Grim scenario for Hawaii"s Obamacare plan: The numbers don"t add up

As the Hawaii Legislature weighs bills that would make sweeping changes to the state’s Obamacare program, the interim director of Hawaii’s healthcare exchange on Wednesday laid out a grim financial picture facing the agency.

With anemic enrollment by individuals and little interest among small-business employers, the state’s nonprofit exchange — known as the Hawaii Health Connector — is unlikely to have enough money to pay its bills, even under the best of circumstances, when federal grant money dries up in 2015.   

The exchange had originally planned to stay afloat by collecting a 2% fee on every plan sold through the exchange, but with the slow pace of enrollment and changing federal rules — delaying the employer mandate and allowing canceled plans to continue — Interim Director Tom Matsuda said Wednesday that the math simply does not add up.

Last week, Matsuda and the Health Connector’s board members used expected enrollments by 2016, as well as the average premium costs, to calculate how much the exchange could collect by exacting its 2% fee on each plan.

“That revenue figure is far below what we think our expenses are going to be,” said Matsuda, who has estimated that the agency will need about $ 15 million a year starting in 2015. Health Connector board members also looked at the best-case scenario for enrollment, and “even then, we’re still short on having enough revenue to cover projected expenses,” he said.

When the Affordable Care Act passed, Hawaii appeared to be one of the states best-positioned to benefit. Because of a 40-year-old state law requiring employers to provide coverage, its uninsured population is among the lowest in the nation at 100,000 people, or 8%. But even with $ 205 million in federal grants, the state’s exchange has been mired in technical problems that have kept enrollment the lowest among the 50 states — just 4,300 as of mid-February. Beyond those problems, Matsuda said that low demand for health insurance in Hawaii would make it difficult for the exchange to stay afloat over the long term.

Of the 100,000 uninsured in Hawaii, about half are expected to be eligible for Medicaid — meaning just 50,000 people would buy individual plans through the Health Connector under the best-case scenario. And while Hawaii hoped to sell thousands of plans through the exchange’s small-business marketplace, Matsuda said so few small businesses are eligible for tax credits that officials are simply not seeing the demand. “What people can get on the Connector versus outside the Connector is the same, so there isn’t really a strong incentive for small employers to use the Connector,” he said.

Further complicating matters, only two insurers offer plans on Hawaii’s exchange, so many companies are continuing to rely on their longtime brokers (who, having essentially been cut out of the process, have no incentive to help Hawaiians buy plans on the exchange).

“This is not a problem of the operations,” Matsuda told lawmakers, who have been demanding more information about how the nonprofit has operated. “It’s a problem with the market not fitting exactly what the [Affordable Care Act] mandate is all about.”

Health Connector officials are pleading with officials at the federal government’s Centers for Medicare and Medicaid for a waiver that would give them more time to spend the $ 205 million in federal grant funds that must be used or allocated by the end of the year.

That flexibility, Matsuda says, would allow the Health Connector to try to fix some of the technical problems that have stifled enrollments. One major source of the problems is a communication breakdown between the two systems that a consumer must navigate to get signed up for a health insurance plan. Every Hawaiian must get a denial of Medicaid eligibility through the state system — built by one contractor — before they can apply for tax credits to help buy a plan through the Health Connector’s system — built by a second contractor.

Nearly 20,000 applications have been caught between the two systems.

If federal officials agreed to give the Health Connector more time to spend the grant money, Matsuda said, the agency could work on streamlining and integrating those two systems, among other things. 

“We’re just going to assume right now that that’s not going to happen,” Matsuda said of the waiver, “but we’re just going to keep pushing to see if we can get a decision.”  

As Hawaii healthcare officials try to find a solution for its financial problems, lawmakers are revising a series of bills intended to improve accountability for the Health Connector, which as a private nonprofit does not directly report to legislators. 

House Bill 2529, a measure introduced by Health Committee Chairwoman Della Au Belatti and 19 of her colleagues, would have dissolved the nonprofit and brought the healthcare plan under the control of the state. At a legislative hearing in early February, Belatti proposed placing the Health Connector temporarily under control of the governor’s office beginning in 2015.

But lawmakers on the House Commerce and Consumer Protection Committee backed off that change because of concerns that the state would then absorb the exchange’s financial and legal liability problems. Instead they drafted changes that would give a legislative committee the right to monitor the Health Connector’s finances and operations, and would require that the agency submit a detailed budget and sustainability plan to lawmakers each fiscal year.

Legislators are also considering adding a “sustainability fee” to every health insurance plan sold in the state, with the money going to pay for the Health Connector’s operations.

“Maybe in the long run, the market just never will be big enough to sustain this,” Democratic State Rep. Angus L.K. McKelvey said at the end of a two-hour hearing Wednesday. “We need to get these numbers; we need this information. We need to talk about IT and all these other things so we can address them now and have good understanding to work with you and others to create the most responsible, transparent and accountable system.”

maeve.reston@latimes.com

Twitter: @MaeveReston

WHAT REALLY HAPPENED

Grim scenario for Hawaii"s Obamacare plan: The numbers don"t add up

Red Light Cameras On The Decline, As Everyone Realizes They Don’t Make Roads Safer, They Just Make Money

Tech Dirt – by Mike Masnick

For many years we’ve written about the problems of red light cameras. Installed over the past few years in many cities, the public statements supporting them were always about increased safety on our roads. However, as we’ve noted, plenty of studies showed that the cameras actually tended to increase accidents, showed little to no safety benefit, and were almost always driven by monetary incentives. Because of this, there were numerous reports of various municipalities actually deciding to decrease the time on yellow lights, thereby getting more money from tickets, but massively increasing the safety risk. Multiple studies have shown that the one way to make intersections safer is to increase the yellow light time — but in order to make more money, many were decreasing it (often below legal limits).   

The anger over these tactics has been increasing quite a bit over the past few years and a variety of cities decided to cancel their programs, causing the leading company providing these systems (who takes a large cut of every ticket), Redflex, to face some financial difficulties.

It appears that the trends are definitely against red light cameras. Cyrus Farivar has a great article (though, annoyingly paginated) about the decline in red light cameras, noting that 2013 was the first year where more red light camera systems were turned off than turned on.

Redflex’s US operations took a hit in 2013 as the company installed 54 new systems—but removed 101. Redflex’s recent fiscal report (PDF) shows that its after-tax net profits in a six-month period have dropped by half: plummeting from $ 7.1 million in the first half of 2012 to $ 3.6 million in the first six months of 2013.

Meanwhile, the article also takes on the various “competing studies” concerning red light cameras, and pointing to one study that compared a whole bunch of the studies, evaluated their methodologies, and found that the ones that showed benefits to red light cameras, almost invariably had dreadful methodologies that didn’t take into account the basic variability in accidents at any given intersection, and the likelihood of a return to the mean (in short: intersections with an abnormally large number of accidents frequently see that amount go down the following year — and red light camera makers and the studies supporting them rarely took into account that variability, but assigned such a decrease to the cameras). When correcting for such problems, the study of studies found the data showed that red light cameras are a problem, not a solution:

The meta-analysis concluded that, when only the best studies were considered, “The results of the meta-analysis are rather unfavorable for RLCs… According to the results from these studies, right-angle collisions are reduced by about 10 percent, rear-end collisions increase significantly by about 40 percent, and the overall effect on all types of crashes is an increase by about 15 percent. Only studies with weaker study designs yield results that are more favorable for RLCs.”

The study which those researches said had the best methodology also found significant negative impact overall:

the increase in costs from the increase in rear-end crashes more than offset the reduction in costs from the decrease in red light running crashes.

Hopefully, this is the beginning of the end for red light cameras. We’re all for making intersections safer, but the way to do that is to increase the time on yellow lights — and for places that still don’t have this: have a brief interval where lights in both directions are red, rather than switching simultaneously to red in one direction and green in the other. And yes, every time I make that last point, people who don’t live in places where that’s the case marvel that any place in the world has this, but it’s true in many, many places. Switching that to having an interval with both directions red, plus a longer yellow light, will actually make people safer, and yet… it doesn’t make any more money, so very few have been willing to make this simple switch.

http://www.techdirt.com/articles/20131218/00014725598/red-light-cameras-decline-as-everyone-realizes-they-dont-make-roads-safer-they-just-make-money.shtml

Red Light Cameras On The Decline, As Everyone Realizes They Don’t Make Roads Safer, They Just Make Money

Texas governor: Don"t fall for Iran"s charm offensive

Texas Governor Rick Perry was excited to visit Israel this week, just like he was in the past. Perry, 63, who has been governor for the past 13 years, has recently had another granddaughter join his family. Perry’s son named her Ella, after the extended family had visited the Ella Valley in the Judean Hills several years ago. “I had no idea how much of an impact the place would have on him,” the 63-year-old governor told me during an interview this week in Tel Aviv.

Governor, I suppose this is not the first time you’ve come to visit us here in Israel. How do you find the country?

“First time I was [here] in ’92. The food is a-lot better.”

When you came here in 1992, we had the same security problems. It seems that we can’t overcome this Iranian issue. And on the other hand, not only in America but also in Europe, people are fascinated by a smiling Iranian president. Do you share this fascination from a smiling Hasan Rouhani?

“You know, smiling is good; but I don’t get confused… The issue is not [about] personality. The issue is the subject of whether or not Iran will become, will be allowed to become actually, a nuclear power, and the answer is no, under any circumstance… The answer for the world has to be no. My recommendation to the American leadership — not just continue the sanctions but actually tighten the sanctions up, elevate the sanctions so that Iran and the Iranian people know that we are serious about this; that you can change leadership, but until you remove the centrifuges, until you remove… Why do you need enriched uranium for your energy industry. Other countries don’t need that.”

Would you say that Israel and the U.S. have a historical pact? Are relations as strong as ever?

“I don’t think there has been a change in the relations between the American people and the Israeli people. I think there is still strong respect and support. I think there is concern that the current administration has an incoherent, muddling foreign policy. When you look at what occurred in Libya, Egypt, in Syria, I think there is appropriate concern by the Israeli people.”

People think that some countries are eroding the U.S.’ role as the only superpower. Do you think Israel’s number one ally is in decline?

“I am not sure we can take a snapshot of just even the last five years, and say, ‘Here is the direction the world is going’ … just four years ago we all looked at a rising China and now [not so much]… I think the United States is still a global superpower. So I think the U.S. is still a global superpower; how we project that and how we engage in the world is the real question. Again, I go back, this administration does not seem to have engaged in the historic way; they have not led from the front, to say the least. I think there is concern from our friends around the world, where they are not seeing consistent strong support from the United States and that is problematic.”

Last time we met it was just one year before the U.S. presidential election; it was during the Republican primaries. Did the president win the election because he was the best choice or because the Republicans made a lot of mistakes?

“We live an interesting world, I would say. That is, one where it’s very sharp sound bytes; little glimpses into this, into that; it’s social media; it’s show business to some degree; and I am not sure the current way we gather our information allows for an in-depth [view] of the accomplishments of individuals. The president is a very charismatic, photogenic, bright and polished orator. I think his policies, because he does not have a great deal of experience in executive management… He came to the job with none, and maybe there is concern about his on-the-job training. But listen, the American people engaged, they paid attention, they made a decision. I respect voters like I respect juries.”

Everyone followed what happened with the shutdown and the debt issue and the fighting. People think America wants to commit suicide. Do you have any opinion about that?

“A number of things. There have been government shutdowns before. I am always intrigued that the media and the general public — probably through the media — point the finger at the Republican party and say, ‘You are the reason the government is shut down.’ The president of the U.S. stood up before this process started with [Senate Majority Leader] Harry Reid as I recall and proclaimed, ‘I will not negotiate.’ I am an executive. Have been for almost 13 years. I would never stand up in public… I can’t think of any time I have even done it in private… and say,’I will not negotiate with you.’ That is not being a leader. That is being a political animal interested in making a political point instead of governing the most powerful country in the world.”

I understand you have come here to further Israel’s relations with Texas. Is there anything new, any new contract or new agreement between Texas and Israel?

“What brought me here the first time in 1992 was the signing of a memorandum of understanding between Texas and the State of Israel on semi-arid land studies, [and cooperation through] professors, technologies, companies like Netafim — which interestingly have offices in Houston now… There is an understanding that Israel and Texas are a-lot alike, like in climate, geography etc. Tomorrow we sign an agreement with the state of Israel and Texas A&M University (which will invest some 70 million dollars to build a campus in Nazareth).”

I think Israelis would like to know whether you plan to run for president again in two years.

“I will let them know around January, February 2015… It’s possible.”

Nevada’s Republican governor, 50-year-old Brian Sandoval, is also excited to be in Israel. It’s his first time here. Because he considers Israel and Nevada to be very much alike, it is likely that cooperation will increase over the coming years.

Governor, how would you sum up this trip?

“This is my first visit to Israel; it’s something that I have looked forward to for a long time. It’s part of my effort to diversify our economy, and part of that is having a global presence for our state. When we identified the things that we could be good at, we found Israel as a natural partner — we have similar climates and we have similar topography. One of the reasons we are here this week is the water conference (called Watec) and the opportunity… Water is very important in Nevada and we felt that we would have an opportunity to partner with Israeli companies. “

The governor adds that education and the economy are his two biggest challenges.

“We still lead the country in unemployment — so it’s my goal to get Nevada working again. We are the second fastest improving state in the country with regard to unemployment… We are outperforming 34 other states in the amount of jobs that have been created in the private sector. We are spending an additional 500 million dollars on K-12 education; I am the first governor in the history of our state to invest $ 50 million on English language learners. The dynamics in the state are changing — 48% of the students in Clark Country, which is Las Vegas, are Hispanic. So it is very important that we invest in early education so that they get a good start… I have to recognize that the demographics in our state are changing. And I have to look at the Nevada of now and at the Nevada of 20 years from now. That is why I am making an investment in those kids’ early education so that when they graduate 12 years from now they will have jobs to step into. I think I am fortunate because I just finished a legislative session. I am a Republican. The legislature is controlled by the Democratic party. I am a fiscal conservative, we didn’t agree on everything but we were able to work things out.”

Can Israel still trust the friendship of the American people for its security and for its future.

“I think Israel can trust the American people… I know I will always be a strong supporter of Israel.”

Can you guarantee that Vegas will stay Vegas 20 years from now?

“[Laughing] Vegas will always be great. That is the beauty of Vegas. It continues to reinvent itself… So I am confident that 20 years from now when you come to Las Vegas you will still have the opportunity to have the best entertainment, the best hotels, the best food, the best shows, all of it.”

When you say I am the governor of Nevada, immediately Vegas comes to people’s minds, right?

“It does… In my speech today I asked everyone ‘How many of you have been to Las Vegas?’ and three quarters of the room raised their hands.”

When are we going to have direct flights from Tel Aviv to Vegas?

“I hope soon.”

When I remind the Sandoval that some governors went on to become president, he smiles and says, “My only goal right now is to get re-elected next year… I love my job.”

WHAT REALLY HAPPENED

Texas governor: Don"t fall for Iran"s charm offensive

Video: Obama Supporters Don’t Know What Party Obama Is Affiliated With

How can Americans even begin to understand Obamacare or the government shut down?

Paul Joseph Watson
Infowars.com
October 4, 2013

In his latest ‘man on the street’ video, Mark Dice talks to Obama supporters in San Diego who struggle to work out which political party Obama is actually affiliated with.

The majority of the people Dice talked to didn’t know which party Obama was associated with and some even thought he was in fact a Republican.

One man thought Obama was associated with the “best ideas” party.

“The average American is a zombie and doesn’t even know what political party he stands for,” Dice tells one man who asserted that Obama was a Republican. “I would agree,” the man responds.

“What political party is Barack Obama affiliated with?” Dice asks another man, who responds, “It’s one of those.”

In response to the same question, another woman responds, “I have nothing good to say, I’m sorry.”

The clip would be hilarious if it wasn’t a tragic reflection of how dumbed down and ignorant of basic facts Americans have become in the modern era. Given that a substantial percentage of them don’t even know that Obama is a Democrat, how could they possibly hope to understand things like Obamacare or the government shut down?

If you think that this footage is a misrepresentation of the average intelligence of Obama supporters and other politically naive Americans, then you should probably become familiar with Dice’s countless other videos, which all point to the same conclusion. They include;

- Obamacare supporters signing a petition to add birth control drugs to the water supply;

- Students at the University of California accepting “abortion in a can” fruit juice drinks;

- Endorsing 19th century communist ideologue Karl Marx as the next President of the United States;

- Signing a petition to repeal the 4th amendment to the Constitution;

- Supporting a move to end the right to remain silent by repealing the 5th amendment;

- Signing a petition to support post-birth abortion up to age 3 and making infanticide a part of Obamacare;

- Signing a petition to support making euthanasia of senior citizens a mandatory part of Obamacare;

- Supporting a move to release all illegal aliens from prison no matter what crime they have committed and then giving them free US citizenship;

- Signing a petition to grant Obama immunity for all crimes he commits while in office.

And those are from just the last few months alone.

Facebook @ https://www.facebook.com/paul.j.watson.71
FOLLOW Paul Joseph Watson @ https://twitter.com/PrisonPlanet

*********************

Paul Joseph Watson is the editor and writer for Infowars.com and Prison Planet.com. He is the author of Order Out Of Chaos. Watson is also a host for Infowars Nightly News.

This article was posted: Friday, October 4, 2013 at 9:24 am

Tags: domestic news

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Video: Obama Supporters Don’t Know What Party Obama Is Affiliated With

Why Good Deeds Don’t Go Unpunished

Being overly generous can get you punished as a nonconformist.

From an early age, we are taught that cooperation, generosity, and altruism are generally things we should strive for. But altruistic acts aren’t always lauded, and researchers have found that generous individuals are sometimes punished for their behavior. Studies suggest that people often react negatively to large contributions, are suspicious of those who offer help, and want to expel particularly charitable individuals from cooperative endeavors. These seemingly counterintuitive behaviors are called “antisocial punishment” and are more common than you might think. But why would people want to punish anyone who is particularly charitable?

The answer to that question would explain a puzzling human behavior, and it could have important ramifications for public policy. Tackling many of the major problems we currently face—from climate change to political stalemates—requires cooperation and collaboration. Understanding why people are sometimes willing to undermine joint efforts out of what appears to be nothing more than spite could go a long way to improve cooperation and discourse in many areas.

Sociologists Kyle Irwin and Christine Horne suggest that our inclination to punish do-gooders may stem from our adherence to social norms. Using a clever experimental design that allowed them to manipulate the level of conformity among group members, the researchers investigated the relationship between antisocial punishment and social norms.

During the study, 310 undergraduates were asked to take part in a game based on points; the more points a participant ended up with, the better chance they had of winning one of three $ 100 Amazon gift cards.

The premise was relatively simple. Each participant was given 100 points and randomly assigned to a group of six players. In each round of the game, individuals would be asked to contribute however many points they like to a “group fund” that would be doubled by the experimenters and divided equally among the participants. In this scenario, everyone in the group would end up with twice what they started with if all participants donate all their points, but free-riders that donated fewer points—or even none at all—could still benefit from others’ contributions.

The participants made their choices in a predetermined order and could see each contribution as it was made, but they interacted with other group members through a computer rather than face-to-face.

But there was a pretty significant twist: since the researchers wanted to control some variables while manipulating others, much of what happened in the study was decided in advance (which, of course, was unbeknownst to the participants). There was only one actual study participant in each group; the other five “group members” were computer programs playing out predetermined roles. The human participant was always “randomly” chosen to be the fifth player to donate, and the four contributions that he or she observed before contributing always averaged 50 points, or half the total possible contribution.

By preprogramming these values, the researchers could manipulate the “social norm,” or the way most group members behaved. In the “strong” social norm condition, the contributions varied only slightly, ranging between 45 and 55 points; this represented a situation in which social conformity was high. In the “weak” social norm condition where conformity was lower, the first four predetermined contributions varied between 30 and 70 points.

Lastly, the contribution of the sixth and final group member was also set by the researchers and was either overly generous (donating 90 of the 100 possible points), or overly stingy (donating only 10 points).

CONTINUE READING

disinformation

Why Good Deeds Don’t Go Unpunished

Don’t Miss It: “Hillary Clinton miniseries coming to NBC”

Posted on July 27, 2013 by # 1 NWO Hatr

The Real Revo

Just in time for the 2016 elections. A couple questions:

Will Lane wear pantsuits?

Will the show include Hillary dodging bullets in Bosnia?

Will the word ‘Benghazi’ be allowed to be uttered on the set?  

From POLITICO:

Actress Diane Lane is starring as Hillary Clinton in a new NBC miniseries, the network announced on Saturday, Variety reports:

Diane Lane Looks Just Like Hillary.

Former Senator, former Presidential candidate, and Secretary of State Hillary Clinton

[NBC Entertainment chief Bob] Greenblatt said the Peacock is working on a miniseries about Hillary Clinton to star Diane Lane; a reboot of “Rosemary’s Baby”; a new version of Stephen King’s “Tommyknockers”; and a historical project with Mark Burnett about the pilgrims’ landing at Plymouth Rock.”

http://therealrevo.com/blog/?p=101876

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Don’t Miss It: “Hillary Clinton miniseries coming to NBC”