How to Protect Yourself From Obamacare

[Red Arrow]

It doesn't end in December.  It starts over.

I have proof positive that we no longer need to worry about health insurance or our 401Ks.

FOX had a special in place of Hannity that the end of the world as predicted by the Mayans is NOT happening on 12/21/2012.

[Red Arrow]

like me and didn't know that bit. 

? ? ? ?

[nathanm]

? ? ? ?

That the Medicaid money could be used to pay for the health care of prisoners.

[Townsend]

Gov. Mary Fallin's office won't release emails on health care decision

Citing executive privilege, Oklahoma Gov. Mary Fallin's office won't release emails explaining the decision to not set up a health insurance exchange.



http://newsok.com/gov.-mary-fallins-office-wont-release-emails-on-health-care-decision/article/3731064/?page=1

Gov. Mary Fallin's office will not publicly release emails that could shed light on how she decided to create a state health insurance exchange and then changed her mind.


Last year, she accepted $54 million from the federal government to set up an exchange, an online insurance marketplace under the Affordable Care Act. She later rejected the money under pressure from Republican colleagues.

Monday, she said the state will not set up such an exchange, meaning the federal government will step in to create one for Oklahoma.

In response to a records request from The Oklahoman, Fallin's general counsel, Steve Mullins, said these emails involve the governor's deliberative process and won't be released.

Open records advocates say that there is no exemption in the state's Open Records Act for these emails and that her office is trying to redefine state law to limit public access.

"Governor Fallin wants a privilege of secrecy that apparently none of her predecessors thought was necessary," said Joey Senat, a media law professor at Oklahoma State University.

Citing executive privilege and attorney-client privilege, Mullins said releasing electronic communications that pertain to state deliberations on public policy decisions could hurt policymakers' abilities to have productive internal discussions.

This marks at least the third time this year the governor's office has refused to release public records despite pledging in 2012 that she would respect the act and its spirit. Public records requests by the Tulsa World and The Associated Press were rejected earlier this year for similar reasons.

Fallin's spokesman, Alex Weintz, said Fallin does not believe the act was meant to allow access to "conversations between executive branch employees working on draft documents, brainstorming on public policy ideas, offering advice and counsel to the governor, or otherwise acting in an advisory role."

"Eliminating the possibility of private dialogue inside the executive branch would damage the ability of the governor to design and implement good policy and would harm the public interest," he said.

Court rulings

A 2009 opinion from the Oklahoma attorney general's office indicates emails generated while conducting the public's business are open to the public:

"Emails, text messages, and other electronic communications made or received in connection with the transaction of public business, the expenditure of public funds or the administration of public property, are subject to the Oklahoma Open Records Act."

Similar rulings have been made in Pennsylvania, Iowa, Colorado, Tennessee, Florida, North Carolina and California, and elsewhere.

A 2008 records request in Detroit led to the release of text messages written and received by that city's mayor and ultimately exposed corruption, leading to his ouster.

In 2009, Alaska released more than 24,000 of former Gov. Sarah Palin's emails despite initial claims that they were exempt.

Mullins, who previously worked for the U.S. attorney's office in Oklahoma City, cited federal law and U.S. Supreme Court decisions in explaining the rejection.

He also said verbiage within the act allows exemption for attorney-client communications and for personal notes created by government employees.

"I'm sure I'm influenced by my past — I'm not saying that's not true — but I think this is a fair reading of the state law," Mullins said.

"The privileges that are in litigation in Oklahoma are no different from the privileges that are in litigation in the federal courts."

Former Oklahoma Gov. Frank Keating, also a former U.S. attorney, said he does not remember rejecting a specific records request, but that he would not release emails that demonstrated behind-the-scenes policy discussions by his staff.

"I always would want to err on the side of full disclosure and transparency, however staff advice to the governor as the chief executive of the state is not the governor's opinion," Keating said.

"That should be a matter of confidential deliberation and debate, because otherwise nobody's going to give you their candid opinion if they think it's going to be on the front page of the newspaper."

The critics' take

But Senat said once a personal note or memo becomes a recorded conversation or directive, it's no longer considered personal. And executive privilege, he said, applies to the federal government and is not listed as an exemption under Oklahoma law.

"This ain't the White House," he said.

"Our statute is very clear: If there's not a state statute that applies directly to those records, then it's open. What he's claiming is so broad it would defeat the very purpose of the Open Records Act."

Senat said Fallin's policy would also shift the burden of proving a record is exempt from public disclosure from the record holder to the record requester, contrary to state law.

Another critic of Mullins' decision, Mark Thomas, executive vice president of the Oklahoma Press Association, said he was troubled and puzzled by the rejection.

"Historically when legal counsel throws up a phalanx of privileges to protect the executive branch, there is something amiss," Thomas said.

"We would think, knowing the financial ramifications of the health care exchange, that she would be pushing out every scrap of information, factual and deliberative, to help the public understand why she is right on this issue."

Kelly P. Kissel, Associated Press news editor for Arkansas and Oklahoma, said Mullins rejected a request last spring for documents related to the state's execution procedures.

He said the bureau was eventually able to get the information from Department of Corrections, but that Mullins' initial denial slowed the organization's reporting for several months.

"We were able to get some documents from her office which Mullins described as non-privileged, but they did withhold some documents," Kissel said.

"She claimed executive privilege, which under the constitution and in state law she does not have."

Mullins said Fallin's administration is "more open than anybody else has ever been."

"I'm not sure that anybody was ever clear to the press before that such documents exist," he said.

"What we're doing is we're saying we're not going to hide the ball from anybody. We're trying to be transparent as we can as far as producing a document, and when we don't produce it, we're trying to tell you why."

Robert D. Nelon, who has practiced media law in Oklahoma City for 35-plus years, said he's never heard of an Oklahoma governor refusing to release public records on the basis of executive privilege, though he conceded it is unlikely that anyone would know unless it went to court.

"Certainly Mullins' approach to transparency is more transparent, but still if you don't get the documents the Open Records Act requires you to produce, then transparency is pretty meaningless," he said. "That is a radical departure from what has happened in the past."

[nathanm]

You think she'd be protesting if they had been discussing how the exchange would hurt the state, rather than discussing how it would hurt her political career?

[Townsend]

Report Finds State Costs of Implementing The Affordable Care Act's Medicaid Expansion Would Be Modest Compared to Increases in Federal Funds, and Some States Would See Net Savings

http://www.kff.org/medicaid/kcmu112612nr.cfm

Washington, D.C. – A new report released today by the Kaiser Family Foundation shows modest state costs for implementing the Medicaid expansion under the Affordable Care Act compared to significant increases in federal funds, allowing some states to see net budget savings even as millions of low-income uninsured Americans gain health coverage.

The new, updated analysis, conducted by John Holahan, Matt Buettgens, Caitlin Carroll and Stan Dorn at the Urban Institute for the Foundation's Commission on Medicaid and the Uninsured, shows that if all states were to expand their programs, state Medicaid spending nationally would rise by $76 billion from 2013 to 2022, an increase of less than 3 percent, while federal Medicaid spending would increase by $952 billion, or 26 percent. As a result, an additional 21.3 million individuals could gain Medicaid coverage by 2022 and, together with other coverage provisions of the ACA, that would cut the uninsured by almost half (48%).

"States are deciding whether to expand the Medicaid program, and they clearly will be balancing improvements in coverage against new costs for states," said Diane Rowland, executive vice president of the Foundation and executive director of the Kaiser Commission on Medicaid and the Uninsured. "While some states will see net savings, others will need to weigh the trade-offs between small increases in state spending in return for large gains in coverage supported by mostly federal dollars."

As with all of Medicaid, the coverage and budget impacts of the Medicaid expansion would vary across states. States that had already expanded coverage to adults – such as Vermont, Massachusetts, New York, Maine, and Maryland – may see savings under the ACA due primarily to higher matching rates for already covered populations. Meanwhile states with relatively large uninsured populations prior to any coverage expansions – including Nevada, Florida and Mississippi – are likely to see higher increases in state costs, but these increases are expected to be small relative to decreases in the uninsured and increases in federal matching funds.

The report provides key data for state officials to consider in light of the June Supreme Court ruling that effectively made the ACA's expansion of Medicaid eligibility a state option. The ACA set a national floor for Medicaid eligibility for adults with annual incomes at or below 138 percent of the federal poverty level, which is $15,415 for an individual in 2012. The analysis also points out that Medicaid enrollment and spending is expected to rise even in states that elect not to expand coverage. That is because other ACA provisions, including the requirement to simplify enrollment and the implementation of the exchanges, are expected to increase Medicaid enrollment of some adults and especially many children who are already eligible for the program but not yet enrolled. States may want to factor the costs of the currently eligible population into their calculations as they weigh the costs and benefits of undertaking the Medicaid expansion to newly eligible individuals. For states that do adopt the expansion, they will see significant increases in coverage with limited incremental state costs and will see large increases in additional federal funds.

If coverage is expanded, states can expect to see declines in uncompensated care costs tied to spending on hospital care for people without insurance. If all states adopted the Medicaid expansion, it is estimated that states could save $18 billion from 2013-2022. That would help to further mitigate the incremental costs of implementing the Medicaid expansion, particularly for states in the South, which tend to spend more on uncompensated care relative to their current spending on Medicaid than do states in other regions.

We limited this analysis to data available for all 50 states and the District of Columbia, so we were unable to estimate several potential sources of state fiscal gain from the Medicaid expansion including increased federal matching rates for current-law beneficiaries other than those covered through 1115 waivers or limited benefit programs; reduced state spending on non-Medicaid health care previously for uninsured populations (like mental health and substance abuse services), as well as additional revenue state revenues tied to economic activity that would result from increased federal Medicaid dollars being spent within the state. If these factors were taken into account, more states could realize net fiscal gains.

More data on how individual states are expected to be affected by the ACA's Medicaid expansion, as well as a discussion of the methods underlying this analysis, can be found in the full report online.

[Townsend]

Wrong Number: Medicaid cost estimates are exaggerated and misleading

http://okpolicy.org/wrong-number-medicaid-cost-estimates-are-exaggerated-and-misleading

In announcing her decision not to participate in the expansion of Medicaid for low-income adults under the Affordable Care Act, Governor Mary Fallin asserted:


"Expanding Medicaid as written in the [Affordable Care Act] would cost the state of Oklahoma as much as $475 million between fiscal years 2014 and 2020. Paying for these increases would necessitate significant cuts to other critical parts of the state's budget like education and public safety. The cost of Medicaid expansion is unsustainable and creates an additional burden on taxpayers and the federal deficit."


The Governor's claim that extending Medicaid would cost the state up to $475 million over seven years is greatly exaggerated and misleading. It is based on unrealistic assumptions of how many people will enroll in Medicaid, includes costs that the state will absorb whether we expand Medicaid or not, and ignores savings and new revenues that will benefit the state budget. When we consider benefits of increased coverage for the health of our citizens and financial well-being of our health care providers, Medicaid expansion is clearly affordable and urgent.

The Affordable Care Act expands Medicaid coverage up to 133 percent of the federal poverty level for all individuals. Currently in Oklahoma, working-age adults are eligible for Medicaid only if they are parents of dependent children and have incomes below 37 percent of the poverty level.  Nearly fifty percent of  Oklahoma adults with income below 133 percent of poverty are uninsured, and the Medicaid expansion would make some 180,000 uninsured adults Medicaid-eligible. Most of this population is not eligible for premium subsidies to purchase private insurance through the new health insurance exchanges, which only assist individuals with incomes between 100 and 400 percent of the federal poverty level.

To encourage states to expand Medicaid, the federal government will pay 100 percent of a state's cost for covering the newly-eligible population from 2014-2016, and then phase down to paying 90 percent on a permanent basis after 2020. While upholding the Affordable Care Act and Medicaid expansion, the US Supreme Court ruled that the federal government could not withdraw all of a state's Medicaid funds if it opted not to expand Medicaid. This effectively leaves states the choice to expand coverage for low-income adults.

The Governor's projected state costs of up to $475 million over seven years if Oklahoma chooses to expand Medicaid is misleading for several reasons:


     It includes costs the state will incur even if it doesn't expand Medicaid. Over sixty percent of the total cost cited by the Governor is attributable to people who can already get Medicaid but are not enrolled.  This includes some 45,000 children and 15,000 adults. Since Oklahoma will be on the hook for this population whether we expand Medicaid or not, their cost is not properly attributable to an expansion

     It is based on unrealistic participation assumptions. The Governor assumes 100 percent participation of every individual who is eligible for Medicaid – both the newly-eligible and those currently eligible and not enrolled.  This is contrary to all prior experiences with participation in public programs. As the Center on Budget and Policy Priorities notes:

          No means-tested public program has ever achieved a 100 percent participation rate. Even Medicare, a popular universal program has a participation rate of 96 percent. More credible estimates prepared by the Urban        Institute assume that of the uninsured individuals who will be eligible for Medicaid, 10-40 percent of those who are currently eligible but not enrolled and 57-75 percent of those who will be newly eligible, will sign up for coverage.

     The Oklahoma Health Care Authority projects  that the total state cost for  newly-eligible  Oklahomans from 2014 to 2020 will range from $120 million, if 57 percent of those eligible participate, to $158 million, if 75   percent participate.  At an average annual cost of $17.1 to $22.5 million, this  is equivalent to less than 0.5 percent of current state appropriations.

     It ignores savings to the state budget.  The state currently spends close to $50 million annually providing health care services to uninsured adults through the Department of Mental Health and Substance Abuse Services, Corrections Department and Health Department. Expanding Medicaid would transfer 90 to 100 percent of the cost of services for newly-insured adults from the state budget to  the federal government. 

     It ignores state revenues that will be generated from increased health care spending. Expanding Medicaid would bring hundreds of millions of additional federal dollars each year to Oklahoma that will be spent on health care. This spending will generate additional jobs, which in turn generates additional tax revenues. State tax collections  will jump $29.8 million in 2014, assuming that 57 percent of  those newly-eligible for Medicaid join, according to an OSU estimate.


Bottom line: If we set aside the population that is already eligible for Medicaid, use realistic participation assumptions, and consider offsetting savings and new revenues, the state will be looking at very modest spending increases by expanding Medicaid and could enjoy net savings. Instead of being a deal we can't afford, Medicaid expansion is a deal we can't afford to pass up.

[nathanm]

I'm going to need some Obamacare if this bird keeps biting me.

[heironymouspasparagus]

So now we have a governor who is actively violating the law in her refusal to release these emails.  Where is the "righteous indignation" of the RWRE to cover ups and "closed" government action??  I have heard comments this last week on Fox about how Obama is the least forthcoming administration...I guess that only applies to Obama...but not Fallin.

Ain't it great...we just keep doing it to ourselves in this state.  Another David Hall.

[Townsend]

Feds Want Oklahoma's Health Care Lawsuit Tossed

http://kwgs.com/post/feds-want-oklahomas-health-care-lawsuit-tossed

OKLAHOMA CITY (AP) — Lawyers for the federal government want a federal judge to dismiss Oklahoma Attorney General Scott Pruitt's lawsuit challenging implementation of the federal health care overhaul law.

A motion filed in U.S. District Court in Muskogee asks U.S. District Judge Ronald White to throw the case out of court. It says the law will expand affordable health care and the state lacks standing to sue the federal government to deprive its residents of the benefits of federal law.

A lawsuit filed by Pruitt in January 2011 challenged the constitutionality of the health care law. Pruitt amended the lawsuit in September after the law was upheld by the U.S. Supreme Court.

In a statement Tuesday, Pruitt said he wants to ensure that the federal government complies with implementation of its own law.

[Red Arrow]

Feds Want Oklahoma's Health Care Lawsuit Tossed

Wow! What a surprise.

[Townsend]

Wow! What a surprise.

Yes.  I'm sure they're looking at the state's record and how much money we waste on pointless litigation.

[Red Arrow]

Yes.  I'm sure they're looking at the state's record and how much money we waste on pointless litigation.

I doubt they care how much Oklahoma has wasted on pointless litigation.  I'm sure they are mostly indignant at the thought of having to defend it.  How could anyone dare to question the Feds?

[Townsend]

I doubt they care how much Oklahoma has wasted on pointless litigation.  I'm sure they are mostly indignant at the thought of having to defend it.  How could anyone dare to question the Feds?

Oklahoma's litigation record is probably being used against it.

Did you mean "How could anyone dare to question the Feds during this administration?"

[Red Arrow]

Did you mean "How could anyone dare to question the Feds during this administration?"

I don't believe I said that.