GUEST POST: Obamacare Poster Child

Las Animas County is Obamacare’s poster child. Obamacare purported to be about selling subsidized insurance through health exchanges. For all that hoopla, here’s the Colorado reality. Most growth of government-supported health care hasn’t been through private exchange coverage. Radical increases of the Medicaid numbers – right at one million total in our state – did happen.

Las Animas County had 2,128 on Medicaid in January. [h/t Steve Block, Trinidad Chronicle-News]. County DHS director Catherine Salazar also reported “other counties in Colorado were seeing similar increases in Medicaid caseload.”

Of Las Animas County’s 14,446 population, 4,344 (30% of the population) are on Medicaid. Medicare covers another 20% (minus some overlap). The state’s Obamacare exchange signed up a paltry 201 people in Las Animas County – fewer than its kids on CHP+ (239).

Las Animas County saw, on average, every single Medicaid patient at the ER once. Is this a rational way to provide care?

There are 25 beds in Mount San Rafael, the county’s only hospital. Voters last year rejected a tax increase for the hospital’s ER facility and other services.

Here’s the spooky thing about this Medicaid increase.

On average, of five Coloradans with ordinary insurance, one hits the ER. Ditto if there’s no insurance.  ER use more than doubles (44%) for Medicaid-covered Coloradans. (Probably because an ER visit is free under Medicaid, rather than requiring a hefty copay.)

I roughly estimate Colorado ER facilities will see an extra 100,000 visits. That’s FY 2015 compared to 2010 due to Medicaid expansion. Add in our 8.5% population growth.

Can Colorado’s emergency rooms handle this massive traffic boost? Where do needed docs and nurses come from?

When you take your child to the ER for a critical health need, how stressed will facilities’ caregivers be? Even assuming your child gets evaluated immediately? Our ER wait times are below the national average, but it’s still 244 minutes (2014 Report Card). That wait time will not shrink.

I promise you that it’s not just Mount San Rafael facing inundation. Nor only Las Animas County voters looking at higher taxes. Or seeing revenues diverted from schools and roads to healthcare needs.

Similar new burdens will hit physicians’ practices. Medicaid patients are just two-thirds as likely to get an appointment as a person with private coverage. And that helps explain their high Medicaid ER usage.

How do caregivers survive financially when they aren’t adequately paid? For most medical service categories – whether in the ER or physicians’ offices – JBC staff found “average reimbursement rates that were less than 80 percent of the Medicare rates.” (HCPF staff believes “the volume of Medicaid clients in Colorado is not great enough to significantly affect” at least some care decisions. Is that true even with a million on Medicaid?)

The feds paying most direct Medicaid enrollee costs for a few years doesn’t begin to cover this tidal wave.

POST SCRIPT

Of course, some of the Medicaid wave is about money (that we don’t have). But it is also about the overloaded admissions clerk after midnight. It’s about the nurse who scrambles to manage care and patients’ prescriptions. It’s about the hospital budget folks balancing different prices for exactly the same care, depending on who’s paying. Even a nonprofit hospital can go broke.

Ordinary Coloradans – who won’t have access to care – will be the truest losers in this destructive surge of “free” care.

 

GUEST POST: Much Opportunity in Little Love for Obamacare

Two things stick out in the most recent PPP poll in Colorado:

  • The Peak has already pointed out Udall’s weak Hispanic numbers.  Udall’s weaknesses also show among Independents and those under 46.
  • Women, Independents and those under 46 aren’t tuned in to this election yet. That’s based on their high “not sure” responses to questions about Republicans’ favorability ratings.

Knowing enough to rate Republicans ends up boosting support of both Republicans and Udall. Greater support for them comes from fewer “not sure” responses.

For John Hickenlooper, knowledgeable voters aren’t a blessing. They know Hickenlooper supports tax hikes and the Democrats’ liberal agenda. Knowing Hickenlooper’s liberal record depresses his support, especially among those over 45.

Poll questions about Obamacare suggest one issue may cut deep into Hickenlooper’s support. Link increased state government cost and higher taxes to the Obamacare Medicaid expansion. Given TABOR, more dollars spent on Medicaid must mean fewer dollars for education, our colleges and our roads. Coloradans will not like this. Exclude Obama-clinging Democrats and only 20% of other Coloradans approve of Obamacare.

The poll identifies one group who aren’t tied to one party. It’s those who didn’t admit they voted either for Obama OR Romney in 2012. These people are:

  • 15% more likely to disapprove of Obama than approve of his job performance; 
  • 27% more likely to disapprove of Udall’s job performance than approve of it and 
  • 30% more likely to disapprove of Obamacare than approve of it.

This group – as they learn more about the candidates – appear ready to join the Republican side. We can reasonably wager that the bulk of truly independent voters share these levels of disapproval.

The Obamacare disaster creates a strong turnout message for conservatives. Democrats seem to think that boosting their turnout requires continued advances in liberalism. We should tell our voters about their extreme left (and harmful) notions so our side’s turnout grows even more. Turnout depends, after all, on two things: effort and messages like these. For the first time since 2002 we have winning messages.

Using both issues and effort, conservatives can put a double whammy on the Democrats.

 

GUEST POST: Medicaid Explosion

This week’s Long Bill Narrative contains some striking news about Medicaid in Colorado.

  • More than one Million Coloradans will be on Medicaid (of 5.5 Million residents)
  • 9.5% of those 65 & up* will get Medicaid in 2015.
  • 19.7% of those under 65 will get Medicaid in 2015

Looking back in time:

  • Both categories of recipients were stable in numbers from 2006 through 2008.
  • From 2009 through 2013, elderly recipient growth averaged under 1,000 people per year.
  • In those same years, non-elderly recipient growth averaged a bit more than 56,000 annually.
  • With 2014, growth of recipients ballooned in both groups. Up almost 150,000 annually for non-elderly, up almost 14,000 for elderly.

In the ten years (’06 to ’15) while Colorado’s non-elderly population will have grown 11%, Medicaid recipients of these ages will have ballooned 157%.

By any measure this is a radical increase … with a substantial chunk who are neither kids nor elderly.

____________________________________________________

* Most seniors have Medicare. Seniors who also get Medicaid are usually both poor and suffer serious medical conditions.

Sources: In addition to this year’s Long Bill narrative, I consulted Appropriations Reports beginning with 2009-2010 and the State Demographer’s website.

 

GUEST POST: Five Easy Lessons for CO from San Diego Mayoral Run-Off

Echoes of Colorado’s recent elections sounded in last Tuesday’s San Diego mayoralty run-off election where the Republican won handily. Some lessons emerge.

1. Republicans can win despite Democratic registration advantages. San Diego is 26% Republican to 40% Democrat. Pueblo’s Sen. George Rivera proved the same point last September, winning the recall in a district that was 47% Democrat to 23% Republican.

2. Used here in Colorado, the “Obama election model – flood the zone with negative attack ads and excite the base of the Democratic party – flopped” in San Diego. Just 6% of Obama’s TV ads in 2012 were positivecontinue…

 

GUEST POST: Senators Spilled the Beans, Don’t Understand How Legislation Works

Nineteen Democratic U.S .Senators butted into offered their opinions about the U.S. Supreme Court Hobby Lobby case, “explaining” two laws they backed. The first is the Religious Freedom Restoration Act (1993), and the second is Obama’s misleadingly named “Affordable Care Act.”

Here are a couple of major points from the Democrats’ 36-page brief (quoting):

  • Congress could not have anticipated RFRA’s application to…
  • Congress did not understand the Affordable Care Act…

Are we having fun yet?

Congress doesn’t understand how its laws will apply … frequently. Remember their stimulus bill of 2009, when they “estimated that the American Recovery and Reinvestment Act will create and maintain over 4 million jobs”? Needless to say, that didn’t happen.

A few months later, Mark Udall – porkmeister – touted some of those four-fifths of a trillion bucks coming to Jeffco’s West Line’s “new transportation solutions to help people get to work and home again,” as Udall explained. With the line open, reality set in. Here’s one time analysis: “Instead of a tedious drive of 18 minutes, using modern mass transit I was able to zip to work in only 1 hour and 19 minutes!”

That’s how stimulus dollars worked, but let’s move on.

Apparently, not a single Democrat understood the Affordable Care Act, more lovingly, Obamacare. Everyone remembers Nancy Pelosi’s statement that “we have to pass the bill so that you can find out what is in it….” She also said of it that it would “create 4 million jobs, about 400,000 jobs very soon.”

So, two important bills rammed through by Democrats would create 8 million jobs. Yeah. Sure. You betcha.

My advice to the justices? Don’t believe anything these Democrats say.

My advice to Colorado voters? Ditto.

 

GUEST POST: Jobs Kicked to the Curb

Let’s rate seven years of the “Hick & Ritter” economy. After 2006 Colorado Democrats have ruled the roost – jamming through higher taxes and fees, adding job-killing regulations, unable to jump start our state’s economy.

The data are out, and they look flatly bad for the Democrats.

Had we kept the Owens economy’s job-holding levels – there would be 244,000 more Coloradans with jobs than Hick & Ritter delivered. 

  • Men’s chances are down 7.5%; women are down 4.6%.
  • African-Americans are down 3%, Hispanics down 5.4% and whites down 5.9%.
  • Young people are down 9.9%, middle-aged down 3.3% and those retired or near are down only 1.2%.

The older crowd clings to their jobs, scared to death they won’t have enough money to retire! continue…

 

GUEST POST: Colorado’s 2013 Conservative Surge No Fluke

Colorado’s Republicans led Democrats by 3.8% in 2013 – which explains Democrats losses last year. That’s based on which party Coloradans supported or leaned toward last year. That’s quite a change from 2010 (Dems up by 2.2%) when Bennet squeaked by.

In off-year elections, voters begin their decision-making process by judging the incumbent President’s job performance. And, somehow, more voters opine about  job performance than will admit their party leanings, even after being pushed. This means that there are fewer wishy-washy folks than “true” Independents.

Things have gone DOWNHILL for Obama – even given his honeymoon high approval ratings early last year. As these ratings show:

2010 45.2% Approved;   46.9% Disapproved;   7.9% No Opinion

2013 42.3% Approved;   51.2% Disapproved;   6.5% No Opinion

In 2010, Coloradans’ job ratings of Obama predicted a squeaker election … & it was.

Assuming no change in Obama’s job approval, Republicans ought to win this year.

Let’s do a bit more digging here. For safety’s sake, let’s say that Colorado’s Republican candidates ought to shoot for 55% of the vote.

To meet that goal in 2010, Buck and Maes would have needed ALL of the anti-Obama vote PLUS 103% of the “no opinion” folks.

In 2014, Colorado Republicans need only 58% of the “no opinion” people. Not nearly such a tough goal.

And five states* with U.S. Senate seats currently held by Democrats have stronger anti-Obama opinions than we do in Colorado.  So strong that they don’t need a single “no opinion” vote to win with 55%, assuming all the “thumbs down on Obama” voters reject his U.S. Senate lackeys.

One final point: 2014 is a favorable year for Republican Senate pickups with many Democrats up for re-election. Republicans need six takeaways for a majority. That said, 2016 will be exactly the opposite, with many more Republicans under the gun. If national Republican and Tea Party leaders want a lasting conservative majority in the U.S. Senate, they must take away more than six seats this fall. To those five seats already likely to go Republican, Louisiana and Colorado must be added, plus a couple more.

                                                                                         

* All data are Gallup or calculations based on that. The five states this analysis suggests will go Republican are Alaska, Arkansas, Montana, South Dakota and West Virginia. Kentucky is a likely ‘keep’ for Republicans, and it will take work for Republicans to hold Georgia.

 

GUEST POST: Intel for 2014

Here’s the Colorado Democrats’ tip sheet … what they say they’ll run on.

#1. GUNS. Even Hickenlooper says restricting rights doesn’t always “make a difference at all” in preventing crazy violence. Yet, liberals think restricting rights is a winner; it’s also #6.

#2. More DEPENDENCY. In CD6, they offer government giveaways. Republicans will promote opportunity … since Democrats’ big spending hasn’t restored the American dream.

#3. STALE issues. Call Republican candidates “stale” so nobody notices the Democrats’ moldy mantra of liberal issues.

#4. DEMOCRATIC OVERREACH. Preserve 2013′s shark-jumping agenda to keep activist/liberal Democrats engaged. Liberals ignore that 52% of Coloradans (offering opinions) disapprove of Dems’ leadership now while 68% approved before. [here and here]

#5. FRACKING. With fewer than 40% opposed to fracking in Colorado, liberals plan a no-fracking ballot initiative to boost turnout. Republicans have the energy jobs card.

#7. IMPROPRIETIES. Character assassination is high on Dems’ list of campaign tactics. Republicans don’t need mud-slinging given Dems’ flops.

#8. TAXES (A66). With Hickenlooper leading Democrats to a two-to-one defeat on higher taxes, Republicans will promise to protect Coloradans’ pocketbooks.

#9. OUTSIDE CASH. Dems love Eastern liberal cash. Those fat cats, however, expect Westerners to toe the liberal line in everything and that emphasizes Hickenlooper’s Eastern wealthy background. Republicans better reflect Western values.

#10. SEX POLITICS. Democrats cherish this tactic, what with moving gay marriage from ballot box to courtroom. With original womens liberationists and the war on poverty (with its gender bent) both getting gray, Republicans can focus on sex crimes, trafficking and child abuse.

The real shocker is what’s missing on the Dems’ tip sheet.

Dems have no plans to fix our economy or help Coloradans who have given up – under the Democrats’ fumbling – on getting a decent job (instead of welfare checks). Republicans can say, “Your jobs programs grew the bureaucracy instead of growing job opportunities.”

[H/T to ColoradoPols for releasing Dems' lame list of campaign themes. Note that Hick's statements and purported positions are being ignored by Democratic planners.]

 

AMENDMENT 66 TURNOUT ANALYSIS

The massive failure of A66 is part of a larger story: Democrats’ 2013 failures to match Obama’s 2012 successes. Sean Trende of Real Clear Politics calls it the drop-off problem. If it persists Republicans will perform three to five percent better in 2014 than Romney did in 2012.

People who voted in 2012 were AWOL in 2013. Colorado matches that downward direction.

Magellan Strategies published detailed Colorado turnout statistics (here and here). The Secretary of State offers similar break-outs of registered voters. Magellan very kindly provided turnout by their previous three factors in every Colorado county matching official registration break-outs. I have previously noted that their September poll was remarkably close to the final outcomes for A66.

We can see what the turnout of registered voters was in both 2012 and 2013 in Colorado. What follows is a verbal analysis (no fancy statistics or tables of numbers). Any errors are mine, not the Secretary of State’s or Magellan’s. This turnout analysis does not compare actual voting behavior to the number of eligible citizens, but rather to the number of registered Coloradans.

The 2012 election turnout showed the power of the Democrats’ registration/identification/persuasion/get-out-the-vote operations. They use this four-part process as their path to victory.

2013 was a different year. continue…

 

Government by Gimmick Since Voters Can’t Understand Stuff

Democrats Skaggs and Feeley pulled no punches in their Denver Post 0p-ed.

State policymakers,” they admit, “resort to government by gimmick….”

Gimmicks? Like the Democrats’ “dirty dozen tax hikes” of 2010 that boosted taxes by a third of a billion dollars? (So much for the notion that TABOR prevents tax hikes. All it takes is a complaisant state Supreme Court.)

Skaggs and Feeley think voters won’t “understand proposed legislation as complicated as Amendment 66.

Let’s translate that from “Democratic politician-speak” to a different lingo: “Don’t worry your pretty little head about big bucks or big government.” It’s elected-Democrat chauvinist piggery, a direct scion of the 1970s male chauvinist pig. And just as wrong-headed and dismissive of others.

They are not alone.

Liberals at the Colorado Fiscal Institute emailed their thoughts about the A66 loss which, they say, “came despite a well-funded, well-run campaign. …[I]t is nearly impossible to pass a statewide tax increase.”

The loss was entirely predictable given American attitudes. September’s Heartland Monitor poll found “60 percent say that the best approach to making parenting more affordable is ‘lowering taxes’” compared to just 34% who prefer “increasing public spending” on education and other government programs.

Colorado’s Democrats have the money, all right.  What they lack is two things:

  • a compelling message that our state’s voters agree with and 
  • any evidence at all that they are willing to listen to the general public.
 
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