Wednesday, May 22, 2013

Ampio rises on FDA ruling on Zertane questionnaire

NEW YORK -- Shares of Ampio Pharmaceuticals Inc. rose Monday after the company said it is ready to conduct a new clinical trial of its premature ejaculation treatment Zertane.

Ampio said the Food and Drug Administration has questionnaire to be used in pivotal trial of Zertane. The study will measure the duration of sex and the patients' responses to the questionnaire.

Ampio shares rose 36 cents, or 9 percent, to $4.35 in midday trading.

Zertane is Ampio's most advanced drug, and it is also developing a version that combines Zertane with a treatment for impotence. The company is also studying an eye drug called Optina, an inflammation drug called Ampion, and Vasaloc, which treats kidney damage caused by diabetes.


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Health Perks Geared To Top Workers Could Trigger Penalties Under Health Law

Many executives have long enjoyed perks like free health care and better health benefits for themselves and their families. But under a little noticed anti-discrimination provision in the federal health law, such advantages could soon trigger fines of up to $500,000.

Employers “should be more concerned about this than anything else” in the law, because many are in violation and the penalties can be stiff, says Jay Starkman, chief executive of Engage PEO in St. Petersburg, Fla., which offers human resources services and advises clients on the health law.

The provision says that employers who offer more generous benefits to highly paid workers could face fines of $100 a day for every worker who doesn’t get the perks, up to $500,000.

It applies to employers who buy benefit packages for their firms from insurers. Those who self-fund their coverage, who tend to be larger firms, already face similar restrictions under Internal Revenue Service rules which pre-date the law.

To make sure his own small company complies with the law, Starkman began paying $600 in premiums toward his family’s coverage last month, putting him on an even playing field with his 60 employees.

He says the rule makes sense, noting that executives are likely to get little sympathy from the public.

“The right way to handle it is to have the same benefits for everyone,” he says, noting that firms can increase wages to managers or executives to cover their additional costs.

But business owner Steve Diddams worries that complying with the provision could erase his profits.

Diddams, owner of seven Diddams Party & Toy retail stores in California, has about 100 employees, most of whom are paid hourly and who don’t get health insurance.  But because he offers about 20 managerial workers HMO coverage, he might fall afoul of the discrimination rule. He could also be subject to a $2,000 per worker penalty for not offering coverage to his hourly employees, although lawyers say they’re not sure he would face fines for both.

Raising his prices to cover the cost of expanded health coverage really isn’t an option. “Our customers are moms with kids, and it comes to a point where they are not going to pay $2 for a balloon,” Diddams says.

The anti-discrimination provision is technically in effect now, but the IRS says it will not impose penalties until it completes regulations and issues guidance about how the provision will be enforced. 

Employers are likely to have until 2015 to figure out whether they comply, says Terry Dailey, a partner at Mercer, a benefit consulting firm.

The IRS rule offers guidelines explaining who is a highly paid employee, and says a plan discriminates if it favors such workers in terms of eligibility or benefits.

There are differences between the IRS rule and the federal health law provision. For example, if a self-insured firm is found to violate the IRS rule, the employees getting more generous benefits could end up paying taxes on their value. In contrast, the federal health law imposes fines on the employer, most of whom are expected to be small and mid-sized firms.

Congress likely saw the provision as “an additional deterrent to [employers] picking and choosing” who gets health coverage,” says attorney Timothy Tornga, of Mika Meyers Beckett & Jones in Grand Rapids, Mich., who advises employers.

Those penalties “fall especially hard on the small business population,” and may encourage some small firms to switch to self-funding their medical coverage, says the Small Business Coalition for Affordable Healthcare, which represents firms involved in agriculture, food service and retail, in comments submitted to the IRS.

In seeking comments, the IRS asked employers and others how to define “benefits.” Do they include, for example, not just the coverage provided, but how much employees pay toward those costs? Some firms, for example, charge executives less than other employees – or nothing at all – toward coverage. Would that count as being discriminatory?

Some groups don’t think so, and are urging the IRS to exclude the employee contributions from its calculations. Benefits are “limited to only those goods and services that are payable by the plan,” says the American Benefits Council, a trade association for employers.

The U.S. Chamber of Commerce, saying the older IRS rules that the federal law builds upon are unclear, rarely enforced and “unworkable,” wants the agency to replace them entirely rather than issuing rules “similar” to them.

Mercer’s Dailey says there are no good national statistics on how many employer plans might be considered discriminatory under the law.

Any fully insured plan that existed before the health law, and which has not been significantly changed is “grandfathered” and therefore exempt.

“We don’t see … [discriminatory policies] every day, but it’s not infrequent,” he says. “There will be many employers who will need to look at their plan designs and potentially make changes.

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Remarks By Tom Donilon, National Security Advisory to the President: "The United States and the Asia-Pacific in 2013"

The White House

Office of the Press Secretary

The Asia Society
New York, New York
Monday, March 11, 2013

“The United States and the Asia-Pacific in 2013”

As Prepared for Delivery – 

Thank you, Henrietta, for that kind introduction and for your service, both in government and here at the Asia Society.  And thank you, Suzanne, for bringing us together today.  I am honored to be with you, especially in these beautiful surroundings.  For almost sixty years, this organization has connected cultures— Asian and American—our ideas, leaders and people. 

Of course, one of those people, a real presence here at the Asia Society, was your chairman and my friend of thirty years, Richard Holbrooke.  Richard was famous for his work from the Balkans to South Asia.  But he was also a real Asia hand as the youngest-ever Assistant Secretary of State for East Asia.   Richard dedicated himself to the idea that progress and peace was possible—a lesson we carry forward, not only in Southwest Asia, where he worked so hard, but across the Asia-Pacific.  I’ve come here today because this project has never been more consequential—the future of the United States has never been more closely linked to the economic, strategic and political order emerging in the Asia-Pacific.

Last November, I gave a speech in Washington outlining how the United States is rebalancing our global posture to reflect the growing importance of Asia.  As President Obama’s second term begins, I want to focus on some of the specific challenges that lay ahead. 

This is especially timely because this is a period of transition in Asia.  New leaders have taken office in Tokyo and Seoul.  In Beijing, China’s leadership transition will be completed this week. President Obama and those of us on his national security team have already had constructive conversations with each incoming leader.  We’ll be seeing elections in Malaysia, Australia and elsewhere.  These changes remind us of the importance of constant, persistent U.S. engagement in this dynamic region.

Why Rebalance Toward Asia

Let me begin by putting our rebalance to the Asia-Pacific in context.  Every Administration faces the challenge of ensuring that cascading crises do not crowd out the development of long-term strategies to deal with transcendent challenges and opportunities. 

After a decade defined by 9/11, two wars, and a financial crisis, President Obama took office determined to restore the foundation of the United States’ global leadership—our economic strength at home.  Since then the United States has put in place a set of policies that have put our economy on the path to recovery, and helped create six million U.S. jobs in the last thirty-five months. 

At the same time, renewing U.S. leadership has also meant focusing our efforts and resources not just on the challenges that make today’s headlines, but on the regions that will shape the global order in the decades ahead.  That’s why, from the outset—even before the President took office—he directed those of us on his national security team to engage in a strategic assessment, a truly global examination of our presence and priorities.  We asked what the U.S. footprint and face to the world was and what it ought to be.  We set out to identify the key national security interests that we needed to pursue.  We looked around the world and asked: where are we over-weighted?  Where are we underweighted?

That assessment resulted in a set of key determinations.  It was clear that there was an imbalance in the projection and focus of U.S. power.  It was the President’s judgment that we were over-weighted in some areas and regions, including our military actions in the Middle East.  At the same time, we were underweighted in other regions, such as the Asia-Pacific. Indeed, we believed this was our key geographic imbalance. 

On one level, this reflected a recognition of the critical role that the United States has played in Asia for decades, providing the stabilizing foundation for the region’s unprecedented social and economic development.  Beyond this, our guiding insight was that Asia’s future and the future of the United States are deeply and increasingly linked.  Economically, Asia already accounts for more than one-quarter of global GDP.  Over the next five years, nearly half of all growth outside the United States is expected to come from Asia.  This growth is fueling powerful geopolitical forces that are reshaping the region: China’s ascent, Japan’s resilience, and the rise of a “Global Korea,” an eastward-looking India and Southeast Asian nations more interconnected and prosperous than ever before. 

These changes are unfolding at a time when Asia’s economic, diplomatic and political rules of the road are still taking shape.  The stakes for people on both sides of the Pacific are profound.  And the U.S. rebalance toward the Asia-Pacific is also a response to the strong demand signal from leaders and publics across the region for U.S. leadership, economic engagement, sustained attention to regional institutions and defense of international rules and norms. 

What Rebalancing Is, and What It Isn’t

Against this backdrop, President Obama has been clear about the future that the United States seeks. And I would encourage anyone who has not already done so to read the President’s address to the Australian parliament in Canberra in 2011.  It is a definitive statement of U.S. policy in the region; a clarion call for freedom; and yet another example of how, when it comes to the Asia-Pacific, the United States is “all in.” 

As the President explained in Canberra, the overarching objective of the United States in the region is to sustain a stable security environment and a regional order rooted in economic openness, peaceful resolution of disputes, and respect for universal rights and freedoms. 

To pursue this vision, the United States is implementing a comprehensive, multidimensional strategy: strengthening alliances; deepening partnerships with emerging powers; building a stable, productive, and constructive relationship with China; empowering regional institutions; and helping to build a regional economic architecture that can sustain shared prosperity. 

These are the pillars of the U.S. strategy, and rebalancing means devoting the time, effort and resources necessary to get each one right.  Here’s what rebalancing does not mean.  It doesn’t mean diminishing ties to important partners in any other region.  It does not mean containing China or seeking to dictate terms to Asia.  And it isn’t just a matter of our military presence.  It is an effort that harnesses all elements of U.S. power—military, political, trade and investment, development and our values.

Perhaps most telling, this rebalance is reflected in the most valuable commodity in Washington: the President’s time.  It says a great deal, for instance, that President Obama made the determination that the United States would participate every year in the East Asia Summit at the Head of State level and hold U.S.-ASEAN summits; that he has met bilaterally with nearly every leader in Southeast Asia, either in the region or in Washington; and that he has engaged with China at an unprecedented pace, including twelve face-to-face meetings with Hu Jintao. 

Let me turn to each pillar of our strategy and several of the challenges we face in 2013. 

Alliances

First, we will continue to strengthen our alliances.  For all of the changes in Asia, this much is settled: our alliances in the region have been and will remain the foundation of our strategy.  I feel confident is saying that our alliances are stronger today than ever before. 

Our alliance with Japan remains a cornerstone of regional security and prosperity.  I am not sure American-Japanese friendship has ever been more powerfully manifest than it was two years ago today, on 3/11, after the tsunami and Fukishima nuclear crisis.  As allies and friends, Americans inside and outside government rushed to lend a hand to Japan’s disaster response and recovery. 

That same spirit of solidarity was evident when Japan’s new Prime Minister, Shinzo Abe, became one of the first foreign leaders President Obama hosted in his second term.  They had excellent discussions on trade, expanding security cooperation, and the next steps toward realigning U.S. forces in Japan. Looking ahead, there is scarcely a regional or global challenge in the President’s second-term agenda where the United States does not look to Japan to play an important role.

With the Republic of Korea, the United States is building on our joint vision for a global alliance and deeper trading partnership.  I just returned from Seoul, where I attended the inauguration of President Park, Korea’s first woman president.  I was struck by how much our leaders have in common in terms of their priorities and vision.  When we met, I conveyed to President Park President Obama’s unwavering commitment to the defense of the Republic of Korea, and President Park gave her full support to modernizing our alliance and continuing the effort to partner on a wide range of regional and global issues.  During my visit, President Park accepted President Obama’s invitation to visit Washington, and I can announce today that we look forward to welcoming her to the White House in May.

In Japan and South Korea, the United States can look to new leaders who are firmly committed to close security cooperation with the United States.  This is no accident and no surprise, because polls in both countries show public support for their alliance with the United States in the range of 80 percent.  At the same time, it is clear that, as we look forward, maintaining security in a dynamic region will demand greater trilateral coordination from Japan, Korea and the United States. 

With Australia—following the President’s visit and joint announcement with Prime Minister Gillard of the rotational deployment of U.S. Marines—we are bringing our militaries even closer.  Prime Minister Gillard has been an outstanding partner in our efforts to advance prosperity and security to the Asia-Pacific region.  The United States has reinvigorated longstanding alliances with Thailand and the Philippines to address counterterrorism, humanitarian assistance and disaster relief.  Philippine President Aquino’s visit to Washington and President Obama’s visit to Thailand and meeting with Prime Minister Yingluck both speak to another key facet of our strategy—the United States is not only rebalancing to the Asia-Pacific, we are rebalancing within Asia to recognize the growing importance of Southeast Asia.  Just as we found that the United States was underweighted in East Asia, we found that the United States was especially underweighted in Southeast Asia.  And we are correcting that. 

In these difficult fiscal times, I know that some have questioned whether this rebalance is sustainable.  After a decade of war, it is only natural that the U.S. defense budget is being reduced.  But make no mistake:  President Obama has clearly stated that we will maintain our security presence and engagement in the Asia-Pacific.  Specifically, our defense spending and programs will continue to support our key priorities – from our enduring presence on the Korean Peninsula to our strategic presence in the western Pacific.

This means that in the coming years a higher proportion of our military assets will be in the Pacific. Sixty percent of our naval fleet will be based in the Pacific by 2020. Our Air Force is also shifting its weight to the Pacific over the next five years. We are adding capacity from both the Army and the Marines.  The Pentagon is working to prioritize the Pacific Command for our most modern capabilities – including submarines, Fifth-Generation Fighters such as F-22s and F-35s, and reconnaissance platforms.  And we are working with allies to make rapid progress in expanding radar and missile defense systems to protect against the most immediate threat facing our allies and the entire region: the dangerous, destabilizing behavior of North Korea.   

North Korea

Let me spend a few moments on North Korea. 

For sixty years, the United States has been committed to ensuring peace and stability on the Korean Peninsula. This means deterring North Korean aggression and protecting our allies.  And it means the complete denuclearization of the Korean Peninsula.  The United States will not accept North Korea as a nuclear state; nor will we stand by while it seeks to develop a nuclear-armed missile that can target the United States.  The international community has made clear that there will be consequences for North Korea’s flagrant violation of its international obligations, as the UN Security Council did again unanimously just last week in approving new sanctions in response to the North’s recent provocative nuclear test.

U.S. policy toward North Korea rests on four key principles:

First, close and expanded cooperation with Japan and South Korea.  The unity that our three countries have forged in the face of North Korea’s provocations—unity reaffirmed by President Park and Prime Minister Abe —is as crucial to the search for a diplomatic solution as it is to deterrence.  The days when North Korea could exploit any seams between our three governments are over.

And let me add that the prospects for a peaceful resolution also will require close U.S. coordination with China’s new government.  We believe that no country, including China, should conduct “business as usual” with a North Korea that threatens its neighbors.  China’s interest in stability on the Korean Peninsula argues for a clear path to ending North Korea’s nuclear program.  We welcome China’s support at the UN Security Council and its continued insistence that North Korea completely, verifiably and irreversibly abandon its WMD and ballistic missile programs.

Second, the United States refuses to reward bad North Korean behavior.  The United States will not play the game of accepting empty promises or yielding to threats.  As former Secretary of Defense Bob Gates has said, we won’t buy the same horse twice.  We have made clear our openness to authentic negotiations with North Korea.  In return, however, we’ve only seen provocations and extreme rhetoric.  To get the assistance it desperately needs and the respect it claims it wants, North Korea will have to change course. Otherwise, the United States will continue to work with allies and partners to tighten national and international sanctions to impede North Korea’s nuclear and missile programs.  Today, the Treasury Department is announcing the imposition of U.S. sanctions against the Foreign Trade Bank of North Korea, the country’s primary foreign exchange bank, for its role in supporting North Korea’s WMD program. 

By now it is clear that the provocations, escalations and poor choices of North Korea’s leaders are not only making their country less secure – they are condemning their people to a level of poverty that stands in stark contrast not only to South Korea, but every other country in East Asia. 

Third, we unequivocally reaffirm that the United States is committed to the defense of our homeland and our allies.  Recently, North Korean officials have made some highly provocative statements.  North Korea’s claims may be hyperbolic – but as to the policy of the United States, there should be no doubt: we will draw upon the full range of our capabilities to protect against, and to respond to, the threat posed to us and to our allies by North Korea.  This includes not only any North Korean use of weapons of mass destruction—but also, as the President made clear, their transfer of nuclear weapons or nuclear materials to other states or non-state entities.  Such actions would be considered a grave threat to the United States and our allies and we will hold North Korea fully accountable for the consequences.

Finally, the United States will continue to encourage North Korea to choose a better path.  As he has said many times, President Obama came to office willing to offer his hand to those who would unclench their fists.  The United States is prepared to help North Korea develop its economy and feed its people—but it must change its current course.  The United States is prepared to sit down with North Korea to negotiate and to implement the commitments that they and the United States have made.  We ask only that Pyongyang prove its seriousness by taking meaningful steps to show it will abide by its commitments, honor its words, and respect international law. 

Anyone who doubts the President’s commitment needs look no further than Burma, where new leaders have begun a process of reform.  President Obama’s historic visit to Rangoon is proof of our readiness to start transforming a relationship marked by hostility into one of greater cooperation.  Burma has already received billions in debt forgiveness, large-scale development assistance, and an influx of new investment.  While the work of reform is ongoing, Burma has already broken out of isolation and opened the door to a far better future for its people in partnership with its neighbors and with the United States.  And, as President Obama said in his speech to the people of Burma, we will continue to stand with those who continue to support rights, democracy and reform.  So I urge North Korea’s leaders to reflect on Burma’s experience.  

Emerging Powers

Even as we keep our alliances strong to deal with challenges like North Korea, we continue to carry out a second pillar of our strategy for the Asia-Pacific:  forging deeper partnerships with emerging powers. 

To that end, the President considers U.S. relations with India—the world’s largest democracy—to be “one of the defining partnerships of the twenty-first century.”  From Prime Minister Singh’s visit in 2009 to the President’s trip to India in 2010, the United States has made clear at every turn that we don’t just accept India’s rise, we fervently support it. 

U.S. and Indian interests powerfully converge in the Asia-Pacific, where India has much to give and much to gain. Southeast Asia begins in Northeast India, and we welcome India’s efforts to “look East,” from supporting reforms in Burma to trilateral cooperation with Japan to promoting maritime security.  In the past year, for example, India-ASEAN trade increased by 37 percent to $80 billion. 

The United States has also worked hard to realize Indonesia’s potential as a global partner.  We have put in place a wide-ranging Comprehensive Partnership.  We have welcomed Indonesia’s vigorous participation in the region’s multilateral forums, including hosting APEC and promoting ASEAN unity.  We are also working with Indonesia and Brunei on a major new initiative to mobilize capital to help bring clean and sustainable energy to the Asia-Pacific. And, of course, no U.S. President has ever had closer personal ties to an Asia-Pacific nation than President Obama does with Indonesia—a warm relationship that was on full display in November 2010 when the President visited Jakarta.

China

The third pillar of our strategy is building a constructive relationship with China. The President places great importance on this relationship because there are few diplomatic, economic or security challenges in the world that can be addressed without China at the table and without a broad, productive, and constructive relationship between our countries.  And we have made substantial progress in building such a relationship over the past four years.

As China completes its leadership transition, the Administration is well positioned to build on our existing relationships with Xi Jinping, Li Keqiang and other top Chinese leaders. Taken together, China’s leadership transition and the President’s re-election mark a new phase in U.S.-China relations – with new opportunities.  

Of course, the U.S.-China relationship has and will continue to have elements of both cooperation and competition. Our consistent policy has been to improve the quality and quantity of our cooperation; promote healthy economic competition; and manage disagreements to ensure that U.S. interests are protected and that universal rights and values are respected.  As President Obama has made clear, the United States speaks up for universal values because history shows that nations that uphold the rights of their people are ultimately more successful, more prosperous and more stable.

As President Obama has said many times, the United States welcomes the rise of a peaceful, prosperous China.  We do not want our relationship to become defined by rivalry and confrontation.  And I disagree with the premise put forward by some historians and theorists that a rising power and an established power are somehow destined for conflict.  There is nothing preordained about such an outcome.  It is not a law of physics, but a series of choices by leaders that lead to great power confrontation.  Others have called for containment.  We reject that, too.  A better outcome is possible.  But it falls to both sides—the United States and China—to build a new model of relations between an existing power and an emerging one.  Xi Jinping and President Obama have both endorsed this goal. 

To build this new model, we must keep improving our channels of communication and demonstrate practical cooperation on issues that matter to both sides.

To that end, a deeper U.S.-China military-to-military dialogue is central to addressing many of the sources of insecurity and potential competition between us. This remains a necessary component of the new model we seek, and it is a critical deficiency in our current relationship. The Chinese military is modernizing its capabilities and expanding its presence in Asia, drawing our forces into closer contact and raising the risk that an accident or miscalculation could destabilize the broader relationship. We need open and reliable channels to address perceptions and tensions about our respective activities in the short-term and about our long-term presence and posture in the Western Pacific.

It is also critical that we strengthen the underpinnings of our extensive economic relationship, which is marked by increasing interdependence. We have been clear with Beijing that as China takes a seat at a growing number of international tables, it needs to assume responsibilities commensurate with its economic clout and national capabilities. As we engage with China’s new leaders, the United States will encourage them to move forward with the reforms outlined in the country’s twelfth Five Year Plan, including efforts to shift the country away from its dependence on exports toward a more balanced and sustainable consumer-oriented growth model.  The United States will urge a further opening of the Chinese market and a leveling of the playing field.  And the United States will seek to work together with China to promote international financial stability through the G-20 and to address global challenges such as climate change and energy security.

Another such issue is cyber-security, which has become a growing challenge to our economic relationship as well. Economies as large as the United States and China have a tremendous shared stake in ensuring that the Internet remains open, interoperable, secure, reliable, and stable.  Both countries face risks when it comes to protecting personal data and communications, financial transactions, critical infrastructure, or the intellectual property and trade secrets that are so vital to innovation and economic growth. 

It is in this last category that our concerns have moved to the forefront of our agenda. I am not talking about ordinary cybercrime or hacking.  And, this is not solely a national security concern or a concern of the U.S. government.  Increasingly, U.S. businesses are speaking out about their serious concerns about sophisticated, targeted theft of confidential business information and proprietary technologies through cyber intrusions emanating from China on an unprecedented scale.  The international community cannot afford to tolerate such activity from any country.  As the President said in the State of the Union, we will take action to protect our economy against cyber-threats.

From the President on down, this has become a key point of concern and discussion with China at all levels of our governments.  And it will continue to be.  The United States will do all it must to protect our national networks, critical infrastructure, and our valuable public and private sector property.  But, specifically with respect to the issue of cyber-enabled theft, we seek three things from the Chinese side.  First, we need a recognition of the urgency and scope of this problem and the risk it poses—to international trade, to the reputation of Chinese industry and to our overall relations.  Second, Beijing should take serious steps to investigate and put a stop to these activities.  Finally, we need China to engage with us in a constructive direct dialogue to establish acceptable norms of behavior in cyberspace.

We have worked hard to build a constructive bilateral relationship that allows us to engage forthrightly on priority issues of concern.  And the United States and China, the world’s two largest economies, both dependent on the Internet, must lead the way in addressing this problem. 

Regional Architecture

This leads to the fourth pillar of our strategy—strengthening regional institutions— which also reflects Asia’s urgent need for economic, diplomatic and security-related rules and understandings.

From the outset, the Obama Administration embarked on a concerted effort to develop and strengthen regional institutions—in other words, building out the architecture of Asia.  And the reasons are clear: an effective regional architecture lowers the barriers to collective action on shared challenges.  It creates dialogues and structures that encourage cooperation, maintain stability, resolve disputes through diplomacy and help ensure that countries can rise peacefully. 

There is no underestimating the strategic significance of this region.  The ten ASEAN countries, stretching across the Indian and Pacific Oceans, have a population of well over 600 million.  Impressive growth rates in countries like Thailand – and a 25-percent increase in international investment in 2011—suggest that ASEAN nations are only going to become more important, politically and economically.

Since taking office, the Obama Administration has signed ASEAN’s Treaty of Amity and Cooperation and appointed the first resident U.S. Ambassador to ASEAN.  As I said, the President has traveled every year to meet with ASEAN’s leaders– and will continue to do so going forward.  The President also has made a decision to participate at the Head of State level every year at the East Asia Summit, consistent with the United States’ goal to elevate the EAS as the premier forum for dealing with political and security issues in Asia. 

Looking ahead, it is clear that territorial disputes in the resource-rich South and East China Seas will test the region’s political and security architecture.  These tensions challenge the peaceful underpinnings of Asia’s prosperity and they have already done damage to the global economy.  While the United States has no territorial claims there, and does not take a position on the claims of others, the United States is firmly opposed to coercion or the use of force to advance territorial claims.  Only peaceful, collaborative and diplomatic efforts, consistent with international law, can bring about lasting solutions that will serve the interests of all claimants and all countries in this vital region.  That includes China, whose growing place in the global economy comes with an increasing need for the public goods of maritime security and unimpeded lawful commerce, just as Chinese businessmen and women will depend on the public good of an open, secure Internet. 

Economic Architecture

Finally, the United States will continue to pursue the fifth element of our strategy: building an economic architecture that allows the people of the Asia-Pacific –including the American people--to reap the rewards of greater trade and growth.  It is our view –and I believe history demonstrates – that the economic order that will deliver the next phase of broad-based growth that the region needs is one that rests on economies that are open and transparent, and trade and investment that are free, fair and environmentally sustainable. U.S. economic vitality also depends on tapping into new markets and customers beyond our borders, especially in the fastest-growing regions. 

And so President Obama has worked with the region’s leaders to support growth-oriented, job-creating policies such as the U.S.- Korea Free Trade Agreement.  The Administration has also worked through APEC and bilaterally to lower economic barriers at and within borders, increase and protect investment, expand trade in key areas, and protect intellectual property. 

The centerpiece of our economic rebalancing is the Trans-Pacific Partnership (TPP)—a high-standard agreement the United States is crafting with Asia-Pacific economies from Chile and Peru to New Zealand and Singapore.  The TPP is built on its members’ shared commitment to high standards, eliminating market access barriers to goods and services, addressing new, 21st century trade issues and respect for a rules-based economic framework.  We always envisioned the TPP as a growing platform for regional economic integration.  Now, we are realizing that vision—growing the number of TPP partners from seven when President Obama took office to four more: Vietnam, Malaysia, Canada and Mexico.  Together, these eleven countries represent an annual trading relationship of $1.4 trillion.  The growing TPP is already a major step toward APEC’s vision of a region-wide Free Trade Area of the Asia-Pacific. 

The TPP is also attractive because it is ambitious but achievable.  We can get this done.  In fact, the United States is working hard with the other parties to complete negotiations by the end of 2013.  Let me add that the TPP is intended to be an open platform for additional countries to join – provided they are willing and able to meet the TPP’s high standards

The TPP is part of a global economic agenda that includes the new agreement we are pursuing with Europe—the Transatlantic Trade and Investment Partnership.  Transatlantic trade is nearly one trillion dollars each year, with $3.7 trillion in investments.  Even small improvements can yield substantial benefits for our people.  Taken together, these two agreements—from the Atlantic to the Pacific—and our existing Free Trade Agreements, around the world could account for over sixty percent of world trade.  But our goals are strategic as well as economic.  Many have argued that economic strength is the currency of power in the twenty-first century.  And across the Atlantic and Pacific, the United States will aim to build a network of economic partnerships as strong as our diplomatic and security alliances—all while strengthening the multilateral trading system.  The TPP is also an absolute statement of U.S. strategic commitment to be in the Asia-Pacific for the long haul.  And the growth arising from a U.S.-Europe agreement will help underwrite NATO, the most powerful alliance in history. 

Conclusion

In conclusion, I believe President Obama’s strategic focus on the Asia-Pacific is already a signature achievement.  But its full impact will require sustained commitment over the coming years.

I would leave you with a simple thought experiment that says a great deal about the role of the United States in shaping the way forward.  I think it’s fair to ask: without the stabilizing presence of U.S. engagement over the past seventy years, where would the Asia-Pacific be today? 

Without the U.S. guarantee of security and stability, would militarism have given way to peace in Northeast Asia?  Would safe sea lanes have fueled Pacific commerce?  Would South Korea have risen from aid recipient to trading powerhouse?  And would small nations be protected from domination by bigger neighbors?  I think the answer is obvious. 

Credit for the Asia-Pacific’s extraordinary progress in recent decades rightly belongs to the region’s hardworking and talented people.  At the same time, it is fair to say – and many leaders and people across the region would agree—the United States provided a critical foundation for Asia’s rise.

As such, the United States will continue to work to ensure that the Asia-Pacific grows into a place where the rise of new powers occurs peacefully; where the freedom to access the sea, air, space, and cyberspace empowers vibrant commerce; where multinational forums help promote shared interests; and where the universal rights of citizens, no matter where they live, are upheld. 

The Obama Administration has worked to make our rebalance to the Asia-Pacific a reality because the region’s success in the century ahead –and the United States’ security and prosperity in the 21st century—still depend on the presence and engagement of the United States in Asia.  We are a resident Pacific power, resilient and indispensable.  And in President Obama’s second term, this vital, dynamic region will continue to be a strategic priority. Thank you.

Extending Middle Class Tax Cuts

Serving communities since 1994, AmeriCorps volunteers touch the lives of millions. We honor this tradition as we celebrate AmeriCorps Week.

This week the White House is highlighting one initiative a day which demonstrates the Obama Administration’s continued commitment to open and accessible government -- the first in the series focuses on progress made improving the administration of the FOIA.

On Monday, March 11, First Lady Michelle Obama will be answering questions on Twitter

view all related blog posts

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Defense Secretary Promises To Examine Military’s Policy For Convicting Rapists

Secretary of Defense Chuck Hagel’s response to Congressional inquiries about what, if anything, he can do following an overturned sexual assault conviction in the Air Force lays bear just how far the military has to go in providing justice to victims of sexual violence.

At issue is Air Force Lt. Gen. Craig Franklin decision to overturn a jury’s conviction in the case of Lt. Col. James Wilkerson on charges of aggravated sexual assault. Wilkerson’s reinstatement in the Air Force last week, where his only punishment appears to be his removal from the possibility of promotion, and the dismissal of the jury’s ruling sparked outrage.

Sens. Barbara Boxer (D-CA) and Jeanne Shaheen (D-NH) wrote to Secretary Hagel, demanding to know what action could be taken in the case. In his response [PDF], Hagel informed the senators that Lt. Gen. Franklin’s decision as the convening authority — or the officer who initiated a court-martial — “cannot be changed, either by the Secretary of the Air Force or by the Secretary of Defense per title 10 U.S.C. 860.”

However, the Secretary added that a review of the Uniform Code of Military Justice’s statutes on convening authorities had already been launched:

I have directed the Secretary of the Air Force, in coordination with the Acting General Counsel of the Department of Defense, to review this case to assess whether all aspects of the UCMJ were followed, and, after consultation with the Secretaries of the Army and the Navy, to report to me on whether the case points to changes that should be considered in the UCMJ, or in the military services’ implementation of the UCMJ and, if so, what changes should be made.

Senator Boxer appeared to take Hagel’s letter well, issuing a press statement praising the swift response. “I am heartened that Secretary Hagel is taking immediate action to review the facts of this troubling case and acknowledges that it is high time to take a hard look at how the military handles sexual assault cases,” Boxer said.

Despite Boxer’s enthusiasm, it appears that the actions available to Hagel are limited under current legislation. While the 2013 NDAA put into place several reforms to better prevent and respond to sexual assault, none of them deal with the issues at play in the case of Wilkerson. Rep. Jackie Spier (D-CA) in response to the situation, has announced that she’ll introduce legislation on Tuesday to specifically reform the convening authority.

Spier’s legislation could be part of the solution suggested by Yale Law Professor Eugene Fidell to “abandon the command-centric aspect” of the military’s justice system. Fidell is in favor of implementing such changes as adding a military trial bench, two tiers of specialized appellate courts, and a clemency and parole system. Along with removing the authority of commanders to block courts-martial in the first place, Fidell believes that the U.S. military’s justice system could in this way shift away from its 18th century foundations. “The switch should not be in the hands of a non-lawyer,” Fidell said, in an interview with ThinkProgress.

All told, sexual assault remains an under-reported phenomenon within the military, with an estimated 19,000 instances of Military Sexual Trauma (MST) thought to have occurred in 2011 alone. Former Defense Secretary Leon Panetta in a public statement last week acknowledged that officials in the military often “look the other way” in instances of sexual violence.


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Calif. Exchange Granted Secrecy

By MICHAEL R. BLOOD, Associated Press 1:37 a.m.May 9, 2013LOS ANGELES — A California law that created an agency to oversee national health care reforms granted it broad authority to conceal spending on the contractors that will perform most of its functions, potentially shielding the public from seeing how hundreds of millions of dollars are spent.

The degree of secrecy afforded Covered California appears unique among states attempting to establish their own health insurance exchanges under President Barack Obama's signature health law.

An Associated Press review of the 16 other states that have opted for state-run marketplaces shows the California agency was given powers that are the most restrictive in what information is required to be made public.

In Massachusetts, the state that served as the model for Obama's health overhaul, the Health Connector program is specifically covered by open-records laws. The same is true in Idaho, where its exchange was established as a private, nonprofit corporation, and in New Mexico.

The Maryland Legislature subjected its exchange to the state's public information act, but protected some types of commercial and financial information.

In California, the explicit exclusions from open-records laws may run afoul of the state constitution, said Terry Francke, head of Californians Aware, a group that promotes government transparency.

If the Legislature wants to limit access, the state constitution requires it produce findings that demonstrate the need for shielding information from the public. In the bill that authorized the exchange, the Legislature devoted two sentences to address that issue. It argued the cloaked spending was "necessary" to protect "powers and obligations to negotiate on behalf of the public."

Those provisions are vulnerable to being declared unconstitutional, according to Francke.

He said, in essence, lawmakers are saying they need it because they need it, with no details or evidence to support it. The Legislature should have answered the questions, "Why couldn't the exchange do its job without this secrecy? What's the worst that could happen?" Francke said.

Exchange spokesman Dana Howard said the agency complies with state law but declined to discuss in detail how it determines what is public and what is not.

"I'm not going to go down item by item, about how it is and what kinds of meetings and what was talked about," he said.

It's routine in government to keep bids secret until contracts are awarded, so one vendor does not get an unfair advantage over others. After a bid is awarded, contracts generally become fully public.

In setting up the California exchange, lawmakers gave it the authority to keep all contracts private for a year and the amounts paid secret indefinitely. "Except for the portion of a contract that contains the rates of payment, contracts entered into pursuant to this title shall be open to inspection one year after their effective dates," reads the code specifying what exchange records are exempt from public disclosure.

According to agency documents, Covered California plans to spend nearly $458 million on outside vendors by the end of 2014, covering lawyers, consultants, public relations advisers and other functions.

Other exchange records that are allowed to be kept secret include those that reveal recommendations, research, strategy of the board or its staff, or those that provide instructions, advice or training to employees. Minutes of the board meetings also are exempt from disclosure.


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Remarks by the President at the Gridiron Dinner

The White House

Office of the Press Secretary

Washington Renaissance Hotel
Washington, DC

10:03 P.M. EST

THE PRESIDENT:  Before I begin, I know some of you have noticed that I'm dressed a little differently from the other gentlemen.  Because of sequester, they cut my tails.  (Laughter.)  My joke writers have been placed on furlough.  (Laughter.)  I know a lot of you reported that no one will feel any immediate impact because of the sequester.  Well, you're about to find out how wrong you are.  (Laughter.) 

Of course, there's one thing in Washington that didn't get cut -- the length of this dinner.  (Laughter.)  Yet more proof that the sequester makes no sense.  (Laughter.)  

As you know, I last attended the Gridiron dinner two years ago.  Back then, I addressed a number of topics -- a dysfunctional Congress, a looming budget crisis, complaints that I don't spend enough time with the press.  It's funny, it seems like it was just yesterday.  (Laughter.)  

We noticed that some folks couldn't make it this evening.  It's been noted that Bob Woodward sends his regrets, which Gene Sperling predicted.  (Laughter.)  I have to admit this whole brouhaha had me a little surprised.  Who knew Gene could be so intimidating?  (Laughter.)  Or let me phrase it differently -- who knew anybody named Gene could be this intimidating?  (Laughter.) 

Now I know that some folks think we responded to Woodward too aggressively.  But hey, when has -- can anybody tell me when an administration has ever regretted picking a fight with Bob Woodward?  (Laughter.)  What's the worst that could happen?  (Laughter and applause.)

But don't worry.  We're all friends again in the spirit of that wonderful song.  As you may have heard, Bob invited Gene over to his place.  And Bob says he actually thinks that I should make it too.  And I might take him up on the offer.  I mean, nothing says "not a threat" like showing up at somebody's house with guys with machine guns.  (Laughter.)  

Now, since I don't often speak to a room full of journalists -- (laughter) -- I thought I should address a few concerns tonight.  Some of you have said that I'm ignoring the Washington press corps -- that we're too controlling.  You know what, you were right.  I was wrong and I want to apologize in a video you can watch exclusively at whitehouse.gov.  (Laughter.) 

While we're on this subject, I want to acknowledge Ed Henry, who is here -- who is the fearless leader of the Washington press corps now.  (Applause.)  And at Ed's request, tonight I will take one question from the press.  Jay, do we have a question?  (Laughter.)  Surprisingly, it's a question from Ed Henry.  (Laughter.)  “Mr. President, will you be taking any questions tonight?”  (Laughter.)  I'm happy to answer that.  No, Ed, I will not.  (Laughter.) 

I also want to recognize David Corn.  He's here from Mother Jones magazine.  He brought his iPhone.  So Bobby Jindal, if you thought your remarks were off the record, ask Mitt Romney about that.  (Applause.) 

I have to say, I thought Bobby was incredibly funny this evening.  (Applause.)  I thought he was terrific.  Amy Klobuchar was sparkling and fantastic and fabulous.  (Applause.)  I am worried about Al Franken though.  (Laughter.)  How do you start off being one of the original writers for Saturday Night Live and end up being the second-funniest Senator in Minnesota?  (Laughter and applause.)  How the mighty have fallen.  (Laughter.)

Now I'm sure that you've noticed that there's somebody very special in my life who is missing tonight, somebody who has always got my back, stands with me no matter what and gives me hope no matter how dark things seem.  So tonight, I want to publicly thank my rock, my foundation -- thank you, Nate Silver.  (Laughter.)  

Of course as I begin my second term, our country is still facing enormous challenges.  We have a lot of work to do -- that, Marco Rubio, is how you take a sip of water.  (Laughter and applause.)

As I was saying, we face major challenges.  March in particular is going to be full of tough decisions.  But I want to assure you, I have my top advisors working around the clock. After all, my March Madness bracket isn't going to fill itself out.  (Laughter.)  And don't worry -- there is an entire team in the situation room as we speak, planning my next golf outing, right now at this moment.  (Laughter.) 

But those aren't the only issues on my mind.  As you are aware -- as has been noted this evening -- we've had to make some very tough, huge budget cuts apparently with no regard to long-term consequences, which means I know how you feel in journalism.  (Laughter.)  I've been trying to explain this situation to the American people, but clearly I am not perfect. After a very public mix-up last week, my communications team has provided me with an easy way to distinguish between Star Trek and Star Wars.  (Laughter.)  Spock is what Maureen Dowd calls me.  Darth Vader is what John Boehner calls me.  (Laughter.)  

Of course, maintaining credibility in this cynical atmosphere is harder than ever -- incredibly challenging.  My administration recently put out a photo of me skeet shooting and even that wasn't enough for some people.  Next week, we're releasing a photo of me clinging to religion.  (Laughter and applause.)  

I'm also doing what I can to smooth things over with Republicans in Congress.  In fact, these days John McCain and I are spending so much time together that he told me we were becoming friends.  I said, “John, stop.  Chuck Hagel warned me how this ends up.”  (Laughter.)  

It took a while, but I'm glad that the Senate finally confirmed my Secretary of Defense.  And I have to say, I don't know what happened to Chuck in those hearings.  I know he worked hard, he studied his brief.  And I even lent him my presidential debate team to work with him.  (Laughter.)  It's confusing what happened.  (Laughter.) 

But all these changes to my team are tough to handle, I've got to admit.  After nine years, I finally said goodbye to my chief speechwriter, Jon Favreau.  I watched him grow up.  He's almost like a son to me, he's been with me so long.  And I said to him when he first informed me of his decision, I said, “Favs, you can't leave.”  And he answered with three simple words -- "yes, I can."  (Laughter.)  Fortunately, he did not take the prompter on his way out.  (Laughter.)  That would have been a problem.  (Laughter.) 

With all these new faces, it's hard to keep track of who is in, who is out.  And I know it's difficult for you guys as reporters.  But I can offer you an easy way of remembering the new team.  If Ted Cruz calls somebody a communist, then you know they're in my cabinet.  (Laughter.)  

Jack Lew is getting started on his new role as Treasury Secretary.  Jack is so low key, he makes Tim Geithner look like Tom Cruise.  (Laughter.)  Don't worry, everybody, Jack signed off on that joke or a five year old drew a slinky.  (Laughter.)  I don't know which.  (Applause.) 

Another big change has been at the State Department.  Everybody has noticed that obviously.  And let's face it -- Hillary is a tough act to follow.  But John Kerry is doing great so far.  He is doing everything he can to ensure continuity.  Frankly, though, I think it's time for him to stop showing up at work in pantsuits.  (Laughter.)  It's a disturbing image.  (Laughter.)  It really is.  (Laughter.)  I don't know where he buys them.  He is a tall guy.  (Laughter.) 

And even though I'm just beginning my second term, I know that some folks are looking ahead to bigger things.  Look, it's no secret that my Vice President is still ambitious.  But let's face it, his age is an issue.  Just the other day, I had to take Joe aside and say, “Joe, you are way too young to be the pope."  (Laughter.)  "You can't do it.  You got to mature a little bit."  (Laughter.) 

Now, I do want to end on a serious note.  I know that there are people who get frustrated with the way journalism is practiced these days.  And sometimes those people are me.  (Laughter.)  But the truth is our country needs you and our democracy needs you.

In an age when all it takes to attract attention is a Twitter handle and some followers, it's easier than ever to get it wrong.  But it's more important than ever to get it right.  And I am grateful for all the journalists who do one of the toughest jobs there is with integrity and insight and dedication -- and a sense of purpose -- that goes beyond a business model or a news cycle.

This year alone, reporters have exposed corruption here at home and around the world.  They've risked everything to bring us stories from places like Syria and Kenya, stories that need to be told.  And they've helped people understand the ways in which we're all connected -- how something that happens or doesn't happen halfway around the world or here in Washington can have consequences for American families.

These are extraordinary times.  The stakes are high and the tensions can sometimes be high as well.  But while we'll always have disagreements, I believe that we share the belief that a free press -- a press that questions us, that holds us accountable, that sometimes gets under our skin -- is absolutely an essential part of our democracy.

So I want to thank everybody for not just a wonderful evening -- and, Chuck, I want to thank you for your outstanding presidency -- but I also just want to thank you for the work that you do each and every day.  And in the words of one of my favorite Star Trek characters -- Captain James T. Kirk of the USS Enterprise -- “May the force be with you."  (Laughter and applause.)

END 10:19 P.M. EST

Extending Middle Class Tax Cuts

Serving communities since 1994, AmeriCorps volunteers touch the lives of millions. We honor this tradition as we celebrate AmeriCorps Week.

This week the White House is highlighting one initiative a day which demonstrates the Obama Administration’s continued commitment to open and accessible government -- the first in the series focuses on progress made improving the administration of the FOIA.

On Monday, March 11, First Lady Michelle Obama will be answering questions on Twitter

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The Coming ObamaCare Shock

In recent weeks, there have been increasing expressions of concern from surprising quarters about the implementation of ObamaCare. Montana Sen. Max Baucus, a Democrat, called it a "train wreck." A Democratic colleague, West Virginia's Sen. Jay Rockefeller, described the massive Affordable Care Act as "beyond comprehension." Henry Chao, the government's chief technical officer in charge of putting in place the insurance exchanges mandated by the law, was quoted in the Congressional Quarterly as saying "I'm pretty nervous . . . Let's just make sure it's not a third-world experience."

These individuals are worried for good reason. The unpopular health-care law's rollout is going to be rough. It will also administer several price (and other) shocks to tens of millions of Americans.

Start with people who have individual and small-group health insurance. These policies are most affected by ObamaCare's community-rating regulations, which require insurers to accept everyone but limit or ban them from varying premiums based on age or health. The law also mandates "essential" benefits that are far more generous than those currently offered.

According to consultants from Oliver Wyman (who wrote on the issue in the January issue of Contingencies, the magazine of the American Academy of Actuaries), around six million of the 19 million people with individual health policies are going to have to pay more—and this even after accounting for the government subsidies offered under the law. For example, single adults age 21-29 earning 300% to 400% of the federal poverty level will be hit with an increase of 46% even after premium assistance from tax credits.

Determining the number of individuals who will be harmed by changes to the small-group insurance market is harder. According to the Medical Expenditure Panel Survey, conducted by the Department of Health and Human Services, around 30 million Americans work in firms with fewer than 50 employees, and so are potentially affected by the small-group "reforms" imposed by ObamaCare.

Around nine million of these people, plus six million family members, are covered by employers who do not self-insure. The premium increases for this group will be less on average than those for people in the individual market but will still be substantial. According to analyses conducted by the insurer WellPoint for 11 states, small-group premiums are expected to increase by 13%-23% on average.

This average masks big differences. While some firms (primarily those that employ older or sicker workers) will see premium decreases due to community rating, firms with younger, healthier workers will see very large increases: 89% in Missouri, 91% in Indiana and 101% in Nevada.

Because the government subsidies to purchasers of health insurance in the small-group market are significantly smaller than those in the individual market, I estimate that another 10 million people, the approximately two-thirds of the market that is low- or average-risk, will see higher insurance bills for 2014.

Higher premiums are just the beginning, because virtually all existing policies in the individual market and the vast majority in the small-group market do not cover all of the "essential" benefits mandated by the law. Policies without premium increases will have to change, probably by shifting to more restrictive networks of doctors and hospitals. Even if only one third of these policies are affected, this amounts to more than five million people.

In addition, according to Congressional Budget Office projections in July and September 2012, three million people will lose their insurance altogether in 2014 due to the law, and six million will have to pay the individual-mandate tax penalty in 2016 because they don't want or won't be able to afford coverage, even with the subsidies.

None of this counts the people whose employment opportunities will suffer because of disincentives under ObamaCare. Some, whose employers have to pay a tax penalty because their policies do not carry sufficiently generous insurance, will see their wages fall. Others will lose their jobs or see their hours reduced.

Anecdotal evidence already suggests that these disincentives will really matter in the job market, as full-time jobs are converted to part time. Why would employers do this? Because they aren't subject to a tax penalty for employees who work less than 30 hours per week.

There is some debate over how large these effects will be, and how long they will take to manifest. However, the Bureau of Labor Statistics reports on a category of workers who will almost surely be involuntarily underemployed as a result of health reform: the 10 million part-timers who now work 30-34 hours per week.

These workers are particularly vulnerable. Reducing their hours to 29 avoids the employer tax penalty, with relatively little disruption to the workplace. Fewer than one million of them, according to calculations based on the Medical Expenditure Panel Survey, get covered by ObamaCare-compliant insurance from their employer.

In total, it appears that there will be 30 million to 40 million people damaged in some fashion by the Affordable Care Act—more than one in 10 Americans. When that reality becomes clearer, the law is going to start losing its friends in the media, who are inclined to support the president and his initiatives. We'll hear about innocent victims who saw their premiums skyrocket, who were barred from seeing their usual doctor, who had their hours cut or lost their insurance entirely—all thanks to the faceless bureaucracy administering a federal law.

The allure of the David-versus-Goliath narrative is likely to prove irresistible to the media, raising the pressure on Washington to repeal or dramatically modify the law. With the implementation of ObamaCare beginning to take full force at the end of the year, there will be plenty of time before the 2014 midterm elections for Congress to consider its options.

For those like Health and Human Services Secretary Kathleen Sebelius, who told a gathering a few weeks ago at the Harvard School of Public Health that she has been "surprised" by the political wrangling caused so far by ObamaCare, there are likely to be plenty of surprises ahead.

Mr. Kessler is a professor of business and law at Stanford University and a senior fellow at the Hoover Institution.

A version of this article appeared April 30, 2013, on page A17 in the U.S. edition of The Wall Street Journal, with the headline: The Coming ObamaCare Shock.


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Dad Challenges Retro Gender Roles By Hacking ‘Donkey Kong’

Mike Mika might be the world’s best feminist dad.

When his 3-year-old daughter discovered that the girl character in Donkey Kong, Pauline, could only sit distressed and wait for a male character to help her, Mika decided to do something about it. So, The Verge reports, he hacked the popular game to make Pauline a functional character, and the male character, Mario, became the damsel (or, lord?) in distress:

Thankfully Mika happens to be a competent developer, and after a few late-night hours spent hacking the NES version of Nintendo’s classic, he accomplished the role reversal his daughter had wished for. Mario was now under Donkey Kong’s control, and Pauline was tasked with rescuing the plumber in distress. Following the successful endeavor, Mika shared some details of how he swapped the characters on a YouTube page demonstrating the hack. “I’ve redrawn Mario’s frames and I swapped the palettes in the ROM,” he wrote. “I replaced the M at the top with a P for Pauline.”

Mika uploaded this video on YouTube to demonstrate how it worked:

Technological hacks for thinking about and subverting gender barriers are gaining in popularity. Another father recently did a gender swap for the game Zelda. And a recent invention, a Google Chrome browser extension called “Jailbreak The Patriarchy,” swaps the gender pronouns on websites to show how gender dynamics affect our views of the world.


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Applying for ObamaCare—Still Not Simple

During his news conference last week, the president sounded defensive in trying to tamp down fears of an impending ObamaCare train wreck. One positive note was his boast about whittling down from 21 pages to three the application for subsidies that individuals have to file. But even that may need some defending.

The three-page application is for people who don't get health insurance at work and are seeking coverage and subsidies for themselves. One big reason the new form is shorter: the type is smaller, with less space for answers.

The much-derided 21-page application was for families. It is now down to 11 pages, thanks to a trick. Eight pages in the longer application called for filling in information for four additional family members. The new form cuts these pages but says that if you have children, "make a copy of Step 2: Person 2 (pages 4 and 5) and complete." The work required of the applicant remains the same.

Then there's a 61-page online application form that is in the draft stage but hasn't been officially released. This is the drill-down version of the three-page and 11-page printed documents. It has all of the if-then questions the government may need to have answered before it can determine if an applicant is eligible for subsidies.

For example, this online form has nine pages of questions and instructions to determine what a family is and how everyone is related. It announces that it is "governed by complex logic in order to ask the fewest number of questions possible." Twenty-eight different options for family relationships will be displayed in drop boxes, including first cousin, former spouse and collateral dependent.

The family application (the paper version and the online draft) assumes that someone in the family has a job that offers insurance. There are two pages the applicant must complete on that front.

One question asks: Does your employer "offer a health plan that meets the minimum value standard*?" Following the asterisk is an explanation of how to make that determination: "*An employer-sponsored health plan meets the 'minimum value standard' if the plan's share of the total allowed benefit costs covered by the plan is no less than 60 percent of such costs (Section 36B(c)(2)(C)(ii) of the Internal Revenue Code of 1986)."

But back to the new, 11-page form. It contains a strong warning not in the earlier, 21-page draft: "I'm signing this application under penalty of perjury . . . I know that I may be subject to penalties under federal law if I provide false and or untrue information." That threat may unsettle applicants already not sure they're correctly answering complicated questions. If they don't, the consequences could be costly. If an applicant understates his income and receives a larger health-insurance subsidy than he is eligible for, the money must be paid back. That may mean thousands of dollars.

Applicants may be further disturbed when they encounter, on the signature page, this message: "We'll check your answers using information in our electronic databases and databases from the Internal Revenue Service (IRS), Social Security, the Department of Homeland Security, and/or a consumer reporting agency. If the information doesn't match, we may ask you to send us proof."

Given the complexity of the questions, many people will need help with the application. So there is a handy Appendix C that allows the applicant to "choose an authorized representative" who can gather information and sign "your application on your behalf." You need to be very sure you can trust this person with the required confidential information (Social Security numbers, income, etc.). Many of those providing help will be footsoldiers in ObamaCare's newly formed army of hourly-paid "navigators."

But this being an Obama administration undertaking, the new application will provide a Web link to "complete a voter registration form."

Ms. Turner is president of the Galen Institute and co-author of "Why ObamaCare Is Wrong for America" (Broadside/HarperCollins 2011).

A version of this article appeared May 11, 2013, on page A13 in the U.S. edition of The Wall Street Journal, with the headline: Applying for ObamaCare: Still Not Simple.


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Statement by the Press Secretary on Robert Levinson

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For Immediate Release March 08, 2013 Statement by the Press Secretary on Robert Levinson

Six years ago tomorrow, retired FBI agent Robert Levinson went missing during a business trip in Iran. Finding him remains a high priority for the United States, and we will continue to do all that we can to bring him home safely to his friends and family, so they may begin to heal after so many years of extraordinary grief and uncertainty.

The Iranian Government previously offered assistance in locating Mr. Levinson and we look forward to receiving this assistance, even as we disagree on other key issues. The FBI has also announced a $1 million reward for information leading to Mr. Levinson’s safe return. This year, we again reaffirm our commitment to bringing him home to those who love him.

Extending Middle Class Tax Cuts

Blog posts on this issue March 11, 2013 11:00 AM EDTAmeriCorps: Service, Sacrifice, and Solutions

Serving communities since 1994, AmeriCorps volunteers touch the lives of millions. We honor this tradition as we celebrate AmeriCorps Week.

March 11, 2013 9:59 AM EDTSunshine Week: In Celebration of Open Government

This week the White House is highlighting one initiative a day which demonstrates the Obama Administration’s continued commitment to open and accessible government -- the first in the series focuses on progress made improving the administration of the FOIA.

March 10, 2013 5:36 PM EDT#AskFLOTUS About Let's Move!

On Monday, March 11, First Lady Michelle Obama will be answering questions on Twitter

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Get Ready for Huge Drug Cost Gap in Obamacare

Cancer patients could face high costs for medications under President Barack Obama's health care law, industry analysts and advocates warn.

Where you live could make a huge difference in what you'll pay.

To try to keep premiums low, some states are allowing insurers to charge patients a hefty share of the cost for expensive medications used to treat cancer, multiple sclerosis, rheumatoid arthritis and other life-altering chronic diseases.

Such "specialty drugs" can cost thousands of dollars a month, and in California, patients would pay up to 30 percent of the cost. For one widely used cancer drug, Gleevec, the patient could pay more than $2,000 for a month's supply, says the Leukemia & Lymphoma Society.

New York is taking a different approach, setting flat dollar copayments for medications. The highest is $70, and it would apply to specialty drugs as well.

Critics fear most states will follow California's lead, and that could defeat the purpose of Obama's overhaul, because some of the sickest patients may be unable to afford their prescriptions.

"It's important that the benefit design not discriminate against people with chronic illness, and high copays do that," said Dan Mendelson, president of Avalere Health, a data analysis firm catering to the health care industry and government.

Avalere's research shows that 1 in 4 cancer patients walks away from the pharmacy counter empty-handed when facing a copay of $500 or more for a newly prescribed drug.

"You have to worry about a world where if you happen to contract cancer or multiple sclerosis, you are stuck with a really big bill," Mendelson said. "It's going to be very important for states to take a long, hard look at their benefit design."

Although the money for covering uninsured Americans is coming from Washington, the heath care law gives states broad leeway to tailor benefits, and the local approach can also allow disparities to emerge.

A spokesman for Covered California said state officials are trying to balance between two conflicting priorities: comprehensive coverage and affordable premiums.

"We are trying to keep the insurance affordable across the board," said Dana Howard, the group's spokesman. "This is just part of trying to manage the overall risk of the pool." Covered California is one of the new state marketplaces where people who don't get coverage on the job will be able to shop for private insurance starting this fall. Coverage takes effect Jan. 1.

Insurers are forecasting double-digit premium increases for individual policies, as people with health problems flock to buy coverage previously denied them. The Obama administration says the industry warnings are overblown, and that for many consumers, premium increases will be offset by tax credits to help buy insurance. And officials say it's important to realize that the law sets overall limits on patients' liability, even if those seem high to some people. Still, a full picture of costs and benefits isn't likely to come into focus until the fall.

Howard said California officials are aware of the concerns about drug costs and are trying to make medications more affordable.

Meanwhile, he said consumers will be protected because the law limits total out-of-pocket costs—the deductibles and copayments that policy holders are responsible for, apart from monthly premiums. In California, the annual out-of-pocket limit for an individual is $6,400, although it can be as low as $2,250 for low-income people. Once that limit is reached, insurance pays 100 percent.

That's still a lot of money, and such reassurances haven't dispelled the concerns.

"The intent of the Affordable Care Act is to make sure that all Americans have access to quality, affordable health care," said Brian Rosen, a senior vice president of the Leukemia & Lymphoma Society. He adds that there is a danger that the insurance marketplaces "will discriminate against the patients with the highest medical need. That would completely undermine the spirit of the ACA."

The group has been joined by Rep. Doris Matsui, D-Calif., in urging state officials to reconsider the policy. The high copays "could prevent many patients from receiving the lifesaving treatments they need because of prohibitively high cost," Matsui wrote to the state.

The problem with costly drugs is similar to another money issue with the health care law—a provision that could price millions of smokers out of coverage. Insurers are allowed to charge tobacco users buying an individual policy up to 50 percent higher premiums. For a 55-year-old smoker, the penalty could reach nearly $4,250 a year, on top of the standard premium. California is trying to override that problem by passing its own law. There's also pending state legislation to address some issues with prescription costs, but its prospects are unclear.

Meanwhile, leukemia patient Lisa Lusk worries about what will happen to her. A nursing assistant who lives near Fresno, Lusk is hoping to return to work in the next few months. When that happens, she expects to lose emergency coverage she's now getting through the state. And the medication Lusk takes to manage her chronic form of the disease costs more than $5,000 a month.

"I'm scared that when I get a job my copay may be more than $1,500 a month," said Lusk. "I'll just be working to pay for my medications."

_ By The Associated Press


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Chick-fil-A Will Not Be Coming Back To Emory University

Emory University is in Atlanta, Georgia, just 20 miles from the Chick-fil-A corporate headquarters. Since the full extent of Chick-fi-A’s anti-gay beliefs and giving fully came to light last summer, student leaders protested the continued presence of a franchise in the campus’s food court. In December, even the Student Government Association passed a resolution opposing Chick-fil-A. Ultimately, campus administrators issued a thoughtful statement acknowledging the stigma attached to the company, but explaining it was not grounds to cancel the contract. The students vowed not to back down, and now it seems Chick-fil-A will not be coming back to campus next year.

According to a tweet from Emory Wheel, the student newspaper, Chick-fil-A has been removed from the food court as part of its new layout. The full details for this change are not yet known, but some clues can be found in the statement originally provided by the university:

Any decision to by Sodexo [the campus dining contractor] to renew or not renew the contract with Chick-fil-A, or any other vendor, must be part of a dining vision to advance the purposes for which Emory has contracted with Sodexo. Opposing views must be acknowledged, recognizing that some differences are truly irreconcilable. [...]

Typical brand selection and replacement considerations include, but are not limited to, preferential surveys, strategic planning processes, campus master planning, sales trends, contract requirements, and brand re-imaging.

Perhaps the franchise’s sales plummeted, or perhaps it simply it no longer fit in the campus’s “master planning.” At any rate, it is a victory for LGBT students, who will no longer have to encounter a glowing symbol of anti-gay prejudice as they partake in lunch on campus.


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