health insurance.

Pickert summarized a few secrets Obamacare architect Jonathan Gruber shared in his now-controversial speeches:

  • In one video, Gruber says that if the public had really understood that the law would require healthy people to pay for sick people, it wouldn’t have passed. 
  • He also says that the penalty for eschewing health insurance is a “tax,” though Democrats avoided that word because it would have made the law politically unfeasible. 
  • In another video, Gruber explains that a new ACA tax on high-cost health plans supposedly levied on insurers would actually be passed through to consumers.

Pickert confesses that she knew the inner workings of Obamacare, since Gruber had talked with her “many times over the past six years.” 

In one conversation she found worthy of sharing, Gruber reportedly described the Cadillac tax with an analogy reminiscent of the fate of 9/11 victims in the Twin Towers:

In pitching the ACA, Democrats had been adamant that the law would support and sustain the employer-based system, not erode it. But Gruber knew better and he told me so, likening workers being kicked off job-based health plans to people “falling off a building,” an outcome that architects of the ACA knew was likely and had planned for.

People falling off a building. 

Isn’t that adorable?

Ms. Pickert apparently believes Gruber’s openness with his private audiences is refreshing. She fails to address why the American public wasn’t privy to Gruber’s secrets.

But, you see, if America had known Obamacare would kill job-based coverage, Obama would have lost his bid for reelection.

And in the world of Kate Pickert and her ilk, that would have been a far worse outcome than falling off a building.