Yes, Virginia, Medicaid Expansion Will Harm the Poor

Last week, Virginia’s general assembly voted to expand Medicaid under the auspices of Obamacare. The commonwealth’s legislators had wisely resisted doing so for years, but four GOP state senators broke ranks to vote for this bill in exchange for a provision stipulating an anemic work requirement. The “news” media have, of course, touted this betrayal as a victory for the poor. It is however, precisely the reverse. Expansion will consign thousands of truly poor and disabled Virginians to purgatorial Medicaid waiting lists while advancing able-bodied adults with incomes above the federal poverty level (FPL) to the front of the line.

Why would Virginia pursue such an obviously unjust policy? Like all Democratic programs, it’s about power and money. Obamacare incentivizes expansion states to shift Medicaid’s focus to able-bodied adults by paying over 90 percent of their coverage costs, while the federal share of costs for traditional Medicaid patients remains below 60 percent. This does not mean, however, that doctors and hospitals will receive more money. Providers will continue to be paid less by Medicaid than the cost of treatment whether the patients are expansion or traditional enrollees. The extra money will go to political slush funds and insurance companies.

Medicaid expansion doesn’t work like the original program, which was administered by the states as a safety net for poor children, pregnant women, the disabled, and the elderly. Management of Obamacare’s corrupted version of the program is farmed out to insurance companies. A typical example is Wellcare, which accrued over $10.6 billion in 2017 from its coverage of able-bodied adults. The company plans to reinvest $2.5 billion of that revenue in the acquisition of Meridian Health Plans of Illinois and Michigan, which will increase its Medicaid portfolio by 37 percent. Meanwhile, truly poor patients die on waiting lists.

This is not conjecture. A recent study, conducted by the Foundation for Government Accountability (FGA), revealed that at least 21,904 Americans have withered away and died on Medicaid waiting lists in the states that expanded the program under Obamacare. Even worse, the 21,904 figure reported in the study almost certainly understates the true death toll. A number of expansion states were somehow “unable” to provide FGA with death totals, while others implausibly claimed that there were none to report. It is nonetheless clear that Medicaid waiting lists in expansion states constitute a kind of death row for the genuinely poor.

The worst carnage has occurred just north of the Beltway. Maryland is easily the deadliest state for traditional Medicaid applicants, chalking up no fewer than 8,495 deaths among individuals languishing on its waiting list. During the same time period, even as these patients were left to die, the bureaucrats of the Old Line State enrolled very nearly 300,000 able-bodied adults under the aegis of Obamacare. Louisiana took second place in killing its traditional Medicaid patients. The Pelican State reported 5,534 deaths among the unfortunates who wound up on its waiting list, while 451,000 able-bodied adults were enrolled under Obamacare’s expansion.

Additional states whose Medicaid waiting lists have killed a thousand or more people include New Mexico, where 2,031 poor and disabled patients died while the state signed up 259,537 enrollees under Obamacare’s expansion scheme. Michigan left 1,970 of its residents to die while enrolling 665,057 in its new and improved Medicaid program. West Virginia allowed 1,093 patients to die on its waiting list while signing up 181,105 able-bodied enrollees. The remaining expansion states are mere also-rans with death tolls ranging from Iowa’s paltry 989 down to Minnesota, which managed to leave only 15 of its poor and disabled citizens for dead.

This is the august company Virginia’s General Assembly chose to join last week. The Old Dominion will become the 33rd state to take Obamacare’s Medicaid expansion bait, demonstrating that the commonwealth’s politicians have learned little or nothing from the deadly experiences of the previous states that were gaffed by their own greed. Those Medicaid expansion states still have nearly 250,000 poor, disabled, and elderly individuals wasting away on waiting lists. Yet Obamacare advocates in Utah, Idaho, and Nebraska — blissfully unaware of the death tolls quoted above — are working to pass expansion in November via referenda.

Maine activists have already tricked the voters of the Pine Tree State into passing a referendum approving expansion, but the program hasn’t been implemented because Governor Paul Lepage has refused to go forward: “My administration will not implement Medicaid expansion until it has been fully funded by the Legislature at the levels DHHS has calculated, and I will not support increasing taxes on Maine families.” This speaks to one of expansion’s most profound ironies. Even if Washington continues footing most of the bill, herding the able-bodied into Medicaid is a budget buster for the states. It nearly broke Maine the last time they tried it.

Medicaid expansion under Obamacare privileges able-bodied adults with incomes above FPL, states can’t pay for it in the long haul, and it causes the genuinely poor to be dumped onto waiting lists where they quietly die in their thousands. Yet the Old Dominion’s newly-minted Governor, Ralph Northam, will gleefully sign an expansion bill into law this week as the leaders of his party and the media beam benevolently from on high. His name may even be uttered by the Great Mentioner as potential presidential material. For any Democrat, that’s certainly well worth a little inequity, the occasional budget deficit, and a few thousand human sacrifices.

The post Yes, Virginia, Medicaid Expansion Will Harm the Poor appeared first on The American Spectator.

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Breaking: A big development in the case against Harvey Weinstein

Harvey Weinsten, the disgraced Hollywood movie mogul, has been indicted on criminal sex and rape charges according to a statement from the Manhattan district attorney’s office.

Here’s what happened 

Weinstein was arrested Friday on first and third-degree rape charges stemming from accusations by two women, one identified as a former acting student. He was released on $1 million bail, but ordered to wear an ankle bracelet.

“This indictment brings the defendant another step closer to accountability for the crimes of violence with which he is now charged,” said district attorney Cyrus Vance, Jr. on Wednesday.

“Our office will try this case not in the press, but in the courtroom where it belongs,” he added. “The defendant’s recent assault on the integrity of the survivors and the legal process is predictable. We are confident that when the jury hears the evidence, it will reject these attacks out of hand.”

Earlier during the hearing, Weinstein’s attorney indicated that he would not be testifying on his behalf in front of the grand jury. Weinsten has denied the charges against him.

Weinstein’s defense

Weinstein’s defense attorney Ben Brafman told reporters Tuesday that one of the accusers had a longtime relationship with the movie producer, in an attempt to cast doubt on the allegations.

“This is an extraordinary case in my judgement where the only rape victim that Mr. Weinstein is accused of raping is someone with whom he has had a 10-year consensual sexual relationship,” Brafman said, “both before and after the alleged incident.”

Brafman came under fire for his previous statement in defense of his client, when he said that Weinstein “did not invent the casting couch in Hollywood.”

The beginning of the “Me Too” movement

The “open secret” of Weinstein’s abuses spurred the “Me Too” movement when it was finally documented and revealed numerous accusations from his alleged victims. The culture of silence that helped him allegedly continue to wield his power to pressure and abuse women was unveiled in the entertainment industry, and encouraged other victims to reveal their abuse in other parts of society.

Some have claimed that the movement has gone too far and has caused false or exaggerated accusations to be made against men who were unfairly harmed in a courtroom of unaccountable public opinion.

Here’s a local news story on the indictment:

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Carthy welcomes Ombudsman’s transparency move against European Council

Sinn FA in MEP Matt Carthy has welcomed the move by EU Ombudsman Emily O’Reilly to refer a Special Report to the European Parliament regarding the Council’s failures when it comes to the transparency and accountability of its legislative processes. The Ombudsman’s report on its strategic inquiry on the transparency of the Council legislative process was published in February 2018.

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They’re the think tank pushing for welfare work requirements….

Speaker of the House Paul D. Ryan , joined by Rep. Cathy McMorris Rodgers and Majority Leader Kevin McCarthy , expresses support for the Farm Bill at a news conference on Capitol Hill on May 16. An obscure, Florida-based policy group with ties to House Speaker Paul D. Ryan and two of the country’s most conservative Republican governors has become one of the loudest and most persuasive voices in the debate over new work requirements in the food-stamp program. The Foundation for Government Accountability – headed by a former adviser to Maine Gov. Paul LePage – spent six years testing welfare changes in Kansas, Mississippi and other states before taking its ideas to Washington in 2017.

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Don’t Let Defense Contract Losers Block Options for Taxpayers

Defense contracting is hard to get right. Unelected government officials dealing out princely sums naturally creates an area of government that is ripe for cronyism and waste if not overseen properly. That’s why the Government Accountability Office has had Department of Defense contracts on its High Risk List since 1992 for programs that are vulnerable to waste, fraud, and abuse. And it’s also why it’s so important that when the DoD awards a contract based on merit and not access, all participants know the reasons and understand the rules of the process.

The battle for the DoD’s cloud-computing contract, known as Joint Enterprise Defense Infrastructure (JEDI), has been heating up for months. Though the DoD initially solicited proposals from single entities as well as multiple companies cooperating together, its decision to make the contract single-award angered many smaller contractors. A larger corporation, such as Amazon, now appears to be the favorite to take home the lucrative contract, which will be worth billions of dollars.

Naturally, some in Congress who are familiar with traditional contracts and the companies who pursue them have begun to cry foul. And some of the remedies they’ve proposed — such as regular reports and justifications for the single-award decision — are smart precautions. Transparency is important.

Companies such as Oracle, Microsoft, and IBM have argued that a single-award contract is “unfair” and implied that Congress should step in and change the rules. Some opinion pages have followed suit — even the Spectator’s Mytheos Holt made a similar argument back in March. Yet this mistakes the purpose of the DoD contracting process — it’s not to give everyone a piece of the pie, it’s to ensure that the DoD gets the best value and service for taxpayer money. And that’s exactly what the DoD’s process is attempting to achieve in this case: it allowed itself the opportunity to evaluate the relative benefits of choosing a single provider or multiple, and decided to go with just one.

In justifying its choice for a single provider, the DoD makes strong enough arguments to throw cold water on the idea that it was in cahoots with big business to shut out the “little guys.” The future of warfare is going to be about the speed of machine learning, allowing troops access to data at the speed machines can process it. Forcing the military to manage connections between multiple providers would risk this speed and disrupt the DoD’s plans to centralize its scattered data so it can be accessed by hundreds of thousands of users. On top of this, the DoD argued that multiple providers would require a drawn-out bidding process for new capabilities, a process avoided with a single-provider contract.

As with most situations where billions of dollars are on the line, both sides have opened up their wallets to bring their lobbying armies to Congress. The danger here is that Congress will overcorrect and end up quashing the single-award approach for political reasons, rather than doing what is best for national defense and taxpayers.

In doing so, Congress would be, ironically, be fighting a cronyism red herring with real cronyism. Cronyism is often mistakenly defined as “government actions that benefit big business” rather than “government actions that unfairly benefit big business at the expense of taxpayers or a competitive process.” The distinction is important — it’s the difference between being anti-corporate and being pro-market.

It’s also important to note that the contract only lasts two years. After that period, the DoD can choose to renew or find a different provider. If Amazon is truly being awarded this contract for reasons other than merit, it will become apparent over that time period, at which point the DoD can switch to another provider. The DoD may even decide over that period that multiple providers are a superior option, and switch the contract award type. What’s important is that, so long as the DoD is acting in the best interests of the country, the process is not allowed to be hijacked.

I’m not exactly Amazon’s biggest cheerleader, but I am a fan of taxpayer dollars being used efficiently. It’s a rare enough occurrence that when it does happen, we can’t afford to let those who miss out change the rules late in the game to benefit their own interests.

The post Don’t Let Defense Contract Losers Block Options for Taxpayers appeared first on The American Spectator.

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Durkan signs Seattle’s head-tax ordinance into law

SEATTLE – Mayor Jenny Durkan signed Seattle’s controversial new employee tax into law Wednesday evening, her office announced in a press release.

The law imposes a tax of $275 per employe per year on companies grossing more than $20 million in Seattle.  It includes a sunset clause after five years, with renewal requiring a council vote in 2023.

The law will take effect Jan. 1, 2019.

“We must make urgent progress on our affordability and homelessness crisis,” Durkan said in a statement Wednesday. “Looking ahead, I am focused on acting to move people off the street and into safer places, to clean up the garbage and needles that are in our parks and in our communities, and to provide resources to those people experiencing homelessness, including job training, behavioral health services, and other supportive services. I’ve heard Seattle loud and clear: they want basic services delivered and are concerned whether the City of Seattle is using their money wisely, efficiently, and responsibly. As part of the budget process, I will remain focused on accountability and transparency for every department and on how this new revenue is going to be used towards homelessness services and new affordable housing.”

The tax is expected to raise about $48 million a year to pay for affordable housing and homeless services. Other cities have implemented similar taxes, but Seattle’s is by far the highest in the nation.

Two state senators – Republican Mark Schoesler and Democrat Mark Mullet – have said the city’s move was a violation of the state constitution and promised to attempt legislation in January that would overturn the tax.

“I fundamentally believe that we must continue to come together to listen to one another to address these significant challenges,” Durkan’s statement Wednesday reads. “I understand there are very strong passions and genuine policy differences between neighbors, businesses, community leaders and people across our City on how to best address this crisis, but I know we can be a City that continues to invent the future and come together to build a more affordable, inclusive, and just future for all who call this great City home.”

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Families of sailors who died in Navy collisions hope for answers in court

Families of some of the 17 sailors killed in two U.S. Navy collisions in Asia last summer say the courts-martial beginning this week probably won’t give them closure. What they really want is answers.

How is it possible that two months after the USS Fitzgerald collided with a merchant container ship off the coast of Japan on June 17, 2017, killing seven sailors, another destroyer, the USS John S. McCain, collided with a commercial tanker in the Straits of Singapore, killing 10 more?

Why were the Navy crews allowed to get so tired they couldn’t perform, so undermanned and overtasked that they were working 100-hour weeks and given no time for training? How could the Navy let readiness erode, allowing so many things to go wrong — twice in a row, following at least two nonfatal mishaps in 2017 in the Japan-based 7th Fleet?

“Ten died, five injured, and we are blaming two people?” said Rachel Eckels, referring to those aboard the McCain, where her son, Petty Officer 1st Class Timothy Eckels, died.

“These things should not be happening in peacetime. They shouldn’t be sailing in the ocean blue, crashing into things,” she said. “It happened in January. It happened in June. It happened in August. And nobody is answering how this happened.”

Reports have been filed and some punishments doled out. But when the first scheduled court proceeding opens at the Washington Navy Yard on Tuesday, the Navy will publicly begin hashing out what went wrong and who should be held accountable. An unnamed junior officer aboard the Fitzgerald is expected to offer a plea Tuesday. An Article 32 preliminary hearing will be conducted Wednesday to determine whether to proceed with charges against two other unnamed junior officers from the Fitzgerald.

The destroyer’s former commanding officer, Cmdr. Bryce Benson, is slated for an Article 32 hearing May 21. He faces charges that include negligent homicide, hazarding a ship and dereliction of duty.

A date has not been finalized for an Article 32 for the relieved commanding officer of the McCain, Cmdr. Alfredo Sanchez, who is facing similar charges for the Aug. 21, 2017, collision.

In the months since the deadly collisions, the Navy has acknowledged that its forward-deployed 7th Fleet in Japan had been stretched too thin. Reports about the collisions point to mistakes by the crew and commanders, calling the deadly mishaps “avoidable” and caused by human error. The reports showed that errors on both ships were compounded, and opportunities to recognize and avoid grave danger were squandered.

Since then, emerging reports have revealed an exhausted fleet conducting so many operations that training fell through the cracks, ship maintenance was deferred and basic seamanship skills were neglected. A Navy review reiterated what had been ignored in earlier warnings: The fleet was undermanned and overworked; readiness was eroding because of a culture that demanded getting the job done no matter the obstacle.

“I think the main culprit for these collisions was that we allowed the training of our surface warriors to atrophy,” retired Vice Adm. Joseph Aucoin, who was fired as commander of 7th Fleet, wrote in an article last month in the U.S. Naval Institute magazine Proceedings. Aucoin accepted responsibility for his decisions but expressed concern that the Navy might not be learning needed lessons.

“I made clear to the Commander, U.S. Pacific Fleet, of the impact of increased operational demand on training and maintenance” well before the guided-missile destroyers’ collisions, he wrote. “Despite these explicitly stated concerns, the direction we received was to execute the mission.”

Like many of the family members, Eckels knows that holding the ship’s commander accountable won’t bring her son back. Still, she wants to look him in the eye at the proceedings.

“He needs to see the anguish on our faces, the hurt, the pain,” she said.

At the same time, she and other parents say the fix has to be bigger than blaming a few people.

“It is a Navy problem, period,” said Darrold Martin, whose only son, Xavier, was a chief petty officer aboard the Fitzgerald.

“This whole blame game — come on,” he said. “This is not one seaman’s fault.”

The collisions left Navy families reeling with grief and fuming.

“I would have felt more comfortable if he had been in a car accident,” Martin said. “This should never have happened.”

Martin raised his son as a single parent after a bitter divorce 15 years ago, and the two were inseparable.

As a kid, Xavier often traveled with his father, who called him his roadie. Xavier grew up an honor student and followed his father’s footsteps into the Navy, his father said.

He was bright and responsible, and he was tapped by the ship’s commanding officer to be his personnel administrator on board.

Martin said his son was working 100-hour weeks and always running. Still, they emailed and talked online several times a day.

Two months before his death, Xavier Martin showed his dad a tattoo he had inscribed in old English on his inner wrist. It said, “We will figure it out.”

He told his father it was because as a kid, when he came to him with a problem, that was what his dad would say. Darrold Martin laughed. He’d say that because he was busy. But Xavier Martin saw more meaning.

“It meant you had me — I didn’t have to worry about it,” he told his father.

Two weeks before the collision, Darrold Martin got a tattoo on his inner wrist. In old English, it says, “We will figure it out.”

Loved ones have been asked to give impact statements for the court.

Darrold Martin describes one piece of his grief as follows: A parent falls in love with their child and drives home each day with the emotional anticipation of seeing his love. But when he gets there, that love is gone, and he has no forwarding address. He’s been abandoned.

“I am in a glass prison,” he said. “It’s like wearing dirty glasses. Nothing is as crisp as it used to be.”

He used to tell his son to date but not get too serious. “You are young,” he’d say. It struck him recently that he will never be a grandfather.

USS Fitzgerald collision

The USS Fitzgerald was navigating out to sea near Yokosuka Port in Japan when it failed to recognize the dangers of three ships heading across its path in the early hours of June 17, 2017.

They were close enough to present risk of collision, according to a U.S. Navy report. Two of the ships maneuvered to avoid a collision. The third, a merchant container ship called the ACX Crystal, did not.

Commanding officer Cmdr. Bryce Benson was not on deck, and the officer of the deck — the person responsible for navigating — did not recognize the danger until it was too late, the report said.

The collision tore a 13-foot-by-17-foot hole in the side of the Fitzgerald, allowing water to rush into a lower berthing section. Twenty-eight sailors escaped the flooded sleeping quarters. Seven died in the bowels of the ship.

Benson and other sailors aboard suffered traumatic brain injuries. Some who managed to get out nearly drowned.

USS McCain collision

The USS John S. McCain was navigating entry into Singapore Straits on Aug. 21, 2017, when the commanding officer saw the helmsman having trouble steering the ship while adjusting the throttles for speed control, a U.S. Navy report said.

He ordered the speed control to be shifted to a second sailor, but steering was inadvertently transferred as well, creating confusion.

For three minutes, the crew was not in full control of the ship, which turned into heavy traffic and collided with a tanker.

The collision tore a hole in the McCain 28 feet in diameter, killing 10 sailors in a berthing area.

The Navy reports on the McCain and Fitzgerald crashes cited poor seamanship, noting that the officers on deck did not possess adequate knowledge of their ship systems or the rules of navigating heavy traffic at sea.

The reports also said they failed to maintain situational awareness, failed to communicate with each other when needed and failed to follow Navy procedures for crisis situations.

The aftermath

The collisions finally sparked change — after years of warnings and two nonfatal incidents earlier in 2017 had failed to spur action.

Navy investigations into a ship running aground in Tokyo Bay in January 2017 and a minor collision between another Navy ship and a fishing vessel in the Sea of Japan in May last year led to similar findings of faulty seamanship, bad decision-making and human errors.

A Government Accountability Office report from 2015 laid out the risks of rolling back manning while ramping up demand on the Navy’s forward-deployed fleet. Training, maintenance and certifications were neglected; readiness eroded even as the pace of operations escalated. But those warnings were ignored.

After the collisions, Navy reviews concluded that its “can-do” culture was putting sailors and operations at risk. But how to fix that in a performance-based hierarchy, when officers and commanders are trying to perform admirably, is a difficult question.

In January, the Navy created an oversight council to shepherd implementation of 111 recommendations — mostly improving manning and training, with a focus on seamanship and navigation, improved systems and equipment, and readiness of the force and the fleet. The Navy says 29 have been fully implemented and more than 75 percent of the recommendations are expected to be implemented by the end of September.

But families wonder whether those are enough. They question whether these courts-martial are creating scapegoats to answer for a system that created a forward-deployed Navy that was not ready to be at sea.

“I don’t like to see people punished because the Navy has a problem and is pointing fingers,” said Magali Ginoux, Xavier Martin’s mother. “It’s not a commander’s problem or a shipmate problem.

“The Navy should take responsibility,” she said.

Eckels said she wants to see the changes that have been made and the processes that have been put in place.

“You have to literally peel back this layer of onion,” she said. “It’s more than a lack of training, more than a lack of procedures not followed. We need to look at everything.”

Collision reports on the USS McCain and the USS Fitzgerald both contained identical paragraphs — something that irked some family members —faulting the commanding officer for exercising poor judgment and decision-making.

“That said, no single person bears full responsibility for this incident,” the reports stated. “The crew were unprepared for the situation in which they found themselves through a lack of preparation, ineffective command and control, and deficiencies in training and preparations for navigation.”

The playout

Repercussions within the Navy have been severe.

Eighteen sailors faced nonjudicial punishment — 10 on the Fitzgerald and eight on the McCain. That includes the executive officers of both ships and the command master chief of the Fitzgerald, who were found guilty of dereliction in the performance of duties. Each received a letter of punitive reprimand.

Aucoin, who commanded the 7th Fleet, and the two top leaders below him were fired, while the Pacific Fleet commander and the commander of Naval Surface Forces in San Diego retired early — the most senior naval officers to step down in the wake of the tragedies.

So where does accountability lie? Some say it sits on the shoulders of the officers on deck, who made decisions on the ships leading up to the collisions. Others say it lies with the Navy admirals who kept tasking 7th Fleet while shrinking its resources, or the politicians who did not listen as the Chief of Naval Operations stated repeatedly that his sailors were running on empty in the face of budget uncertainty.

The upcoming military proceedings could determine whether either is right or if the answer lies somewhere in between.

Eckels will be there, taking in every word. “It doesn’t matter how hard it is. I will be going gavel to gavel,” she said.

“Someone has to be my son’s advocate. The Navy sure isn’t.”

———

© 2018 the Stars and Stripes

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