GUEST POST: Even the feds …

Published on July 7, 2014 by

… spotted problems with Colorado’s Obamacare health exchange.

The Inspector General’s audit report  doesn’t look good. The IG’s job: to see how well Obamacare “ensured the accuracy of information submitted by applicants for enrollment in qualified health plans and for advance payment of premium tax credits and cost sharing reductions.” Unverified information creates “inconsistencies.”

Colorado gets four mentions. The quotes: 

  • The Colorado, Minnesota, Oregon, and Nevada marketplaces did not provide data on inconsistencies.
  • Colorado reported that it relied on the Medicaid office to verify all applicant information through the first calendar quarter of 2014. As of March, the Colorado marketplace reported that it had assumed responsibility for resolving the inconsistencies.
  • Four State marketplaces could not provide data on inconsistencies (Colorado, Minnesota, Nevada, and Oregon).
  • Colorado and Minnesota reported that they rely on their State Medicaid offices to resolve inconsistencies and that they had limited access to State Medicaid data. [My boldings]

So.

Did Colorado insurance applications have eligibility-denying inconsistencies? Is that why nobody provided HHS with data about them? (Hide your mess under the bed so nobody sees it.)

Any verification failures aren’t chargeable to the glorious Connect for Health Colorado health exchange. Goodness no. (If mom discovers the mess under the bed, blame your sibling.) The exchange points the finger at Colorado’s Medicaid operation, saying they “relied” on them and only had “limited access” to the raw data. (They shoulda done it themselves, right?)

Consider the Medicaid data specialists – the people who the Colorado exchange hung out to dry. Colorado has added more Medicaid beneficiaries, proportionately, than almost any other state. These data mavens, bless them, have a tough job. They must track hundreds of thousands of new Medicaid enrollees, as directed by Governor Hickenlooper we assume.

If the feds can’t give Colorado a clean report, do we add this to the list of Hickenlooper’s flubs?

When given data by other states, the IG found verification rules weren’t followed. Which means failure to verify citizenship or residency or income, among other requirements.

We know that Colorado did not provide data on inconsistencies. We can’t prove Colorado is currently insuring ineligible persons. Nor that they gave out bogus subsidies. But failure to provide data to the Office of Inspector General is damning.

Hickenlooper must hope he’ll get past the election before the facts appear.

 

GUEST POST: Turnout Boosts Republicans

Republicans’ primary turnout averaged 167% of Democrats’ turnout. Possible good news for this fall’s Republican candidates.

Democrats pile into presidential general elections, but are often no-shows in other elections.

From 1998 through 2014 in Colorado, Republicans voted at a rate that was 152% of the Democrats’ turnout. Our Republicans vote more faithfully than Democrats.

2014′s Republican primary turnout advantage nearly matches 2002′s advantage. Here are the percentages.

Year    Sen       Gov         Avg
2014    156%    177%     167%
2010    120%    129%    124%
2006     n/a        136%    136%
2002    172%    192%    182%
1998    150%    148%    149%

2014 is looking like 2006 – with the parties’ status reversed. President Bush sported terrible job approval numbers in 2006, President Obama now drags down every Democrat.

2012 had low Republican primary turnout nationally. Respected political observers Prof. Michael McDonald and Curtis Gans thought low turnout proved Romney left Republican voters unexcited.  

Both Udall and Hickenlooper appear to be in trouble under this theory. Hickenlooper pulled 34% fewer Democratic votes than in 2010 – uncontested both years. Udall had no contest both years. He dropped almost 4,000 votes. United evidence many Democrats may yawn “why bother?”

BOTTOM LINE?

Hickenlooper barely beat Rollie Heath’s 2002 comparative excitement level among Colorado’s Democrats. Heath and Hickenlooper both supported gigantic tax hikes – a voter turnoff. That’s exciting news for both Cory Gardner and Bob Beauprez.

 

GUEST POST: Keg Stands and Cushy Jobs

Published on May 12, 2014 by

EDITOR’S NOTE: This is a guest post. It should be noted that it has yet to be proven that taxpayer dollars funded Brosurance ads.

For every Colorado Obamacare sign up, taxpayers paid $1,427.

The average national cost per sign up was $922. So we didn’t get much of a bargain.

So says former Missouri Insurance Commissioner Jay Angoff.  Angoff has testified about insurance issues in Colorado; he knows his stuff.

Total Colorado spending? Right at $179 million.

Those bucks paid for the Colorado “brosurance” keg stand ads. Remember them? Aimed at young adults … resulting in a bit more than 10,000 enrollments by those 18-25. Whoop-D for 8% presumably healthy young people to balance out the older, sicker sign ups. Not a statistical success.

Those bucks also paid for the sterling public and media relations efforts of Onsight Public Affairs. They got $537,000 from Democratic candidates and liberal issues campaigns (including payments directly to major employees).

Do I need to mention that Hickenlooper’s campaigns have paid Onsight money? They did. He did. No special favors here, though, right?

And Connect for Health Colorado chief Patty Fontneau. Who gave $2,470 in political contributions – including maxing out to John Hickenlooper. And who, when she writes a candidate check, it always goes to a Democrat.

Their media contact, Linda Kanamine, also contributed to Hickenlooper. [All political cash from Secretary of State website]

Isn’t it nice to know that there’s nothing partisan or political about Colorado’s healthcare sign up efforts? And that it’s not being used to warehouse Democratic operatives between campaigns?

At least they live up to the Democrats’ image of big-spenders of taxpayer money.

 

GUEST POST: Medicaid: Does It Work?

John Hickenlooper pushed to increase Colorado’s Medicaid coverage. Extravagant promises appeared.

Proponents promised greater Medicaid coverage would improve recipients’ health. It would even out health outcomes across society, some said.

In fourteen counties more than one-fourth of all county residents have now signed up for Medicaid. Suppose Medicaid worked well. These folks would be healthier than the rest of the state, right?

So, did having lots of people on Medicaid make people healthier?

ZERO BENEFIT

Nope. They’re almost 20% less healthy in total. Here’s how we know.

Colorado has a measure of healthiness called the “illness burden.” All Coloradans average an illness burden rating of 1. Some people are sicker (higher numbers). Some are healthier (lower numbers). Every Colorado county has an illness burden number. [Colorado All Payer Claims Database for 2012]

These counties’ residents have an average illness burden of 1.19. Only one county (Saguache) has a rating on the healthy side (less than 1.0). That’s with 31% of residents in these counties on Medicaid.

Dive down a bit. Only three counties’ Medicaid patients are healthier than the statewide Medicaid average. The more people on Medicaid, the worse the system seems to work for them. Democrats want to cram even more people into a creaking system. Swell.

Closing the gap? No joy there either. These counties’ privately insured are 3.4% less healthy than the statewide private coverage average. Those having Medicaid are 7.6% less healthy.

Medicaid works exactly opposite to Hickenlooper’s promises.

This is a big deal. Colorado will spend two billion extra dollars (over FY 2012) offering Medicaid to more people. For this pile of cash we ought to get more, shouldn’t we?

Sure, there may be other factors causing these counties to look sickly. But Colorado’s Medicaid failure echoes a formal study of Medicaid’s impact in Oregon.

Oregon had a lottery for Medicaid. Some Oregonians “won” Medicaid. Some missed out in the lottery. Winners’ Medicaid coverage “generated no significant improvement in measured physical health outcomes.”

Two billion bucks in Colorado for this? Add on the latest proposed $13 million fee you pay on unsubsidized private insurance. 

Set aside purported financial mumbo jumbo claims about Medicaid expansion. They rely on fairy gold deficit federal spending. Purported benefits vanish in the cold light of reality. Deficits must eventually be paid. [Gory details here.]

__

High Medicaid counties: Alamosa, Baca, Bent, Conejos, Costilla, Huerfano, Las Animas, Montezuma, Montrose, Otero, Prowers, Pueblo, Rio Grande, Saguache. Assumption: Current high Medicaid coverage replicates 2012 coverage.

 

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…

 
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