Norquist Aims to Stop Internet Sales Tax Legislation


English: Grover Norquist at a political confer...

English: Grover Norquist at a political conference in Orlando, Florida. (Photo credit: Wikipedia)

English: Christopher Hitchens at a party at th...

English: Christopher Hitchens at a party at the house of Grover Norquist following the CPAC convention in January 2004 (Photo credit: Wikipedia)

English: Official photo cropped of United Stat...

English: Official photo cropped of United States Senator and Minority Leader Mitch McConnell (R-KY) (Photo credit: Wikipedia)

Tuesday, 23 Apr 2013 02:07 PM

By David Yonkman, Washington Correspondent  –

Internet sales-tax legislation racing through the Senate is likely to

face roadblocks when it moves to the House, anti-tax activist Grover

Norquist told Newsmax Tuesday.

“The reason we have a House and Senate is when you rush something

through one body, you have a chance to think it through in the other

body,” said Norquist, president of Americans for Tax Reform.“We’re

making the case on the House side of either seriously amending it or

even stopping it.”

The Senate is likely this week to pass the bill, which would greatly

expand the ability of states to collect sales taxes across state lines

on online purchases. Under current law, states can collect sales taxes

from retailers only if they have a physical presence in the state — a

store, warehouse, or office.

The Marketplace Fairness Act would allow states to collect taxes even if

the retailer does not have a physical presence in the state.

That’s just wrong, according to Norquist, who describes the legislation

as a massive expansion of taxing authority over businesses that have no

recourse in the matter.

“You should only be taxing people who can vote for you or against you,” Norquist said.

The Senate voted 74 to 20 on Monday to clear the Internet sales tax bill

for consideration on the floor, but on final passage it will have at

least one high-ranking Republican dissenter.

Senate Minority Leader Mitch McConnell of Kentucky cited the difficulty

for businesses to comply with the different tax codes in all the areas

where their customers reside. McConnell says that creates an enormous

advantage to large retailers who can afford such costs over smaller

businesses.

“If states decide they need this revenue, they should keep in mind the

tremendous burden they’ll be placing on the little guys who do so much

to drive this economy,” McConnell said in remarks on the Senate floor.

“In my view, the federal government should be looking for ways to help,

not hurt, these folks.”

© 2013 Newsmax. All rights reserved.

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Study Finds Health Care Spending Will Rebound When Economy Picks Up


Responses to the question: "For future pr...

Responses to the question: “For future presidential elections, would you support or oppose changing to a system in which the president is elected by direct popular vote, instead of by the electoral college?” Data from Washington Post-Kaiser Family Foundation-Harvard University Survey of Political Independents, conducted May-June 2007, available at http://www.washingtonpost.com/wp-srv/politics/interactives/independents/post-kaiser-harvard-topline.pdf (Photo credit: Wikipedia)

The analysis by The Kaiser Family Foundation says the slowdown in
health spending over the past several years was largely driven by the
economic malaise.

Los Angeles Times: Study: Growth In Health Spending, Curbed By Recession, To Rebound

A new study attributes a slowdown in U.S. healthcare spending to the
recent recession and predicts more rapid growth as the economy
strengthens. The report issued Monday by the Kaiser Family Foundation
seeks to shed light on the reasons behind the recent drop-off. The
analysis found that economic factors related to the recession accounted
for 77% of the reduced growth in national healthcare spending, which
totaled an estimated $2.8 trillion in 2012 (Terhune, 4/22).

The Washington Post’s WonkBlog: Here’s Why Health-Care Costs Are Slowing

The answer has huge implications for the federal budget, which now faces
threats of really fast growth in Medicare, Medicaid and other health
programs. If those programs grow like they have for the past few years —
at the same rate as the rest of the economy — then that frees up lots
of funds for whatever other investments the federal government wants to
make (Kliff, 4/22).

The Hill: Study Predicts Rise In Healthcare Cost Growth By 2019

A stronger U.S. economy will contribute to a rise in the growth of
healthcare costs over the next six years, ending the current
record-breaking slowdown, according to a new study. The Kaiser Family
Foundation (KFF) predicted that by 2019, annual healthcare cost growth
will be closer to historic averages — over 7 percent compared to 3.9
percent between 2009 and 2011 (Viebeck,4/22).

CQ HealthBeat: Nation’s Health Spending Problem Remains Unsolved, Kaiser Analysts Say

Speculation that the nation’s health spending problem has somehow been
solved or cut down to size is unrealistic, says a new Kaiser Family
Foundation study that concludes 77 percent of the slowdown stems from
the weak economy. … But the analysts had a bit of good news. They said
the chilling effect on individual health spending due to the weak
economy will continue for a few more years (Reichard, 4/22).

(KHN is an editorially independent project of The Kaiser Family Foundation.)

Meanwhile, a different analysis is released on health issues–

Reuters: S&P Sees Pension Funding Burden Of Nonprofit Healthcare

Pension liabilities, expenses and contributions remain a burden on U.S.
not-for-profit hospitals despite improvements in the investments used to
fund the retirement systems, Standard & Poor’s Ratings Services
said on Monday. Large pension funding demands will likely “be a drag on
the sector for several years,” it added (Lambert and Trokie, 4/22).

This is part of Kaiser Health News‘ Daily Report – a summary
of health policy coverage from more than 300 news organizations. The
full summary of the day’s news can be found here and you can sign up for e-mail subscriptions to the Daily Report here. In addition, our staff of reporters and correspondents file original stories each day, which you can find on our home page.

Some Boston Marathon Bomb Victims Will Face Insurance Coverage Limits


Boston Marathon

Boston Marathon (Photo credit: Wikipedia)

Payments for prosthetics, rehabilitation and a range of other
treatments may fall outside some insurance limits and could continue
long into the future.

The New York Times: For Wounded, Daunting Cost; For Aid Fund, Tough Decisions

Many of the wounded could face staggering bills not just for the trauma
care
they received in the days after the bombings, but for prosthetic
limbs
, lengthy rehabilitation and the equipment they will need to
negotiate daily life with crippling injuries. Even those with health
insurance may find that their plan places limits on specific services,
like physical therapy or psychological counseling (Goodnough, 4/22).

Politico: Coverage Limits Are Harsh Reality For Amputees

Those who lost limbs in the Boston Marathon bombings now need care to
learn to navigate the world in a new way — and navigate a thorny area of
health care coverage, too. In the case of the Boston bombings, pledges
and offers of support have poured in to help with the health care costs
of the 14 people who reportedly lost all or part of a limb. But for some
amputees, covering the staggering cost for prosthetics care can be a
struggle (Smith, 4/23).

This is part of Kaiser Health News‘ Daily Report – a summary
of health policy coverage from more than 300 news organizations. The
full summary of the day’s news can be found here and you can sign up for e-mail subscriptions to the Daily Report here. In addition, our staff of reporters and correspondents file original stories each day, which you can find on our home page.

Proposal Would Require Insurers To Report Health Law Taxes


English: , member of the United States Senate....

English: , member of the United States Senate. Español: John Cornyn, un senador del Senado de los Estados Unidos (Photo credit: Wikipedia)

The measure’s sponsor, Sen. John Cornyn, R-Texas, bills it as a
way to educate consumers about how the health law’s benefits are funded.

The Hill: Insurers Would Report ObamaCare Taxes Under GOP Bill

A new bill from Sen. John Cornyn (R-Texas) would require health insurers
to disclose taxes they pay under ObamaCare to policyholders. In a
statement Monday, Cornyn touted the measure as a way to educate
consumers about how the Affordable Care Act’s benefits are funded
(4/22).

Also in the news, health law opponents are pressing for repeal of the
health law’s medical device tax, among other provisions, in
comprehensive tax reform legislation –

Roll Call: Health Law Tax Foes Find Hope In Overhaul Effort

Proponents of doing away with provisions such as the medical-device tax
and the annual fee on health insurance companies say they already have
bipartisan support for their repeal legislation. But the efforts still
will face health care politics and the need for significant offsets,
making their inclusion far from certain as lawmakers work toward
comprehensive tax legislation that can pass in both chambers (Attias,
4/22).

This is part of Kaiser Health News‘ Daily Report – a summary
of health policy coverage from more than 300 news organizations. The
full summary of the day’s news can be found here and you can sign up for e-mail subscriptions to the Daily Report here. In addition, our staff of reporters and correspondents file original stories each day, which you can find on our home page.

Competition Key Ingredient To Success Of State Health Exchanges


Stateline reports that even some of the strongest health exchange
enthusiasts are concerned that some states will still only have limited
insurance choices for consumers. Meanwhile, in other news, the Arkansas
Medicaid expansion model gains momentum, Florida’s efforts face
continued complications, Arizona’s expansion standoff continues and the
Missouri Senate rejects the concept. Also, the shape of Ohio’s
compromise exchange is beginning to emerge.

Stateline: Lack Of Competition Might Hamper Health Exchange

The White House sums up the central idea behind the health care
exchanges in the new federal health law with a simple motto: “more
choices, greater competition.” But even some stalwart supporters of the
Affordable Care Act worry that in many states, people won’t have a lot
of health insurance choices when the exchanges launch in October. Health
economists predict that in states that already have robust competition
among insurance companies—states such as Colorado, Minnesota and
Oregon—the exchanges are likely to stimulate more. But according to
Linda Blumberg of the Urban Institute, “There are still going to be
states with virtual monopolies” (Vestal, 4/23).

Health News Florida: ‘Private Option‘ Plan, Florida Model, Passes In Ark.

Arkansas’ state legislature passed a model plan to expand Medicaid last
week, even though its Legislature is dominated by Republicans and the
measure had to pass by a three-quarters vote, the Associated Press
reports. The Arkansas plan is the model for Florida state Sen. Joe
Negron’s plan, which would accept an estimated $51 billion in federal
funds over 10 years to expand insurance to about 1 million of the
state’s low-income uninsured (Gentry, 4/22).

Miami Herald: Legislators Poised To Adjourn With No Medicaid Plan

As the clock winds down on the legislative session, Florida lawmakers
are sending signals that they are likely to adjourn without resolving
the issue of whether to accept federal Medicaid money to insure the
state’s poorest residents. “It’s not something you put together in a
week,”’ said Sen. John Thrasher, R-St. Augustine, chairman of the Senate
Rules Committee and a close adviser to Senate President Don Gaetz.
“It’s a very big, complicated issue and these issues take some time.” He
said he does not expect there would be political repercussions if the
Republican-led Legislature waits another year (Klash, 4/22).

Arizona Republic: Brewer, GOP In Medicaid Standoff

Three months after she stunned political observers and made her case for
expanding Medicaid coverage in Arizona, Gov. Jan Brewer is no closer to
reaching agreement with Republican legislative leaders on the issue,
which has driven a wedge through GOP ranks and is delaying work on the
state budget. By most accounts at the Capitol, Brewer has just enough
votes in the House and Senate to get expansion approved. Even some
lawmakers who oppose the plan predict it eventually will pass, owing in
large part to the power of the governor’s veto pen and her reputation
for tenacity, as well as pressure from top-flight lobbyists and
heart-tugging health-care crisis stories (Reinhart, 4/22).

The Associated Press: Mo. Senate Votes Down Federal Medicaid Expansion

Republican senators have made it clear that there will be no Medicaid
expansion in Missouri this session. The Republican-led Senate voted down
a Democratic attempt Monday night to insert $890 million of federal
funds into Missouri’s budget to expand Medicaid eligibility to an
estimated 260,000 lower-income adults (4/23).

Cleveland Plain Dealer: Ohio’s Medicaid Expansion Alternative Could Use Private Insurance

For the first time since Gov. John Kasich won national attention by
supporting Medicaid expansion, a clear picture is emerging on how the
Republican governor’s compromise with federal regulators could work.
Some uninsured Ohioans would be enrolled in the state’s traditional
Medicaid program, while others would sign up for private health
insurance using federal funding, said Greg Moody, director of Ohio’s
Office of Health Transformation. The proposal, which Kasich hopes to
sell to GOP lawmakers reluctant to support an outright Medicaid
expansion, has been dubbed “The Ohio Plan.” And it differs from the
standard federal expansion program on one crucial point: It puts some
enrollees in the private insurance market (Tribble, 4/22).

This is part of Kaiser Health News‘ Daily Report – a summary
of health policy coverage from more than 300 news organizations. The
full summary of the day’s news can be found here and you can sign up for e-mail subscriptions to the Daily Report here. In addition, our staff of reporters and correspondents file original stories each day, which you can find on our home page.

John Kasich

John Kasich (Photo credit: Wikipedia)

Insurer Centene: We Can Do Arkansas-Style Medicaid


English: House Bill and Senate Bill subsidies ...

English: House Bill and Senate Bill subsidies for health insurance premiums. (Photo credit: Wikipedia)

By Jay Hancock

April 23rd, 2013, 3:33 PM

Arkansas
is the latest and perhaps best hope for those who want states resistant
to the Affordable Care Act’s Medicaid expansion to reconsider.

Illustration by Darwinek via Wikimedia Commons

Last week the Arkansas legislature approved
a plan to give Medicaid beneficiaries money to buy individual policies
from private insurers on the state’s health insurance exchange — the
subsidized, online markeplaces due to be in business next year. The
governor signed the bill Tuesday — making it law.

The Department of Health and Human Services, which has said it “will consider approving a limited number” of such arrangements, still needs to negotiate details and sign off.

One insurer is already expressing interest.

“We
are very capable of doing an Arkansas-type model,” Centene Corp. CEO
Michael Neidorff said Tuesday. “That’s something that would be a sweet
spot for us.”

Centene sees opportunity in participating in the
health law’s coverage expansions, whether Arkansas-style or not. It
already runs Medicaid managed care plans for those with very low incomes
in several states, although not in Arkansas. Now it wants to offer
plans to individuals with slightly higher incomes through the exchanges.

“We
believe we can achieve increased profitability in 2014 upon the
commencement of the ACA,” Neidorff told stock analysts Tuesday. “The
exchange market represents the largest growth opportunity for Centene
over the next several years, estimated at $52 billion in our existing
markets.”

Policy analysts expect considerable “churn”
from members moving between the ACA’s expanded Medicaid program and
commercial policies sold on the exchanges as their incomes fluctuate.
Centene wants to be on both sides of the line, selling “a product that
offers people a comfortable transition,” said K. Rone Baldwin, chief of
the company’s insurance group.

Whether managed by Centene or some
other carrier, private, individual insurance in the Arkansas mode could
help Medicaid members keep the same doctor and otherwise minimize
disruptions when they graduate to a non-Medicaid exchange plan, some
have suggested.

The Arkansas model faces large questions. Not least are those about cost.
Commercial insurance of the type Arkansas sees covering Medicaid
members typically pays doctors and hospitals more than traditional
Medicaid or Medicaid managed care plans like Centene runs.

But the plan is being praised as a “conservative alternative” to Obamacare classic and is reportedly being eyed by Pennsylvania, Ohio and other states resisting the Medicaid expansion.

Centene
executives spoke to investment analysts on a conference call about the
company’s quarterly profits. Like other insurers, they were coy about
saying where they plan to offer exchange plans and on what terms.

“We
do expect to be on the exchanges in a subset of the places where we
have health plans today, and we’re entering into contracts with
hospitals,” said Baldwin. How well will Centene be paying those
hospitals to care for its exchange members? “It’s certainly not exactly
at [lower] Medicaid rates but I wouldn’t say it’s exactly at [higher]
commercial rates either,” he added.

The company earned $23 million for the quarter on revenue of $2.5 billion.

Viewpoints: ‘Big Risks’ Of Buying Private Insurance With Medicaid Dollars; One Month Of Sequestration


US residents with employer-based private healt...

US residents with employer-based private health insurance, with self insurance, with Medicare or Medicaid or military health care and uninsured in Million; U.S. Census bureau: Income, Poverty, and Health Insurance Coverage in the United States: 2007 (Photo credit: Wikipedia)

Topics: Medicaid, Medicare, Health Reform, States, Health Costs, Women’s Health, Uninsured

Apr 01, 2013

The New York Times: Using Medicaid Dollars For Private Insurance
The Obama administration and Republican officials in several states are exploring ways to redirect federal money intended to expand Medicaid, the main public insurance program for the poor, and use it instead to buy private health insurance for Medicaid recipients. The approach could have important benefits for beneficiaries and for the future of health care reform. But the idea also carries big risks. Federal officials will need to enforce strict conditions before agreeing to any redirection of Medicaid dollars that were originally intended to enlarge the Medicaid rolls (3/31).

Forbes: The Arkansas-Obamacare Medicaid Deal: Far Less Than It First Appeared
When Arkansas Gov. Mike Beebe (D.) first announced that he had reached a deal with the Obama administration to use the Affordable Care Act‘s private insurance exchanges to expand coverage to poor Arkansans, it seemed like an important, and potentially transformative, development. … A Good Friday memo from the U.S. Department of Health and Human Services, however, splashes cold water on that aspiration. It’s now clear that the Beebe-HHS deal applies a kind of private-sector window dressing on the dysfunctional Medicaid program, and it’s not obvious that the Arkansas legislature should go along (Avik Roy, 4/1).

USA Today: ‘Sequester’ Still Looks Stupid, As Planned: Our View
Congress and the White House exempted some programs when they finalized the original deal, and the spending bill they agreed to last month to keep the government open to Sept. 30 spared some vital functions — food inspections, for example. But not enough. Nor does the sequester seriously address the major spending driver: health care costs. The best outcome would be for the sort of anger that forced Congress and the White House to re-open the government in 1996 to push Congress and the White House back to the table on a realistic budget deal this year. The outlines of that deal have been obvious for too long: Trim entitlement programs such as Medicare and Social Security, overhaul the hopelessly inefficient and corrupt tax code to bring in more money, and cut defense and domestic programs with a scalpel instead of an ax (3/31).

USA Today: ‘Sequester’ Needed To Rein In Spending: Another View
Let’s get real on the “sequester.” One month in, not much has changed. Nor is it likely to. Rather than devastating the federal government, the sequester is necessary to rein in the unbridled growth of federal spending. The sequester is certainly flawed. It’s a blunt instrument leaving the biggest spending drivers, entitlements, virtually untouched (Alison Fraser, 3/31).

The Wall Street Journal: The Liberal Medicare Advantage Revolt
A big political story this year is likely to be Democrats turning on their White House minders as the harmful and unpopular parts of the Affordable Care Act ramp up. On the heels of the recent 79-20 Senate uprising against the 2.3% medical device tax, now comes the surge of Democrats pleading on behalf of Medicare Advantage. Liberals have claimed for years to hate this program, but by now Advantage provides private insurance coverage to more than one of four seniors. And those seniors like it (3/29).

The Chicago Tribune: Scrubbing Medicaid
In January, Illinois launched an effort to scrub ineligible people from the state’s Medicaid rolls. … The initial results of this audit are … astonishing: Of the first 20,500 recipients screened by an outside contractor, the auditors recommend that 13,709 be removed from the rolls. Yes, that’s two-thirds of the first group screened, flagged as ineligible to receive their current Medicaid benefits. How so? In some cases, the recipients make too much money to qualify. In other cases, they don’t live in Illinois (3/31).

The New York Times: The Campaign to Outlaw Abortion
Anti-abortion groups have been trying to re-impose restrictions on abortion rights for 40 years, but the Legislature and governor of North Dakota have taken this attack on women’s reproductive health and freedom to a shocking new low … The clear message is the need for a stepped-up effort to hold state officials electorally accountable for policies that harm women in states where right-wing Republicans control the machinery of government (3/29).

The Seattle Times: State Senate Health Care Committee Should Vote On Abortion Measure
After the Senate Health Care Committee hearing on the Reproductive Parity Act Monday, members should vote for it before a key deadline Wednesday. State lawmakers do not need to complicate this issue. House Bill 1044 would maintain insurance coverage for women seeking abortions after federal health reforms take effect (3/31).

Los Angeles Times: The Starbucks Syndrome In Healthcare
Medicare statistics, for example, reveal that Los Angeles leads the nation in the amount of medical services provided during the last six months of a person’s life. Healthy seniors here are also big consumers of healthcare, getting about 65% more MRI studies and utilizing ambulances three times as often as seniors elsewhere. Commercial insurance data point to similar patterns in the healthcare of the younger population in Southern California. What explains such avid use of medical services. … Part of the problem is that Angelenos approach healthcare as they do other kinds of consumption. They expect their CT scans, when they want them, in much the same way they expect their decaf caramel extra hot low-fat macchiatos. (Daniel J. Stone, 3/31).

Los Angeles Times: Bump In The Road For Healthcare Law
One figure in a new report neatly summarizes the potential pitfalls for Obamacare: 30.1%. That’s how much premiums could rise next year, on average, for the roughly 1.3 million moderate- and upper-income Californians who buy individual health insurance policies. Most of that increase is attributable to the insurance reforms in the 2010 law, also known as the Affordable Care Act. The bill’s title is not ironic — its provisions will slow the growth of healthcare costs and lead over time to a more rational and efficient system. But the transition will have some rough patches, and we’re about to hit one (3/29).

Houston Chronicle: The Affordable Care Act Is A Poor Solution
Senator Orrin Hatch has speculated that the Affordable Care Act was designed to fail. A close look at the Act’s contents and history suggests he may be right. The Affordable Care Act is nothing more than a political stopgap, a waypoint on the road to something that might work. Republicans could stand around complaining or we could seize this opportunity to determine what comes next (Chris Ladd, 4/1).

Richmond Times-Dispatch: Moving Forward On Medicaid: More Important Than Ever
As a community physician for more than eight years, I’ve seen how medical care helps keep families strong and secure. When parents and their kids can access health care — and have a way to pay for it — they are much less likely to face unpaid bills or have to put off doctor visits. Instead of worrying about how their family is going to survive, they can focus on how their family is going to thrive. Unfortunately, too many Virginians — more than a million, in fact — find that getting health care is a real challenge because they don’t have insurance (Dr. Christopher Lillis, 4/1).

The Wall Street Journal: The Skinny On Anti-Obesity Soda Laws
New York Mayor Michael Bloomberg’s anti-obesity campaign to ban the sale of certain sugary drinks in large servings, especially sodas, was struck down last month in state court. A proposal for a penny-per-ounce excise tax on sweetened beverages also floundered in Vermont’s House of Representatives in February. … As an economist, I have two big gripes with such paternalistic public-health initiatives: The proposals aren’t grounded in data or compelling economic models, and soda taxes might catalyze a dismal chain reaction, with escalating government intrusions on personal freedom (Michael L. Marlow, 3/31).

Oregonian: Don’t Take Portland’s Sick-Leave Mistake Statewide: Agenda 2013
By voting to mandate paid sick leave last month, Amanda Fritz and her city council colleagues furthered Portland’s reputation as a place where businesses fear to tread. One way to protect city employers burdened by this mandate is to adopt a similar requirement statewide, erasing a competitive advantage a restaurant in, say, Beaverton might have over one in Portland. In other words, bail out Portland by making things tougher all over (3/31).

USA Today: ER Key To Curb Painkiller Abuse
Most opioids are prescribed in the doctor’s office, which has prompted some states to restrict primary care physicians like myself from prescribing them and to encourage referrals to pain specialists. New York City Mayor Michael Bloomberg has taken these curbs a step further by focusing on emergency departments. In January, he announced a voluntary initiative to limit prescription of opioid painkillers in the emergency rooms of the city’s 11 public hospitals. This approach should be expanded across the nation. From 2004 to 2009, the number of emergency visits in New York City hospitals related to opioid abuse or misuse more than doubled (Dr. Kevin Pho, 3/31).

This is part of Kaiser Health News’ Daily Report – a summary of health policy coverage from more than 300 news organizations. The full summary of the day’s news can be found here and you can sign up for e-mail subscriptions to the Daily Report here. In addition, our staff of reporters and correspondents file original stories each day, which you can find on our home page.