Leon Panetta and Jimmy Carter’s Irrational Attacks On Obama

There has been a lot of criticism of Obama’s Middle East policy from those of both parties who fail to recognize that we were placed in a situation with no good outcome the moment George Bush invaded Iraq. Leon Panetta has been all over the talk shows promoting his book, which echoes the criticism of Obama from Hillary Clinton.

Seeing the poor logic in these attacks makes me glad that Obama as opposed to either Clinton or a Republican have been calling the shots. It is easy to say that acting sooner would have helped, but no real evidence of this. The situation which allowed ISIS to develop and succeed in Iraq were created by the American intervention and subsequent actions of the Malacki government.

The actual advice given makes no sense. Arming Syrian moderates last year would have just led to increased bloodshed and more weapons in the hands of ISIS. Propping up Malicki longer was a dead-end policy, even if the United States could have stayed despite the desire of the Iraqui government for us to leave. While Panetta has criticized him over not bombing in Syria, Obama showed wisdom, not weakness, when he backed away from the military option when there was a diplomatic option to stop the use of chemical weapons.

The Neocon policies have been disastrous, causing this mess and Obama was right in opposing them, and attempting to disengage from the region. The Clinton/Panetta line is a repeat of the Bush/Cheney line and the current Clinton/Panetta attacks are no more credible than the attacks we are hearing from Dick Cheney

Other attacks are more petty. In a dispute between the White House and Pentagon over not giving the Pentagon everything it wants, I’ll generally side with the White House. It comes down to money on two levels. Now Panetta is cashing in to make money on his book, along with doing Hillary’s dirty work.

Kevin Drum put Panetta’s world-view in context:

…his basic worldview is simple: as long as Obama is launching lots of drone attacks and surging lots of troops and bombing plenty of Middle Eastern countries—then he’s a “strong leader on security issues.” But when Obama starts to think that maybe reflexive military action hasn’t acquitted itself too well over the past few years—in that case he’s “kind of lost his way.”

That’s the default view of practically everyone in Washington: Using military force shows strong leadership. Declining to use military force shows weakness. But most folks inside the Beltway don’t even seem to realize they feel this way. It’s just part of the air they breathe: never really noticed, always taken for granted, and invariably the difficult but sadly necessary answer for whichever new and supposedly unique problem we’re addressing right now. This is what Obama is up against.

Steve Benen had a great response to all the hypocrisy and poor arguments from the right being made by Panetta. He concluded:

The former Defense Secretary last week wrote a piece blaming Obama’s withdrawal of U.S. troops from Iraq for the chaos gripping much of the country. And yet, it was none other than Leon Panetta who defended Obama’s withdrawal policy, repeatedly, before he was trying to boost book sales.

Panetta now says he believes Obama should have pressed Iraqi officials to keep thousands of U.S. troops in Iraq indefinitely. What would those troops have accomplished that they didn’t already try over the last decade? Panetta hasn’t really said. What was Obama supposed to do about the fact that Iraq wanted American servicemen and women out? Panetta hasn’t really explained that, either. Why did Panetta see a residual force as impossible in 2011, only to believe the opposite now? He hasn’t offered an explanation of this, either.

And yet, Panetta just keeps complaining, not just about Iraq, but about U.S. policy in Syria, too, where the former Pentagon chief apparently believes it’s irrelevant that Obama rid Syria of its chemical-weapons stockpiles – weapons that now can’t fall into the hands of Islamic State militants.

Making matters slightly worse, as part of Panetta’s all-out media blitz, he complained to the New York Times about Obama going to Congress last year before intervention in Syria, and then complained about Obama not going to Congress this year before intervention in Syria.

Who knows, maybe this is a terrific public-relations strategy for a guy on a book tour. If Panetta hoped to generate chatter about his book, the past couple of weeks have been a triumph. If he hoped to get White House critics interested in his memoir, Panetta has done what he set out to do.

But those looking for real insights into a sensible national security policy probably haven’t learned much from Panetta’s p.r. campaign.

I would question if Panetta’s motivation is purely to make money from his book. He is also serving the Clintons well, considering that Hillary has motivation to separate herself from Obama but cannot speak out against him to this degree without looking calculating and disloyal. Of course both possible motives are served by the same actions.

The Daily Beast has further criticism of Panetta:

At both Langley and the Pentagon he became a forceful advocate for—or, some might say, bureaucratic captive of—the agencies he ran. As CIA Director he pushed back on efforts to expose the agency’s illegal activities during the Bush Administration —in particular, the use of torture (which he had once decried).

At DoD he ran around with his hair practically on fire denouncing cuts to the defense budget in out-sized, apocalyptic terms. The “catastrophic,” “draconian” cuts would initiate a “doomsday mechanism” and “invite aggression,” he claimed and always without specific examples. Ironically, when Panetta was chairman of the House Budget Committee in the early 1990s, he took the exact opposite position and pushed for huge cuts to the defense budget.

For Panetta, principles appear to be determined by wherever he happens to be sitting at any given moment.

However, his irresponsible threat-mongering and his constant stream of gaffes and misstatements (like the claim that the US was in Iraq because of 9/11 and that the war was worth it) masked a stunningly narrow and parochial foreign policy vision. It wasn’t just that Panetta was saying crazy things. As his new memoir shows, he apparently believed them.

The post went on to further criticize Panetta’s current ideas on what Obama should have done, along with his support for using force without adequate recognition of the consequences of using force, or of the positive benefits of Obama achieving an agreement to end the use of chemical weapons in Syria.

Jimmy Carter  has also raised similar attacks but the same issues remain that intervention earlier would have probably worsened the situation in Iraq and Syria. It is also easy to criticize in retrospect, but his current attacks are not consistent with previous criticism of Obama whichwere for being too aggressive.

While I have qualms about some of Obama’s actions, from drones to the current bombing, he is looking far better than most of those who are now attacking him.

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Can John Hinckley Be Tried For The Murder Of James Brady?

Jamess Brady

Having completed countless death certificates over the years I find these to be far less meaningful than the general public--a fact that I bet most physicians are well aware of. The cause of death is often questionable, especially when a patient dies at  home and no autopsy is done. In that case we must assume that the medical examiner is correct when they say that the cause of death is natural, and typically attribute the cause to whatever chronic conditions the patient might have. Realistically we know that there are also many other possibilities which might have caused death such as a sudden myocardial infarction, arrhythmia, or pulmonary embolism. This week we saw an unusual situation in which a death was ruled to be homicide years after a shooting, in the case of James Brady. It is certainly a valid argument that he did die from medical problems which arose as a consequence of the shooting, and knowing the common ambiguities in death certificates I see no problem with attributing the cause of death to the shooting.

This has ramifications beyond the cause of death on the death certificate, ranging from adding to the homicide rate to raising the question of whether the shooter, John Hinckley, could now be tried for murder. A couple of attorney bloggers, Doug Mataconis and Eugene Volokh  have looked at this issue. Volokh’s opinion is that Hinkley cannot be tried for murder for two reasons:

1. The year-and-a-day rule: At common law, a murder charge required that “the death transpired within a year and a day after the [injury]” (see Ball v. United States (1891), and this apparently remains the federal rule (see United States v. Chase (4th Cir. 1994)). Many states have apparently rejected this rule, given the changes in modern medicine that make it much easier to decide whether an old injury helped cause a death; but though the Supreme Court in Rogers v. Tennessee (2001) held that a court could retroactively reject the rule without violating the Ex Post Facto Clause (which applies only to legislative changes to legal rules) and the Due Process Clause, any such retroactive rejection of the year-and-a-day rule seems unlikely in this case (given that for the rule to be reversed the case would likely need to go up to the Supreme Court, and that in any event the rule had been applied relatively recently, in Chase).

UPDATE: But wait! Hans von Spakovsky points out that D.C.’s highest court rejected the year-and-a-day-rule in United States v. Jackson (1987). I at first didn’t check the D.C. precedents, focusing just on precedents from the normal article III federal system, since Hinckley was tried in federal district court. But Hinckley was tried for violating D.C. law as to the shooting of Brady (though the case was in federal district court because of the federal charges as to the shooting of President Reagan and the Secret Service agent), and by hypothesis would be retried for violating D.C. law. It is D.C. law that would apply here.

Yet Jackson was a 1987 case, decided after the Hinckley shooting. It expressly stated that, as of 1987, the year-and-a-day rule was in effect under D.C. law:

The common law of the District of Columbia encompasses all common law in force in Maryland in 1801, unless expressly repealed or modified. [Citations omitted throughout. -EV] In 1776, Maryland adopted the common law of England as it then existed. Therefore, we look to early Maryland law to resolve the question whether the year and a day rule is law in the District of Columbia.

The Court of Appeals of Maryland has held [in 1974 and in 1985] that the year and a day rule is part of the common law of Maryland because it was part of the English common law in 1776. A division of this court (in an opinion subsequently vacated for reasons not pertinent here) has unanimously concluded [in 1979] that the rule retains its viability in the District of Columbia. In re J.N., Jr., 406 A.2d 1275, 1283 (D.C. 1979).

We follow this reasoning in concluding that the common law year and a day rule is today the law in the District of Columbia.

And the D.C. court (in Jackson) expressly held (based on the Ex Post Facto Clause) that its abrogation of the rule would thus apply only prospectively, to prosecutions after that decision.

What should the effect of that be? On one hand, as I noted above, the U.S. Supreme Court in Rogers held that Tennessee courts could change the rule without violating the Ex Post Facto Clause, so that might undermines Jackson‘s prospectivity-only reasoning. This might mean that the prospective-only rule can be retroactively changed to a retroactivity-OK rule.

But on the other hand, Jackson expressly stated — in a discussion of substantive D.C. law, not of the Ex Post Facto Clause — that, as of 1987, the year and a day rule was still the law in D.C. And the U.S. Supreme Court in Rogers stressed that “perhaps [the] most important[]” part of the reasons for its acceptance of the Tennessee court’s retroactive rejection of the rule was that, “at the time of petitioner’s crime the year and a day rule had only the most tenuous foothold as part of the criminal law of the State of Tennessee.” The D.C. Court of Appeals’ analysis in Jackson makes clear that “at the time of [Hinckley's crime] the year and a day rule” had much more than a “tenuous foothold” as part of D.C. criminal law.

So I think that, if Hinckley were tried now for murder under D.C. law (which he couldn’t be, for the independent reasons below, but let’s set those aside for now), he would be tried under D.C. law as it existed in 1981, at the time of the shooting. And, given the D.C. highest court’s analysis of D.C. law in Jackson, that as-of-1981 law would include the year-and-a-day rule, which would make Hinckley substantively not guilty of the crime of murder.

2. Double jeopardy and collateral estoppel: But say the year-and-a-day rule didn’t apply here — hasn’t Hinckley already been tried for the shooting, and doesn’t the Double Jeopardy Clause stop him from being retried? The answer is yes, but in a circuitous way.

a. It’s OK to try someone for murder, even if he’s already been convicted of the attempted murder: If Hinckley had been tried for attempted murder and found guilty when Brady was still alive, he could be tried for murder after Brady died. Indeed, this is pretty much what happened in Diaz v. United States (1912), and this remains the law today, see Garrett v. United States (1985):

In Diaz v. United States, 223 U.S. 442 (1912), the Court had before it an initial prosecution for assault and battery, followed by a prosecution for homicide when the victim eventually died from injuries inflicted in the course of the assault. The Court rejected the defendant’s claim of double jeopardy, holding that the two were not the “same offense” ….

For a recent state case applying this rule, see State v. Hutchinson (N.H. 2011), which also cites other cases from other states.

b. It’s sometimes OK to try someone for murder, even if he’s already been acquitted of the attempted murder: Say someone (not as in the Hinckley case) acted extremely recklessly and injured someone else as a result. If the reckless person were tried for attempted murder, he’d be acquitted, because attempted murder generally requires a conscious purpose to kill, not just reckless endangerment.

But say the injured person then dies. The defendant could then be retried for murder, and convicted, because actual murder (not attempted murder) can happen even if the defendant didn’t have a conscious purpose to kill, so long as he was extremely reckless.

c. But the jury’s conclusion that Hinckley was insane is now binding on the government, and thus precludes a retrial for murder: Under the “collateral estoppel” doctrine (Ashe v. Swenson (1970)), “when an issue of ultimate fact has once been determined by a valid and final judgment, that issue cannot again be litigated between the same parties in any future lawsuit.” That’s most commonly applied in civil cases, but it also applies in criminal cases, against the government (so long as it’s the same government involved in both cases).

The jury determined by a valid and final judgment that Hinckley was insane, and thus couldn’t be liable for attempted murder. This judgment is binding on the government, and since the insanity defense applies the same way for murder as for attempted murder, it means that Hinckley would now be conclusively presumed to have been insane for purposes of any murder prosecution as well. He would have an ironclad defense to the murder charge, and thus any case against him couldn’t proceed. For a similar case, see United States v. Oppenheimer (1916), though there the defense was the statute of limitations rather than insanity.

(Note that The federal insanity defense has been considerably narrowed since the Hinckley trial — indeed, as a result of the Hinckley trial. But this legislative narrowing can’t be retroactively applied, given the Ex Post Facto Clause.)

So no retrial for Hinckley, despite the medical examiner’s conclusion, and even if that conclusion could be proved beyond a reasonable doubt.

Mataconis concluded his post by saying that, “Ultimately, the question of whether or not murder charges are brought will be in the hands of the U.S. Attorney in Washington, and the District’s Attorney General. As things stand right now, though, it seems as though such charges would be on legally tenuous grounds.”

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What’s The Matter With Thomas Frank?

Obama Green Lantern

Thomas Frank has fallen for the Green Lantern view of the presidency, thinking that the president has the power to do anything he wishes. His criticism of Obama:

Why did he do nothing, or next to nothing, about the crazy high price of a college education, the Great Good Thing that he has said, time and again, determines our personal as well as national success? Why didn’t he propose a proper healthcare program instead of the confusing jumble we got? Why not a proper stimulus package? Why didn’t he break up the banks? Or the agribusiness giants, for that matter?

Well, duh, his museum will answer: he couldn’t do any of those things because of the crazy right-wingers running wild in the land. He couldn’t reason with them—their brains don’t work like ours! He couldn’t defeat them at the polls—they’d gerrymandered so many states that they couldn’t be dislodged! What can a high-minded man of principle do when confronted with such a vast span of bigotry and close-mindedness? The answer toward which the Obama museum will steer the visitor is: Nothing.

In point of fact, there were plenty of things Obama’s Democrats could have done that might have put the right out of business once and for all—for example, by responding more aggressively to the Great Recession or by pounding relentlessly on the theme of middle-class economic distress. Acknowledging this possibility, however, has always been difficult for consensus-minded Democrats, and I suspect that in the official recounting of the Obama era, this troublesome possibility will disappear entirely. Instead, the terrifying Right-Wing Other will be cast in bronze at twice life-size, and made the excuse for the Administration’s every last failure of nerve, imagination and foresight. Demonizing the right will also allow the Obama legacy team to present his two electoral victories as ends in themselves, since they kept the White House out of the monster’s grasp—heroic triumphs that were truly worthy of the Nobel Peace Prize. (Which will be dusted off and prominently displayed.)

But bipartisanship as an ideal must also be kept sacred, of course. And so, after visitors to the Obama Library have passed through the Gallery of Drones and the Big Data Command Center, they will be ushered into a maze-like exhibit designed to represent the president’s long, lonely, and ultimately fruitless search for consensus. The Labyrinth of the Grand Bargain, it might be called, and it will teach how the president bravely put the fundamental achievements of his party—Social Security and Medicare—on the bargaining table in exchange for higher taxes and a smaller deficit. This will be described not as a sellout of liberal principle but as a sacred quest for the Holy Grail of Washington: a bipartisan coming-together on “entitlement reform,” which every responsible D.C. professional knows to be the correct way forward.

Frank both ignores the real obstacles which Obama faced and is not very accurate in describing Obama’s record. He forgets that the there was a very good reason that Obama never had a chance to reason with the Republicans–they decided right off the bat that they would oppose anything Obama supported for political reasons. Frank might check out the work of  centrists Norman Ornstein and Thomas Mann on how Republicans are responsible for the current gridlock along with  this Frontline documentary:

On the night of Barack Obama’s inauguration, a group of top GOP luminaries quietly gathered in a Washington steakhouse to lick their wounds and ultimately create the outline of a plan for how to deal with the incoming administration.

“The room was filled. It was a who’s who of ranking members who had at one point been committee chairmen, or in the majority, who now wondered out loud whether they were in the permanent minority,” Frank Luntz, who organized the event, told FRONTLINE.

Among them were Senate power brokers Jim DeMint, Jon Kyl and Tom Coburn, and conservative congressmen Eric Cantor, Kevin McCarthy and Paul Ryan.

After three hours of strategizing, they decided they needed to fight Obama on everything. The new president had no idea what the Republicans were planning.

There were clear institutional limits on Obama in a system where forty Senators could block the majority on anything. The Democrats had sixty votes for a very brief time due to the delays in swearing in Al Franken and later Ted Kennedy’s death.  Even when Obama technically had sixty Senators voting with the Democrats, this included Joe Lieberman and Ben Nelson who would never go for the type of leftist agenda Frank favored.

Obama chose to use his limited political political capital to concentrate on health care reform, passing a comprehensive health reform package after previous presidents from Harry Truman to Bill Clinton were unsuccessful. Ted Kennedy once expressed regret at working with Richard Nixon and instead insisting upon a single-payer system at the time. Similarly Hillary Clinton convinced Bill to threaten to veto anything other than her plan, rejecting a Republican proposal which was very similar to the Affordable Care Act. It would be far better to accept what can be passed and then work to improve it over time.

Sure the Affordable Care Act is a confusing jumble, but that is because it built upon our current system. It would have been better if the system was even more complex and perhaps confusing, including either the public option or Medicare buy-in. Neither could pass because both Lieberman and Nelson opposed them. Obama certainly could have never received sixty votes for a single-payer plan, breaking up the banks, or a bigger stimulus.

Beyond Congress, Obama was limited by conservative media bias on economic matters. Obviously Fox was out there spreading lies and attacking anything Obama wanted to do, but the problems weren’t limited to Fox and its viewers. Most of the media is owned by the wealthy, and much of the news, especially on television, is reported by wealthy television stars. They might not share the Republican views on social issues or their opposition to science and reason (leading to the conservative view of  a liberal media) but many of them are quite conservative on economic issues. They were biased towards tax cuts and cutting spending. Media reports on the economy typically stressed the size of the deficit and included the assumption that a reduction in government spending was necessary. Few pointed out the degree to which Republican spending and tax cuts in the Bush years contributed far more to the deficit than Obama’s stimulus spending. The atmosphere was hardly conducive to pushing an even bigger stimulus, regardless of how much more this would have helped the economy recover. He also ignores the degree to which Obama’s stimulus did help bring about economic recovery.

Just as Frank ignores the benefits of Obama’s policies, including the Affordable Care Act and the stimulus, he exaggerates what Obama did not do. No, Obama did not destroy Social Security and Medicare. It is the other party which has been seeking to do that. Offering  Chained CPI in exchange for a grand bargain on the deficit might never have been a good idea, but we can’t blame Obama for making a bad deal when such a deal was never made and we don’t know what he would have held out for before making such an agreement.

Obama’s record has much in it to displease the far left. It is doubtful that any other president would have achieved more than he actually did.

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BBC America Renews Orphan Black

orphan black renewed

BBC America has announced that Orphan Black has been renewed for a third season. Filming begins in September with another ten episode season starting next spring.

Now hopefully Showcase will have a similar announcement in the near future regarding renewal of Continuum.

BBC America has also announced that Broadchurch will be returning for a second season. In addition to David Tennant of Doctor Who reprising his role, Eve Myles of Torchwood will be joining the cast.

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Stephen Colbert To Succeed David Letterman

Colbert Letterman

White smoke could be seen rising from CBS Headquarters today. CBS will not be going through the same drama which we saw at NBC when Johnny Carson and Jay Leno left The Tonight Show (twice in the case of Leno). There was no consideration of forcing Letterman out before he was ready. One week after David Letterman announced his planned retirement on his own schedule, CBS has announced that Stephen Colbert will be replacing him. While I think Craig Ferguson does an excellent job following Letterman’s show, it was not expected that Ferguson would receive the 11:35 time slot. I do like Ferguson’s show but, if he leaves CBS, it would not be as significant as David Letterman and later Conan O’Brien leaving NBC. I hope Ferguson does remain where he is, providing a choice between his show and Seth Meyers at 12:35.

Stephen Colbert has already said that (as would be expected) he is not going to do the show in character as on The Colbert Report on Comedy Central show. It has been an excellent run, but I am also confident Colbert can do a fine job hosting as “himself.” I do hope that from time to time Colbert, instead of stupid pet tricks, goes back into his stupid conservative character for a skit.

I suspect that Colbert will tone down politics to some degree with the move to a late night network talk show. His liberal credentials are well known after pointing out that “reality has a well-known liberal bias.” Or maybe not. A study at Ohio State in 2009 found that many conservatives took him seriously and didn’t realize he was mocking them.

Here is a selection of one liners from Stephen Colbert when in character, many of which have been featured here as a Quote of the Day:

“Our president has gotten so desperate that he appeared on this website Funny or Die. By the way, ‘funny or die’ is also the ultimatum you got from Obamacare’s death panels.” –Stephen Colbert

“No one has signed up for Obamacare, give or take 4.2 million people.” — Stephen Colbert

“You know what, folks? I miss George W. Bush. That man knew how to sell a war. Obama has hard evidence of weapons of mass destruction and he can’t even get England to go along with it. Meanwhile, President Bush got an international coalition with nothing more than Colin Powell’s reputation and half a test tube of crystal light.” –Stephen Colbert

“Conservatives like me know that in a budget crisis, everything nonessential has to go — whether it’s food for kids who aren’t mine or some other stuff for people I don’t know.” –Stephen Colbert

“It seems like every single day, President Obama finds a new way to waste our tax dollars. I mean, two daughters? Seems a little redundant.” –Stephen Colbert

“Where did we go wrong? The Republicans had everything going for them – a terrible economy, an unpopular incumbent, and a positive message for the American voter: ‘less than half of you are parasites.’” –Stephen Colbert

“Folks, I’m no fan of ‘Sesame Street.’ They expose our children to dangerous liberal ideas like befriending the homeless, two men sleeping in the same bedroom and counting.” –Stephen Colbert

“This is America. We must defend the principles symbolized by Lady Liberty – unless she’s on the pill, in which case, she is a giant green tramp.” –Stephen Colbert

One of Stephen Colbert’s finest moments outside of his show was at the White House Correspondents’ Dinner in 2006. Here is the video of his tribute to George Bush, with full text under the fold:

(more…)

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Obama Administration Announces Increase In Payments To Medicare Advantage Plans

Presumably in response to Republican scare stories about Medicare cuts to Medicare Advantage plans and insurance company lobbying, CMS has announced an increase in payments of  0.4% in 2015, in place of the expected 1.9% rate cut as of February. This negates a distorted Republican attack that Obama is cutting payments to Medicare.

The proposed cuts were to what is essentially corporate welfare for insurance companies running  Medicare Advantage plans. The plans increased payment compared to what it costs to care for similar patients in the government Medicare plan. Republicans have included the same cuts which were previously proposed by the Obama administration in their proposed budgets despite faux attacks against Democrats for cutting Medicare.

Update: Full Text of Press Release from CMS

CMS Ensures Higher Value and Quality for Medicare Health and Drug Plans

Rate Announcement Details Plan Payments and Other Program Updates for 2015

Today, the Centers for Medicare & Medicaid Services (CMS) issued the 2015 rate announcement and final call letter for Medicare Advantage and prescription drug benefit (Part D) programs. The announcement sets a stable path for Medicare Advantage and implements a number of policies that ensure beneficiaries will continue to have access to a wide array of high quality, high value, and low cost options while making certain that plans are providing value to Medicare and taxpayers.

Since the Affordable Care Act was passed in 2010, Medicare Advantage premiums have fallen by 10 percent and enrollment has increased by 38 percent to an all-time high of more than 15 million beneficiaries. Today, nearly 30 percent of Medicare beneficiaries are enrolled in a Medicare Advantage plan. Furthermore, enrollees are benefiting from greater quality as over half of enrollees are now in plans with 4 or more stars, a significant increase from 37 percent of enrollees in such plans in 2013.

 “The policies announced today will provide improved benefits in Medicare Advantage and the Prescription Drug Plans while keeping costs low for Medicare beneficiaries,” said Jonathan Blum, CMS principal deputy administrator. “We believe that plans will continue their strong participation in the Medicare Advantage program in 2015 and beneficiaries will continue to have access to a wide array of high quality and affordable Medicare health and drug plans.”

After careful consideration of public comments, key changes and updates finalized in the Rate Announcement and final Call Letter include:

Lower Out-of-Pocket Drug Spending: Beneficiaries in the Part D prescription drug coverage gap, or “donut hole,” will benefit from greater savings on prescription drugs. As a result of the Affordable Care Act, in 2015, enrollees who reach the donut hole will receive coverage and discounts of 55 percent on covered brand name drugs and 35 percent on covered generic drugs, an increase from 52.5 percent and 28 percent, respectively, in 2014. The Affordable Care Act’s Coverage Gap Discount Program has provided discounts to more than 7.9 million Medicare beneficiaries, saving $9.9 billion on prescription drugs, or an average of $1,265 per beneficiary.

Greater Protection for Beneficiaries: CMS intends to again use its authority, provided by the health care law, to protect Medicare Advantage enrollees from significant increases in costs or cuts in benefits, and, for the 2015 contract year, finalizing the permissible amount of increase in total beneficiary cost to $32 per member per month (down from $34 per member per month for the 2014 contract year). CMS also continues to require plans to refine their offerings so that beneficiaries can easily identify the differences between their options.

Increased Protections for Beneficiaries Affected by Changes in Medicare Advantage Plan Networks: The final Call Letter strengthens tools used to ensure compliance with established provider access requirements and establishes best practices for Medicare Advantage Organizations to follow when they make significant changes to their provider networks.

Payments to Medicare Advantage Plans:

  • CMS estimates that the overall net change to plan payments between 2014 and 2015 to be +0.4 percent, compared to the estimated overall net change to plan payments of -1.9 percent for the proposals in the Advance Notice   Individual plan payments will vary by plan based on, but not limited to, its location and star rating.
  • Before the Affordable Care Act, Medicare Advantage plans were paid more than 10 percent compared to traditional Medicare, costing the program more than $1,000 per person each year, while quality and health outcomes were similar to those enrolled in traditional Medicare. The changes underway reduce excessive payments to Medicare Advantage plans, while incentivizing quality improvements by basing part of Medicare Advantage payment on plan quality performance.
  • To provide for continued stability in the Medicare Advantage program, CMS will implement a new phase-in schedule for the Part C risk adjustment model introduced in 2014. In addition, to improve payment accuracy, CMS has refined its risk adjustment methodology to account for the impact of the influx of baby boomers. In addition, for 2015, CMS will not finalize the proposal to exclude diagnoses from enrollee risk assessments.

Other policies that are not being finalized as proposed include:

Delayed implementation of new Part D Risk Adjustment Model.

Not implementing some proposed changes to the Star Ratings.

Not implementing the proposal to require additional coverage in the gap for generic and brand drugs in Enhanced Alternative plans.

To view a fact sheet on the 2015 Rate Announcement and final Call Letter, please visit: http://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2014-Fact-sheets-items/2014-04-07.html

The 2015 Rate Announcement and final Call Letter may be viewed later today through: http://www.cms.hhs.gov/MedicareAdvtgSpecRateStats/ and selecting “Announcements and Documents.”

Update II: The mainstream media is starting to pick up the news. Here are reports from AP and from The Hill.

Cross posted at The Moderate Voice
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Brewer Vetoes Arizona Bill Legalizing Discrimination Against Gays

In the second of two reports of good news today, Arizona Governor Jan Brewer hasvetoed the bill recently passed by the state legislature to permit discrimination. The law would have allowed businesses to legally practice discrimination against homosexuals. I discussed the bill and conservative cherry picking of religious teachings further here.

Conservatives are promoting similar “religious freedom” bills in other states. To the religious right, “religious freedom” means the freedom to impose their religious views upon others in violation of the Constitutional protection of separation of church and state which this nation was founded upon. A similar bill in Georgia is expected to be defeated.

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Cuts To Medicare Advantage Plans Half Of Amount Expected–Watch For Hypocritical Republican Reaction

Paul-Ryan-End-Medicare

One of the ways in which the Affordable Care Act is funded is by reducing subsidies to Medicare Advantage plans which receive more money to care for Medicare beneficiaries than it costs to care for the same patients in the government Medicare program. Republicans have been using this to raise bogus claims of cuts to Medicare patients despite the fact that Republicans have also included similar cuts to Medicare Advantage plans in their budget proposals.

Insurance companies have been predicting cuts of approximately 7 percent. CMS released their calculations today regarding proposed cuts for 2015 (pdf here). The current proposal is for a 3.55% cut in payments to Medicare Advantage plans, about one-half of what they have been projecting.

The Republican Party was already prepared today to use this news to attack the Democrats. They do not explain why it is necessary for private companies, which any Republican believes should be more efficient than a government program, requires more money to care for patients than the government Medicare plan does. Nor do they account for the fact that most Republicans voted for the Ryan budget three years in a row which includes the same cuts to Medicare Advantage plans. Or what about the same Ryan plan which would turn Medicare into a voucher system?

Also don’t expect the Republicans to point out that, while the Affordable Care Act will cut profits to Medicare Advantage plans, it also increases benefits to Medicare patients including phasing out the donut hole for prescription drugs and covering preventative services which were previously not covered.

Cross posted at The Moderate Voice

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White House Postpones Employer Mandate For Medium Sized Employers

Republicans have been trying to blame everything on the Affordable Care Act including long standing health care issues, unemployment, the poor performance of Denver in the Super Bowl, and Justin Beiber’s recent antics. Okay, I’m exaggerating a little, but to blame Obamacare for any of these problems is untrue. I’ve already discussed the false claims from conservatives that the Congressional Budget Office shows that Obamacare will increase unemployment when it will actually do the reverse and decrease unemployment.

Unemployment is a serious problem but the attempts to tie it to the Affordable Care Act do not hold up. In addition to the information released by the Congressional Budget Office, the argument that employers are not hiring due to the mandate to provide insurance coverage also fails to hold up. The argument fails to take into account the subsidies which will help employers provide the coverage, along with the fact that the employer mandate had not been scheduled to start until 2015. The White House has today announced a further delay in the employer mandate until 2016 for employers with 50 to 99 employees. (The mandate does not affect employers with under 50 employees).

Derek Thompson has more on the myth that Obama has been killing jobs or is responsible for an increase in part-time employment.

Paul Krugman looked more at the unemployed, and how the right wing is impervious to evidence regarding government action.

Steve Benen explains once again what the “insurance trap” means and why freeing people from having to keep their current job to maintain their insurance is a feature, not a bug, of Obamacare. Face it, if the conservatives don’t understand this yet, they are (intentionally) never going to understand.

Update: Sarah Kliff has a good rundown of the additional changes announced today including relaxing the requirements for employees covered by large companies. The most important change is probably that volunteers won’t be counted as full-time employees. There had been some speculation that volunteers such as volunteer firefighters would be covered by the  mandate, making it more expensive to use such volunteers. She also makes the valid point that, as the majority of companies offer insurance, the postponement of the employer mandate won’t affect very many people.

The conservative reaction has been to denounce this as a dictatorial action from Obama. If these people are so concerned about potential abuse of Executive power, where were they during the Bush years when Republicans backed the Unitary Executive theory which would greatly expand the power of the President (or during the Busy years, the Vice President)?

Update II: Two more thoughts on the conservative spin:

Strange that they are complaining so much about a delay in the employer mandate when they have been predicting such dire consequences of the mandate.

The reason much of this, right or wrong, is being done by executive order is that the system is broken. We know whose fault that is. Congress has voted, at last count, 47 times to repeal the Affordable Care Act but the Republicans are not willing to work on fine tuning the law as would normally be done after such a huge law was passed.

Cross posted at The Moderate Voice

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Happy Thanksgiving

Happy Thanksgiving, a favorite holiday for conservatives who can gather around the dinner table and discuss all the things they are hateful about.

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