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States explore teaming up on Obamacare exchanges

Fri, 05/22/2015 - 10:58
Screenshot from HHS billboard marketing health insurance exchanges Running health insurance exchanges, states have found, is a complicated and expensive proposition. For a handful of states, that meant opting to use the federal Obamacare exchange, which is now threatened by the Supreme Court in the King v. Burwell case, the challenge that says Congress intended to only allow subsidies to go to people buying insurance on exchanges established by states. The prospect of losing those subsidies, as well as the fact that federal support to states to maintain the exchanges ends next year, is leading states to explore merging exchanges, a provision that is allowed under the law.
The idea is still only in the infancy stage. It’s unclear whether a California-Oregon or New York-Connecticut health exchange is on the horizon.

But a shared marketplace—an option buried in a little-known clause of the Affordable Care Act—has become an increasingly attractive option for states desperate to slash costs. If state exchanges are not financially self-sufficient by 2016, they will be forced to join the federal system, HealthCare.gov.

"What is happening is states are figuring out the money is running out," said Jim Wadleigh, the director of Connecticut’s exchange, hailed as one of the most successful in the country. "At the end of 2016, everyone has to be self sustaining." […]

"In the last seven business days, I've probably had seven to 10 states contact me about contingency plans," Wadleigh said, though he declined to disclose the names of states he's been talking to. "You can imagine the political backlash that would be if the names got out."

And, of course, King. Some states actually do care about the tens of thousands of their residents who could lose subsidies and believe merging with states that have their own is a viable solution, since they sure as hell can't count on a Republican Congress to come up with one. How far states can go in combining systems is the big question. States are still responsible for regulating health insurers operating within them, and many insurers don't operate across state lines, complicating any regulatory aspect that they have to deal with.

But they could share technology and things like call centers and navigators. States would still have to work out things like cost-sharing and divvying up administrative responsibilities. But it could be the best solution available barring congressional action.

Obama administration throws Rick Scott a temporary Medicaid bone

Fri, 05/22/2015 - 09:44
Governor Rick Scott speaking at CPAC FL in Orlando, Florida. September, 2011 The Obama administration has offered Florida Gov. Rick Scott a partial compromise in Scott's ongoing fight to get federal money for health care that's not Obamacare Medicaid expansion money. Scott has asked the administration to reverse its decision—made and communicated to the state a year ago—to end a demonstration program that funded a Low Income Pool, funds that went to hospitals providing charity care. The administration is coming part way.
On Thursday, it proposed cutting more than $1.6 billion over two years in funding for Medicaid's Low-Income Pool in Florida. The offer, made in a letter from the Centers for Medicare and Medicaid Services to state officials, signals public progress in the negotiations that have been ongoing for months in that there actually is something on paper.

The LIP program has been the linchpin of the administration's fight with the state over Obamacare. It would be getting cut whether the state expands Medicaid or not, but CMS reminded Florida yet again Thursday that expansion would help make up the revenue it's about to lose through LIP—about $2 billion annually, by some estimates—while covering hundreds of thousands of poorer residents.

"We believe that Medicaid expansion as evidenced by experience in other states would bring significant benefits to low income Floridians and the Florida health care system," the agency wrote.

That's a 55 percent cut to the LIP for next year, from $2.16 billion funding this year to $1 billion next year and then to $600 million the following year. From 2006-13 the state got $1 billion a year, then got the big bump up last year. CMS is clearly letting Florida know that they can't count on this money to bail them out in their next budget crisis. It's also a signal to other states, including Texas, whose LIP money will be up for renewal in the near future. This funding was never intended to be a permanent healthcare solution, especially so after Medicaid expansion passed with Obamacare.

What this means for Scott's bogus lawsuit against the administration isn't immediately clear, but House Speaker Steve Crisafulli told his caucus that he believes this funding could resolve the current budget crisis. The legislature reconvenes next month to try to come up with a budget and stave off the government shutdown Scott has been threatening.

Despite Republican attacks, Obama is 'very clear on the lessons of Iraq'

Fri, 05/22/2015 - 09:07
U.S. President Barack Obama (R), flanked by Secretary of State John Kerry, delivers remarks to reporters at the top of a cabinet meeting at the White House in Washington May 21, 2015.  REUTERS/Jonathan Ernst - RTX1E0KN The official Republican talking point on Iraq and the extremist group known as ISIS is that everything would be peachy if only President Obama had continued the policies of George W. Bush. Except not the policy where Bush negotiated a withdrawal timeline and Obama stuck with it. The policy where Bush would have ignored that plan and continued occupying Iraq if he darn well felt like it.

All of this, not just the part where Rick Santorum advocates "bomb[ing] them back to the 7th century," is ridiculous, yet Obama remained characteristically calm and polite in answering some of those claims in an interview with Jeffrey Toobin. "I’m very clear on the lessons of Iraq," Obama said. "I think it was a mistake for us to go in in the first place, despite the incredible efforts that were made by our men and women in uniform."

But, he argued, at some point Iraq has to find its own way:

I know that there are some in Republican quarters who have suggested that I’ve overlearned the mistake of Iraq, and that, in fact, just because the 2003 invasion did not go well doesn’t argue that we shouldn’t go back in. And one lesson that I think is important to draw from what happened is that if the Iraqis themselves are not willing or capable to arrive at the political accommodations necessary to govern, if they are not willing to fight for the security of their country, we cannot do that for them. We can be effective allies. [...]

But we can’t do it for them, and one of the central flaws I think of the decision back in 2003 was the sense that if we simply went in and deposed a dictator, or simply went in and cleared out the bad guys, that somehow peace and prosperity would automatically emerge, and that lesson we should have learned a long time ago. And so the really important question moving forward is: How do we find effective partners—not just in Iraq, but in Syria, and in Yemen, and in Libya—that we can work with, and how do we create the international coalition and atmosphere in which people across sectarian lines are willing to compromise and are willing to work together in order to provide the next generation a fighting chance for a better future?

Gee, rejecting permanent occupation, letting other countries govern themselves, trying to be an ally rather than a conqueror, and trying to build coalitions. How dare he have an answer that doesn't start with bombs and end with massive troop commitments?

Cartoon: Jeb Bush and Brotherly Love

Fri, 05/22/2015 - 08:50

Jeb Bush has performed a valuable service with his recent missteps and flubs, he’s reminded the world of the baggage he willingly carries. I’m not tarring him with the same brush as George W. Bush just because they are brothers. Jeb has voluntarily staffed his foreign policy team with 17 people from his brother’s administration. (This is out of a foreign policy team of 21, mind you.)

Sure, the dynasty thing is bad enough and it’s the same Bush family as before—but whether Jeb is a Bush or not, he deserves to be pilloried for putting people like Paul Wolfowitz in places where they might have an impact on, you know, foreign policy. (It boggles my mind Wolfowitz is actually showing his face in public, never mind appearing on cable news and advising another Bush.)  

Besides Wolfie, there are loads of other people on Jeb’s list of advisers—people like Porter Goss, who gets a bone-chilling shout out in this week’s Frontline piece. (Right after the 43 minute mark.) While the run up to the Iraq war may seem like a long time ago and a president or two away, Jeb is actively bringing these guys back.  

These inept hawks are the ones who took this country to war on a lie and actively contributed to the deaths of thousands of United States servicemen and women and hundreds of thousands of Iraqi citizens. And remember, this was not just about "faulty intelligence," the George W. Bush administration (many of who are now in Jeb Bush’s circle of advisers), knowingly used false intelligence to make the case for an unnecessary war. It’s important to remember the recent past so we don’t put the same criminals and idiots in power again. Fortunately, things aren’t looking too good for Jeb right now, but the campaign has barely begun. Enjoy the cartoon, like, comment and all that other good stuff—and be sure to check out the links behind the cartoon.

New York Times does its best to be a 'real opponent' to Hillary Clinton

Fri, 05/22/2015 - 08:43
U.S. presidential candidate Hillary Clinton speaks to reporters after a roundtable campaign event with small businesses in Cedar Falls, Iowa, United States, May 19, 2015.    REUTERS/Jim Young   - RTX1DOLO Anyway, this is the polite version of the face I made when reading this article. New York Times reporters really aren't bothering to hide their loathing of Hillary Clinton anymore, to the point where the next logical step is for the newspaper to adopt the mottoes "fair and balanced" or "we report, you decide." Here's how one Times reporter tweeted his latest article:
In Iowa, Queen Hillary and the Everyday Americans of the Round Table distribute alms to the clamoring press. http://t.co/...
@jasondhorowitz Yeahhhh, Queen Hillary. "We report, you decide!" As for the article itself ...
Unlike in 2008, when Mrs. Clinton’s regal bearing was brought low by Barack Obama’s insurgent campaign, there is no one to force her out of her Rose Garden. Neither Bernie Sanders, the socialist senator from Vermont, nor Martin O’Malley, the former governor of Maryland, has applied significant pressure on her. That leaves the news media as her only real opponent so far on the way to the Democratic presidential nomination, and while it may not be great for an educated populace or the furtherance of American democracy, it makes all the political sense in the world for Mrs. Clinton to ignore them, too. "That leaves the news media as her only real opponent so far." It's a horrible premise, as Jay Rosen among others has made clear. But boy is it ever a premise Jason Horowitz does his best to live out in an article with personal animus oozing from under every line. Here's how Horowitz describes Clinton taking press questions, as they'd been endlessly whining she was not doing:
“Tell me — tell me something I don’t know,” she said, almost musically, as she snapped her head to the left in a Janet Jackson-era dance move. “Ha, ha, ha, ha.”

The smile on Mrs. Clinton’s face slowly faded as she nodded and replied and obfuscated in response to the half-dozen questions asked of her.

Later in the piece, "She seems less a presidential candidate than a historical figure, magically animated from a wax museum to claim what is rightfully hers." So, Janet Jackson-era dance moves and a historical figure magically animated from a wax museum—she's old! To claim what is rightfully hers—Queen Hillary, so entitled! How dare she be a strong presidential candidate when we, the press, don't like her?

The entitlement here is on the part of the press, claiming a role in politics that does not belong to it by any reasonable read of the role of the press, with reporters insisting that their inane questions and picayune obsessions are what's important in this race. Insisting that, rather than covering Bernie Sanders' campaign as seriously as they're covering the campaigns of Republicans with lower polling numbers than Sanders, the right way to cover the Democratic primary is by dismissing Sanders and setting themselves up as Clinton's true opposition. It's disgraceful.

The Republican replacement plan for Obamacare in one graphic

Fri, 05/22/2015 - 08:42
Screenshot of Tweet showing Chris Murphy's Senate floor appearance with poster. That's Sen. Chris Murphy (D-CT) on the Senate floor Thursday, summing up the Republican plan for the millions of Americans who could lose health insurance with the Supreme Court's King v. Burwell decision. Nailed it.

Daily Kos Radio is LIVE at 9 am ET!

Fri, 05/22/2015 - 07:30
Daily Kos Radio logo Today, I'm just going to say, "Josh Duggar" over and over for one hour and fifty-two minutes.

Then, Rosalyn MacGregor's Michigan update will fill the rest.

Oh, wait. Greg.

OK, Greg will interrupt me by saying "Josh Duggar" before I do for half an hour, then I'll go, then Rosalyn.

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Greg Dworkin rounds up stories about Rand Paul's non-filibuster, Huckabee passing on the IA straw poll, Fox setting the rules on who'll debate, media still mad at Hillary, and how Luis Lang was short-changed by the media, and could end up getting screwed again. Finally, ICD codes: an insider's peek at games doctors play to pass the time. A reminder of the somewhat sketchy practice of Members of Congress living (rent & utility-free) in their offices. The NSA's back door into your smartphone. One of the bikers arrested in the Waco shootout was among the group lobbying for looser gun laws at the TX capitol. State legislatures increasingly banning local bans. On everything. Scotland Yard once thought Star Trek fans were a national security threat. Florida bar owner shows us the worst thing wrong with "Stand Your Ground" laws. Guess what? Conservatives are taking a 54th crack at developing their own Move On.

Need more info on how to listen? Find it below the fold.

Abbreviated pundit roundup: Military equipment order, minimum wage and more

Fri, 05/22/2015 - 06:44
We begin today's roundup with The Des Moines Register's take on the military equipment use by American police forces:
Documents obtained by CNN in April found the Missouri National Guard referred to Ferguson protestors as "enemy forces" during demonstrations last summer. Many Americans don't trust an officer with a department-issued handgun, let alone a grenade launcher. Yet grenade launchers are among the equipment given to local law enforcement by the Department of Defense over the last few decades. Iowa agencies have seven of them.

In this state, 144 agencies have acquired military gear from the federal government valued at about $11.5 million. Items include mine-resistant armored vehicles, automatic handguns, sniper scopes and night-vision goggles. Last year the Register's editorial board reported that the Iowa State University campus police were among the agencies that sought and received M-16 rifles.

Does any of this make Iowans feel any safer?

Probably not.

The Boston Globe:
The Defense Department’s 1033 program is a prime example of a well-intentioned initiative that, in the absence of clear strategy and oversight, has lost some measure of sense. Created in the 1990s, and resurgent after 9/11, the program has funneled billions of dollars’ worth of surplus military equipment to police departments around the country, including many in Massachusetts. Some of the equipment that departments have received — such as rifles, helmets, trucks and night-vision glasses — might on rare occasions prove tactically useful. Others seem patently out of place: Police in the town of Rehoboth, population 11,000, got a mine-resistant tank valued at $658,000.

The Obama administration’s order, sensibly, doesn’t end the 1033 program outright. It bans the transfer of certain items, such as armored vehicles that run on tracks, grenade launchers, and some types of camouflage uniforms. To receive other items, police departments now must offer a plan and justification. That’s a process worth going through before any acquisition. Indeed, police departments around the country have, in recent months, tried to return some expensive military equipment — most notably, those mine-resistant vehicles — after finding that it was costly to maintain and unnecessarily divisive.

More on the day's top stories below the fold.

A good many Republican presidential candidates posed for pictures with a child molester

Fri, 05/22/2015 - 03:32
Do as I say, not as I do. That particular idiom about hypocrisy is especially true if you're a Republican espousing "family values." A good example of this occurred recently when the media obtained a 2006 police report indicating that Josh Duggar, the oldest son of TLC’s 19 Kids and Counting Duggar family, molested at least five underage girls when he was a teenager. And some of the victims were his sisters. Duggar, his wife and his parents released separate statements admitting to the charges, while also saying he "acted inexcusably" and mentioning God in almost every other sentence.

The entire 19 Kids and Counting series is predicated on the oddity of watching a woman have a "litter" of children, and also appealing to an evangelical audience who wants to see a wholesome family with "Christian values" in all their goodness. Those values usually entail total female submission, chaperoned dating, and clothing restrictions as part of the Quiverfull movement. The Duggar's religious views have made them popular among conservatives, with Republican candidates, anti-choice groups and anti-gay movements using the family members for publicity and photo ops. Josh Duggar, in his capacity as an executive director at the Family Research Council (FRC), has been outspoken in arguing against equality for gays, and claiming the LGBT community is a threat to the well-being of young children.

With the disclosure of these incidents of molestation, Josh Duggar resigned from the FRC, in what is likely the first step of social conservatives and Republican politicians cutting ties with the Duggar family. It's quite a thing when Duggar has to resign from a group which is classified as a hate group by the Southern Poverty Law Center in order to spare them shame. And therein lies a bit of the rub. Even before he was revealed to be a sexual predator, there was enough out there where Republicans should have been ashamed to be seen with Duggar. Because now there are a lot of pictures of Duggar standing next to 2016 Republican presidential candidates and tweets where the Republican National Committee (RNC) felt Josh Duggar's thoughts on Hillary Clinton were important.

Continue below the fold for more.