Open Thread
Deliberately choosing bad risk pools
Bloomberg’s Zachary Tracer has a good review of the impact of Humana leaving the Exchange market with a focus on eastern Tennessee.
At least 40,000 people in the Knoxville area may have no health plans to pick from in the Affordable Care Act’s markets after insurer Humana Inc. opted to pull out from all 11 states where it still sell plans in 2018. Another 39,000 in the state would be forced to find a new insurance company….
Humana chose a strategy that would give healthy individuals comparatively bad deals. So healthy individuals stayed away.
Bloomberg has a great chart on the composition of the risk pool for Humana in the counties where they are the only carrier. It is an old risk pool.
The total risk pool is 32% under the age of 35. The adult (18+) risk pool is 27.5% under the age of 35. Age is a good first pass predictor of health although it is a very rough predictor. In 2016, Healthcare.gov states had 36% (Table 4) of their enrollment be under the age of 35 and 30.5% of their adult enrollment be between 18 and 34.
Humana’s strategy was to offer a single Silver plan in these counties. This was the benchmark plan. Anyone who signed up on Healthcare.gov and was eligible for subsidies paid their full personal responsibility contribution. There was no chance for a better deal. In zip code 37763 here are what people at various incomes had to pay for a Silver plan:
Silver plans get expensive very quickly. The Bronze plan for a 40 year old is roughly $90 less expensive but it comes with a $4,800 deductible and a $6,550 out of pocket maximum. What this cost curve means is that quite a few healthy individuals who are not rolling in cash will look at the prices (even after the subsidies) for coverage and take the risk that they will either be okay in 2017 or that they can get some type of coverage some other way if they really need it. This logic does not apply to people who are sick as they know that they need coverage and they will pay the post-subsidy price.
This was a deliberate choice by Humana to engage in a strategy that made them attractive to an older population that is likely to be sicker.
A BFD that passed amongst the chaos
In most strands of the multi-verse, the below would have sent the health wonk community ablaze. Instead in this strand, we spent all day yesterday talking about a proposed rule from CMS and generally shaking our head as our government continues to say “Hold my beer and watch this….”
But this is normally a BFD:
Lamar Alexander tells me Senate is NOT planning to pass ACA repeal bill Obama vetoed last year. "That's not the plan that we're working on."
— Sahil Kapur (@sahilkapur) February 14, 2017
What does this mean?
Repeal and Replace or Repeal and Delay and Pray is dead. There is no coherent coalition of 218 and 51. The Republican Senate caucus can afford to lose two votes (assuming Democrats are healthy and have everyone show up). The 2016 ACA Repeal bill defunded Planned Parenthood and knocked out Medicaid Expansion. Either of those elements will cost the Republicans at least two votes. Combined, those two provisions probably cost the Republicans six to ten votes. That is a blocking coalition when combined with Democrats.
In the House, Speaker Ryan would like to pass anything with only Republican votes in order to not be hung out to dry like former Speaker Boehner (remember he has tough votes on the debt ceiling coming up). That means he needs 90% of his caucus on board with anything. The Republican House Freedom Caucus has enough members to deny Ryan a Republican only majority. The HFC is demanding a word for word replica of the 2016 bill.
This is a Big Biden Deal as the status quo bias works in our favor for the avalanche approach that I feared in November can’t get started. Long, boring committee meetings, calls to the CBO, wonks ripping apart a plan to help advocates find very sympathetic people to tell true stories with high emotional punch is where we’re going for anything more complicated than a technical correction bill or rebranding.
Thursday Morning Open Thread: Brown Bag Democracy
Donald Trump is unpopular enough that Republicans could lose the House in 2018: https://t.co/8XZOBYt3HV
— FiveThirtyEight (@FiveThirtyEight) February 15, 2017
That's the plan. https://t.co/kyVxGbPS7g
— Swing Left (@swingleft) February 15, 2017
More immediately, the Resistance targets the expense-account demographic…
Roster of DC restos supporting #ADayWithoutImmigrants protest ranges from fast-casual to @beardfoundation nominee https://t.co/0wV3mgD6jQ
— Eater DC (@Eater_DC) February 15, 2017
We have made the decision to close the majority of our restaurants in NYC tomorrow, 2/16 in support of #ADayWithoutImmigrants! https://t.co/ikrC5gpkt3
— Blue Ribbon (@eatblueribbon) February 15, 2017
Doggedly painstaking NYTimes explainer:
… The campaign, spread on social media and messaging apps, has called for a “day without immigrants.” It asks foreign-born people nationwide, regardless of legal status, not to go to work or go shopping in a demonstration of the importance of their labor and consumer spending to the United States’ economy.
Activists and groups in cities across the country have picked up the call, reposting fliers found online, and in some cases organizing demonstrations to coincide with the event. Several activists said that they did not know how the campaign began or how many people would heed it, and that as far as they knew, there was no national organization behind it.
But the dining scene in Washington, where the new Trump administration is taking a hard line on immigration and deportation, took notice. At least a few dozen restaurants in and around the Beltway have committed to staying closed on Thursday. Others have said they would offer limited service in the expectation that many of their employees would be out for the day. Some restaurants in other cities, including several of the Blue Ribbon restaurants in New York, have joined in…
Hey, when it was just lobbyists schmoozing backbenchers down in The Swamp, cute little joke. But if it inconveniences the important Media People and financiers in the Big Apple, well…
Actually, I expect a spate of mean-girl posts tattling on colleagues who Just Can’t (make their own lunches). Betting on Maureen Dowd to be first into pixels, since she doesn’t seem like she consumes many calories in solid form.
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What’s on the agenda as we slog through this interminable week?
Thursday Morning Open Thread: Brown Bag DemocracyPost + Comments (140)
Oh, Yay, We’re Gonna Relitigate Watergate Now
Watergate is the biggest political scandal of my lifetime, until maybe now: https://t.co/9NCmordowo
— Dan Rather (@DanRather) February 14, 2017
Thing is, Nixon didn't need Watergate to win. But Trump needed Russians & Comey to squeak out electoral college win https://t.co/cn4QLCEH4f
— Dana Houle (@DanaHoule) February 15, 2017
Sensible people understand that Gerald Ford pardoning Richard Nixon — and thereby eliminating any chance of airing the true extent of the nitwitted criminality of the entire Nixon Administration and its GOP supporters — was a national tragedy. It allowed all the low-level CREEPsters to scurry away into wingnut-welfare hidey-holes from which they would reemerge, stronger and ever more venal, first during the Reagan Adminstration (aka ‘Iran-Contra’), and later during the Cheney Regency. What the country needed in 1974 was the equivalent of South Africa’s Truth & Reconciliation Commission, where amnesty might be granted, but only after a full examination of the crimes and their impact on civil society.
Of course the criminals in the permanent Republican Party, and their nitwit courtiers among the Media Village Idiots, persist in their self-defensive fantasies that Watergate was a cruel and misguided assault on a great man and his loyal acolytes. Since paranoia, racism, and a lust for cruelty are never out of fashion in the authoritarian fringes of the far right, whole generations of would-be Haldemans and Ehrlichmans have nursed ambitions to avenge Tricky Dick… and it seems that they may be seizing upon the President-Asterisk and his klown klavern as their last best hope.
As a leading indicator, Drum-Major-General and Bothsider-in-Chief David Brooks meeps out a preemptive call for Truth and Honor, once again, to submit to the needs of The Narrative. After hastily dismissing both the Democratic tactic of actual resistance to Trump’s no-longer-hidden attempts to subvert our democracy, and the #NeverTrumpist withdrawal into their think-tank boltholes, Brooks declaims that “we” need… another Gerald Ford:
… The third possibility is that the primary threat in the Trump era is a combination of incompetence and anarchy. It could be that Trump is a chaotic clown incapable of conducting coherent policy. It could be that his staff members are a bunch of inexperienced second-raters…
If the current reign of ineptitude continues, Republicans will eventually peel away. The Civil Service will begin to ignore the sloppy White House edicts. The national security apparatus will decide that to prevent a slide to global disorder, it has to run itself.
In this scenario, the crucial question is how to replace and repair. The model for the resistance is Gerald Ford, a decent, modest, experienced public servant who believed in the institutions of government, who restored faith in government, who had a plan to bind the nation’s wounds and restored normalcy and competence.
Personally, I don’t think we’re at a Bonhoeffer moment or a Benedict moment. I think we’re approaching a Ford moment. If the first three weeks are any guide, this administration will not sustain itself for a full term. We’ll need a Ford, or rather a generation of Fords to restore effective governance…
… and “we” will find them, never doubt, among the comers at the Heritage Institute, the young sprigs of the National Review, and whichever statehouse seatwarmers the Kochs and Mercers decide are ready for a bigger platform.
Gerald Ford's pardon of Nixon not only gave Trump his presumption of impunity but allowed Trump's particular cronies to stay in politics. pic.twitter.com/UqhAwvD18x
— Tom Scocca (@tomscocca) February 14, 2017
Oh, Yay, We’re Gonna Relitigate Watergate NowPost + Comments (53)
Open Thread: Trumpstuntin’ Status, Moving From SNAFU to FUBAR
The day is beginning with people adjudicating which untruths are acceptable and which aren't from White House. Slippery slope.
— Maggie Haberman (@maggieNYT) February 15, 2017
TRUMP: Flynn has been treated badly by the "fake media" and leaks to media are a "criminal act" and a cover-up for Hillary's "terrible loss" pic.twitter.com/mbBPw31Eg1
— Bradd Jaffy (@BraddJaffy) February 15, 2017
Can you stand by someone you just fired? https://t.co/myIJMZ4Ohh
— Sara Murray (@SaraMurray) February 15, 2017
The FBI does not believe Michael Flynn will face legal jeopardy, sources tell @PeteWilliamsNBC https://t.co/EFCX1875Wc pic.twitter.com/74BMFmoCkY
— Bradd Jaffy (@BraddJaffy) February 15, 2017
Sunday: Flynn staying
Monday: Flynn gone
Tuesday: Flynn bad
Wednesday: Flynn good
Thursday: Who Flynn?
Friday: Flynn named to replace Flynn— James Poniewozik (@poniewozik) February 15, 2017
The #Flynnghazi story says less about Flynn than it does about Trump, who chose Flynn despite the warning signs. https://t.co/1eRv3uQjnS
— Keith Boykin (@keithboykin) February 15, 2017
Got to wonder what's in them. Enough dirt to flip the Senate perhaps?
— Schooley (@Rschooley) February 15, 2017
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Meanwhile, in another part of the galaxy…
Siren: Sounds like the Trump administration just put our NATO allies “on notice,” if you will https://t.co/HynpgbUL1j pic.twitter.com/DB2PigmQ0p
— Bradd Jaffy (@BraddJaffy) February 15, 2017
Open Thread: Trumpstuntin’ Status, Moving From SNAFU to FUBARPost + Comments (114)
I Don’t Even Know What to Fucking Say Anymore
These fucking people:
House Oversight Committee Chairman Rep. Jason Chaffetz told Fox News’ “The First 100 Days” Wednesday night that he would ask the Justice Department’s inspector general to investigate leaks of classified information that led to the resignation of former national security adviser Michael Flynn.
The Utah Republican told host Martha MacCallum that “no matter where you are on the political spectrum, you cannot have classified information migrating out into a non-classified setting.”
Chaffetz’s letter to Inspector General Michael Horowitz, which was also signed by House Judiciary Committee Chairman Bob Goodlatte, R-Va., described “serious concerns about the potential inadequate protection of classified information” and requested “that your office begin an immediate investigation into whether classified information was mishandled” in the Flynn case.
Flynn resigned Monday night after a series of media reports purportedly detailed his conversations with the Russian ambassador to the U.S. about sanctions levied against Moscow by the Obama administration. The reports indicated Flynn had given Vice President Mike Pence “incomplete information” about the calls, leading Pence to deny discussion of sanctions took place.
Earlier this week, Chaffetz sent a letter to the White House questioning security protocols at President Trump’s Mar-a-Lago resort in Florida after the president and Japanese Prime Minister Shinzo Abe discussed North Korea’s recent ballistic missile test in a public setting.
jesus christ
I Don’t Even Know What to Fucking Say AnymorePost + Comments (186)