Rep. Ryan: We have more questions for IRS

Members of the House Ways and Means Committee have more questions on the Internal Revenue Service targeting conservative groups after outgoing acting commissioner Steve Miller testified before the committee on Friday, Rep. Paul Ryan (R-Wis.) said.

Asked Friday afternoon in an interview with CNN if Miller answered all the questions Ryan had, the congressman from Wisconsin, who is a member of the Ways and Means Committee, said "no."

"We —we have many more questions that resulted from today's hearing.  The one answer we did get, though, is that the IRS withheld information from Congress," Ryan told CNN's Jake Tapper.

Miller's appearance came a week after the IRS publicly apologized for applying a higher level of scrutiny to conservative organizations applying for tax exempt status. Since the IRS admitted to targeting conservative organizations, a number of congressional committees have planned hearings investigating the service's conduct.

Ryan said Ways and Means had been receiving reports about the IRS focusing on conservative organizations.

"Jake, you had to know that last year, we had these investigations on the Ways and Means Committee," Ryan said. "We were receiving all of these reports of this kind of harassment.  We questioned the IRS in hearings, in letters, and the IRS withheld all of this information that they were in possession of as to whether this targeting was occurring or not.

"We do now know that this targeting did occur, that it was politically biased.  It was only of conservative groups.  Now we're getting lots of questions with respect to religious groups and other kinds of groups."

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Op-Ed by President Obama: A Partnership That Delivers

The White House

Office of the Press Secretary

The piece was published today in Turkish by Turkish Daily “Sabah” and can be found here. The full English text of the op-ed by President Obama is printed below.

A Partnership That Delivers
By President Barack Obama

Turkey and the United States have been partners since shortly after the birth of the modern Turkish Republic.  As NATO allies, we have defended our common security for more than six decades.  And in the United States we are grateful for the many Turkish-Americans who enrich our national life every day.

Today, when I welcome my friend Prime Minister Erdogan back to the White House, we’ll chart the next steps in our alliance—a partnership that delivers security, prosperity and progress for both our peoples.

On a personal level, the prime minister’s visit will be another opportunity for me to reciprocate the hospitality that he and the Turkish people showed me when I visited Ankara and Istanbul during my first year in office.  I came to Turkey during my first overseas trip as president because I am committed to an even deeper relationship with our Turkish friends.  Four years later, U.S.-Turkish relations are as strong as ever, and Prime Minister Erdogan’s visit will allow us to expand our cooperation in several important areas.

First, we will reaffirm our solemn obligation to our shared security.  As allies, our commitment to our collective defense is unwavering, as demonstrated by NATO’s deployment of Patriot missile defenses to help protect the Turkish people.   And I applaud the prime minister’s courageous efforts to seek a lasting peace in Turkey after the PKK violence that has taken so many innocent lives.  The United States strongly supports Turkey’s efforts to defend itself from terrorism, even as we support efforts to uphold rule of law, good governance and human rights.  

Just as our nations stood together after the attack this year on our embassy compound in Ankara, we condemn last week’s outrageous bombings in Reyhanli, which killed innocent Turkish civilians.  To our Turkish friends, we say basiniz sag olsun.  In Washington, we’ll have the opportunity to deepen our security cooperation, including against the threat from terrorist groups like al-Qaeda.        

Second, we can continue increasing U.S.-Turkish trade and create more jobs for our people.  Our aerospace companies are moving ahead with $3.5 billion deal to jointly build our most advanced helicopter.  American and Turkish pharmaceutical and research firms can partner to realize state-of-the art Turkish health care.  We can collaborate on clean energy and energy efficiency to meet Turkey’s growing energy needs.  And our technology companies can help put the most advanced educational tools in the hands of Turkish children and help turn Turkey into a regional hub of educational software and innovation. 

Meanwhile, we can expand educational exchanges so we bring more American students to Turkey and more Turkish students to the United States.  Like the extraordinary students I met in Turkey four years ago, these young people can help drive Turkish innovation and help Turkey reach its goal of becoming one of the world’s ten largest economies.  

Third, Prime Minister Erdogan and I will address regional challenges, including our shared interest in a just and lasting peace between Israelis and Palestinians, and the need to support democratic transitions in Egypt and Libya.  And even as we recognize that sanctions on Iran bring costs for countries like Turkey, we need to keep standing together to prevent a nuclear-armed Iran, which would threaten the entire region, including Turkey.  

Most urgently, we need to keep working together to end the Assad regime’s horrific slaughter of the Syrian people.  Prime Minister Erdogan and I will discuss how we can keep increasing the pressure on the Assad regime, strengthening the moderate opposition, and preparing for a transition to a democratic Syria without Bashar Assad.  At the same time, the United States will continue to provide critical humanitarian relief to Syrian refugees, including those in Turkey who owe so much to the tremendous generosity of the Turkish people.

Finally, given Turkey’s growing role on the world stage, I look forward to consulting with Prime Minister Erdogan on global challenges.  Our forces continue to serve bravely together in Afghanistan, where Afghans will soon take the lead for their own security.  We’re partners in promoting security and stability in Africa.  And as members of the G-20, we can help sustain the global economic recovery with a focus on creating jobs and opportunity for our people.   

This is an ambitious agenda, but it reflects the many interests our nations share as well as Turkey’s unique place in the world.  As I told the Turkish parliament four years ago, “Turkey's greatness lies in your ability to be at the center of things.  This is not where East and West divide – this is where they come together.” 

I look forward to welcoming Prime Minister Erdogan back to Washington.  And I’m confident that if our two great nations continue to work closely together, our alliance will continue to deliver the security, prosperity and progress that our citizens deserve.

###

Here’s a quick glimpse at what happened this week on WhiteHouse.gov.

The President and the Department of Defense are taking unprecedented steps to protect our environment, achieve significant cost savings, and give our military better energy options.

Today at the White House, we convened the 10th annual meeting of the President’s Interagency Task Force to Monitor and Combat Trafficking in Persons.

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WashPost Notes 'Small-Business Owners Dread' ObamaCare Tax; Paper Buries Story on A15

"Many small-business owners worry that a new tax on insurance providers in the health-care law will mean higher premiums for them, undermining the law's capacity to lower their health-care costs," Washington Post staff writer J.D. Harrison opened his 15-paragraph May 13 story, "Small-business owners dread impact of health insurance tax." The website headline was even starker: "Health insurance tax ‘scares the daylights’ out of some small-business owners."

Unfortunately for print edition, readers, Post editors buried this front-page-worthy article on page A15. Yes, today's front page was mostly populated with meaty, hard-news stories, but a large photo from last night's Capital-Rangers hockey game dominated the center of the page while London bureau chief Anthony Faiola's "Letter from Britain" feature, headlined, "Eurovision drought feels like a hard day's night," was published directly beneath that [see image following page break].

"Starting next year, the federal government will charge a new tax on health insurance firms based on the plans they sell to individuals and companies, known as the fully insured market," Harrison noted. "Meanwhile, the provision exempts health insurance plans that are set up and operated by businesses themselves (the self-insured market." Harrison went on to explain that "experts warn that insurance companies will pass the costs directly to small businesses, [t]he vast majority" of which "purchase coverage in the fully insured market," as opposed to many "large corporations" which self-insure and hence will avoid the tax.

In 2010, then-Speaker Nancy Pelosi (D-Calif.) said we had to pass ObamaCare to find out what's in it. As time goes on and full implementation nears, we're finding out more and more of what's in ObamaCare and the deleterious effects it's having on individuals, families, small businesses, and ultimately the American economy writ large. It isn't pretty, and for the most part it seems the national liberal media are doing their best to downplay the imminent train wreck.

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NYT's Peters Hits 'Waste of Time' Obama-Care Repeal Votes and GOP's 'Myopic Focus' on Deficits

New York Times reporter Jeremy Peters let the Republicans in Congress know he was tired of their silly and "waste of time" attempts to repeal Obamacare in Wednesday's "House to Vote Yet Again On Health Care Repeal."

(Peters was last seen helping Chuck Hagel, Obama's nominee for Secretary of Defense, limp across the confirmation finish line.) He wrote on Wednesday:

The 37th time won’t be the charm. But House Republicans are charging forward anyway this week on a vote to repeal President Obama’s signature health care overhaul, which will put the number of times they have tried to eliminate, defund or curtail the law past the three-dozen mark.

“This is what, the 40th time they’re going to do it?” scoffed Representative Nancy Pelosi of California, the Democratic leader, confessing that she had lost count. “Thirty-eight? 39? 40? 41?” She eventually settled on “high 30s” as her best guess.

....since 2011, Republicans have spent no less than 15 percent of their time on the House floor on repeal in some way.

Liberals mock Republicans for what they dismiss as a waste of time. It represents a fitting ordering of priorities, they say, for a body whose few accomplishments this year include passing a bill that kept the Federal Helium Reserve open, heading off a critical shortage of the gas, and another that modifies the requirements for gold and silver coins commemorating the National Baseball Hall of Fame.

Indeed, the Republican House leadership is sensitive to the perception that they are squandering even more time on a repeal vote that is going nowhere.

With the national debt at over $16 trillion, Peters accused the Republicans of suffering from "an almost myopic focus on deficit reduction and budgets."

Republican leadership put off scheduling a vote on an outright repeal of the health care law despite pleas from conservative members who believe it is an issue of paramount importance to voters back home. After losing the presidency and seats in both houses in Congress, the House leadership initially wanted to focus on pursuing an agenda crafted by Representative Eric Cantor of Virginia, the majority leader, aimed at softening the party’s image by moving off an almost myopic focus on deficit reduction and budgets.

They were able to hold off a vote for some time. At this point in 2011, House Republicans had already voted nine times on some form of repeal.

But conservatives pressed on, noting that their newly elected colleagues had not had a chance to vote on something that is a Republican rite of passage.

Clay Waters is the director of Times Watch, an MRC project tracking the New York Times. Click here to follow Clay Waters on Twitter.

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Obamacare: 3 Years In, It Faces Steep Challenges

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President Obama signs the health care bill into law at the White House on March 23, 2010. (Photo: Charles Dharapak, AP)

Just over a third of Americans, 35%, have a favorable opinion of the health lawUncertainty about the law has risen as time has passedFour in 10 Americans don't believe the law is still in place

WASHINGTON -- The Affordable Care Act is sure to survive the latest vote by the House of Representatives Thursday to repeal it — since the Senate doesn't plan to take it up and President Obama would veto a repeal bill if it somehow reached his desk — but the administration's signature legislative achievement still faces serious perils ahead.

Americans have a dimmer view of the health care law now than they did when Obama triumphantly signed it three years ago, according to monthly tracking polls by the Kaiser Family Foundation. The public's divided view and relentless Republican attacks have made it easier for governors and state legislators to balk at cooperating with the law. It is designed to provide coverage for millions of Americans who haven't qualified for Medicaid in the past and don't get insurance through their employers.

That could have a cascading effect: Resistance by the states will make it harder for the law to work as promised when Medicaid expands next year and the health-insurance marketplaces where the uninsured can shop for plans open this fall.

That could fortify the arguments of those who warned the law was a mistake from the start and threaten fundamental provisions of it down the road.

"For most of the Obama administration, the thought was the bill was passed and it's over," says Robert Blendon, a Harvard professor and influential analyst who supports the law. The president understandably turned his attention to the fragile economy, and the most far-reaching expansions of coverage were delayed until 2014 — leaving the door open for opponents to warn of calamity ahead. "By the time they returned to it," Blendon says of White House officials, "opinions were really embedded."

Just over a third of Americans, 35%, have a favorable opinion of the health law, according to the Kaiser survey taken last month, down from 46% who had a positive view when it was signed in 2010. Now 40% have an unfavorable opinion — precisely the same as three years ago — and nearly one in four, 24%, say they don't have an opinion.

The poll of 1,203 adults, taken April 15-20, has a margin of error of +/–3 percentage points.

Uncertainty about the law has risen as time has passed, and confusion about what it does and how it works is especially high among those it is designed to help. In fact, four in 10 Americans don't believe the law is still in place, saying inaccurately that it's been overturned by the Supreme Court or repealed by Congress.

As you know, a health care bill was signed into law in March 2010. What's its current status? Poll taken April 15-20 of 1,203 adults. Margin of error +/- 3 percentage points.

"People haven't really seen the benefits of it, and it's had hundreds of millions of dollars in ads attacking it," says Neera Tanden, who helped shape the law as Obama adviser and now heads the liberal Center for American Progress. "One party was definitely consistently criticizing it, and Democrats have not been sufficiently defending it. So it's been a lopsided argument."

The White House is scrambling to bolster support for and knowledge about the law, in part to encourage younger and healthier Americans who lack health insurance to shop for a plan when the exchanges open Oct. 1. Officials are trying to spotlight popular policies that already have gone into effect, including provisions that provide free preventive care for seniors and allow young adults to stay on their parents' insurance plans.

They also are trying to reassure skeptical employers about the law and its provisions. In a Gallup Poll last month, owners of small businesses predicted by 5-1, 48%-9%, that the Affordable Care Act was going to be bad rather than good for their businesses. About four in 10 said they had held off plans to hire new workers and pulled back on plans to grow their businesses because of the law and its mandates.

"The law is here to stay," Obama declared at an East Room event last week — not an assertion presidents typically feel compelled to make. He noted that not only did Congress pass the law in 2010 (albeit without a single Republican vote) but also the Supreme Court upheld it last year. Then voters "went to the polls and decided to keep going in this direction" by re-electing him last November.

"With something as personal as health care, I realize there are people who are anxious, people who are nervous, making sure that we get this done right," the president said. "I'm here to tell you, I am 110% committed to getting it done right. It's not an easy undertaking, but if it were easy, it would have already been done a long time ago. Undoubtedly, there will be some mistakes and hiccups as the thing get started up, but we're learning already from them."

REMEMBERING TOWN HALLS

Among those most anxious and nervous about possible "mistakes and hiccups" ahead are Democratic members of Congress who voted for the law.

Opposition to Obamacare fueled the rise of the Tea Party and the Republican takeover of the House in the 2010 congressional elections. "Those of us who remember 2009 and the town-hall meetings, we want to be fully prepared now," says Rep. Jan Schakowsky, D-Ill., recalling raucous meetings with constituents who saw the health care plan as an expensive and dangerous government overreach. "People are concerned that we do some better messaging before the August recess."

She and other congressional Democrats met last week with Ron Pollack, head of Families USA, a leading backer of the law. "People are very much wanting to make sure the implementation goes as smoothly as possible," Pollack says. "In 2009 and 2010, congressional Democrats played rope-a-dope and they got hurt." This time, he advised, they should be prepared to detail the law's benefits and rebut any "false claims" about it.

Amy Brighton from Medina, Ohio, demonstrates against the health care law outside of the Supreme Court in Washington on March 27, 2012. (Photo: Charles Dharapak, AP)

Meanwhile, Republicans relish the idea of brandishing Obamacare as a political weapon in the midterms. House Speaker John Boehner says the House brought up overall repeal of the law for the third time since it was enacted simply to give Republican freshmen a chance to stand against it. "We've got 70 new members who have not had an opportunity to vote on the president's health care law," he told reporters beforehand.

Boehner's office says it is the 37th vote in the House on repealing, curtailing or defunding all or part of the Affordable Care Act.

This time, the repeal passed 229-195.

Republicans have failed to repeal the law in its entirety, but seven bills revising particular provisions have been enacted. The GOP also has denied funding requests by the Department of Health and Human Services to help implement the law, including the campaign to boost participation in the insurance exchanges. That's particularly important because if only people with chronic conditions and higher medical bills sign up, premiums would soar and the underpinnings of the system would be undercut.

While the law mandates that most of the uninsured get insurance, the annual penalty for failing to do so is low enough ($95 in 2014, rising to $695 in 2016) that some people simply will choose to pay it.

News reports that HHS Secretary Kathleen Sebelius has been raising private money for the effort sparked objections and demands for information this week from Republican lawmakers. Tennessee Sen. Lamar Alexander, the top Republican on the Senate Health committee, says he will formally request an investigation by the congressional General Accounting Office this week, comparing her actions to the Iran-contra scandal in the Reagan administration.

Since March, Sebelius has made fundraising calls on behalf of Enroll America to the Robert Wood Johnson Foundation and H&R Block, according to her spokesman, Jason Young. Enroll America, a non-profit organization created to encourage the uninsured Americans to sign up for the exchanges, is headed by Anne Filipic, a former aide to Obama and Sebelius who worked in the White House before resigning to lead the group.

Sebelius also made more public appeals to charitable groups, insurers, pharmaceutical companies and others to help the enrollment effort.

Health and Human Services Secretary Kathleen Sebelius testifies on Capitol Hill on April 12. (Photo: J. Scott Applewhite, AP)

Young says Sebelius' fundraising efforts were permitted under provisions that date to 1976 in the Public Health Service Act, which allows the HHS secretary to encourage support for non-profit groups that promote public health. He said her predecessors made similar appeals when other new federal programs were launched, including the Medicare prescription drug benefit during the Bush administration and the children's health insurance program during the Clinton years.

Alexander is not persuaded. "I don't see how that's different from what Oliver North did at the end of the Reagan administration to raise money privately and use it to support the contra rebels" in Nicaragua, he said in an interview. "A joint select committee of Congress that was bipartisan said the principle problem with Iran-contra is that the Reagan administration was using private funds and private entities to do something that Congress had refused to do."

He said that Sebelius may be violating the Constitution and the Anti-deficiency Act, which prohibits federal employees from spending money beyond that authorized by law.

26 STATES: YOU DO IT

The Affordable Care Act envisioned most states establishing and running their own insurance exchanges. But only 17 states and the District of Columbia are moving ahead with plans to do that; another seven are setting up "partnership exchanges" with the federal government.

But 26 states, including six of the 10 most populous ones, are leaving the job entirely to the federal government. The administration says one-third of the prime target group nationwide — healthy 18- to 34-year-olds who don't have insurance — live in California, Florida and Texas. Of that trio of states, only California is setting up a state exchange.

The other major part of the Affordable Care Act to cover the uninsured, expanding Medicaid to include more low-income Americans, is opposed by at least 20 governors, according to the Kaiser foundation. The Supreme Court ruling last year upheld the law's controversial individual mandate but gave states the option of choosing not to participate in the Medicaid expansion. In the states that don't, the uninsured who are too poor to afford to buy coverage in the exchanges, even with a federal subsidy, are out of luck.

Democratic pollster Mark Mellman says the public still could be won over to embrace the law. "It's slightly more unpopular than popular, but it's not radioactive," he says, despite a concerted and well-funded campaign against it.

In the end, views of the law will depend on whether it works as promised, Republican pollster Bill McInturff agrees. "If in fact this is a good and affordable product that works, it will work," he says. "If what starts to happen is small employers start dumping people into the exchanges and they lose good private coverage; if healthy people would rather pay the penalty than sign up — then it's going to immediately turn into a problem with demands to change it."

Over the next year, the health care law is likely to succeed in some states and fail in others, analyst Blendon says.

"Best case: the governor and the legislature support it, they have a state exchange, and what I call the civic leadership is all behind it — the business people, the unions, the religious leaders. Then the problem is just technically, how do we get this set up and how do we get people to understand" how it works?

At the other extreme are states that are declining to participate in the Medicaid expansion and to put the force of the state government and local leadership behind the new marketplaces. "If you don't offer Medicaid and you don't have a lot of support for the federally run exchange, it will be incredibly easy for the one-third of people younger and healthier not to enroll," he cautions. "At least in 20 states, it's set up to fail."

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Scientist

(Difference between revisions)Prior to this, scientists were usually called "natural philosophers" or "natural historians." (The oldest scientific journal in the world, established in 1665, is entitled ''Philosophical Transactions of the Royal Society of London.'' Among its early numbers are letters from Leeuwenhoek describing his discovery of [[microorganism]]s).Prior to this, scientists were usually called "natural philosophers" or "natural historians." (The oldest scientific journal in the world, established in 1665, is entitled ''Philosophical Transactions of the Royal Society of London.'' Among its early numbers are letters from Leeuwenhoek describing his discovery of [[microorganism]]s).== Science and Christianity ==Many scientists have been devout Christians or held a belief in God ([[Isaac Newton]] http://www.newton.cam.ac.uk/newtlife.html or monk Gregor Mendelhttp://www.adherents.com/people/pm/Gregor_Mendel.html). Modern science has become increasingly [[atheism|atheistic]],http://www.atheists.org/flash.line/atheism1.htm rejecting God and his works in explanations of the world and all of human experience. Instead readily embracing [[liberal logic]] and pseudo or [[junk science]] such as [[Counterexamples to Evolution|evolution]], [[Counterexamples to Relativity|relativity]], [[global warming]], [[paleontology]]  and much of [[cosmology]] and [[geology]] based on a [[Counterexamples to an Old Earth|time frame]] which predates [[creation]]. Consequently the rigid [[logic]] of [[creation science]] is gaining in importance, enabling intelligent people to distinguish real science from atheistic secular junk science. A 1998 study indicates that among U. S. scientists belief in God has declined between 1914 and 1998, with 7% believing, 72.2% disbelieving, and 20.8% professing doubt or agnosticism.http://www.stephenjaygould.org/ctrl/news/file002.htmlMany scientists have been religious or held a belief in God ([[Isaac Newton]] http://www.newton.cam.ac.uk/newtlife.html or monk Gregor Mendelhttp://www.adherents.com/people/pm/Gregor_Mendel.html). Scientific ideas date back to the ancient Greeks, and scientists come from a variety of religious traditions, including Jews, Muslims, Budists and Hindus. Many scientists believe that scientific discoveries are God-inspired. A 1998 study indicates that among U. S. scientists belief in God has declined between 1914 and 1998, with 7% believing, 72.2% disbelieving, and 20.8% professing doubt or agnosticism.http://www.stephenjaygould.org/ctrl/news/file002.html This reflects the decline in the United States among non-scientists as well.

A scientist is someone who practices science.

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Depending on the context, the term "scientist" might refer to anyone using the scientific method or anyone with a qualification in a field of science. In most cases, both will be true, but in other cases only one or the other may be true.

The invention of the word scientist is often credited to William Whewell (1794-1866), who was himself a scientist as well as a moral philosopher and Anglican priest. In 1858, he wrote:

As we cannot use physician for a cultivator of physics, I have referred to him as a Physicist. We need very much[sic] a name to describe a cultivator of science in general. I should incline to call him a Scientist. Thus we might say that as an Artist is a Musician, Painter, or Poet, a Scientist is a Mathematician, Physicist, or Naturalist.[1]

Prior to this, scientists were usually called "natural philosophers" or "natural historians." (The oldest scientific journal in the world, established in 1665, is entitled Philosophical Transactions of the Royal Society of London. Among its early numbers are letters from Leeuwenhoek describing his discovery of microorganisms).

Many scientists have been religious or held a belief in God (Isaac Newton[2] or monk Gregor Mendel[3]). Scientific ideas date back to the ancient Greeks, and scientists come from a variety of religious traditions, including Jews, Muslims, Budists and Hindus. Many scientists believe that scientific discoveries are God-inspired. A 1998 study indicates that among U. S. scientists belief in God has declined between 1914 and 1998, with 7% believing, 72.2% disbelieving, and 20.8% professing doubt or agnosticism.[4] This reflects the decline in the United States among non-scientists as well.

? Whewell, William (1858), Novum Organon Renovatum: Being the second part of the philosophy of the inductive sciences, J. W. Parker and Son, p. 338? http://www.newton.cam.ac.uk/newtlife.html? http://www.adherents.com/people/pm/Gregor_Mendel.html? http://www.stephenjaygould.org/ctrl/news/file002.html

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Some Nevadans May See Higher Premiums Under Obamacare

Editor’s note: This is one in an occasional series of stories on health care reform.

The Affordable Care Act may not be so affordable for some Nevadans.

The law, commonly called Obamacare, combines benefit mandates and subsidies designed to make health insurance less costly for millions of Americans who now lack coverage.

But observers ranging from state insurance officials to employee benefit consultants say some consumers could see premium increases big enough to price them out of insurance markets. If that happens, fewer people than expected could buy into the system, and that might mean the difference between Obamacare’s success or failure.

It’s not yet clear how dramatic Nevada’s premium increases might be. The state Division of Insurance has received no new product filings for the state’s public insurance exchange, Nevada Insurance Commissioner Scott Kipper said.

Kipper and other division officials declined to estimate what premiums might be, post-reform.

But they did say changes are coming, especially for consumers who buy plans on the individual market, rather than through their employers. Individual buyers make up 15.4 percent of the state’s fully insured market, excluding people who buy through self-insured businesses or government programs.

“They will see something that looks very different from what they have, and it may be priced very differently as a result,” said Glenn Shippey, an actuary in the life and health section of the Division of Insurance. “We’re not sure what that difference is going to be on an individual basis, but it’s important to understand there will be a lot of changes in existing policies.”

VANISHING INDIVIDUAL PLANS

Simply put, if you have an individual insurance plan, it will probably cease to exist. Its replacement will be a minimum benchmark — basic — plan with “essential health benefits” that all Nevada insurers must offer after January. Officials for the Division of Insurance and the Silver State Health Insurance Exchange recommended a benchmark plan similar to Health Plan of Nevada’s comprehensive yet flexible point-of-service plan, which is already the small-group market’s largest plan by enrollment.

The benchmark doesn’t mean every Nevadan must buy point-of-service coverage through Health Plan of Nevada, but it does mean every insurance carrier’s individual plan must meet those coverage levels.

So, whether they need it or not, Nevadans buying individual policies will be covered for maternity care, mental health services, infertility treatments, home health, bariatric surgery, chiropractic care and hearing aids.

Those benefits are common for comprehensive, large-group plans, but rare in individual coverage.

Obamacare also mandates that new plans pay for at least 60 percent of the cost of care they cover. Many individual policies pay just 40 percent of expenses.

The enhanced coverage could boost access to care for thousands of Nevadans, but there is a pricey flip side to those add-ons.

“There’s no way these plans can remain at the (premium) costs they were, because carriers have to provide more benefits in their plan structure,” said Todd Rich, chief deputy commissioner of the Division of Insurance. “They have to price the plans higher.”

Added Shippey: “Individuals in all states are going to see some significant increases, depending on what type of individual we’re talking about. The new laws and rules coming into effect could cause substantial premium increases for some individuals.”

But a richer benefits package isn’t the only factor set to drive up premiums.

New restrictions will limit the difference in premium costs between young, healthy people and older, sicker patients. Nevada law allows insurers to charge older, unhealthy people premiums as much as six times more than younger consumers pay. After January, that gap can only be three times more.

Also gone will be premium reductions for healthier groups. Today, insurers under­write businesses.

An athletic club staffed with healthy, young people gets a preferred rate, while a bar and grill where older employees live on fatty food gets a maximum rate, said Assurance Ltd. employee benefit consultant Frank Nolimal. He travels Southern Nevada giving businesses a presentation called, “The Good, the Bad and the Ugly of Health Care Reform and Beyond.”

Post-reform, insurers won’t be able to reward or penalize employee behavior. The community rating will be the same for all.

Those rating changes mean young, healthy people could see big increases in premium costs, while unhealthier populations could get a break.

“One side of the fence is subsidizing the other side to keep premiums level,” Nolimal said.

That could be a problem for individual buyers, because they lack tax benefits or employer assistance to pay for coverage, said Robert Zirkelbach, spokesman for the Washington-based trade group America’s Health Insurance Plans.

When someone must buy coverage on their own, they pay the full cost, and that makes them more price-sensitive, Zirkelbach said. That’s why many individuals trade comprehensive coverage for lower premiums.

LESS COVERAGE VS. LOWER PREMIUMS

Toying with that trade-off between less coverage and lower premiums could affect whether Obamacare works.

“The positive is that people are getting more benefits, and they’ll pay less out-of-pocket,” Zirkelbach said.

“But any time you add new benefits to a policy, you add to the cost of coverage. There’s a pretty broad agreement that, for these reforms to work, we need broad participation in the system, particularly among the younger and healthier, to offset the costs of those with high health-care needs. To the extent new mandates increase costs for younger people, they may price them out of the market altogether. That will drive up costs for everyone.”

Division of Insurance officials said it’s too early to tell how much premiums could change in January. And representatives of the state’s two biggest insurers, UnitedHealth Group and Anthem Blue Cross Blue Shield, either declined to comment or didn’t respond to a request for comment.

Advocacy groups and lawmakers have taken a stab at guesstimating, though. Their predictions vary wildly.

FEDERAL SUBSIDIES

As far back as 2009, Anthem officials crunched the numbers and said premiums for Nevada members with the company’s individual policies would rise 85 percent on average. For small businesses, the typical premium increases would be 70 percent.

Some groups would be hit harder than others: For a healthy, 25-year-old male, the monthly premium on an individual plan with a $2,500 deductible and comprehensive pharmaceutical coverage would jump 115 percent, from $119 to $257. A family of four in average health would pay 61 percent more, with premiums rising from $674 to $1,088.

But a 60-year-old couple in poor health would see an 11 percent decline, as monthly charges fell from $1,741 to $1,558.

In March 2012, a study prepared for the state by Massachusetts-based Gorman Actuarial found that individual-market premiums in Nevada could rise 11 percent to 30 percent on average, though federal subsidies could blunt that blow for lower-income consumers.

A January report in Contingencies, the American Academy of Actuaries’ publication, also predicted that people 21 to 29 will pay 42 percent higher premiums nationwide, while those 30 to 39 can expect to shell out 31 percent more. What’s more, adults 21 to 29 making $25,000 or more a year can expect to pay more.

An April study by consulting firm Milliman for America’s Health Insurance Plans found that a healthy 27-year-old U.S. male could see an average 149.8 percent annual premium jump, from $1,414 to $3,532.

Federal subsidies could change that calculation: A young man earning less than $25,000 or so a year would see premiums drop by 25 to 60 percent, thanks to tax breaks, while one who earns about $42,000 a year or more would see premiums spike 169 percent.

For an unhealthy, 57-year-old woman, yearly premiums could tick up 4.1 percent, from $7,892 to $8,214, though federal aid would bring down premiums 51 percent or more for women making less than roughly $42,000 a year.

‘GRUMBLINGS AND RUMORS’

Policymakers are now weighing in. U.S. Health and Human Services Secretary Kathleen Sebelius didn’t put numbers on it, but she told the Wall Street Journal in March that “there may be a higher cost associated with” moving individual buyers into a “fully insured product for the first time.”

Sebelius added that some men and younger customers could see rates rise, while women and older customers might enjoy rate drops.

Though the state Division of Insurance wouldn’t offer its own analysis, it is issuing caveats. Adam Plain, an insurance regulatory liaison with the agency, cautioned that premium studies use differing methods, and may rely on distinct regional demographic data that don’t apply in every market. Plus, assumptions used in studies may be outdated because new regulations are added daily to the books.

Employee benefits experts give mixed reviews to existing studies.

Nolimal said a 115 percent premium jump for younger, healthier consumers is “very close” to estimates he hears .

Quincy Branch, president and CEO of Branch Benefits Consultants in Las Vegas, said he hears “grumblings and rumors,” yet nothing concrete from carriers.

New premiums could become more concrete in coming weeks.

Insurers will begin filing plans with the Division of Insurance late this month and in early June. The division will make those plans available to the public shortly after they receive them, though Kipper said that won’t mean the agency has signed off on the premiums. He said the division would study rate requests to ensure they’re not excessive, inadequate or unfairly discriminatory. The approval process for each plan could take two to 10 weeks, depending on complexity. Plans would take effect Jan. 1.

Large-group markets for bigger employers will see fewer effects. Those plans typically offer the kind of comprehensive coverage just now coming to individual and small-group plans, and they’re spared community- and age-rating changes for two years, Nolimal said.

Self-insured companies, which pay health costs directly, are exempt from many mandates, though they often offer richer coverage than individual plans.

Still, Rich said the agency believes small and large groups will also feel the effects of new plan mandates, if not as much as individual buyers will.

Contact reporter Jennifer Robison at jrobison @reviewjournal.com or 702-380-4512. Follow @J_Robison1 on Twitter.

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Dr. Jill Biden Announces Sarah Baker as Policy Director

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For Immediate Release May 16, 2013 Dr. Jill Biden Announces Sarah Baker as Policy Director

Washington, D.C.—The Office of the Vice President today announced that Sarah Baker, who most recently served as Deputy Associate Counsel in the Office of Presidential Personnel, will serve as Dr. Jill Biden’s new Policy Director.  Sarah replaces Kirsten White, who was policy director for the first term and recently returned to practicing law. 

Prior to joining the Administration, Sarah worked at Hogan Lovells US LLP, most recently serving as the United States Senior Associate for the firm’s pro bono department and formerly as a member of the White-Collar Criminal Defense and Government Investigations group. While at Hogan Lovells, she worked on a variety of issues including healthcare fraud, civil rights, housing discrimination, hate speech, and immigration.

She earned her undergraduate degree from Rutgers College and received her J.D. from the University of Virginia School of Law.

Blog posts on this issue May 17, 2013 6:08 PM EDTWeekly Wrap Up: “What Our Families Deserve”

Here’s a quick glimpse at what happened this week on WhiteHouse.gov.

May 17, 2013 5:50 PM EDTA Stronger and Sustainable Military for the 21st Century

The President and the Department of Defense are taking unprecedented steps to protect our environment, achieve significant cost savings, and give our military better energy options.

May 17, 2013 5:28 PM EDTComing Together to Stop Slavery

Today at the White House, we convened the 10th annual meeting of the President’s Interagency Task Force to Monitor and Combat Trafficking in Persons.

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Obamacare Gets New Court Challenge

Opponents of the health-care overhaul have filed a new lawsuit Thursday against the federal government on behalf of four individuals and three employers in the U.S. District Court for the District of Columbia.

The complaint focuses on the law’s distribution of federal subsidies for Americans to purchase insurance, and whether people can get them if they live in one of the 33 states that have refused to set up their own insurance exchanges and have left that task up to the federal government.

The health law was designed around the idea that states would run exchanges where people could compare insurance plans and apply for the subsidies. Some critics say that language in the legislation bars the Obama administration from allowing those subsidies to be distributed in exchanges run by the federal government.

The individual plaintiffs in the new lawsuit, from Tennessee, Texas, Virginia and West Virginia – states that didn’t set up exchanges — say they should not be considered eligible for the subsidies and should not have to pay a fine if they don’t purchase insurance.

The “subsidies actually serve to financially injure and restrict the economic choices of certain individuals,” the new complaint says. “For these people, the Subsidy Expansion Rule, by making insurance less ‘unaffordable,’ subjects them to the individual mandate’s requirement to purchase costly, comprehensive health insurance that they otherwise would forgo.”

The employers from Missouri, Kansas and Texas are arguing that they should not be subject to penalties that they may have to pay if their workers receive tax subsidies through the exchanges.

Oklahoma’s attorney general, Republican Scott Pruitt, filed a similar challenge in federal court for the Eastern District of Oklahoma on behalf of the state. The Obama administration has argued that the case should be thrown out because Oklahoma cannot show it is being harmed.

U.S. Treasury officials have also said that they believe Internal Revenue Service rules applying the law’s provisions to the federally run exchanges are in keeping with the statute. They have criticized opponents for trying to prevent millions of Americans from getting tax credits.

The new plaintiffs are being represented by Michael Carvin, a former Reagan administration lawyer who helped to represent the Bush campaign in the 2000 presidential election cases.

Mr. Carvin, of Jones Day, also represented the National Federation of Independent Business in its unsuccessful case arguing that the Affordable Care Act was unconstitutional because of its requirement that individuals purchase insurance or pay a fee.

A libertarian think-tank, the Competitive Enterprise Institute, said it is coordinating some of the legal work in the case and helping to fund it.

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Remarks by the President After Meeting on Sexual Assault in the Military

The White House

Office of the Press Secretary

Cabinet Room

4:53 P.M. EDT

THE PRESIDENT:  I appreciate all of you coming in just for a second.  We have gathered here all the top people in not just our military but our entire national security operation.  And I want to start off by thanking all the people sitting around this table and in this room for the extraordinary service that they’ve rendered this country. 

And I want to also remind everybody that we have folks active in theater right now -- men and women in uniform -- who are making heroic sacrifices on behalf of our security.  And our thoughts and prayers are with them and their families because they are dealing with a whole lot to make sure that we are safe.

We have focused this conversation, though, on something that is at the core of our effectiveness as a military.  I told all these people that one of the great honors of my life is serving as Commander-in-Chief to what I consider to be the best military in the history of the world.  And I am in awe of the work that the vast majority of our men and women in uniform do. 

But the reason we are so good is not because of the fancy equipment.  It’s not because of our incredible weapon systems and technology.  It’s because of our people.  And the capacity for our men and women in uniform to work as a team, a disciplined unit looking out for each other in the most severe of circumstances, is premised, as Ray Odierno said, on trust.  It comes down to do people trust each other and do they understand that they’re all part of a single system that has to operate under whatever circumstances effectively.

The issue of sexual assault in our armed forces undermines that trust.  So not only is it a crime, not only is it shameful and disgraceful, but it also is going to make and has made the military less effective than it can be.  And as such, it is dangerous to our national security.  So this is not a sideshow.  This is not sort of a second-order problem that we’re experiencing.  This goes to the heart and the core of who we are and how effective we’re going to be.

Now, the good news is I am absolutely confident that everybody in this room and our leadership, starting with Chuck Hagel and Marty Dempsey and the Joint Chiefs, as well as our top enlisted men and women, they care about this.  And they’re angry about it.  And I heard directly from all of them that they’re ashamed by some of what’s happened.

But it’s not fixed yet, and that’s clear.  So even though I think there’s a level of concern and interest that is appropriate, we haven’t actually been able to ensure that our men and women in uniform are not experiencing this, and if they do experience it, that there’s serious accountability.

So what I’ve done is I’ve asked Secretary of Defense Hagel and Marty Dempsey to help lead a process to continue to get at this.  That starts with accountability, and that means at every level.  And that includes accountability not just for enforcing the law, but also training our personnel effectively, putting our best people on this challenge.

I think Secretary of the Army McHugh made a very good point, which is I’m not sure we’ve incentivized some of our top people to understand this is as core to our mission as anything else.  And we’ve got to reward them, not think of this as a sideline for anything else that they do, but incentivize ambitious folks in the ranks to make sure that they understand this is important.  So that’s part of accountability. 

Empowering victims.  We’ve got to create an environment in which victims feel that they’re comfortable coming forward and they know people have their backs, and that they will work through this process in a way that keeps the focus on justice and make right what’s been wrong as opposed to suddenly they’re on trial, it may weaken their position, it make compromise their ability to advance.  That’s going to be important.  They’ve got to know that they should have no fear of retaliation, no fear of stigma, no damage to their careers, and certainly no protection for criminals. 

Third thing is justice for the victims.  When victims do come forward, they deserve justice.  Perpetrators have to experience consequences.  And I’m pleased that Secretary Hagel has proposed reforms that would restrict the ability of commanders to overturn convictions after trial.  Those reforms have my full support. 

There are a range of ideas that are being proposed on Capitol Hill, and I know that Chuck and Marty are both engaged with those members of Congress.  But what I’ve said to them is I want to leave no stone unturned and I want us to explore every good idea that’s out there in order to fix this problem.  And I’m pleased to say that Secretary Hagel is not only consulting with Congress but is also looking at militaries around the world -- the Canadians or the Israelis or others -- that may have design systems that get at this to see if there are any lessons learned in terms of best practices. 

And Vice President Biden, who has been a champion for issues -- around issues of domestic violence for 20 years or more, he made an important point, which is that we’ve got to make sure that advocates and professionals who are in the civilian system and have been working on this problem for a long time, that we’re listening to them as well; that we don’t assume that the military has to completely recreate the wheel.  And I think that’s a very important point.

So I want to thank all the work that Congress is doing, especially our friends in the Senate.  All of us here are committed to working with them.

The last point I’m going to make, and that is that there is no silver bullet to solving this problem.  This is going to require a sustained effort over a long period of time.  And that’s why I’m very pleased to know that Secretary Hagel is going to be having weekly meetings on this.  And I want us to make sure that we’ve got effective metrics and feedback loops, so that we are continually evaluating how well we’re doing.

And one point that was made around the table is that a sign that we’re actually getting at this problem may initially be increased reporting rather than less reporting.  We may see more reporting of incidents, in part because even outside of our military, traditionally, these problems of sexual assault are vastly underreported.  And so over the next several months and years, if I start seeing data that shows that in fact we are seeing more reports, that may actually indicate to me that people are becoming more confident about moving forward.

On the other hand, I then want those trend lines to start going down because that indicates that we’re also starting to fix the problem and we’ve highlighted it, and people who are engaged in despicable behavior, they get fully punished for it.

So, again, I want to emphasize -- everybody in this room has heard from me directly.  They’ve heard from Secretary Hagel, and they’ve heard from Marty Dempsey.  They all understand this is a priority and we will not stop until we’ve seen this scourge, from what is the greatest military in the world, eliminated. 

Thank you very much, everybody.

END
5:03 P.M. EDT

Here’s a quick glimpse at what happened this week on WhiteHouse.gov.

The President and the Department of Defense are taking unprecedented steps to protect our environment, achieve significant cost savings, and give our military better energy options.

Today at the White House, we convened the 10th annual meeting of the President’s Interagency Task Force to Monitor and Combat Trafficking in Persons.

view all related blog posts

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What Is To Be Done: Reveal And Replace Obamacare

Reps. Fred Upton, right, and Dave Camp, both R-Mich.

Millions of Americans now find themselves in the midst of a massive botched experiment called Obamacare. Nearly every poll-tested health care commitment is evaporating into thin air, leaving us with higher costs and headaches of uncertainty.

Unfortunately, this was both predicted and avoidable. Obamacare was premised on an outmoded, top-down approach to health care - a 40 year-old liberal aspiration, enabled by unified Democrat control of Washington in 2010.

Three years later, the implications are staggering. Despite the White House's claims to the contrary, we are faced with higher health care costs, many will lose or face substantial change to their insurance coverage, and job creation is threatened as hours and wages are reduced as a result of Obamacare. And the number of people dependent on the government for their health care will expand exponentially, exposing future generations to massive fiscal risks.

As Republicans we find ourselves in a challenging position witnessing this slow motion calamity. Repealing the bungled law and replacing it with a modern, common sense, bottom-up alternative is our preferred approach, which is why the House will vote tomorrow to fully repeal this government takeover of the health care system. Yet, while this vote is important, President Obama's reelection makes full repeal unlikely - at least for now.

So, if repeal is not a viable short-term option, reveal must be. Dissecting Obamcare's defective anatomy while offering alternatives is the way to get our health care system back on track. That's why the two committees we chair will continue our aggressive oversight, exposing Obamacare's failures - and discussing ways to provide more affordable health care to all Americans.

What have our efforts "revealed" so far?

For starters, Obamacare suffers from its own pre-existing condition: hyper-partisanship. You can't build an entirely new health care regime using a partisan hammer. But that's exactly what the Democrats in Congress did, with no Republican votes in the House or Senate.

Enduring health care change must garner some bipartisan support. So, we pledge to focus our efforts on policies that can actually make our health care system work better for families and employers struggling to continue providing benefits for their workers.

Second, the most important health care issue for Americans is cost. Health care costs are far too high for workers and employers. Democrats lost sight of the main priority. Roughly 85 percent of Americans already have health insurance. Instead of figuring out how to offer more affordable options for the uninsured, Obamacare upends the coverage of those that have it.

A recent investigation by one of our committees found that the new health law could drive individual premium increases as high has 400 percent and rates in the small business market could rise by as much as 200 percent.

It is a sad statement on Obamacare that Americans in the individual market will have to hope they only get hit with the average expected premium increase: 96 percent.

Republicans have a lot of affordability ideas. We support the creation of purchasing options across state lines, more flexibility for civic and fraternal associations to provide health insurance, incentives for states that control health care costs, the offering of high deductible plans, the creation of state-based high risk pools for people with pre-existing conditions, and medical liability reform. Unlike Obamacare's top-down mandates, these ideas would all reduce the cost of health care.

Consider this one example. A recent college graduate, Ashley, gets a job at a new start up company. She's excited about the work. Because the firm is just getting off the ground, it cannot yet afford to offer health care benefits.

Under Obamacare, Ashley is forced to buy a plan with all the bells, whistles, and coverage options designed for a woman two and three times her age who faces very different health care needs. We believe Ashley should have more options available to her and the ability to buy a plan tailored to her needs and her budget.

These affordability policies would allow us to remove one of the most unpopular features of Obamacare - the mandate that everyone must purchase government-approved insurance. We don't think it is right for Washington to force Ashley to buy a certain type of health care plan or face a tax.

Eliminating the mandate means the massive expansion of Medicaid, as well as most of the subsidies to purchase insurance in health exchanges, would no longer be necessary, saving taxpayers over a trillion dollars over the next ten years.

We are revealing better health care ideas. A bipartisan, affordability first approach, based on encouraging innovation and market-based choices must replace the bungled gambit of the massive old Washington spending and top-down regulatory mandates known as Obamacare.

Rep. Dave Camp, R-MI, is chairman of the House Ways and Means Committee. Rep. Fred Upton, R-MI, is chairman of the House Energy and Commerce Committee.

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Why Obamacare Is Oversold

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Robert J. SamuelsonOpinion WriterWhy Obamacare is oversold By Robert J. Samuelson, Robert J. SamuelsonMay 09, 2013 05:47 PM EDT

The Washington Post

It’s the great moral imperative behind the Affordable Care Act (“Obamacare”): People should not be denied health care because they can’t afford insurance. Health status and insurance are assumed to be connected, and opponents have often been cast as moral midgets, willing to condemn the uninsured to unnecessary illness or death. The trouble is that health status and insurance are only loosely connected. This suggests that Obamacare may result in more spending and health services but few gains in the public’s health.

We now have a study based on Medicaid in Oregon implying just that. Judging the effect of insurance on health has always been difficult, because the uninsured are different from the insured: They’re poorer, younger and often sicker. How much of their worse health reflects a lack of insurance? To answer, researchers need to compare similar people with and without insurance.

Robert J. Samuelson

Samuelson writes a weekly column on economics.

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Oregon’s expansion of Medicaid — the federal-state insurance for the poor — unwittingly solved this problem. In 2008, the state decided to increase enrollment by 10,000. But there were 90,000 people on the waiting list, so the state adopted a lottery to decide who would receive coverage. The result was two similar groups of poor people — one with insurance (Medicaid) and one without — that could be compared. The New England Journal of Medicine recently published the study.

The most overlooked finding is that the uninsured already receive considerable health care. On average, the uninsured annually had 5.5 office visits, used 1.8 prescription drugs and visited an emergency room once. Almost half (46 percent) said that they “had a usual place of care,” and 61 percent said that they had “received all needed care” in the past year. About three-quarters (78 percent) who received care judged it “of high quality.” Health spending for them averaged $3,257.

True, when people were covered by Medicaid, many of these figures rose. The annual number of office visits went to 8.2; the number of drugs, to 2.5; the share of patients with a usual place of care, to 70 percent; the proportion receiving all needed care, to 72 percent. Preventive care also increased. The share of patients receiving screening for cholesterol moved from 27 percent for the uninsured to 42 percent; the share of women older than 50 having mammograms jumped from 29 percent to 59 percent; the share of men older than 50 getting PSA tests for prostate cancer doubled, from 21 percent to 41 percent. Spending rose to $4,429.

Unfortunately, the added care and cost didn’t much improve physical health. The study screened for high blood pressure, high cholesterol, diabetes and the risk of heart attack or stroke. No major differences were detected between the uninsured and Medicaid recipients. There was more treatment for diabetes, although no difference was found between the two groups on a key indicator of the disease.

The only major health gain was psychological. Depression dropped from about 30?percent to 21?percent between the groups. One reason may have been that Medicaid recipients don’t fear huge medical bills. Their out-of-pocket health costs were $337. For the uninsured, out-of-pocket costs were 64 percent higher. (Presumably, most non-out-of-pocket costs for the uninsured were covered by free clinics, charity care and uncollected debt.)

“Health insurance is a financial product that is aimed at providing financial security,” the study says. On that ground, the expansion succeeded; by most clinical measures, it didn’t. Perhaps it is too early. The expanded Medicaid coverage was only two years old at the time of the study. Maybe greater health improvements will emerge. But maybe they won’t, and not only because the uninsured already receive care. Many uninsured are relatively healthy; insurance won’t make them healthier. For others, modern medicine can’t cure every health problem. For still others, bad luck or bad habits are hard to change. About two-fifths of Oregon’s uninsured were obese or smoked; Medicaid didn’t alter that.

Much of this was known — or could have been surmised — during the debate over Obamacare. The Congressional Budget Office reported that the uninsured typically received 50 to 70 percent of the care of the insured. A study in 2007 of the 1965 creation of Medicare — insurance for the elderly — concluded that it had “no discernible impact on elderly mortality” in the first 10 years but improved recipients’ financial security by limiting out-of-pocket expenses.

Obamacare’s advocates ignored these ambiguities. They were too busy flaunting their moral superiority. Universal health insurance is a legitimate goal, but 2009 — in the midst of a major economic crisis — was the wrong time to pursue it. Predictably, it polarized public opinion and subverted confidence for what seem to have been, based on the available evidence, modest likely public health improvements. The crusade for universal coverage has been as much about advocates’ sense of self-worth as about benefits for the uninsured.

Read more from Robert Samuelson’s archive.

Read more at PostOpinions:

Matt Miller: Republicans to sick people: Tough luck

George F. Will: Obamacare’s contract problem

Drew Altman and Larry Levitt: We still have a health-care spending problem

The Post’s View: Repairing Medicare

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