Half of U.S. Small Businesses Think Health Law Bad for Them

PRINCETON, NJ -- Forty-eight percent of U.S. small-business owners say the 2010 Affordable Care Act (ACA) is going to be bad for their business, compared with 9% who say it is going to be good, and 39% who expect no impact.

These findings are from a Gallup survey of 603 small-business owners, conducted April 1-5.

Similarly, 52% of owners say the ACA is going to reduce the quality of healthcare they and their employees receive. This contrasts with 13% who feel it will improve the quality of care their employees get, and 30% who see no impact.

In a separate question, 55% of small-business owners expect the money they pay for healthcare to increase. Five percent expect their healthcare costs to decline, while 37% say the health law will have no impact on what they pay for healthcare.

Owners Already Responding to Healthcare Law

When asked if they had taken any of five specific actions in response to the ACA, 41% of small-business owners say they have held off on hiring new employees and 38% have pulled back on plans to grow their business. One in five (19%) have reduced their number of employees and essentially the same number (18%) have cut employee hours in response to the healthcare law. One in four owners (24%) have thought about eliminating healthcare coverage for their employees.

Implications

Small-business owners are worried about the way the Affordable Care Act is going to affect their business, with about half believing the law is going to be bad for business, add to their healthcare costs, and simultaneously reduce the quality of care they and their employees receive. This overall impression of the ACA is consistent with owners' tendency to be more Republican than Democratic, higher income, more against big government, more conservative, and less optimistic than Americans overall.

However, more important for the U.S. economy in the short term is what small-business owners say they are already doing in anticipation of the new law's continuing implementation. About four in 10 say they are holding off on hiring and new growth plans. About one in five say they are letting people go or cutting employees' hours. Even after discounting small-business owners' political views, these actions suggest the ACA could be a significant drag on the U.S. economy -- at least in the short term.

Survey Methods

Results for the total dataset are based on telephone interviews with 603 small-business owners, conducted April 1-5, 2013. For results based on the total sample of small-business owners, one can say with 95% confidence that the maximum margin of sampling error is ±4 percentage points.

Sampling is done on a random-digit-dial basis using Dun & Bradstreet sampling of small businesses having $20 million or less of sales or revenues. The data are weighted to be representative of U.S. small businesses within this size range nationwide.

In addition to sampling error, question wording and practical difficulties in conducting surveys can introduce error or bias into the findings of public opinion polls.

For more details on Gallup's polling methodology, visit http://www.gallup.com/.

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Six Months to Go –– Will the Health Insurance Exchanges Be Ready on Time? Survey: Health Plan Execs Don't Think So

As the Obama administration continues its top secret effort to build federal insurance exchanges in about 34 states while 16 states are doing it on their own, that continues to be the big question.

HHS is using IT consulting firm CGI for much of the work on the exchanges and the federal data hub. CGI has their plate full since they are not only working on the federal exchange but also doing work for the state exchanges in at least Colorado, Vermont, and Hawaii.

Earlier this month, the Senate Finance Committee held an oversight hearing. The Obama guy in charge of exchange development testified before them. I thought it was notable that it was the Democrats who expressed the greatest concern, and frustration, over senators not getting a clear idea for just where the administration is toward the goal of launching the new health insurance exchanges on October 1.

I thought the following Reuters quote was telling;

I am absolutely confident that every state will have an exchange that will be functioning and ready, said Gary Cohen [HHS executive in charge of the effort], who declined to elaborate on the number and identity of states that could be in for difficulties."

He wouldn't elaborate on just where there might be problems? Why? Why does the administration have to be so secretive?

This lack of transparency has the health insurance industry––the people the feds are going to have to connect with––very worried.

In early February, information technology consultant Edifecs, which provides health care software services to health plans, hospitals, and other organizations, held a "Compliance Summit" for 125 executives from hospitals, clearing houses, state health insurance exchanges, and health plans. The audience included executives from 34 different health plans. I gave the conference's opening keynote speech.

These are the industry executives that the state and federal exchanges are working with day-to-day. So, if you want to get the perspective from those in the trenches with the state and federal health insurance exchanges (HIXs) on whether they'll be ready, this is a pretty good group to ask.

Edifecs did just that using interactive software in the room to get the audience's response to a number of questions.

The input from the marketplace doesn't inspire confidence:
The vast majority of those who attended are planning to participate in the new health insurance exchanges. They are worried that, with the feds and states getting such a late start in detailing requirements and with so little time left, that their own organizations can be ready. They are also worried because the information they are getting from the health insurance exchanges in order to do their share of the work is poor, to very poor. They are not optimistic that the government-run exchanges will be ready on time. Almost all of those surveyed are concerned that the exchanges have not involved them as users in gaining input from the industry––traditionally a very bad sign in system development. And, the executives are very concerned about being able to reconcile billing and eligibility information from the exchanges.From the Edifecs survey:

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Half of U.S. Small Businesses Think Health Law Bad for Them

PRINCETON, NJ -- Forty-eight percent of U.S. small-business owners say the 2010 Affordable Care Act (ACA) is going to be bad for their business, compared with 9% who say it is going to be good, and 39% who expect no impact.

These findings are from a Gallup survey of 603 small-business owners, conducted April 1-5.

Similarly, 52% of owners say the ACA is going to reduce the quality of healthcare they and their employees receive. This contrasts with 13% who feel it will improve the quality of care their employees get, and 30% who see no impact.

In a separate question, 55% of small-business owners expect the money they pay for healthcare to increase. Five percent expect their healthcare costs to decline, while 37% say the health law will have no impact on what they pay for healthcare.

Owners Already Responding to Healthcare Law

When asked if they had taken any of five specific actions in response to the ACA, 41% of small-business owners say they have held off on hiring new employees and 38% have pulled back on plans to grow their business. One in five (19%) have reduced their number of employees and essentially the same number (18%) have cut employee hours in response to the healthcare law. One in four owners (24%) have thought about eliminating healthcare coverage for their employees.

Implications

Small-business owners are worried about the way the Affordable Care Act is going to affect their business, with about half believing the law is going to be bad for business, add to their healthcare costs, and simultaneously reduce the quality of care they and their employees receive. This overall impression of the ACA is consistent with owners' tendency to be more Republican than Democratic, higher income, more against big government, more conservative, and less optimistic than Americans overall.

However, more important for the U.S. economy in the short term is what small-business owners say they are already doing in anticipation of the new law's continuing implementation. About four in 10 say they are holding off on hiring and new growth plans. About one in five say they are letting people go or cutting employees' hours. Even after discounting small-business owners' political views, these actions suggest the ACA could be a significant drag on the U.S. economy -- at least in the short term.

Survey Methods

Results for the total dataset are based on telephone interviews with 603 small-business owners, conducted April 1-5, 2013. For results based on the total sample of small-business owners, one can say with 95% confidence that the maximum margin of sampling error is ±4 percentage points.

Sampling is done on a random-digit-dial basis using Dun & Bradstreet sampling of small businesses having $20 million or less of sales or revenues. The data are weighted to be representative of U.S. small businesses within this size range nationwide.

In addition to sampling error, question wording and practical difficulties in conducting surveys can introduce error or bias into the findings of public opinion polls.

For more details on Gallup's polling methodology, visit http://www.gallup.com/.

View the original article here

Welcome to the Revolution … I Think

by Auden Schendler

There’s a taboo and terrifying thing people do in the mountains called “trundling.” It means pushing an often frighteningly big rock off the side of a mountain, then watching it roll down, bounce, explode, crush trees, and smoke off into the valley below. It is not sanctioned; it is dangerous to the trundler and to others; people who do it don’t talk about it. But it happens.

If you have ever “trundled” a big rock (and I’m not saying I have, at least not intentionally) you know that the moment it tips from massive geologic inertia to kinetic energy is both terrifying and thrilling.

That is the uncomfortable point we may have reached in the climate movement. I saw this at a rally in Denver last week, which I attended with my wife and two young children:

The first characters we ran into wore black bandannas as facemasks and backpacks. And there were a lot of them. My response was a gut feeling of panic. What, exactly, did these guys think was going to happen here? They seemed ready for the Seattle world trade protests, or something gnarly out of Eastern Europe.

I had thought this protest was about stopping the Keystone XL pipeline as a way for Obama to draw a line in the sand on climate. But there were people railing against just about everything connected to the environment, including social justice, indigenous people’s rights, and fracking. “What the Frack!” was one chant. There was a guy carrying a book on Marx, there were some homeless guys with the agenda of not being bored. Later, at the rally, a child activist (who emceed the event) talked about suing Boulder for violating the public trust by polluting the air.

Suing Boulder, one of the greenest cities in the world, seems like an odd tactic: it’s like suing Jesus for not being loving enough. (Turns out, on further research, they were suing Colorado, not Boulder.) Whatever—there were many different viewpoints, from the hobo who blessed me, to the 12 year old radical, and many of them I did not agree with. It was both a rainbow coalition and a Babel of agendas.

Despite the facemasks, the event was civil: I never saw a cop, and I heard grumbling from some of the several hundred marchers that “when we have half a million, that’s when we’ll take over the street…” and “this is the only protest march that stayed on the sidewalk…” Point being, it might have even been too civil. See “At climate rally, some signs of fraying in a movement’s big tent.”

Only at one point did the event tip slightly to the radical.

Almost at the park where the rally was to be held, the crowd surged across a heavily trafficked four-lane road in defiance of the stoplight. In the streets the Marxists and the anarchists were exhorting people to ignore the lights. The traffic was honking now out of outrage, not support. A woman fell down and several people hauled her back up. “Now,” I thought, not particularly happily, “maybe something is happening.” I held my children well back on the curb and waited for the light.

I have become skeptical of the idea of working within the system for change, because I think the system itself is corrupted—by money in politics, by crackpot governance (the filibuster, gerrymandering) and by apathy. But when things start to get even a little bit crazy, the system starts looking pretty damn good. That’s why I was on the sidewalk, an unintentional gesture in support of the status quo. I had an urge to envelop my kids in my arms.

And yet, waiting awkwardly at a stoplight in the middle of a revolution, we were no better off. My children would be no safer in a world warmed by 4 degrees C than out on the most dangerous streets. This corner was a place of false refuge. On my wife’s urging, we surged into the road, with the crowd, in defiance of the light.

Barry Lopez calls the uncomfortable balance point between fear and accomplishment “the cusp on which human life finds its richest expression.” Perhaps only at these scary points in our lives, or in history—when neither forward nor backwards nor stasis is ideal—does the object you have been pushing on begin to move.

– Auden Schendler is Vice President of Sustainability at Aspen Skiing Company and author of the book Getting Green Done: Hard Truths from the Front Lines of the Sustainability Revolution.

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Meet The Four Republican Senators Who Think The Violence Against Women Act Is Unconstitutional

Since then-Delaware Senator Joe Biden first authored the law in 1994, the Violence Against Women Act (VAWA) has earned bipartisan praise for providing vital protections against domestic violence and assistance to victims. But of the eight Senators — all Republicans — who voted Monday against even considering VAWA renewal, at least four apparently did so because they believe the bill is unconstitutional.

Several of these senators have expressed similarly radical views about the constitutional role of the federal government in other contexts. Sen. Mike Lee’s (R-UT) claimed that national child labor laws, Social Security and Medicare violate the Tenth Amendment, for example; and Sen. Ted Cruz (R-TX) once led a Tenth Amendment project at a conservative think tank and co-authored a paper proposing an unconstitutional process to nullify the Affordable Care Act. The four senators who claim that the Violence Against Women Act is unconstitutional are:

1. Sen. Jim Risch (R-ID): In a statement, Risch explained: “It is at the state and local level where I believe enforcement and prosecution must remain. The federal government does not need to add another layer of bureaucracy to acts of violence that are being handled at the state and local level. In addition to my 10th Amendment concerns, this legislation raises additional constitutional questions regarding double jeopardy and due process. I opposed this legislation, however well intended it was, because it is another effort of the federal government extending its reach into the affairs of state and local jurisdictions.” 2. Sen. Rand Paul (R-KY): In a 2012 letter explaining his opposition to last year’s VAWA re-authorization attempt, Paul wrote: “Under our Constitution, states are given the responsibility for prosecution of those violent crimes. They don’t need Washington telling them how to provide services and prosecute criminals in these cases. Under the Constitution, states are responsible for enacting and enforcing criminal law. As written, S. 1925 muddles the lines between federal, state, local and tribal law enforcement.”3. Sen. Mike Lee (R-UT): In 2012, Lee claimed VAWA “oversteps the Constitution’s rightful limits on federal power. Violent crimes are regulated and enforced almost exclusively by state governments. In fact, domestic violence is one of the few activities that the Supreme Court of the United States has specifically said Congress may not regulate under the Commerce Clause. As a matter of constitutional policy, Congress should not seek to impose rules and standards as conditions for federal funding in areas where the federal government lacks constitutional authority to regulate directly.”4. Sen. Ted Cruz (R-TX): A Cruz spokeswoman told ThinkProgress: “For many years, Senator Cruz has worked in law enforcement, helping lead the fight to ensure that violent criminals—and especially sexual predators who target women and children—should face the very strictest punishment. However, stopping and punishing violent criminals is primarily a state responsibility, and the federal government does not need to be dictating state criminal law.” While the statement does not explicitly call VAWA unconstitutional, his previous comments leave little doubt that that is what he means.

These senators’ apparent belief that the federal government cannot constitutionally play a role in preventing violence against women is not even shared by most Republican members of Congress. 216 House Republicans agreed just last year that the Constitution does not prohibit a version of the Violence Against Women Act. The Supreme Court did strike down one piece of VAWA in 2000, but it left most of the law intact.

While the other four Senators who voted against the “motion to proceed” did not respond to a request for an explanation of their votes, Sen. Tim Scott (R) voted for the watered-down House version of VAWA last year and Sen. Marco Rubio (R-FL) claims he supports a scaled-back version of the legislation.

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NRA Head Fearmongers About Background Checks: ‘I Just Don’t Think You Can Trust These People’

National Rifle Association Executive Vice President and CEO Wayne LaPierre offered a litany of excuses for his organization’s opposition to universal background checks on gun sales and purchases this morning, telling Fox News Sunday host Chris Wallace that the American Medical Association and other organizations were to blame for thwarting an expanded background check system. He also warned that universal checks could lead to a national registry:

LAPIERRE: I think what they’ll do is they’ll turn this universal check on the law-abiding into a universal registry of law-abiding people, and law-abiding people don’t want that.

WALLACE: Forgive me sir, but you take something that is here, and you take it all the way over there. There is nothing anyone in the administration has said that indicates they’re going to have a universal registry.

LAPIERRE: And Obamacare wasn’t a tax until they needed it to be a tax. I just don’t think you can trust these people.

The NRA has consistently used this as an excuse to oppose expanded background checks, even though federal law prohibits agencies from retaining information on people who pass background checks, making a national gun registry virtually impossible.

The gun lobby backed expanded background checks following the 1999 Columbine High School shooting, but LaPierre reiterated during a hearing in front of the Senate Judiciary Committee this week that the organization no longer supports those checks and told Wallace that the mental health community is also against them. “I have finally become convinced, after fighting to get the mental records computerized for 20 years and watching the mental health lobby, the HIPAA laws, and the AMA oppose it, I don’t think it’s going to happen,” he said. “The mental health lobby won’t let it happen.”

In addition to computerizing mental health records, LaPierre told Wallace that he would “change civil commitment laws” and “interdict” more mental health patients, an approach that would blatantly ignore concerns about patient privacy and the stigmatization of mental health patients, which drove the AMA’s opposition to some elements of universal background checks in the past. President Obama, meanwhile, issued an executive order last month that sought to rework the Health Insurance Portability and Accountability Act (HIPAA) to make it easier for states to report information to the National Instant Criminal Background Check System while addressing concerns about privacy and stigmatization.

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Hagel: ‘I Think It’s Always Wise To Try To Talk To People Before You Go To War’

One of the main themes senators on the Senate Armed Services Committee committed themselves to today during Chuck Hagel’s confirmation hearing to be the next Secretary of Defense was — not wondering whether Hagel fully supports a diplomatic approach to Iran’s nuclear program, as most Americans do — but rather, whether the former Republican senator is willing to take this nation into another war in the Middle East if necessary.

Senator after senator, both Republican and Democrat, repeatedly sought Hagel’s reassurance that he is committed to starting a war with Iran — as if the last 10 years of a disastrous war in Iraq had never happened.

Sen. Kelly Ayotte (R-NH) was one of those senators. During one series of questions in which Ayotte wondered if Iran was “responsible” enough to deal with, Hagel explained that his priority is diplomacy. “I think it’s always wise to try to talk to people before you get into war,” he said:

AYOTTE: Because here we have a regime that doesn’t respond to in a responsible or sane behavior as a state-sponsor of terrorism and why that would be an appropriate manner for us to address them?

HAGEL: Well first I said engagement and I think we should talk, we actually are indirectly in the P5 plus one, we have been. I think that’s responsible. I think it’s always responsible to try to talk first. North Korea. I don’t consider North Korea a responsible, sane administration but we’re talking to North Korea. We’ve been talking bilaterally to North Korea. We are talking with the party of six to North Korea. I think that’s wise. I think it’s always wise to try to talk to people before you get into war.

Ayotte continued to badger Hagel about his past support for talks with Iran. “I’ve always thought that that’s smarter and wiser” to push countries into international organizations, Hagel said, adding:

HAGEL: Because when they go in to world bodies they have to comply with some semblance of international behavior it doesn’t mean they always will, they won’t, they cheat. But I think we’re smarter to do that. I’ve never thought engagement is weakness. I’ve never thought it was surrender. I never thought it was appeasement. I think it’s clearly in our interests. If that doesn’t work then I think the President’s position and his strategy has been exactly right. Get the United Nations behind you. Get the international sanctions behind you. Keep military options on the table. If the military option is the only option, it’s the only option.

Watch the clip:

“At Hagel hearing,” the Washington Post’s Rajiv Chandrasekaran observed on Twitter, “136 mentions of Israel and 135 of Iran. Only 27 refs to Afghanistan. 2 for Al Qaida. 1 for Mali.” Indeed, the neocons aren’t dead, yet — at least not in the Senate.

(Photo: Bloomberg via Getty Images)

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Michigan Governor Backs Off ‘Unfair’ Electoral Rigging Plan: ‘I Don’t Think This Is The Right Time’

Michigan Gov. Rick Snyder (R)

The prospects of a proposal to rig Michigan’s electoral votes in favor of Republicans took a nosedive on Tuesday as Gov. Rick Snyder (R) came out against the plan this year.

Snyder had previously been considering the plan to shift Michigan’s presidential system from a winner-take-all system to divvying electoral votes by congressional district.

However, in an interview with Bloomberg, Snyder backed off, saying he was “very skeptical” of the idea, noting it would “change the playing field so it’s an unfair advantage.” He finished by saying, “I don’t think this is the appropriate time to look at it.”

HUNT: There is a move in your state by some Republican legislators to change the presidential electoral system from a winner-take-all to doing it by congressional districts. If that happened last November, Barack Obama–who carried this state by a huge margin, almost double-digits–would have won only 4 of the 14 congressional districts. It would tilt the tables tremendously in the Republicans’ favor. You have said you wanted to look at it, let’s see what it is. Gov. McDonnell of Virginia, Haley Barbour and others have said it’s a bad idea. Are you still neutral or are you becoming convinced it’s a bad idea?

SNYDER: I’m very skeptical of the idea and the timeframe that would be done, because I really view it as a question of you don’t want to change the playing field so it’s an unfair advantage to someone. A lot of ways, we want to make sure we’re reflecting the vote of the people, and this could challenge that. So in many respects, the right time to do it is if people are looking as, we should do it before census is taken and before redistricting takes place and it should be a bipartisan effort.

HUNT: So if you do it, you do it much later.

SNYDER: Yeah. I don’t think this is the appropriate time to look at it.

Watch it:

State Senate Majority Leader Randy Richardville (R) also cast doubt on the proposal Tuesday, saying of the current system, “I don’t know that it’s broken, so I don’t know that I want to fix it.” The state’s House Speaker, Jase Bolger (R), supports the plan.

This is potentially a major victory for opponents of the electoral rigging plan. In addition to holding the governorship, Republicans currently enjoy an 8-seat majority in the State House and a 15-seat majority in the State Senate.

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Conservative Think Tank Ranks Countries With Government-Run Health Care As The Freest In World

Heritage President Jim DeMint.

Former Senator Jim DeMint, the new president of the conservative Heritage Foundation, has decried Obamacare as “a cancer” that is “is fundamentally inconsistent with liberty.” During the Senate Obamacare fight, DeMint famously declared “If we’re able to stop Obama on this, it will be his Waterloo. It will break him.”

But a new report from DeMint’s own organization suggests that, far from being incompatible with freedom, countries with health care systems with as much or significantly more government control over healthcare are the freest countries in the world.

The report in question is Heritage’s Economic Freedom Index, released annually since 1997. The report defines the concept of “economic freedom” in misleading right-wing terms, but even by those standards, it appears that universal health care systems far more expansive than Obamacare aren’t “fundamentally inconsistent with liberty.” In fact, the ten “freest” economies in 2013 by Heritage’s lights range from mandating individuals save a certain amount of money for health care to almost the entire health care system, including hospitals, being owned and operated by the government:

1. Hong Kong: The semi-autonomous city inside China has a universal, publicly run health care system: about 80 percent of Hong Kong hospitals are government owned and operated. While private supplemental insurance is available, it’s more expensive than public services.

2. Singapore: Singapore is often cited as a free-market health care system that works. But one of the centerpieces of the Singaporean model, as conservative David Frum notes, is a government mandate requiring citizens to place a certain percentage of their income in “medical savings accounts” to ensure they can pay for routine health care costs out of pocket (when their income is inadequate to pay, the government pays direct subsidies a la Obamacare’s Medicaid expansion). Hardly seems consistent with DeMint’s point that health care mandates are “slippery slopes” towards the death of freedom.

3. Australia: Australia has a single-payer system in which, like Canada, doctors are privately employed but all Australians are eligible for insurance coverage through a government-run provider called Medicare.

4. New Zealand: The Kiwi government has made most services free or nearly free to all residents; the government covers roughly 80 percent of national health care expenditures and directly owns and operates about half of all health care services in the country.

5. Switzerland: This Swiss system is closer to the American health plan post-Obamacare than most other national systems; Switzerland has both privately owned health care and privately-provided insurance together with an individual mandate to purchase health insurance. Interestingly, Swiss insurers are legally prohibited from profiting on the basic, mandatory insurance package.

6. Canada: Our northern neighbor is, of course, the most famous example of a single payer system in the United States.

7. Chile: Like Singapore, Chile mandates that individuals pay into health savings accounts to cover health care costs and supplements the accounts of poor Chileans. It also has both publicly and privately run health care services.

8. Mauritius: A tiny island nation in the Indian ocean, Mauritius has government-run health services that cover roughly 70 percent of the country’s health expenditures, with private supplemental practices making up the remainder. All government health services are provided free of charge to Mauritian citizens, which has helped the country improve quality of life for its citizens markedly in the past two decades.

9. Denmark: As in Mauritius or the United Kingdom, the Danish government owns and operates the vast majority of the health care system.

Number 10 on the list is, of course, the United States, which will finally join the rest of the top ten “most economically free nations” in providing universal or near-universal health care when Obamacare is fully implemented.

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