Monthly Archives: September 2017

Some Thoughts on Graham-Cassidy

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These are…triggered…by Thursday’s Wall Street Journal piece on how the Graham-Cassidy Plan Would Change Health Coverage.

The Congressional Budget Office has said that, without a rule requiring insurers to charge all customers comparable premiums, health plans could become prohibitively expensive for some people with pre-existing conditions.

The plans wouldn’t be insurance plans, either, since the premiums wouldn’t have anything to do with the risk being transferred.  The plans would be welfare plans.

Separately, states could also waive a requirement that insurers provide a set of medical benefits like mental-health services and prescription-drug coverage. If those benefits aren’t required, people with costly medical conditions could have difficulty buying insurance with the relevant services or medications.

Certainly a possibility. However, that’s a matter between a State’s citizens and their State government. The Federal government has no legitimate role to play in this.

The bill seeks to distribute funding roughly equally among states. But under the ACA, 31 states expanded Medicaid, and some states had considerably higher enrollment in subsidized plans. Because that funding would go away to be replaced by block grants, some states would see a net funding gain and others would see a loss.

This is the only problem I have with Graham-Cassidy, albeit not for the reasons the WSJ cites others as having.  With roughly equal funding across States, low-population States will get more per capita money than those with larger population without regard to the relative health of the populations.  The block grants should be sized to each State’s population of citizens and legal immigrants, so that the per capita funding is roughly equal, not the per-State funding.  The biggest “losers” would still tend to be States with Progressive-Democratic Party-led governments, but these also are the States with the most profligately wasteful spending, and on a host of programs, not only on Medicaid.  There’s no valid reasons other States should be forced to continue to subsidize these wastrels with continued taxpayer dollar redistributions.

The bill rescinds the ACA’s Medicaid expansion, which for the first time extended coverage to childless, low-income adults. So states couldn’t use their block grants to cover these low-income adults under Medicaid.

Money is fungible, though, and Medicaid is a State program, even if it is heavily subsidized with Federal (i.e., your and my tax) dollars.  If a State thinks covering childless, low-income adults, et al., is a good idea, it certainly can reallocate monies from other spending to its Medicaid program for the purpose.

[T]he bill also for the first time places funding caps on traditional Medicaid and shrinks spending on the program significantly over time. Analysts say the reduced federal spending could blow a hole in state budgets….

It’s a start.  The Federal block grants should be put on an annually declining basis so that over 10 years (say), the grants disappear, and the States would be free to—and responsible for—designing and funding their own Medicaid programs without Federal strings, without subsidization with the tax dollars of other States’ citizens, and without having to send their own citizens’ tax dollars to subsidize other States.

Too, the analysts are wrong on this, and they demonstrate a breathtaking lack of understanding of responsibility.  Reducing Federal transfers to the States won’t blow a hole in any State budget.  The only thing capable of blowing holes in State budgets are those States’ governments via their spending decisions.  State governments just will have to spend their own citizens’ money, with less OPM coming in.

Unfortunately, guys like Senators John McCain (R, AZ) and Rand Paul (R, KY) prefer Obamacare to even this much compromise-y progress, and so they’re going to betray their constituents by voting to preserve Obamacare rather than replace it with Graham-Cassidy.  Their reasons for preferring Obamacare?  In McCain’s case, it’s all about ego and his precious Maverick status.  Nothing will ever be pure enough to suit Paul, so he’ll just vote “No,” no matter what.

If this bill fails, that’ll be these two Senators’ legacy–voting to keep Obamacare intact.  Senate Majority Leader Mitch McConnell (R, KY) should bring the bill to a vote this week regardless of his vote count.  He needs to put those Republicans who prefer Obamacare on the voting record for the coming Republican primaries.

Raise Taxes, Don’t Lower Them

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That’s what the European Commission says is the correct thing to do.

The European Commission said the EU should proceed with an overhaul of taxes on digital firms even if the rest of the rich world did not follow suit, a draft report said.

And to the point:

The document is part of an EU push to tap more revenues from online multinationals such as Amazon and Facebook, who are accused of paying too little tax in Europe by routing most of their profits to low-rate countries such as Ireland or Luxembourg.

The right answer couldn’t possibly be that the high-tax members of the EU should lower theirs in competition with Ireland or Luxembourg.  Mm, mm.  Gotta destroy the competition—at the expense of the citizenry, yet.

And collect more money from those pesky businesses, too.  After all, it’s not like the money belongs to those businesses.  No, Sir: the money is the EU’s, and those bureaucrats will determine what is a sufficiency for the businesses (and the citizenry) to use for themselves.

Due Process and Colleges/Universities

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Recall the Department of Education’s 2011 egregious and cynically biased Dear Colleague Letter and its attack on due process and equal protection under law.  Things are being restored to legitimacy under the  Betsy DeVos DoEd via interim guidance just issued.

Colleges can now apply a higher standard of proof when determining guilt in sexual misconduct cases and must offer equal opportunity for the accused and accuser to have legal advisers participate in their hearings, according to interim recommendations issued by the US Department of Education on Friday.

Because

The Education Department on Friday formally rescinded guidelines issued by the Obama administration in 2011 and 2014….

There is one item to be cleared up; hopefully it will be when formal, final guidance is issued by DoEd.

Schools now have the discretion to apply either the “preponderance of the evidence” standard, or the higher “clear and convincing evidence” standard….

The criminal standard, preponderance of the evidence, must be the only standard allowed.  And the accusation must be investigated by the police, not by ad hoc amateurish kangaroo courts and pseudo-investigators of school faculty or staff.  A victim of sexual misconduct is not helped in the slightest by a jumped up school tribunal bent on social justice rather than justice.

Tax Reform and Legislation

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Business CEOs want tax reform.  They’re right, even though to an extent their wish is self-serving.  Or because of that—Adam Smith’s invisible hand, and all that, where every economic actor seeing to his own self interest aggregates to the benefit of all the actors, including those not party to a particular arrangement among particular actors.

Which brings me to a (not very) tangential point regarding a remark by Business Roundtable President & CEO Joshua Bolten regarding target tax rates:

15% would be terrific….  But it doesn’t have to end up at 15% for Business Roundtable companies to be happy about it.

To which Suzanne O’Halloran, the Reuters author of the piece at the link added

It just needs to get done.

The point is this: it doesn’t have to “get done;” tax reform legislation doesn’t have to get to 15% (or my 0%) in one fell swoop.  Reduce the rates significantly today, taking what’s actually politically possible given the timidity of so many of our politicians and how deeply so many are in with special interests wanting this or that subsidy or credit or loophole.  Come back tomorrow and get more.  And the next day, until the goal is reached.

No piece of tax legislation need be taken as the final word; it’s all interim compromise that moves the ball toward the goal.

This principle applies to health care reform and to health care coverage plan reform, too, as it does to all legislation, but especially legislation that seeks to implement large changes or to modify large sectors of our economy.

More Mueller Leaks

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Even Howard Kurtz seems to be catching on, as he wrote for Fox News.

Robert Mueller’s special counsel investigation leaks are continuing apace.

Suddenly, there are a whole lot of leaks about Paul Manafort.

Could this, just possibly, be the special counsel’s way of putting pressure on President Trump’s former campaign chairman?

And

[T]he detailed nature of the leaks is also troubling. As a onetime Justice Department reporter, I can tell you that such leaks in a criminal investigation are rare, as well as illegal.

Here are two of the latest Mueller team leaks (leaks Mueller continues to allow, if not encourage, as demonstrated by his choosing to do nothing about stopping them):

The [New York] Times discloses that when federal agents conducted an early-morning raid at Manafort’s Virginia home in July, they picked the lock. As for details, the story says the agents not only took documents and copied computer files, “they even photographed the expensive suits in his closet.”

Who knows such detail other than Mueller’s agents conducting the raid (assuming we can accept that the NYT isn’t making up such entertaining items)?  Certainly not Manafort; had he been there he surely would have opened the door for the agents.

And

CNN reported that federal investigators wiretapped Manafort both before and after the election.

Certainly, Manafort or anyone associated with him would not have known about the taps and so could not have leaked this item.  Their knowledge would have defeated the purpose of the tap.

And another leak, this one unmentioned by Kurtz:

Special Counsel Robert Mueller’s office has interviewed Deputy Attorney General Rod Rosenstein about President Donald Trump’s firing of former FBI Director James Comey, according to people familiar with the investigation.

The only people familiar with the investigation would be Rosenstein and his team and Mueller and his team.  Rosenstein and his associates have no interest in leaking this interview; indeed, Rosenstein and his associates plainly know better than to leak, both from a legal perspective and a political one as members of the Trump administration.  Only Mueller has an interest in leaking this interview.

It’s time for Mueller and his team to be fired for cause and an honest cop put in charge of the special investigation, together with an honest team of investigators.  And yes, at this late date, an honest investigation needs to occur—promptly, efficiently, and speedily—in order quickly and without further delay or stall either to vindicate Manafort, Trump, the Trump campaign, et al., or to produce legitimate and serious charges.

And Mueller and each member of his team need to be investigated regarding the felonious nature of these leaks.