BUCKNACKT'S SORDID TAWDRY BLOG
We should not be a journey to the grave with the intention of arriving safely in an attractive & well preserved body, but rather to skid in sideways, chocolate, bier or wein in hand, body thoroughly used up, totally worn out and screaming "WHOO-HOO, WHAT A RIDE!!!!!!"
verse of the day
You will know the truth, and the truth will make you free.
- John 8:32
voice of the day
You shall know the truth, and the truth shall make you odd.
-Flannery O'Connor
prayer of the day
Lord, may your truth make us both free and odd in a world that breeds bondage and demands conformity. Amen.
OBAMACARE. The very mention of the ACA / Affordable Care Act can set repiglicans and tea-baggers off on a foaming at the mouth, spit flying rampage. While that is all some of their supporters need to justify their voluntary ignorance and racist hatred, others need lies, deception and manipulation to make their voluntary ignorance and racist hatred more acceptable to themselves and those like them. Here are two examples of the continuing lies, manipulation, deception and fear started by greedy fascist pig koch brother's american action forum being spread on the internet by anonymous cowards and the blatantly fascist, racist and hateful karl rove's & ed (lost the VA Senate race) gillespie's american crossroads organization. From +PolitiFact .....
As a result of Obamacare, "California seniors face benefit cuts of over $1,700."
By Lauren Carroll on Friday, October 31st, 2014 at 9:30 a.m.
A recent American Crossroads ad attacks Rep. Ami Bera, D-Calif., for supporting Obamacare.
Even though Rep. Ami Bera, D-Calif., wasn’t in office when
Obamacare passed, a pro-Republican ad in California’s seventh
congressional district is using the law to attack him.
Bera is running against Republican Doug Ose for a second term, and
it’s a tight race. Less than six months into his first term, Bera voted against
repealing the Affordable Care Act, and American Crossroads, Karl Rove’s
conservative political action committee, used this fact to appeal to
California seniors in a recent ad.
"Bera voted to keep Obamacare, which cut $716 billion from Medicare,
slashing Medicare Advantage," the ad’s narrator says. "Now California
seniors face benefit cuts of over $1,700."
Many times, we’ve rated the claim that there are $716 billion in Medicare cuts as Half True. But we hadn’t heard claims about specific benefit cuts by state before, so we decided to check it out.
We found that the claim that California seniors will see $1,700 in
benefit cuts as a result of the Affordable Care Act is misleading. The
statistic comes from a report that ignores critical context and evidence
that the law has expanded Medicare’s benefits packages. Advantages
We should first note that the statistic comes from an April 2014 report by the American Action Forum,
and they have a stake in the election. The American Action Forum is an
arm of the American Action Network, which is a conservative political
nonprofit with financial ties to the Koch brothers. According to the Center for Responsive Politics, the group shares office space with American Crossroads -- the group that produced the very ad we’re checking.
Now to the claim. The ad makes it sound like all California
seniors will face cuts to this degree. However, the report only
addresses Medicare Advantage. About one-third of seniors use Medicare
Advantage, which is a private coverage option.
Medicare Advantage plans are required to provide at minimum the same
array of benefits as traditional Medicare. Many Advantage plans offer
extra benefits -- things like gym memberships, vision exams or generous
cost-sharing -- that have contributed to escalating program costs.
The creators of Medicare Advantage thought that letting seniors
choose plans from private insurance providers would be more
cost-effective than traditional Medicare. But Advantage has turned out
to be more expensive. Medicare paid insurers about 114 percent more for
Advantage plans than for traditional plans, as of 2009 before enactment of the federal health care law.
The law attempted to close that gap in part by gradually reducing how
much Medicare pays Advantage plan providers. It was estimated that its
changes would slow down spending
on Medicare by about $716 billion over 10 years, and Medicare Advantage
cost-saving measures accounted for about one-third of that. (Though the
Obama administration has reversed these cuts for the past two years -- facing pressure from insurance providers, Republicans and some Democrats, including Bera.)
Critics argue that the cuts will force insurance providers to reduce
the benefits they offer to Medicare Advantage enrollees. However,
Medicare Advantage plans are still required to offer, at minimum, the
same level of benefits as traditional plans. And Obamacare includes language protecting that set of guaranteed benefits from shrinking.
In fact, the law expanded Medicare’s required benefits to include
certain preventative services, annual visits, closing a gap in
prescription coverage and more.
Additionally, the law rewards Medicare Advantage providers
with financial bonuses to encourage quality and cost-efficiency.
Providers are required to use the bonuses to offer extra benefits,
attracting more enrollees. Nearly all Medicare Advantage plan providers received these bonuses in 2012, according to the Kaiser Family Foundation. A matter of speculation
It’s possible that Medicare Advantage providers could respond to
their pay cut by reducing benefits, but the only benefits they could cut
would be those extra benefits that go beyond Medicare plan
requirements.
"It's not automatic and won't affect every (Advantage) enrollee or
any of the (traditional Medicare) enrollees," said Dylan Roby, an expert
in health economics at the University of California Los Angeles Center
for Health Policy Research.
Insurance providers could also respond to lower payments by offering
the same benefits while operating more efficiently. They could cut
administrative costs, adjust cost-sharing plans, take in less profit or
drop out of the market altogether.
But, according to the Kaiser Family Foundation, the Department of Health and Human Services
and more, insurance providers’ response to the cuts has been less
dramatic than was expected when Obama signed the legislation in 2010. In
fact, Medicare Advantage enrollment is at an all-time high, and the
percentage of plans with four or more stars in the program’s five-star
rating system is increasing.
"When Congress debated the payment reductions in 2010, forecasters
and analysts also projected that reductions would drive insurers to
raise premiums, cut extra benefits and even pull out of the Medicare
Advantage market," Kaiser experts wrote in May. "Thus far, however, the
response by insurers to the (Affordable Care Act) cuts has been more
muted."
Health and Human Services reported in fall 2013
that "The average number of plan choices will remain about the same in
2014 and access to supplemental benefits remains stable. Since passage
of the Affordable Care Act, average MA premiums are down by 9.8
percent."
Experts also told us that they haven’t seen evidence of reduced Medicare Advantage cuts.
"The evidence is that plan participation has been stable, premiums
have been stable or even a little bit lower, and there are no overall
changes in the benefits provided," said Jack Hoadley, a research
professor at Georgetown University and a member of the nonpartisan Medicare Payment Advisory Commission.
"In my view, the claims in this advertisement are misleading,"
Hoadley added. "Seniors have not faced benefit cuts in Medicare
Advantage, even though the plans (and providers) have to manage with
somewhat lower payments."
So how did the American Action forum report come up with their estimated benefit cut figures?
The American Action Forum report breaks down the reduction in
Medicare payments to Advantage plan providers by state and county. It
says, compared to pre-Obamacare, Medicare Advantage benefits in
California are down $1,718 per beneficiary.
We asked several experts to take a look at the report, and they told
us that it is misleading because it assumes that Obamacare’s spending
reductions directly results in reduced benefits.
Yes, Obamacare reduces Medicare’s spending per Advantage beneficiary,
but this does not necessarily mean fewer benefits for seniors with
Advantage plans. Like we said before, there are multiple ways that an
insurance provider can deal with the spending cuts other than slimming
down its offerings.
"To immediately treat it as a cut to benefits is an exaggeration,"
said Judith Feder, a professor of health policy at Georgetown
University. Our ruling
American Crossroads said that as a result of Obamacare, "California seniors face benefit cuts of over $1,700."
First of all, this claim is misleading because it makes it seem like
all seniors will face these cuts, when the statistic actually refers to
Medicare Advantage enrollees -- only about one-third of seniors.
The statistic comes from a report that assumes all reductions in
Medicare Advantage spending results in fewer benefits for enrollees.
While insurance providers feel the cuts, there are multiple ways for
them to respond other than reducing benefits, such as trimming
administrative costs. We heard from multiple experts and researchers who
said Medicare Advantage benefits have remained stable.
The ad also leaves out the fact that the federal health care law
expanded Medicare’s minimum required benefits and established incentives
for Advantage plans to provide extra benefits.
It’s possible that some Medicare Advantage enrollees could see their
benefits shrink, but this ad blows that possibility out of proportion
and ignores important context. We rate this claim False.
By Steve Contorno on Thursday, November 6th, 2014 at 4:11 p.m.
A chain email
claims more than 200,000 doctors aren't accepting patients with coverage
bought on Affordable Care Act marketplaces.
Are doctors en masse refusing patients who gained health care coverage due to the Affordable Care Act?
That’s the claim in a chain email a reader asked us to check. "More,
truly scary Obamacare news," said the email, sent just before Halloween.
The accompanying story was from CNSnews.com, a site operated by the conservative Media Research Center.
"Over 214,000 Doctors Opt Out of Obamacare Exchanges," read a headline on CNSnews.com.
We found the source of the claim. It was coming from American Action
Forum, a self-described "center-right policy institute." The
organization put out an analysis on Oct. 27 titled: "Health Care
Providers are Opting-Out of Obamacare Exchange Plans."
How many? According to the post, "as many as 214,524 American
physicians will not be participating in any (Affordable Care Act)
exchange products." It went on to list some reasons "doctors are opting
out of the exchange plans."
That’s a lot of doctors. Have that many decided to turn away patients with insurance purchased on the marketplaces?
Let’s take a look. Can doctors opt out of Obamacare exchanges?
The Affordable Care Act requires essentially everyone to have
insurance. To make it easier for people to buy insurance, the government
created federal and state insurance marketplaces, sometimes called
exchanges. The biggest one is HealthCare.gov, but some states elected to operate their own as well.
These marketplace policies are private plans sold by insurance
companies. In some states, just one or two companies are providing
plans; in others, it’s many. Consumers typically have dozens of choices
ranging from bronze policies, which pay 60 percent of health costs on
average, to platinum, which pay 90 percent of costs. (For comparison, a typical employer-based plan covers about 80 percent of costs.)
Can doctors choose not to participate in the networks of policies
purchased on exchanges? Sure. While some states require doctors to
accept any plan for an insurance provider they do business with, in most
cases insurance companies are constantly negotiating with physiciansand hospitals to determine which policy networks they will participate in, experts and industry officials told us.
Some doctors might decide they don’t want to be in the network of
plans purchased on federal or state marketplaces. In other instances,
insurance providers might choose not to include certain doctors or
health groups in policies they created for the marketplaces.
It’s a two-way street, and marketplace policies are just the latest
twist to a contracting process that has always existed between doctors
and insurance companies. 200,000 doctors?
We asked American Action Forum to explain their analysis to us. The
organization based its findings on an April survey from the Medical
Group Management Association, a trade organization for physician groups.
"The survey found that 23.5 percent of doctors said they would not
participate in (Affordable Care Act) exchange plans," said Marisol
Garibay, spokeswoman for American Action Forum.
That percentage was multiplied by the total number of professional
active physicians, which Kaiser Family Foundation estimates is 893,851.
That equals 210,054 doctors, close to the American Action Forum number.
Garibay called it an "upper bound" estimate.
But when we looked at the survey ourselves, we found this to be a pretty dubious figure.
Here’s the rub, from the research: "The survey includes responses
from more than 700 medical groups in which more than 40,000 physicians
practice nationwide."
While there’s a lot of interesting information gleaned from this
survey, the results cannot be extrapolated to represent all the doctors
in the country. Why not? Because the Medical Group Management
Association only represents doctors who are part of medical groups. This
does not include physicians who run independent practices, for example,
and there’s no reason that a poll of 700 medical groups is
representative of all 900,000 physicians in the country.
"That’s a significant difference," said Anders Gilberg, a senior vice
president of government affairs for Medical Group Management
Association. "I wouldn’t generally suggest using it as a proxy for all
physicians."
Let’s put that aside for a second and dig further. The survey found
that as of April, 76.5 percent of respondents were accepting health
insurance sold on a state or federal marketplace.
Of those not participating in marketplace policies, 42 percent said
it was because insurance companies in their area didn’t ask them to
participate in the networks of plans sold on marketplaces.
Meaning, even if this limited survey could be extrapolated to
represent all doctors, not all of them are "opting out" of Obamacare.
Many — almost half — weren’t asked to participate in ACA marketplace
policies.
Why weren’t they asked? One reason is that the insurance companies
want to limit which doctors will serve their customers by creating
narrow networks.Narrow networks are a way for insurance providers to keep costs lower for insurers.
How? If you create a narrow network, it guarantees a doctor will get a
bigger share of your patients, and a doctor would be willing to accept
lower reimbursement rates in exchange for more business.
Narrow networks are also more common on the exchanges because
consumers can pick the plan with the doctors that fit their needs, said
Paul Ginsburg, a professor of the practice of health policy and
management at University of Southern California.
"Employer plans tend to have a broad network because they’re trying
to satisfy everyone (at the company)," Ginsburg said. "On an exchange,
you don’t have to satisfy everyone with one policy, you can offer many,
so you can have narrower plans."
There are plenty of broad plans on the exchanges, they just tend to
be more expensive. According to a May survey of individuals likely to
use the marketplace, 54 percent said they would accept more limited
networks to get a cheaper sticker price. As it is, 85 percent of plans
bought on federal and state marketplaces were the less expensive bronze
or silver plans, according to the Department of Health and Human
Services.
To be sure, it appears some doctors want nothing to do with these cheaper marketplace plans or the customers who buy them.
Among other things, doctors worry that many of the plans on the
marketplace, particularly bronze and silver plans, have high
deductibles. Some patients won’t be able to meet their obligations for
cost-sharing, potentially forcing physicians to eat those costs or shake
down customers.
These are legitimate concerns, and there is reason to believe that
some doctors are choosing not to contract with marketplace insurance
plans. But there is no evidence to suggest the number is anywhere near
214,000. Our ruling
A chain email claimed that more than 214,000 American doctors are
"opting-out of Obamacare exchange plans." That is based on a survey of a
select group of doctors and even the makers of the survey said it can’t
be extrapolated for the entire country. Further, of the doctors
responding to the survey, 42 percent said they weren’t participating in
marketplace plans because they were never asked to, not because they
were "opting out."
The estimate is the result of a flawed methodology and a misreading of survey data. We rate the claim False.
Dark money, shadowy groups, and secret millionaires.
One result of the 2010 campaign is clear before any ballots are counted: Democracy is in danger.
That sounds hyperbolic. But whatever remains of the quaint notion—call it a myth—that in a democracy citizens are more or less equal is in the process of being shredded, due to the rise this year of super PACs and secretive political nonprofits. Thanks to the Supreme Court's notorious Citizens United decision and other rulings, a small number of well-heeled individuals (or corporations or unions) can now amass a tremendous amount of political influence by throwing an unlimited amount of money into efforts to elect their preferred candidates. And certain political nonprofits, such as Crossroads GPS—the outfit set up this year by GOP strategists Karl Rove and Ed Gillespie (which with an affiliated group is spending about $50 million)—can pour tens of millions of dollars into the elections without revealing the source of their campaign cash.
The secret and unlimited flow of dollars into congressional campaigns this year is largely unprecedented—at least since campaign finance reform was implemented following Watergate in the 1970s. Almost half a trillion dollars have been spent so far by outside groups—with about one-quarter of that coming from dark-money groups that don't disclose donors. And it's not just a Republican phenomenon. Unions and Democratic-leaning advocacy outfits are playing the game. Still, the advantage goes to the GOP. Of the outside groups not connected to either political party, those supporting Republicans and opposing Democrats have so far spent $119.2 million, and those supporting Democrats and opposing Republicans have dumped $73.8 million into races. This split is dramatic, but there's another factor to consider: Much of the pro-Democratic money comes from large membership groups (including the SEIU and the National Education Association), yet much of the pro-Republican money originates from a small number of millionaires (or billionaires). Consequently, fat cats have gained even more disproportionate influence.
The White House has complained about the rise of super PACs and the spread of secret money, though it miscalculated by focusing on the possible flow of foreign money into these endeavors—blasting the Chamber of Commerce's pro-Republican efforts—when the issue is the overall boost in special interest money. And here's the kicker: The 2010 campaign is merely a warmup for 2012 and campaigns after that.
It doesn't take a New York Timesarticle—such as the one headlined "Conservative Donor Groups Lay a Base for 2012 Elections"—to predict what's coming. The permanent, neverending campaign will become even more permanent and neverending. These big-and-secret-money groups will be working 24/7, opposing and discrediting President Barack Obama and the Democrats in the so-called off-year and then revving up for the 2012 presidential and congressional elections. The negative ads never have to stop. ("President Obama and Representative [fill in the name of a local House Democrat] are trying to ruin this nation's future with their reckless and risky schemes to [expand government spending/raise taxes/provide amnesty to illegal immigrants/impose socialized medicine on American families].") Surely, Rove and others can find enough right-wing millionaires to underwrite a constant blitzkrieg against Obama and the Democrats.
The argument for this is an obvious one: It will soften up the Dems for the final kill in 2012. Rep. Tom Perriello, the incumbent House Democrat freshman in Virginia's 5th Congressional District, has faced such a daunting reelection this year partly because outside conservative and corporate groups started running ads against him soon after he took office in January 2009. Perriello stood out as a target, given that he won by a measly 727 votes in a GOP-friendly district. But if enough money is bagged, Rove and his comrades will be able to target not just out-on-a-limb Democrats but a host of House and Senate Democrats year-round. Local television station owners, your payday has come. Secret money will flow before, during, and after elections.
Campaign finance reform advocates are in total despair. For decades, they have tried to lessen the impact of special interest money on the political system. (The House Democrats passed Obama-backed legislation earlier this year to force disclosure of contributors, but the bill stalled in the GOP-obstructed Senate.) Now the dam seems gone, blown up, in rubble. Moreover, the Federal Election Commission, which is responsible for enforcing the campaign finance rules that still exist, is in shambles. And the Internal Revenue Service has not yet demonstrated an ability or willingness to go after the political nonprofits under its jurisdiction, which may be violating IRS rules that supposedly limit their campaign-related activities. (And how bad would it be for any of these groups to be slapped with an IRS fine after succeeding in changing the political landscape?)
All this places Obama in a jam. Does he continue to decry the rise of super PACs and secret-donor nonprofits? Or does he encourage Democrats to fight big-secret money with big-secret money of their own? In the past, the Democrats have had success marshaling such resources. (See George Soros.) But can Obama do both—assail the new campaign finance order and explain that Democrats have no choice but to play by these anti-democratic rules? Mixed messages tend not to resonate well with voters. If Obama signals Democrats that he'd like them to unleash their own big-money hounds, he will likely find it tough to score political points by opposing the GOP's big-money efforts. Then again, can racking up debate points help Obama and his Democrats stand up to a tsunami of campaign cash? It's a dilemma.
The election news tomorrow night and in the days ahead will naturally focus on who won and who lost and the subsequent shift in the balance of power in Washington. But this campaign season has brought about a profound and fundamental shift in systemic, money-based political power. And it's far from done.
David Corn is Mother Jones' Washington bureau chief. For more of his stories, click here. He's also on Twitter and Facebook. Get David Corn's RSS feed.
Ratcheting up the debate over the influence of outside groups in congressional elections, the Democratic National Committee has made a major ad purchase pushing the case that the November elections could very well be "stolen" by foreign influences.
The committee is airing a spot on national cable this coming week that turns an already harsh spotlight on the roles being played by former Bush strategists Karl Rove and Ed Gillespie in addition to the Chamber of Commerce. Pivoting off reports that the business lobby has used foreign donations for its campaign activities, the spot ends with fairly conspicuous if not ominous shot of Chinese currency being stacked up -- ostensibly for use against Democratic candidates.
"Karl Rove, Ed Gillespie: They're Bush cronies. The US Chamber of Commerce: They're shills for big business," the ad goes. "And they're stealing our democracy. Spending Millions from secret donors to elect Republicans to do their bidding in Congress. It appears they're even taking secret foreign money to influence our elections. It's incredible, Republicans benefiting from secret foreign money. Tell the Bush Crowd and the Chamber of Commerce - stop stealing our democracy."
The spot, timed to preempt Rove and Gillespie's appearances on the Sunday talk show circuit, echoes what has quickly and clearly become the closing argument Democrats (from the White House on down) are making as the election nears. But it comes at a time of conflicting reports over the veracity of the charges. On Saturday the New York Timespublished a story questioning a basis of the report uncovering the Chamber's foreign pools of cash. Specifically, the story quoted White House counsel Bob Bauer acknowledging that there was no specific evidence that the Chamber had crossed legal lines by using foreign money for its electioneering.
"The DNC ad is rubbish," said Tom Collamore, senior vice president of Communications and Strategy for the U.S. Chamber. "The U.S. Chamber will continue to discuss ways to create jobs and grow the economy no matter how often others may try to change the conversation. We've been working for growth, jobs, and opportunity for 100 years and we won't be deterred now."
The Center for American Progress, which runs the Think Progress site that published the original report, has responded to critics by noting that the fundamental question at the heart of the debate had still not been answered: "How many foreign sources of funding does the Chamber have?" A spokesman for the DNC, likewise, pointed to a lack of transparency and disclosure on the part of the Chamber as the basis for the ad.
Story continues below
"They all can, of course, clear all this up by releasing their donors," said DNC Communications Director Brad Woodhouse. "We just think that it is vital that the American people know that this election is on the verge of being stolen by secret donors, anonymous special interests, and possibly foreign corporations. And these folks aren't lurking in the shadows refusing to reveal themselves and their intentions and interests because they have the greater good in mind. It's because they want to get their fingers back in the till and exert the influence they had when Republicans were last in charge."
Ratcheting up the debate over the influence of outside groups in congressional elections, the Democratic National Committee has made a major ad purchase pushing the case that the November elections co...
Ratcheting up the debate over the influence of outside groups in congressional elections, the Democratic National Committee has made a major ad purchase pushing the case that the November elections co...
In yet another example of its willingness to throw punches inside the Democratic tent, MoveOn.org has decided to target Democratic candidates who are being aided...
Wisconsin Democratic congressional candidate Julie Lassa is calling on her opponent to denounce a new attack ad by the U.S. Chamber of Commerce that displays...
Tomorrow, the U.S. Chamber of Commerce plans to hold a reception for the Bahrain Banks Association, a trade group for banks operating in the Kingdom...
Pressure has been mounting on the U.S. Chamber of Commerce since a ThinkProgress investigation published Tuesday revealed that the right-wing business group may be using...
