Tonight the Greensboro city council heard nearly a dozen speakers from the floor debate a toothless resolution urging the state to expand Medicaid under the ACA. Then the council members themselves each held forth briefly on the topic before passing it by a predictable 7-2 margin, whence it was dispatched to a circular file in Raleigh.

Former mayor Bill Knight and State Rep. John Blust, both congenial as always, speak in opposition. It’s expensive. No such thing as free money. We have a lot of debt already. Hmm. That’s all true! George Hartzman makes some good points about pricing transparency, negotiated rates, and insurance companies, and also takes an odd little side trip into the economics of abortion and says something inscrutable about the price and value of human life, so, you know, George.  And a nice man whose name I miss says the council shouldn’t address the issue because it’s a partisan issue.

Next come a bunch of speakers in favor of the resolution. Rabbi Guttman says non-expansion is hurting people, shutting down clinics and hospitals. Wayne Abraham makes a broad economic argument, Andy Brod a specific one (expansion will help, not hurt, the state budget). Sober words from the League of Women Voters, passionate ones from Rev. Peeples (she follows one sometimes called the great healer). Jay Poole (UNCG, social work) says vulnerable people are forced to use expensive emergency services.

Nice work, speakers from the floor. 

Councilmembers speak concisely and well.

• Hoffmann: “No sensible or justifiable argument" against helping the working poor.
• Fox: “Morally right.”
• Barber: So many of us are very fortunate, it’s hard to contemplate having to choose between the necessities of life, I support this resolution.
• Johnson: Against! LOL jk.  
• Matheny: This is a tough one. He wants to help others. He wants a true plan for citizens in need and hopes his retired healthcare CEO friend Dennis can whip one up. But, no. (Translation: “Normally I would vote for this, but I’m running for Congress as a Republican, so I can’t. Duh.”)
• Wilkins: Tough call for him, too. Appreciates the comments he’s gotten. Reads news brief saying GOP leadership in Raleigh has a plan of its own, pretends to believe that might work, and, out.
• Abuzuaiter: Yes we should be involved in state issues. Let’s fix this. The perfect time to help the poor.
• Hightower: Not a partisan issue, a human issue. We talk all the time about quality of life, live work and play, hard to do when you're not well.  Current system "absolutely absurd."
• Mayor Vaughan: We talk a lot about the at-risk population here. We're financing other states. This will save businesses money and also save hospitals and clinics. Many GOP govs have accepted, and in case you don’t believe me I will now read their names. Jan freaking Brewer, amirite?

Go Greensboro. Sometimes you make me proud.

Comments

[Hartzman]

“Normally I would vote for this, but I’m running for Congress as a Republican, so I can’t. Duh.”

Agreed.

[Hartzman]

"Jay Poole (UNCG, social work) says vulnerable people are forced to use expensive emergency services."

Talked to him afterward. Sharp fellow.

We had a cordial conversation about how different people see things in different ways, and that's ok.

Fred didn't quite say the same.

[Hartzman]

"The ACA and Medicaid expansion is mathematically unsustainable, as are the prescriptions of most right to life movements. There’s no way our economy could afford the abolition of abortion due to the coincident increase in Medicaid and related social services costs."

George Hartzman
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Same cognitive dissonance only different

[Billy Jones]

Meanwhile Greensboro remains the hub of the 2nd hungriest metropolitan statistical area in these united states, has a poverty rate of over 21% and the highest unemployment of any comparable city in North Carolina and Mayor Vaughan's City Council does nothing to resolve those issues.

It's easy to point your fingers at others when hiding behind your own greed.

The resolution in itself might be a good thing but it is no substitute and no excuse for failing to act on issues Mayor Vaughan and the rest of Council all knew existed before they took office. I'll post my economic plan today, let's see if they're willing to put our money where their mouths are.

[Bob Wineburg]

Take a look at this interactive piece of work in NE Journal of Medicine and zero in on Insurance spending from 1980 to 2011 and all the talk about socialized Medicine, and the lack of talk about the devastation this model has caused for people, can be boiled down to $$$$$
http://www.nejm.org/doi/full/10.1056/NEJMp1310228?query=TOC Toothless perhaps, but it was the people speaking up about something that isn't right regarding the common good. A close examination of Medicare finance changes and how payments are moving from fees for the volume of service, to fees for outcomes of service, and we start to get some sober discussion if people can handle it. Change for the common good in the US does not come without the rhetoric about the communists wanting to take over McDonalds, health care and our lives is, but it is a game of shadow boxing, with an industry behind the rhetoric devoted to keeping the individual good prime. When the facts come into the picture, it is like arguing that the moon is not made of cheese with those truly convinced it is. They only let you argue whether it is Brie, Cheddar or Swiss. I like Zach Methany but to have to talk cheese talk to gain political office --so perhaps he can eventually say it might not be made of cheese??? That l is up being down and down being up --WHAT ABOUT 80,000 people in our county who lack access to sustained health care? Where is the discussion about what that means? For whom does he want to be a public servant? Ha! Check out some ground reality NC style https://www.youtube.com/watch?v=K3e7JgCJa2Q

[Andrew Brod]

It's silly to say that the ACA is "mathematically unsustainable." The best math we have on this are projections by the CBO, which indicate that the ACA is quite sustainable. The CBO projects that the ACA will (slightly) reduce the federal deficit over the next couple of decades. That doesn't mean the deficit will fall, but that it'll be (slightly) lower with the ACA than it would have been without.

Now, one can choose not to believe the math, but one can't reasonably point to the math to claim the ACA (with Medicaid expansion a part of that) is unsustainable.

[Andrew Brod]

That math is why the comments by Knight and Blust were so far off the mark. Complain that Medicaid expansion is bigger government? Fine. But you can't reasonably complain about the deficit. The implication of the CBO projection is that the ACA pays for itself. And not through some hoped-for magic, or in any case not primarily because of that. The ACA pays for itself because it includes various taxes and penalties.

And we know that, don't we? ACA opponents have criticized those taxes. But it's hard to take seriously an argument that objects to the existence of such taxes and then denies that they might raise some revenue.

[Hartzman]

Considering how much the law has been broken to date, and how short the enrollment is, how do you know the program will still reduce the deficit?

They didn't make the SGR cuts that the CBO counted to reduce the deficit.

We already had this conversation.

Why are you repeating a lie, or do you have any current data to back up your claims, because I haven't seen any.

[Hartzman]

Andrew, what is the date of the CBO report you are citing?

Of the deficit reducing CBO numbers you cite, did it include the states that didn't expand medicaid into the calculations?

Did the CBO report you cite count all the delays of fine revenues that have occurred after implementation?

[Andrew Brod]

SGR issues ("the doc fix") are utterly unrelated to the ACA. It's not about data; it's common sense, simple logic, and a rudimentary understanding of what these programs are. The doc fix was an issue before the ACA and if there isn't a permanent fix soon, it'll be an issue for many years.

House Republicans are currently trying to tie this year's doc fix to ACA repeal. Why do they have to tie it? Because it's not part of the ACA!

* The "doc fix" is an annual adjustment to Medicare physician reimbursement. The formulae for Medicare spending increases need fixing, and until they are, these annual ad hoc fixes are required. They have nothing to do with Obamacare.

[Andrew Brod]

I'm referring to the latest CBO report, I believe from February. It took all the recent information into account, including the slower pace of sign-ups.

[Hartzman]

Missed the fine print Andrew

From Table 1;

"Unless otherwise noted, positive numbers indicate an increase in the deficit, and negative numbers indicate a decrease in the deficit."

"e. Positive numbers indicate an increase in revenues, and negative numbers indicate a decrease in revenues."

Says it twice

Changes in Mandatory Spending
37
103
156
186
196
207
217
229
241
254
267

Total 2014-2024 = $2,056 Billion in deficits.

That's $2 trillion is deficits Andrew.

http://www.cbo.gov/sites/default/files/cbofiles/attachments/43900-2014-02-ACAtables.pdf
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Please retract your statement.

[Ed Cone]

The arguments that we can't afford expansion (at least the ones presented last night, and here) fail to address the costs of non-expansion, or the benefits of expansion. So even aside from AB's argument on the numbers themselves, these talking points are incomplete at best.

There seems to be some consensus that the old system of insurance coverage was unsustainable. I've argued here that it's also irresponsible and immoral to tacitly guarantee medical care for all, but not hold all responsible for coverage or provide it for those who can't get it for themselves.

So we've got a kludgy, complex plan that's being implemented. Just saying "it won't work" doesn't cut it at this stage of play. Viable alternatives and specific fixes are the only currency of exchange now.

[Hartzman]

"Just saying "it won't work" doesn't cut it at this stage of play. Viable alternatives and specific fixes are the only currency of exchange now."

Agreed.
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Either way, Andrew needs to stop saying what isn't true.

My understanding is the CBO takes current law and applies it to the numbers asked for.

The SGR is current law, so the cuts to my knowledge are included in the ACA calculations.

The doc fix is what eliminates the cuts when it comes up.

So the deficits mentioned above are really less than how big they actually are if the SGR cuts are repealed.

Again, and PhD in Economics is peddling untruths and soiling the reputation of his credentials.

[Hartzman]

A Summary of the Health-Related Provisions of the American Taxpayer Relief Act of 2012 (H.R. 8)

January 8, 2013

Summary of Title VI

Medicare Extensions

Medicare Physician Payment Update

Fixes SGR by effectively delaying the scheduled slash in payment through December 31, 2013. Medicare physician payment rates were scheduled to be cut by approximately 27% at the end of 2012.[1]

[1] H.R. 8, Title VI, Section 601, Part A, page 86.

http://www.healthreformgps.org/resources/a-summary-of-the-health-related-provisions-of-the-american-taxpayer-relief-act-of-2012-h-r-8/
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The act delayed the SGR cuts, then congress and the pres did it again, increasing the deficit, and now they are going to do it again.

Meanwhile, the guy who spoke at a press conference as an expert yesterday...

[polifrog]

The only reason proponents for Medicaid expansion exist is that the ACA is not the solution to the problem of the uninsured we were told it would be.

If the ACA were functional the same people who are now pushing for Medicaid expansion would be pushing for Medicaid reduction. That they are not is an indication that the ACA is failing not only America as a whole, but Americans individually.

Alternatively we can argue with ACA dead-enders who claim the would ACA work if only we extend state care to all those individuals the ACA forced out of self-funded health insurance. Mind you these are the same people who also call for expanded unemployment to cover those forced out of work due to the ACA and these are the same people who wish to expand programs to tend to the growing class of newly part-time workers who only exist due to the ACA.

But hey, these are Democrats and they care about you; it's their fantasy. Perhaps we should let them tend the injuries they cause... let them offer band-aids to those they maim as they swing their ball-peen hammer of "health-care" upon America.

[Walter Salinger]

Harzman "facts" seem counterfactual, according to the CBO http://www.cbo.gov/publication/45159

[Andrew Brod]

Of course I won't retract my statement about the ACA reducing federal deficits. Why retract an accurate statement?

Once again, Hartzman misinterprets a simple table. But doesn't the table he shared with us show quite clearly that the insurance-coverage provisions of the ACA will increase deficits? Yes, it does. Hartzman's right that someone missed the fine print, but it wasn't me.

From the CBO: "Those estimates address only the insurance coverage provisions of the ACA; they do not constitute all of the act’s budgetary effects. Many other provisions, on net, are projected to reduce budget deficits."

[Andrew Brod]

Now, to address the next Hartzman attack before it happens:

The last projection of the overall budgetary impact was in 2012, which means that I will indeed retract my statement that the projection factors in all recent information. However, the revisions in the CBO's projected budgetary impacts of the insurance-coverage provisions have been relatively small. Clearly, even in February 2014, the CBO sees its 2012 projection of the overall budget effects as valid. In any case, there is no CBO projection that estimates the ACA will increase the deficit.

I presume Hartzman will disagree about the 2012 projection's validity, but as I noted earlier, that's based on his hunches and biases, not the math.

[Andrew Brod]

Just to drive home a point, one of the section headings in the CBO article to which I just linked reads:

"The Estimated Budgetary Effects of the ACA’s Coverage Provisions Have Changed Little on a Year-by-Year Basis Since March 2010"

[Ed Cone]

"The only reason proponents for Medicaid expansion exist is that the ACA is not the solution to the problem of the uninsured we were told it would be."

This is just not accurate. Medicaid expansion has been integral to the ACA from the start, which is why the Supreme Court ruling on it was such a big deal.

[Andrew Brod]

Right. The whole purpose of Medicaid expansion was to take higher-risk people out of the individual insurance market. One of the other economic downsides of rejecting Medicaid expansion in North Carolina is effectively moving the higher-risk folks into the ACA exchange. That raises the overall risk profile of the insurance pool, and that raises premiums on everyone in the exchange.

A study by the Rand Corporation looked at this phenomenon in Texas, Louisiana, and Florida, and estimated an 8-10% increase in premiums due to Medicaid non-expansion. One presumes the effect will be similar in North Carolina; maybe a bit less, maybe a bit more.

(By the way, that's on top of the 3.5% surcharge the federal government assesses on insurance premiums in states that don't establish their own ACA exchanges. Good going, North Carolina!)

[Hartzman]

From Appendix B link from Mr. Salinger's link above, and at the link itself;

CBO and JCT Estimate That the Coverage Provisions of the ACA Will Have a Net Cost to the Federal Government of $1.5 Trillion Over the 2015–2024 Period

The new baseline estimates rely on analyses completed by the early part of December 2013 and account for administrative actions that were taken before then. The estimates, however, do not reflect CBO’s updated economic projections, the most recent data on enrollment through insurance exchanges or the plans that have been offered through exchanges, and any
federal administrative actions or decisions by states about expanding Medicaid coverage that have occurred since that time. Hence, these updates are both partial and preliminary.

http://www.cbo.gov/sites/default/files/cbofiles/attachments/45010-breakout-AppendixB.pdf
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From Appendix B;

Net Cost of Coverage Provisions
41
88
127
142
151
151
156
161
166
170
173

Total $1,487 Billion
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"It's silly to say that the ACA is "mathematically unsustainable." The best math we have on this are projections by the CBO, which indicate that the ACA is quite sustainable. The CBO projects that the ACA will (slightly) reduce the federal deficit over the next couple of decades. That doesn't mean the deficit will fall, but that it'll be (slightly) lower with the ACA than it would have been without.

Now, one can choose not to believe the math, but one can't reasonably point to the math to claim the ACA (with Medicaid expansion a part of that) is unsustainable.

you can't reasonably complain about the deficit. The implication of the CBO projection is that the ACA pays for itself. And not through some hoped-for magic, or in any case not primarily because of that. The ACA pays for itself because it includes various taxes and penalties."

Andrew Brod's factual inexactitudes, which don't count the most recent revenue delays.

[Andrew Brod]

Well, at least you're good at cutting and pasting my comments.

[Walter Salinger]

Mr Hartzman, the relevant figures provided by the most recent CBO output, http://www.cbo.gov/publication/45159 , dated March 4, 2014 are found in the last column of the bottom portion of figure, entitled "Comparison of CBO's Current and Previous Estimates of the Effects of the Insurance Coverage Provisions of the Affordable Care Act" The bottom portion of that figure is labeled, "Current estimate of the Effects on the Cumulative Federal Deficit, 2014 to 2023 and it reports that the CBO estimated costs were revised downward by 9 billion dollars from the earlier cost estimate.

(Billions of dollars)

Exchange Subsidies and Related Spending -16
Medicaid and CHIP Outlays -2
Small-Employer Tax Credits **
Gross Cost of Coverage Provisions -18

Penalty Payments by Uninsured People n**
Penalty Payments by Employers 10
Excise Tax on High-Premium Insurance Plans 0
Other Effects on Revenues and Outlays -1
Net Cost of Coverage Provisions -9

[Fred Gregory]

Butt out with silly ressolutions.Nobody cares, No please don't do one for World Peace. An NBA player already has that name.

Thank you John Blust, Bill Knight and George Hartzman for your " non-moralistic" presentations unlike Rabbi Guttman's trite whining about social justice

Prof Brod if you like your statement , you can keep it

Fasten your seat belts dead enders Obamacare premiums are about to skyrocket

[Fred Gregory]

Unsustaiable. Indeed !

The Insiders: Democrats should bail on Obamacare

Listening Kay ?

"Oh by the way, while Washington is debating whether enrollment in Obamacare is terrible or just awful, the Washington Examiner brings to our attention a February 2014 cost report by eHealthInsurance that reveals the premiums for private health insurance policies (those outside of Obamacare) have risen by 39 to 56 percent for individual and family plans. And The Hill’s Elise Viebeck writes this morning that “Health industry officials say Obamacare-related premiums will double in some parts of the country, countering claims recently made by the administration.” So Obamacare has resulted in higher costs, limited plans, restricted doctor options, a reduction of about 2.5 million full-time equivalent jobs and has failed to get the uninsured to actually sign up.

If Obamacare isn’t a disaster, what does a disaster look like? How could this be any worse?

[Fred Gregory]

From a left wing journalist Who got mugged by the ACA

[pfknc]

I find it a bit amusing that "Obamacare has resulted in higher costs, limited plans, restricted doctor options". Best I can tell that has been the trend since I entered the health insurance markets, out of school in 1981, and I actually believe the data supports and is not based on my belief or faith. There have been periods of very high cost increases and severe changes to plan benefits and patient choice. The overall trend has persisted and perhaps, at least cost growth, is now being mitigated - time will tell.

So best I can tell what has occurred over the past 33 years has been the result of market expectations of the impact of Obamacare.

I get tired of listening, reading the constant whining about where we are without proposals or alternatives to fix an obviously broken system. What we do know is during the last 33 years more people have been excluded from the health care insurance market. In my opinion that is its greatest failing and is now being addressed.

[Hartzman]

Mr. Salinger,

As the text from the link you provided says;

"CBO and JCT Estimate That the Coverage Provisions of the ACA Will Have a Net Cost to the Federal Government of $1.5 Trillion Over the 2015–2024 Period

In the current interim projections, CBO and JCT estimate that the ACA’s coverage provisions will result in a net cost to the federal government of $41 billion in 2014 and $1,487 billion over the 2015–2024 period.

...Compared with last year’s projections, which spanned the 2014–2023 period, the new estimate represents a downward revision of $9 billion in the net costs of those provisions over that 10-year period.

he estimated net costs in 2014 stem almost entirely from spending for subsidies that will be provided through exchanges and from an increase in spending for Medicaid. For the 2015–2024 period, the projected net costs consist of the following:

Gross costs of $2,004 billion for Medicaid, the Children’s Health Insurance Program (CHIP), subsidies and related spending for insurance obtained through exchanges, and tax credits for small employers; and

Receipts of $517 billion from penalties on certain uninsured people and certain employers, an excise tax on high-premium insurance plans, and other budgetary effects—mostly increases in tax revenues.

The annual net costs are projected to rise noticeably over the next few years—to $151 billion in 2018— and then grow by more modest amounts in the following several years, reaching $173 billion in 2024."
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It looks like the net cost dropped about $9 billion from the last time they calculated it, but it's still "$1,487 billion over the 2015–2024 period."

Which makes Andrew's statement incorrect.

[Andrew Brod]

Wow.

I must say, I'm at a loss to know whether you're a moron or an odd kind of performance artist. As now both Walter and I have noted, in different ways, the coverage provisions of the ACA are not the totality of the ACA's provisions. And therefore, the budgetary implications of the coverage provisions aren't the same as the overall budgetary implications of the ACA. The blog post to which Walter and I both linked makes this quite clear. No one's disputing the words you keep cutting and pasting. But you clearly don't know what they mean.

Haven't you noticed that the excerpts you're regurgitating to us refer repeatedly to "the coverage provisions of the ACA" or "the ACA's coverage provisions" rather than "the ACA"?

I presume you'll add this to your list of times when I've insulted you. But one solution would be stop saying things that warrant insults.

[Andrew Brod]

I should note that the ACA has a number of provisions, and insurance coverage is a biggie. But the law also includes various reforms, e.g. to the Medicare payment system, tax credits, and a series of taxes and fees and mandates. Many of the taxes and fees, e.g. the tax on medical devices, are designed to raise revenues.

The tables on which Hartzman is focusing address the coverage provisions but omit a number of revenue-generating elements of the ACA. That omission is like complaining that a company's marketing department is losing money without looking at the performance of the entire business.

[Ed Cone]

I lean towards "performance art" - the guy's certainly enjoying himself - but I wish George would hold himself to the same standards he applies to others. And I wish he applied more rigor to his own work, e.g., acknowledging simple factual errors (another recent example in this thread, re on Germany's health insurance system). I know it's frusrating to have him essentially challenging your professional abilities, but "moron" doesn't help much and as you note only feeds his sense of victimization.

[Fred Gregory]

Below is a link to the analysis ( from the Galen & Manhattan Institutes ) that Rep. Blust attempted to provide the council.

Sadly the Mayor displayed contempt for facts challenging her silly resolution.

Why states should not expand Medicaid

Here are some bullet points from it but do please RTWT

12 reasons NOT
to expand Medicaid

1. Medicaid harms the poor

2. Medicaid spending will explode

3. Access to physicians will
become even more difficult

4. Washington will likely alter the
100% match rate

5. Expansion will worsen the cycle
of dependence

6. As many jobs could be lost as
created by expansion

7. Medicaid crowds out private
coverage

8. Expansion will increase
premiums for private insurance

9. Medicaid’s low payment rates
exacerbate uncompensated care

10. Expanding Medicaid will
increase the prevalence of fraud
and waste

11. Refusing to expand saves
taxpayer dollars

12. States should demand more
options and control

[Ed Cone]

1. Medicaid harms the poor

Not as much as not having access to a doctor does.

5. Expansion will worsen the cycle of dependence

Right, keeping people from healthcare is definitely the way to help them be independent and productive.

7. Medicaid crowds out private coverage

Because insurance cos would be lining up to serve poor folk otherwise.

9. Medicaid’s low payment rates exacerbate uncompensated care

Not the prevailing view of the people who pay for uncompensated care.

Most of the other bullet points fall into the same cost-without-consideration-of-benefit bucket that undermined the presentations by Blust and Knight.

Here are your choices: Deny uninsured people all access to the system, or find ways to bring them into the system. The system we're changing granted access in the most inefficient way, and didn't require people who can pay to carry their share of the load. Unless you're willing to say either "let them die" or "here's my workable alternative," you're not really in the conversation at this point.

[Fred Gregory]

Sorry Ed, but to ignore the harm the ACA has built intp it's time bomb is not sound fiscal or social policy.

Report: Premiums rising faster than eight years before Obamacare COMBINED

"Health insurance premiums have risen more after Obamacare than the average premium increases over the eight years before it became law, according to the private health exchange eHealthInsurance.

The individual market for health insurance has seen premiums rise by 39 percent since February 2013, eHealth reports. Without a subsidy, the average individual premium is now $274 a month. Families have been hit even harder with an average increase of 56 percent over the same period — average premiums are now $663 per family, over $426 last year.

Between 2005 and 2013, average premiums for individual plans increased 37 percent and average family premiums were upped 31 percent. So they have risen faster under Obamacare than in the previous eight years."

[Ed Cone]

I don't know about the quality of these numbers, given the short time frame they cover and its mismatch with the actual launch of ACA. Also, funny how I'm always reminding you not to quote huge swaths of text, and this time you cut off right before "An important caveat is that eHealth’s prices don’t include subsidies, so the prices for anyone earning between 100 and 400 percent of the federal poverty level will be lower...Premiums are being hiked across the board for several reasons."

Anyway, I would have liked to see a public option to limit the pricing power of for-profit insurance companies. What's your alternative plan, Fred? Just saying ACA sux doesn't do much good.

[Fred Gregory]

Exactly Ed, thank you. That's the poison pill for the ACA.. the pool.

"Premiums are being hiked across the board for several reasons, but the biggest contributor is the Obama administration’s highly touted “essential health benefits,” services that insurers on and off exchanges must provide.

Some benefits, such as emergency and laboratory services, are uncontroversial. But others, like maternity, newborn and pediatric services, are causing headaches for huge swaths of the population that don’t need them. Anyone past childbearing age, single men, the infertile, even nuns — their premiums are rising as well, because their plans must, by law, provide more services.

But premiums aren’t the only key to health care costs — deductibles and out-of-pocket costs like co-pays are also rising. When it comes to employer health plans alone, four out of five U.S. companies have increased deductibles or are considering doing so."

[Hartzman]

"the coverage provisions of the ACA are not the totality of the ACA's provisions."

Brod
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Then why does it say;

"Receipts of $517 billion from penalties on certain uninsured people and certain employers, an excise tax on high-premium insurance plans, and other budgetary effects—mostly increases in tax revenues."
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Why does it say;

"The key elements of the insurance coverage provisions of the ACA that are encompassed by the estimates discussed here include the following:

Most legal residents of the United States must either obtain health insurance or pay a penalty tax for not doing so,
Certain employers that decline to offer minimum health insurance coverage to their employees will be assessed penalties,
A federal excise tax will be imposed on some health insurance plans with high premiums...",

if these issues are not included in the numbers?

Thanks for the ridicule gentlemen.

At least you are consistent.

Do you teach your children to insult if they can't win an argument on the merits?

Do you use pejoratives with your friends if you don't like the results of rational conversations?

[Hartzman]

Why does the math at the link's tables include;

"Penalty Payments by Uninsured People
Penalty Payments by Employers
Excise Tax on High-Premium Insurance Plans
Other Effects on Revenues and Outlays"
.
.
"...the law also includes various reforms, e.g. to the Medicare payment system, tax credits, and a series of taxes and fees and mandates. Many of the taxes and fees, e.g. the tax on medical devices, are designed to raise revenues.

The tables on which Hartzman is focusing address the coverage provisions but omit a number of revenue-generating elements of the ACA."

Brod
.
.
WTF?

[Hartzman]

Why does it say at the beggining;

"In preparing the February 2014 baseline budget projections, the Congressional Budget Office (CBO) and the staff of the Joint Committee on Taxation (JCT) have
updated their estimates of the budgetary effects of the provisions of the Affordable Care Act (ACA) that relate to health insurance.1

1. As referred to in this report, the Affordable Care Act comprises the Patient Protection and Affordable Care Act (Public Law 111-148); the health care provisions of the Health Care and Education Reconciliation Act of 2010 (P.L. 111-152); and the effects of subsequent judicial decisions, statutory changes, and administrative actions."

http://www.cbo.gov/sites/default/files/cbofiles/attachments/45010-breakout-AppendixB.pdf

[Andrew Brod]

I'm sorry you don't understand this material, but there's nothing more I can do.

[Hartzman]

Dr. Andrew Brod, my deadline for this article is Monday morning at 10am. I believe you are not telling the truth. If you would like to provide proof that you are not, please do so, otherwise the following should be published in Yes Weekly next Wednesday;

"On March 21, 2014, the Obama administration's Whitehouse.gov stated "the Affordable Care Act reduces the deficit, saving over $200 billion over 10 years".

In online debates at Council Member Tony Wilkins' Facebook page and Ed Cone's blog before and after the council debate, UNCG Senior Research Fellow Dr. Andrew Brod stated "It's silly to say that the ACA is "mathematically unsustainable." The best math we have on this are projections by the CBO [Congressional Budget Office], indicate that the ACA is quite sustainable. The CBO projects that the ACA will (slightly) reduce the federal deficit” and "the ACA will reduce the federal deficit over time, precisely because "how we pay for it" has already been nailed down in the law."

Directly contradicting the Obama administration and Dr. Brod's assertions, Table B-1 of a February, 2014 report by the CBO entitled "Effects on the Deficit of the Insurance Coverage Provisions of the Affordable Care Act" says the Net Cost of Coverage Provisions to the federal government is projected to be $1.487 Trillion between 2015 and 2024."

[Andrew Brod]

I presume Yes Weekly hired you for a reason, and clearly it wasn't accuracy. Of course you and they may print what you want. Unfortunately, the above is bullshit.

On the other hand, perhaps that's what your editor wants.

[Hartzman]

http://hartzman.blogspot.com/2014/03/dr-andrew-brod-my-deadline-for-this.html

[Hartzman]

What's not accurate Andrew?

Please show your work.

I will remove the text if you would clarify on what we disagree on, with some actual facts instead of insults and invective.

[Andrew Brod]

I've made it quite clear. You can figure this out or you can publish bullshit. Your call.

[Ed Cone]

George's columns have been more responsible than his online work, perhaps because he has some discipline imposed upon him by editors and publishers; I hope Jeff Sykes will read this thread carefully before allowing a columnist to way whatever he wants.

[Hartzman]

Where do you stand on this Ed?

Do you think I'm lying?

[Ed Cone]

George, I don't see you addressing this: "Those estimates address only the insurance coverage provisions of the ACA; they do not constitute all of the act’s budgetary effects."

If you have addressed it, my apologies, but perhaps you can point it out?

(I do find your style hard to follow. You once told me at the Bench Tavern that your style was deliberate, and certainly your columns are more coherent, so maybe you could modify your presentation here as well?)