Transcript Document

Washington Update: What’s
Really Going on in Washington
Wisconsin AAHAM
May 9, 2014
How Government Really Works
Throw out all preconceived notions you have about
government and how it is “supposed” to work.
In reality, it works nothing like what you learned in
school or read about in books.
Not so sure it works anymore
What
A
Ride!
Maybe this is the new norm
What Congress Has Been Up To
What Congress Has Been Up To
ABSOLUTELY
NOTHING!!!!!!!
What Congress Has Been Up To
913
178
Can anyone tell me what these numbers represent?
913 Days Until the
2016 Presidential Elections
178 Days Until the
2014 Congressional Elections
2016 Here We Come!!!!
Rep. Paul Ryan
Sen. Rand Paul
Gov. Scott Walker
Sen. Marco Rubio
Rick Santorum
Jeb Bush
Gov. Rick Perry
Gov. Chris Christie
Sen. Ted Cruz
Scott Brown
Gov. Susana Martinez
Bridge Gate
Governor Christie went from top tier 2016 Presidential candidate to struggling to stay afloat
these days. When it goes wrong it goes wrong and may be hard to recover from.
Tornado Ted Cruz
His government shutdown sideshow has made him stronger within the Tea Party, but has
made him an outcast among most of his other colleagues.
Tornado Ted’s brand has put Republicans in a very tough spot and has forced business
community to now disavow those they helped get elected in 2010
Tornado Ted
You said you wanted a third party.
Democratic Party
Republican Party
Tea Party
State of the Tea Party
* Started in 2010 and really caught on
* Won large number of seats in 2010 elections
* Failed to nominate Tea Party candidate for WH in 2012
* Other than Sen. Cruz they have really not faired well on
national stage (losses in DE and NV in 2010, losses in MO and
IN in 2012)
* Big blows to Tea Party from fallout over government shutdown
State of the Tea Party
* King of the Tea Party loses race for Governor in VA
* Biggest sign of change for me was the special election in
Alabama
* Alabama businessman Bradley Byrne defeated Tea Party
candidate Dean Young in Republican primary
* Business community now disavowing Tea Party
candidates
If you are a Democrat
here is your choice in 2016
Others who want to run and still may even with
Clinton running
VP ”Smokin” Joe Biden
Gov. Martin O’Malley
Sen. Elizabeth Warren
Gov. John Hickenlooper
Before we get to 2016 we need to get through 2013
President really has to be asking himself “Can I catch a
break here!”
* IRS Scandal
* Benghazi
*Another game of chicken with shutting government down
*Increased debt limit
* Republican(s) efforts to defund ACA
* President has to put off key pieces of ACA/Rollout of ACA/Website/You can keep your
insurance
* Syria
* Finally got a spine and stood up to Republicans
* Have people asking the question:
Miss Me Yet?
How About Me
Probably Not Me
(But I may not go down as worst President ever)
Or Me
Before we get to 2016 we need to get through 2013
Republicans have to asking what are we doing!”
*Party may be learning lessons from 2012 (Debt ceiling vote beginning)
*Becoming more polarizing (reverse effect – far right getting primaried by
moderates – MI is perfect example)
*Republican leadership in tough spot
*Having the 2010 crop of Freshman not so energizing now for party’s future
* Becoming the Democrats of the 1990’s
* Like you today hate you tomorrow mentality (Sen. Marco Rubio)
* Gay marriage and race issues
* Fight to defund ACA – even most Republicans see as a losing issue
* Shutting government down
* Syria
* 2014 debt ceiling
2014 elections critical to Republican’s future
2014: Senate Democrats have to defend 25 seats
Senate Republicans have to defend 16
Redistricting in the House makes taking control
difficult for Democrats – Really only 17 seats that
one would consider truly competitive.
Why Republicans Can’t Win Key Elections
Republican U.S. Senate candidate Rep. Todd Akin (R-MO), who stated that pregnancy rarely
occurs as a result of what he called "legitimate rape.“
Republican Senate candidate Richard Murdock (R-IN), who said that life was
"something that God intended", even if the pregnancy was due to rape.
Rep. Steve King (R-IA) - For every one who's a valedictorian, there's another 100 out
there who weigh 130 pounds -- and they've got calves the size of cantaloupes
because they've been hauling 75 pounds of marijuana across the desert.
Mitt Romney - “There are 47 percent of the people who will vote for the
president no matter what. All right, there are 47 percent who are with him, who
are dependent upon government, who believe that they are victims, who
believe that government has a responsibility to care for them, who believe that
they are entitled to health care, to food, to housing, to you name it… And they
will vote for this president no matter what…
“Super Republicans” Rise Within GOP’s Ranks
House Republicans by Partisan Voter Index (PVI)*, 1995-1996 and 2013-2014
(231 Members)
(236 Members)
The percentage of
House GOP Members
with a PVI score of R+5
or greater jumped from
56% to 78%
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As a result of redistricting and a huge sorting-out of voters and seats, the share of House “Super Republicans”—
Republicans from districts with a PVI score of R+5 or higher—has grown nearly fourfold since ‘95/’96
The “Super Republican” majority means that House Republicans today are likelier to play to a primary audience
than be bullied into submission by Democrats
Redistricting Whitewashes Republican Districts
Non-Hispanic White Share of
the Average House District
* White share of district, pre-redistricting (2010)
Non-Hispanic White Share of
Select GOP Districts
* White share of district, post-redistricting (2012)
Analysis
• After 2010 redistricting, the white share of the average GOP House district increased by 2 percentage points, while the white share of the average
Democratic district decreased by 1 percentage point
• In Tea Party and other Republican districts across the country the increase in the share of white voters was sharper, often completely altering the
demographics in the district such that they bore no resemblance to national demographics
• The higher share of white voters gives many Republicans a competitive advantage; for example Rep. Farenthold won his 2010 election by fewer than
100 votes, but after redistricting the white share of the district increased by 21% and he won handily
Democrats Have Their Own Challenges
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President Obama Approval Rating Hoverin in the mid 40% range
33% of voters vote in November will be to oppose President (his agenda)
•
56% of voters oppose ACA
Democrats lose key special election in FL
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Lobbyist David Jolly defeated Alex Sink
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True Swing District
Sink strong Democratic candidate
Jolly was not top choice of Republican party – poor candidate, poorly run campaign and
ran around the district with his 26-year old girlfriend
•
Big problem for national Democrats worried about November
HEALTHCARE
ROLLOUT
www.healthcare.gov
1-800-318-2596
(F1UCKYO)
Cruel Joke by someone
California Exchange
“Welcome to America’s hottest talk line. Ladies, to
talk to interesting and exciting guys free, press one
now. Guys, hot ladies are waiting to talk to you.
Press two to connect free now.”
What deaf Obamacare customers were greeted with
after being mistakenly directed to a sex chat number
instead of insurance line
Mo Money Mo Money Please
• President’s FY’15 budget requests more money for the
implementation of the ACA
• WH needs $630 million more to operate the exchanges
• ACA law did not provide funding for federally run
exchanges
Website “Glitches”
.
Roughly 22,000 people who have signed-up for the ACA have filed
appeals with the government trying to get mistakes corrected.
Problem is the website not equipped to handle appeals so these
22,000 appeals are sitting there untouched.
This could be a real problem when people need to use the insurance
and find they may not have the coverage they thought or tried to
get.
2 Companies in MN paid their premiums for all their employees
and federal government cashed the check, but now has told them
they do not have coverage. Class-action lawsuits are next.
An then… that line you wish you could take back
President Obama: You can keep your healthcare
* This statement has the President floundering and Democrats a very bit concerned –
especially Senate Democrats up for re-election.
* The unified Democratic base shown during government shutdown showing cracks over this
issue. Loss in FL special will cause more cracks leading up to November.
* Members on both sides of the aisle introduce legislation allowing people to keep their
insurance as promised. 39 Democrats vote with R’s to allow you to keep healthcare – go
against President.
* Former President Bill Clinton throws President Obama under the bus.
* President had to come out on tv and admit the failures and has his own plan to allow
people to keep their plan – pure political move to protect Democrats up for re-election –
state not sure if they can do this.
* President say’s he didn’t have any idea these problems existed prior to rollout.
* Presidents poll numbers hover around mid-40% range
* Rasmussen poll claims over 50% of Americans want ACA repealed.
YOU’RE FIRED!
(Technically she resigned)
Had to be done – she was becoming a bigger liability and would be the poster child for
failure closer to 2014 mid term elections.
Sylvia Burwell new HHS Secretary appointee. Comes over from OMB. Limited health
experience, but strong manager.
Real Marketing of ACA
WE DID IT!!!!!!
7.5 MILLION PEOPLE SIGNED UP FOR ACA
DID WE REALLY?
SIGN-UPS DO NOT EQUATE TO PAID
CUSTOMERS.
Calling All Young People!
The ACA really only works if:
1) the young people sign up and they are not; and
If the young people don’t sign up, you could see this program blow
up due to costs exploding next year.
33% - 55-64 age group
22% - 45-54 age group
15% - 35-44 age group
15% - 26-34 age group
6% Under 18 age group
2) People actually pay their premium – signs-up do not equal paid.
Calling All Young People!
Gender Breakdown for enrollment:
46% Males
54% Females
21% of ALL enrollments do not qualify for subsidy
79% of all enrollments eligible for subsidy (Ehealth Data shows
big premium spikes for individuals not eligible for subsidies)
* HHS.Gov data
States Role
WH may get kinks in website all worked out, but one of
the keys to long-term success is how the states handle the
ACA rollout and enrollment.
Rollout in states will or could become political tool and its
success could depend on how those political forces are
able to do damage to the ACA in those particular states.
This battle is far from over.
Uninsured
• Main thrust of the ACA was to get uninsured people
insurance
• According to governments own data only 1 in 10
uninsured people are enrolled in the exchange
• Reasons being state is they don’t believe they can afford
the plans
•
McKinsey Survey 2014
Unions
• Unions were the biggest advocates for the ACA
• Switched their tune late in the game once they realized their plans
(Cadillac plans) would be taxed by the ACA
• Unions have now become one of the most outspoken critics of the
ACA
• Unions have been pressing the White House for an exemption,
which he has resisted up until this point
Do members of Congress
have to use the exchanges?
This has been a much debated topic and we finally have the answer:
Yes, but with a twist.
MOC and their staff have 75% of their monthly healthcare costs paid for.
ACA would have eliminated that benefit.
Earlier this summer MOC were complaining on the impacts such a move would have
on their ability to earn a living.
President comes out and agrees to continue paying 75% monthly
premium for MOC and their staffs.
MOC and staff are required to purchase insurance through the exchange.
Senator David Vitter (R-LA) and Sen. Mike Enzi (R-WY) trying to strip this
provision.
Employer Mandate
* For a second time the President announced another delay in the employer
mandate.
* Very large employers are required to offer health care coverage to their full-time
employees or pay a penalty to the federal government beginning January 1, 2015.
* Under the final regulations released by the U.S. Department of Treasury (Treasury
Department) on February 10, 2014, however, employers with fewer than 100 fulltime employees will have an extra year to plan for and implement the employer
mandate (2016).
* Former Obama advisor Robert Gibbs recently said on Meet the Press he doesn’t believe
employer mandate will ever kick in.
Medicaid
•
Expansion of Medicaid meant that roughly 6.3 million people would be able to sign up
for coverage.
•
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The problem with the new Medicaid expansion means that it will create new headaches
for states, health plans, and patients
•
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Between 1-2 million have signed-up.
Because the income of these individuals will fluctuate meaning they will find
themselves in and out of the Medicaid expansion efforts.
This would mean some would find themselves with gaps I their coverage due to the
income fluctuation.
Income bumps could leave these people without insurance because they cannot afford
in private market.
40-Hour Work Week
• Under ACA the work week is defined as anyone working 30 hours
per week.
• Has caused businesses to drop hours for employees.
• New legislation pending in Congress changing the definition of
work week back to 40 hours per week.
• I’d see this as an election year move by Republicans. Is getting
some traction with Democrats. Rep. Lipinski is (D-IL) first
Democrat to co-sponsor
Full-Time Employee Careveouts
•
Fewer and fewer employees fit into the neat definition of full-time employees.
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Poses real challenges for the IRS.
IRS say’s it needs carveouts and exemptions to various industries to make this law work
effectively.
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In the category of carveouts include:
• Flight Attendants and Pilots;
Cruise Ship Workers (because they do work outside the US on these ships would this
affect their employers requirement to offer healthcare?)
• Adjunct Faculty
• On-Call Employees
• Temp Firm Employees (some work full-time)
Third Party Payments of Marketplace Health Plan Premiums
• Interim Final Rule sitting over at OMB
• Just days after the federal Department of Health and Human Services (“DHHS”) issued a
letter which seemed to sanction third-party premium subsidies for patients who
purchase insurance through a health care exchange under the Affordable Care Act
(“ACA”), DHHS released new guidance cautioning against that practice. As a result, any
hospital or health care provider that seeks to provide premium assistance to patients
who purchase insurance through an exchange risks investigation or sanction by the
federal government. The government’s position may also mean that issuers of such
plans will not accept premium payments from third parties (other than the
government).
Paul A. Miller
(703) 383-1330 – office
(703) 930-7790 – cell phone
[email protected]
@mwcapitol – Twitter
@mwceo – Twitter
https://www.facebook.com/Paul.Miller.MWCapitol