Maggie's Farm

In the rush to enact ObamaCare, the uproar from Democrats should not be surprising over the few announcements so far by major corporations of billions of dollars of charges for the elimination of part of the Medicare Part D prescription drug coverage subsidy to employers.

Indeed, the Senate Republicans had not featured this explosion in employer costs before the corporations began announcing the charges, nor had the corporations (except Caterpillar).

The Democrats’ motivation to be quiet is evident.  The Republicans had a hard enough time exposing the many real direct federal budget impacts. Major corporations are not, despite liberal assertions, conservative nor brave, probably avoiding the pillorying of them that is now happening from Democrats, heads in the sand when it may have helped avoid the ill consequences to them and their retirees by ObamaCare.

Now, corporations, already under severe pressure from retiree medical plan costs, have to face the music and have further justification and impetus to reduce or abandon their retiree Rx programs. They are imploring Congress to repeal this portion of ObamaCare, but receiving back Obama administration opposition to repeal.

Prescription benefits to employer plan retirees is broader than from Part D. The Part D subsidy to corporations is to encourage corporations to continue their benefits, at a savings to the federal budget and to retirees.

The subsidy will continue.  However, after 2012 corporations will no longer be able to deduct against income that portion of their Rx plans that are subsidized. The Congressional Joint Committee On Taxation’s (JCT) March 20 calculation (page 2) estimates that $4.5 billion higher federal taxes will be paid by corporations between 2013-2019, rising from $400 million to $1 billion a year over that period.

Let’s look deeper into the numbers.

According to the 2009 Medicare Trustees Report, about 19% of those covered by Part D are in the plans of former private employers (excludes TRICARE, VA and FEHB for military and former federal employees), or 6.3 million out of 33.2 million beneficiaries. (page 160)  The employer subsidy amounts to an average $594.54 per enrollee. (page 163)  The subsidy is about 28% of employer retiree plan drug expenses.  So, the total 2009 employer retiree Rx cost in 2009 is about $2123.36 per covered retiree, or $13.4 billion.

Congressionally mandated accounting rules require employers to take current charges for the future actuarial costs of their retirement programs. Depending on the employer’s present and forecast tax bracket, each employer offering a retiree Rx program must add up to 35% or more to their tax liability for the program for the future years.  Hence the charge that employers must now take and fund is cumulatively many multiples of the $4.5 billion initial eight year increased taxes that proponents of passing ObamaCare depended  upon.  The exact amount will not emerge until all companies finish their calculations, but the $1 billion charge to AT&T alone gives us some idea of the cumulative effect.

Now, let’s look at the impact on the federal budget if all the corporations now offering retiree Rx coverage abandon their program. They should be expected to be looking at that, even more favorably now than before ObamaCare.

According to the 2009 Medicare Trustees Report, total benefit payments, including the employer subsidy, was $50 billion in 2008 (expected to increase to $140 billion in 2018).  Subtracting the entire $3.7 billion subsidy, that leaves $46.3 billion. Divide that by the 26.9 million Part D beneficiaries not covered by a subsidized employer retiree Rx plan, and you get $1721.19 budget cost per enrollee.  Let’s subtract 10% from that as a guesstimate that retirees from employers may be healthier than the other average Part D beneficiaries, and that Medicare Part D benefits are lower (though increased by ObamaCare in future years to nearer parity), and you get $1549.07.  That is $954.53 higher than the subsidy, or would have meant $6 billion increased federal budget expense in 2008, an increase of 12% if private employers had abandoned their retiree Rx programs in 2008.

Multiply that $6 billion and increase it for an average annual 7% increase in prescription costs, 7% being the Medicare estimate, and you have literally hundreds of billions of dollars of increased federal expenses, further deepening the already intolerable projected budget deficits.

The CBO estimate of ObamaCare depended upon the JCT estimate for the initial costs of ObamaCare, and did not take into account employers consequently being motivated to cease their retiree Rx programs.

Corporate, Medicare and other actuaries will be working and reworking the actual figures as this debacle unfolds.  Actual impacts may well be less than the above worst case, but the dimensions are clear.

As we can see with regards to Part D as well as most other portions of ObamaCare, to believe in the incomplete CBO forecasts or the Democrats’ thinly veiled promises deserves a big Part D for Dummy.

P.S.: Democrats charge a "CEO Conspiracy". Actually, it's the Democrats' conspiracy to keep you poor and stupid.  Doesn't seem to be working.

P.P.S.: The New York Times editorializes that the eliminated Part D tax break is "double dipping."  The NYTs conveniently, totally ignores that it saves the federal budget many tens of billions of dollars, while helping to continue better retiree Rx benefits.  The NYTs asserts that, after all, " If some retirees do lose their company drug benefits, they can buy government-subsidized coverage in Medicare..." and the added cost to taxpayers is irrelevant to the NYTs.

Joshua and Caleb are the only Jews from the original exodus from Egypt 40-years earlier who are specifically permitted to enter the promised land of Israel. Even Moses wasn’t.  When others wavered, Joshua and Caleb never did, from faith and courageous optimism and actions.  Others in the exodus wavered and needed to have their children educated in their purpose before they could enter Israel.

At the Passover Seder tonight traditional prayers and foods remind us of the trials and purpose of the exodus.  The centrality of Jerusalem to Jews across the millennium is seen at the conclusion of the Seder when we all say “Next Year In Jerusalem,” as in every removal of the Torah from the ark we sing, “For from Zion [Israel] shall come forth Torah and the Word of Hashem [G-d] from Jerusalem.”

The manner in which the Seder is conducted is intended to educate the children, a wise one, a wicked one, a simple one, and one who doesn’t know to ask, as are all adults whether Jewish or other. Hence, we begin the narrative of Exodus (Haggadah) with the Four Sons.

The Four Sons

The Torah refers to four sons: One wise, one wicked, one simple and one who does not know how to ask a question. What does the wise son say? "What are the testimonials, statutes and laws Hashem our G-d commanded you?" You should tell him about the laws of Pesach, that one may eat no dessert after eating the Pesach offering.

What does the wicked son say? "What does this drudgery mean to you?" To you and not to him. Since he excludes himself from the community, he has denied a basic principle of Judaism. You should blunt his teeth by saying to him: "It is for the sake of this that Hashem did for me when I left Egypt. For me and not for him. If he was there he would not have been redeemed."

What does the simple son say? "What's this?" You should say to him "With a strong hand Hashem took me out of Egypt, from the house of servitude."

And the one who does not know how to ask, you start for him, as the Torah says: "And you should tell your son on that day, saying 'It is for the sake of this that Hashem did for me when I left Egypt.'"

The passage of the four sons raises many questions:

The major media has neglected to examine one of the major sections of ObamaCare, its long term care program CLASS, the Community Living Assistance Services and Supports Act.

The New York Times’ chosen "New Old Age" guru, wrote on March 24 that,

I’ve read so little about the Class Act in recent weeks that when President Obama signed the health care bill yesterday, surrounded by a gaggle of happy Democrats, I had to call the National Council on Aging to reassure myself that yes, this often overlooked but potentially transformational program remained part of the package.

Of course, the Wall Street Journal did manage an op-ed, last December, “Congress’s Long Term Care Bomb,” written by a professor of health-care management and insurance and risk management at the University of Pennsylvania's Wharton School.

But CBO and the Centers for Medicare & Medicaid Services (CMS) have identified parts of the program that will subject it to considerable financial risk.

First, those who enroll would likely be more apt to need care and will be more expensive to cover than those who buy private insurance. To cover its costs, the program would have to charge more than private insurers.

The best objective and factual summary and analysis of CLASS I’ve found is that by one of the preeminent global consulting firms on benefits, Towers Perrin.

The Senate version is projected to bring in $72 billion, with an average monthly premium of $123. The initial positive cash flows come, of course, from the five-year period before participants vest, when premiums are paid but benefits are not. Tens of billions are foreseen to flow into the trust fund during those five years. In later decades, however, the flows would turn negative and increase the federal deficit.

(Note that $72-billion is over half of the highly doubtful supposed first 10-year federal budget deficit reduction of ObamaCare, which itself ignores the tens of $billions of mandates in Medicaid imposed on the states from the majority of ObamaCare’s increased coverage of the uninsured and the tens of $billions of extra costs imposed on private firms that continue retiree prescription benefits.)

Let’s look closer at that estimated 2011 average premium of $123 per month, or $1476 per year.

I checked the standard risk premiums charged in most states by one of the largest top-rated long term care insurers for an individual to have a lifetime benefit period, as in CLASS.

Insurers cover working and non-working applicants. CLASS will only enroll working participants, who are more likely to be of reasonable health if working.  As the CBO points out, non-working spouses are more likely to have impaired health and are more likely to enroll than are workers, which increases the actuarially required premiums. Insurers will cover seriously impaired risks at about a 50% higher premium than standard risks, and only for a 6-year benefit period versus the lifetime benefit period in CLASS (average benefits actually needed by all insurer claimants is about 3-years), while insurers reject some applicants with severely impaired health. The CBO did not reveal the details of its analysis, but one may expect that these factors and others were considered.

To get at an apples-to apples comparison of a $50 dollar a day benefit, I further adjusted the insurer rates downward by 30%, as would be charged for a joint policy with spouse from that insurer, to estimate efficiencies of marketing and administration to a larger pool mostly garnered via the workplace in CLASS. Further, CLASS will not be paying commissions to agents as does insurers, so I subtract another 5% from the adjusted insurer premiums below, for a total reduction of 35%. The elimination period, or time to have the qualifying inabilities to manage activities of daily living, by the insurer is 30-days. In parentheses I include the insurer’s annual premium for a preferred risk. CLASS has substantially more liberal reinstatement provisions for non-payment of premiums than this or any insurer, for example, along with other provisions which increase the cost of the program. CLASS subsidizes those of low income, but claws back part of their benefit if qualified for Medicaid, which private insurers don’t.

CBO estimate of average premium for CLASS in the Senate version enacted: $1476

Adjusted Insurer Premium: Age 25 $373.93 ($317.84); Age 40 $483.91 ($411.33); Age 60 $978.82 ($832.00).

Unadjusted Insurer Premium: Age 25 $575.28 ($488.99); Age 40 $744.48 (632.81); Age 60 $1505.88 ($1280)

An $80/day benefit insurer premium is higher, but still below the CLASS initial estimated premium, which includes a $75/day benefit for nursing home care which is much less preferred or used by claimants than the $50/day for home health care.

The House version of CLASS included non-working spouses, according to the CBO more likely to have impaired health and more likely to enroll than are workers, at the following estimated annual premiums: Age 18-39 $1632, Age 40-49 $1728, Age 50-59 $1824, Age 60-69 $2772. The actuaries estimate anticipates that those older are much more likely to enroll than those younger.  One may expect political pressure in coming years to open CLASS to non-working spouses.

So, first of all, it does seem that CBO and actuaries did a reasonable job of estimating initial CLASS premiums, though the Medicare chief actuary did warn that, as the WSJ op-ed indicates,

[P]remiums would be set so high they would discourage healthier people from buying in. As the healthy stayed on the sidelines, the program would have to charge more to those who did enroll. This in turn would price more people out of the program, risking what the memo called an "insurance death spiral."

An insurance death-spiral occurs as due to adverse selection, when the healthier don’t join or leave the program, and the costs of the remaining less healthy escalate future premiums, leading even more of the healthier to leave or find other alternatives. The death-spiral leads to the program’s costs rising to bankruptcy, otherwise.  Although CLASS says they won’t have to, one may expect a future Congress to bail it out with taxpayer funds rather than abandon this new entitlement.

Private long term care insurers have not opposed CLASS.  Of course, they expect that the added consciousness of the need for long term care insurance prompted by CLASS marketing at workplaces will, together with insurers’ lower premiums, increase their own sales.  Similarly, life and annuity insurers may expect increased sales of their products that contain a long term care component.

That just leaves taxpayers on the future financial hook for CLASS, and disappointed ObamaCare supporters on the hook for letdown.

As Ed Morrissey points out from the latest Washington Post poll on ObamaCare, opposition continues to mount.  Relatively few are aware of the details of the CLASS failure, so more should be expected to become disappointed in the non-classy failure of Democrats to be responsible.

Why believe in a conspiracy when stupidity is explanation enough?  With that at the front of my mind as a major caveat to my and others’ conjecture, aside from not knowing what is going on in the privacy of White House meetings, there may actually be a secret purposeful plan behind President Obama’s public undermining of Israel.

Stupidity isn’t enough of an explanation:

First off, there’s every reason to believe Obama’s pledge to be a “transformative” president.  Nearly every policy, law and appointment from him and his allies have been distinctly left of those from previous Democrat and Republican administrations.

Second, there’s every reason to believe that Obama and his counsels are aware, how can they not be, of the past refusals by Palestinian leaders to accept offerings, to obstruct negotiations, to foment violence, to foster corruption, to be divided between the violently hostile and the very violently hostile, and that repeated and continuous Israeli concessions and withdrawals have encouraged more of the same from the Palestinians.

Third, there’s every reason to believe that Obama and his advisors are aware of Iran’s impending nuclear status (even the IAEA has finally publicly woken up) and that other MidEast nations are accommodating themselves to Iran, they seeing little likelihood that the US will push for severe enough sanctions in the face of Russian and Chinese opposition and European profits or the US striking Iran’s nuclear installations.

Fourth, there’s every reason to believe that the US has more influence upon Israel, given that Israel has heavily depended upon the US as a bulwark of support, than upon the Palestinians, MidEast nations, Russia, China or even Europe.

Fifth, there’s every reason to believe that President Obama and advisors, some of whom are Jewish, depend upon the Democrat’s base supporters, some of whom are Jewish, to at worst weakly react to the Obama administration undermining Israel. (See this post.)

Sixth, there’s a big difference between occasional ignorance or mistakes and a consistent pattern of such, particularly when the facts and errors are so well known.

Secret Plan:

Yesterday, I had a brief conversation with a very liberal, very smart friend who visits Israel several times a year to study.  I shared my conjecture in an email to another very knowledgeable MSM friend:

My theory is that the O master plan, if there is one, is to force Israel to bomb Iran, then disavow Israel and further isolate it, and maybe even let it be overwhelmed.

It very well may not be true, but it does explain a lot.

This morning, Glenn Reynolds similarly conjectured:

WHY HAS BARACK OBAMA TREATED NETANYAHU SO RUDELY? “Obama would never treat the president of Equatorial Guinea that way.”

Possibly Obama just hates Israel and hates Jews. That’s plausible — certainly nothing in his actions suggests otherwise, really.

But it’s also possible — I’d say likely — that there’s something else going on. I think Obama expects Israel to strike Iran, and wants to put distance between the United States and Israel in advance of that happening. (Perhaps he even thinks that treating Israel rudely will provoke such a response, saving him the trouble of doing anything about Iran himself, and avoiding the risk that things might go wrong if he does). On the most optimistic level, maybe this whole thing is a sham, and the U.S. is really helping Israel strike Iran, with this as distraction. The question for readers is which of these — not necessarily mutually exclusive — explanations is most plausible.

The Jewish holiday of Passover begins this year next Monday night with the first Seder. (Translation = Order or sequence and content of the prayers, symbolic foods, and retelling of the Exodus, with emphasis on educating the children.)  Many Christians also celebrate the Passover Seder, which was their Last Supper.

Less known is that the Exodus was central to the minds of the new United States' Founding Fathers.  The first committee of the Continental Congress assigned to design our Great Seal, the symbol of our sovereignty, was comprised of three of the five men who drafted the Declaration of Independence: Thomas Jefferson, Benjamin Franklin and John Adams. Franklin chose a design of "Moses standing on the Shore, and extending his Hand over the Sea, thereby causing the same to overwhelm Pharaoh who is sitting in an open Chariot, a Crown on his Head and a Sword in his Hand. Rays from a Pillar of Fire in the Clouds reaching to Moses, to express that he acts by Command of the Deity." The motto: "Rebellion To Tyrants Is Obedience To God," which was later adopted by Jefferson as his personal motto.

The above is drawn from this website about the US' Great Seal. Click around the site.  It is fascinating.

Here's a relevant quote:

"All the armies of Europe, Asia and Africa combined could not by force take a drink from the Ohio or make a track on the Blue Ridge, in a trial of a thousand years. At what point then is the approach of danger to be expected? I answer, if it ever reaches us, it must spring up amongst us. If destruction be our lot, we must ourselves be its author and finisher." – Abraham Lincoln