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The Dead End of Rhode Island’s Government Plantation Model

The entitlement mentality in this state will be palpable as the federal government rolls back the Obama Administration’s give-aways. Lynn Arditi writes about the potential cost to Rhode Island if it refuses to change its Medicaid program to reflect federal spending under the Republican health care plan:

Predicting how much it might cost the state to cover the roughly 70,000 adults in the Medicaid expansion population under the Republican plan is especially difficult, health experts say, because people move on and off the rolls. If, for example, the job market weakened and people who had left the Medicaid rolls return, the lower federal cost-sharing rate means they’d be much more expensive to re-enroll.

“While certainly we’d support the state continuing to fund the Medicaid expansion population,” [Linda] Katz [of the Economic Progress Institute (no relation)] said, “the reality is … it would be very difficult to replace with state dollars the federal dollars and keep people insured.”

Rhode Island never should have signed on to the Medicaid expansion if this was possible, and the likes of the RI Center for Freedom & Prosperity were ignored when we warned that it was most definitely possible.  What everybody can see clearly now is that insiders and bureaucrats padded their budgets at great cost and risk to others.

And it’s not just Medicaid.  Dan McGowan reports from Providence for WPRI:

President Donald Trump’s proposal to eliminate the $3-billion Community Development Block Grant (CDBG) program would be a “devastating” blow to Rhode Island’s capital city, Mayor Jorge Elorza said Friday.

Trump’s proposed budget would do away with the 42-year-old CDBG program, which provides local governments across the country with funding for community centers, housing programs and neighborhood improvements.

None of these programs should ever be built into state government budgets or the local economy.  They should be treated as gravy on a healthy, independent economy.  Instead, we’ve allowed our elected officials to suffocate real industry and substitute a government plantation model premised on being able to bill the federal government and local taxpayers for government services for others.

Eventually, when you turn toward an obvious dead end, you reach it.

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CBO Points to the ObamaCare Abusive Spouse

This Wall Street Journal editorial offers some worthwhile perspective on the meaning of the Congressional Budget Office’s (CBO’s) estimates around Republicans’ initial ObamaCare repeal bill:

The CBO attributes “most” of this initial coverage plunge to “repealing the penalties associated with the individual mandate.” If people aren’t subject to government coercion to buy insurance or else pay a fine, some “would choose not to have insurance because they chose to be covered by insurance under current law only to avoid paying the penalties, and some people would forgo insurance in response to higher premiums.”

What this finding says about the value Americans attach to ObamaCare-compliant health insurance is damning. If CBO is right, some 14 million people would rather spend their money on something else, despite the subsidies.

In keeping with the general worldview of central planners, if you cease to get something through them, you’ve “lost” it.  This attitude permeates government, from charitable grants that local governments give to their preferred charities up to massive federal entitlements.  In this case, the government isn’t even just taking credit for something it’s using other people’s money to provide, but behaving as if forcing people to do something gives them that something.

As perverse as that is, it may be the perfect representation of progressive government.  It’s like an abusive spouse who rationalizes his or her pathology into the belief that commanding and berating his or her significant other is for the other person’s good.

As for the CBO, the Journal also reminds us that it’s a policy group working off a model, not a mystic order of prophets telling the future.

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Paying for the Entitlement That Never Should Have Been Extended

This is a great idea that Rhode Island should pursue, as reported by Michelle Hackman in the Wall Street Journal:

Ms. Verma, a health policy consultant, made a name for herself as the architect of Indiana’s Medicaid expansion program under then-Gov. Mike Pence, which that state administered through a federal waiver. Ms. Verma struck a deal with  the Obama administration allowing Indiana to charge enrollees under the expansion monthly premiums.

There is no reason childless, able-bodied adults relying on a government welfare-insurance program can’t pay something to give them a stake in their coverage.  From the beginning, we’ve seen examples of people who were willing to pay for private insurance, but who discovered their eligibility for a free plan through Medicaid.

Moreover, the state of Rhode Island never should have leaped into the ObamaCare Medicaid expansion with so little thought. Some of us warned at the time that the state shouldn’t count on the federal government holding the share it would pay at 90%, particularly as part of an unpopular and entirely partisan bill.  Since the state government conducted absolutely zero public debate over whether to accept the expansion, we can only surmise that elected officials and bureaucrats in Rhode Island either didn’t care to look that far ahead or counted on their ability to do what they’re trying to do now: get political mileage out of the federal government’s predictable move and attempt to transfer the burden to state-level taxpayers.

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The “Real” News About Healthcare Reform

The Providence Journal and Rhode Island progressives are doing a disservice to the people of our state by advancing a biased and non-realistic perspective on the federal healthcare reform debate.

There are few issues that are more personal or important than planning for the care that can preserve the health of ourselves and our families. But what governmental approach best helps us accomplish this?

Currently, our state is following the federal Obamacare approach of seeking to insure more people with government-run Medicaid or with a one-size-fits-all government-mandated private insurance plan. This approach is in a death-spiral.

Continue reading at Rhode Island Center for Freedom and Prosperity.

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Approval of the Cognoscente Versus Approval of the People

It seems to me that politicians (particularly those on the right) should take data points like this, from Austin Yack on NRO, as justification for further experimentation going against the common wisdom of their Washington–New York social set:

The Republican-majority Congress also polled well. Americans trust Republicans to legislate on issues pertaining to the economy, jobs, immigration, energy, and health care — and, astonishingly, these responses were recorded during the days in which the Congressional Budget Office found that 24 million people will be uninsured by 2026 under the Republican-majority Congress’s health-care plan. Forty-six percent of registered voters approved of the health-care plan; 35 percent disapproved, and 19 percent had no opinion.

Perhaps people are learning that the news media hypes stories from a point of view benefiting a particular political party, not the country, and perhaps people understand that when a country (like a person) has let itself go, getting back on track involves some discomfort.

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The Poster Hairdresser for How Government Interferes with Civil Society

Rhode Islanders may have noticed that Providence Democrat Representative Anastasia Williams has submitted legislation to allow people to braid hair for pay without requiring a license.  This is actually a subject that the RI Center for Freedom & Prosperity has raised in the past (although I can’t find a link, just now) and is consistent with both our long-running insistence that the state government is strangling our economy with regulations and our more-recent emphasis on shifting policy in favor of helping Rhode Island families and facilitating non-government civil society.

Via Instapundit, however, comes an entry by Eric Boehm of Reason, who may very well have spotted the poster child for the government’s overreach in directing our lives and preventing us from serving one another as human beings:

The Arizona State Board of Cosmetology is investigating Juan Carlos Montesdeoca after receiving complaints that he was cutting hair without a license, Tucson News Now reported Monday. According to the complaint, which Montesdeoca shared with the TV station, the board received an anonymous complaint alleging that Montesdeoca was “requesting local businesses and local stylists to help out with free haircuts (unlicensed individuals) to the homeless.”

This morning, the Tiverton Budget Committee (of which I’m a member) toured the town’s Senior Center, and the new director related some of the anecdotes that she’s heard about the 100-year-old building.  Back when it was a school, apparently doctors would open weekend clinics for various procedures, including the removal of tonsils.

Now, given advancements in knowledge, we can surely agree on a role for government in requiring sanitary conditions and licensed professionals to perform such surgeries.  At the same time, we should be able to agree that rules against hair braiding and charity trims don’t really protect anybody but established practitioners who are able to charge more money the less competition they have.

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Anybody Buying the UHIP Spin?

Come on, now. This is like lie-detector 101:

“There was pressure [to launch UHIP despite its not being ready], no doubt about it,” Raimondo told reporters. “High ranking members of the General Assembly said, ‘Deliver this now.'” …

[Department of Human Services Director Eric] Beane, called to testify about his month-long probe of UHIP, tempered his answer, saying employees he spoke with at DHS and the Executive Office of Health and Human Services talked about pressure from former House Finance Committee Chairman Raymond Gallison and former Rep. Eileen Naughton, who chaired the finance subcommittee on health and human services.

So, the governor tried to deflect some blame, and the administration realized it was starting a political fight, so a flunky ostensibly testifying with a neutral assessment of what went wrong implied (indirectly, notice) that the blame should fall on two legislators whom a governor would hardly take seriously as directing the administration’s actions and who, conveniently, are no longer in office (one because he was jammed up with criminal investigations).

This is cover-up land. The governor can’t be trusted.  As I suggested in my “Last Impressions” podcast this week, it appears that Raimondo has invested in the tagline that she’s the “governor who gets things done,” and sliding down the UHIP wormhole had to be a major concern.

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A New Winner for Most Pro-Government-Spin Headline in the Providence Journal?

I’ve been meaning to nominate the headline that the Providence Journal used in its print edition for this article (from the Associated Press):

‘Obamacare’ sees high enrollment

To be fair, the Projo headline writer was taking his or her cue from and amplifying the spin of AP writers, Ricardo Alonso-zaldivar and Kevin S. Vineys who try to slip in the real story in the third paragraph:

Although initial enrollment is about 4 percent lower than last year, the sizable number of sign-ups illustrates the risk Republicans face as they begin moving to dismantle the Affordable Care Act and put in its place a yet-to-be-defined conservative approach.

You can’t get from a 4% drop in enrollment to a headline proclaiming “high enrollment” without being something more like propagandists than journalists.  If I were an objective journalist working for one of these organizations, I’d be furious with my coworkers for undermining our publication’s credibility.

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The Creeping Grim Reaper of Euthanasia

Just in case you’re thinking the grim reaper of euthanasia won’t be a creeping killer, here’s a Catholic News Agency article to consider:

An Oregon bill on advanced medical directive rules could allow patients who suffer from dementia or mental illness to be starved or dehydrated, opponents warned.

These are patients who are awake, can chew and swallow and want to eat, even though in some cases they may need help in delivering food to their mouths,” Gayle Atteberry of Oregon Right to Life said Jan. 31. “Current safeguards in Oregon’s law protect these patients from this type of cruelty. This bill take away these safeguards.”

Whether proponents see euthanasia as compassion or as a scheme to slough off some excess population, it has no boundaries once one cedes the argument over the sacred value of human life.

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Freestanding ER Bill Shows How Price Has Been Disconnected from Service

The lesson of Susan Campbell’s WPRI story about one woman’s surprise bill from a “freestanding ER” business from which she received service may not be quite what’s intended:

“They gave me oxygen, they did chest X-rays, an EKG, and blood work,” [Elizabeth] Darling said.When she got to the ER, however, Darling overlooked a sign at the front desk, warning patients that Medicare and Medicaid are not accepted at the facility. She was billed more than $1,600.“I never would have stayed there,” Darling said. “I would have walked out that door, had I known.”

This may look bad — and we’ve been trained to see the word “gouging” between the lines of such stories — but it goes with my broader analysis: We’ve completely disconnected price from service.

Given her insistence that she would have gone elsewhere if she’d known her price of service, this woman could obviously have made it to another service provider that would have saved the system money.  Instead, within a system that ensures that the decision-making consumers don’t usually care about the price of services, she chose a high-cost option.

A great many people would do the same thing, because the way the government has manipulated our health care system, people not only don’t associate direct payments with services, we don’t even have a concept of what those services actually cost to provide.  It’s a system designed for waste.

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Transfer to Medicaid “Main Driver” of HealthSource Decline

Rhode Island’s Affordable Care Act (“ObamaCare”) health benefits exchange lost 5,027 members (18.6%) as of the December 31 deadline for open enrollment.  Officials largely blame the withdrawal of UnitedHealthcare’s plans:

HealthSource RI said in a statement that the “main driver” of the enrollment decline was the departure from the market of UnitedHealthcare, which HealthSource RI estimated insured roughly 1,400 exchange customers in 2016.

One source of lost customers was more significant, however: Medicaid.  A HealthSource spokesperson tells the Current that “about 1500 individuals who had [qualified health plan] coverage at the start of Open Enrollment have since been determined eligible and enrolled in Medicaid.”  A request for the number of Medicaid recipients who went the other way — losing the taxpayer-funded welfare benefit and signing up for a paid (if taxpayer subsidized) plan — had received no reply as of this writing.

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Since the beginning of HealthSource RI and the related Unified Health Infrastructure Project (UHIP), the RI Center for Freedom & Prosperity has warned that the system was designed to draw Rhode Islanders toward welfare benefits and dependence on government.  From the beginning, new Medicaid enrollment has far exceeded the numbers of Rhode Islanders who have used the exchange to purchase insurance.

These decisions and results have been a significant part of Rhode Island’s drop to 48th in the country on the Center’s Jobs & Opportunity Index (JOI) and to 39th on the index’s Freedom Factor, which is the ratio of jobs and employment to reliance on welfare programs.

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Never Any Way to Fix Costly Government Programs, Medicaid Edition

Reporting on a study by a couple of health care experts, Ted Nesi writes on WPRI:

Using 2015 data, their projections showed Rhode Island would lose $514 million in annual federal Medicaid funding under such a formula – a huge amount of money, equal to 22% of the state’s $2.3 billion in total Medicaid spending during the 2014-15 budget year. Massachusetts would lose $3.4 billion under the scenario.

First, let’s have a little perspective, here.  The revised spending on “Medical assistance (including Medicaid)” for fiscal 2015 was $2,382,919,281.  The year before — in fiscal 2014 — it was $1,819,597,682.  If you don’t have a calculator handy, that’s a difference of $563,321,599, or about $50,000,000 more than the “huge amount of money” in the possible reduction.

According to the mainstream calculus, government spending can never go down, even just to the prior year’s level.  On the one hand, we’re told it would be a terrible thing if Congress were to block grant Medicaid based on state income because states that rely on the program as a large part of their budgets would face massive reductions.  As the study says, it “would result in a seismic redistribution of federal spending.”

On the other hand, the authors go on to say, we can’t possibly calculate block grants based on current spending, because that “would lock in large and arguably unfair variation in funding across states.”  The only solution, clearly, is to just keep giving states as much money as they need for however many Medicaid recipients they’re able to sign up.

Folks, this is the government plantation, or company state.  As I wrote when I first began tracing that economic model in Rhode Island, when the state’s major industry (government) relies on its ability to sign up people for services in order to charge other people for them, the people forced to pay the bill will eventually flee the system, if they’re local, or push their own representatives to stop the bleeding, if they’re in other states being soaked by the feds.

Rhode Island should take the opportunity of the Trump Administration to get off this track.  The chasm toward which it leads has no bridge.

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If It’s “Unpaid Care,” It Cuts into the Government Plantation’s Market

It seems a point of personal pique for him, but Wesley Smith makes a great point when he objects to the characterization of families’ taking care of their own special needs children as “unpaid care”:

Really? What about mothers providing “unpaid care” for their babies? Or spouses for each other? Should such care also be measured in terms of the cost of having services provided by professional caregivers?

As Smith goes on to insist (emphasis in original), “the societal expectation should also be that families are the first line of care-giving.”  The first line of care-giving.  The first line of financial assistance.  The first line of loan guarantees.  The first line for education.  The first line, period.

The problem is that such activities cut in on the government plantation’s market.  Governments can’t tax other people to provide the services.  Labor unions can’t take a cut (although they do try).  And politicians can’t count on votes from people who aren’t dependent on government.

The deeper affront of the “unpaid care” attitude is how it teaches us to see caring for those we love.  The insinuation can be that families would (and maybe should) offload care if they can afford to do so, just as a homeowner may patch a wall to save the cost of a tradesman.  As a new state senator from Lincoln touchingly exemplifies, caring for loved ones can be a joyful fulfillment, and society should encourage us to see it as such.

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The Political Realities of “Fixing” ObamaCare

Megan McArdle is well worth a read on why Congressional Democrats designed ObamaCare in the flawed way they did and what the consequent political reality means for Republicans’ likely steps for repeal-and-replace.  Both those who would prefer to save the law and those who would prefer to trample it to dust should consider the political reality.

Option One:

For Republicans to fix the system as it stands, they would have to jack up the parts people hate — not to deliver new benefits, but mostly just to keep the existing system from flaming into a tailspin. Only the price tag would now be much higher, for boring technical reasons I’ll leave in a footnote.

Option Two:

Yet repeal and replace now seems almost as unlikely, because it means taking something away from voters — stuff that polls really well, such as, er, prohibiting insurers from looking at pre-existing conditions.

Option Three:

Of course, the last option — doing nothing while the individual market flames into a tailspin — doesn’t look all that hot, either.

McArdle states that she’d probably go with a variation of the third:

I’d announce a blue-ribbon commission designed to study the matter and propose a comprehensive alternative. I’d give it plenty of time to study and make recommendations. Then I’d wait and see if 2017 brings more premium hikes and insurers pulling out of smaller counties — disasters that could then be blamed on Obama…

The key point, here, is that we’re in this situation — with our healthcare system, economically, and politically — because President Obama and his fellow partisans who controlled both chambers of Congress felt they had to, and had the power to, push through something big (as the vice president put in vulgar terms at the time).  But the American people didn’t want what the Democrats were pushing, so a party-line Congress created a system destined to fail and hoped its failure would teach Americans to want the socialized medicine that the party wanted to provide.

November made that possibility so unlikely that McArdle doesn’t even mention it.

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Government as Majority Customer, Making Healthcare Worse

So when do problems in healthcare stop being the fault of the proverbial greedy insurance companies and start being an indication that the system is too socialized already?  Maybe when it’s more than 50% reliant on government?  Consider this from a Ted Nesi report on WPRI.com:

Care New England also said more than half its gross revenue from patient services came from the two major government health programs in 2015-16, with Medicare accounting for 32% and Medicaid accounting for 28%. The share from Blue Cross was roughly steady at 20%.

At this point, Care New England is essentially what I’ve been calling a “government satellite.”  Given heavy regulations, it’s essentially a quasi-public agency that has some independent revenue.

Keep this in mind, too, the next time you hear about how government is going to hold reimbursement prices down for Medicare and Medicaid.  If you ran a business and your biggest — indeed, majority — customer (which also happened to have regulatory power over you) dictated prices for the services you provided to it, your only option would be to reduce services to other clients or find ways to soak those clients for more.

This is just one way in which government involvement in the healthcare industry is making things worse.

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Science and News and a Sexism Double Standard

I think we can safely say that if the findings of this study were reversed, it wouldn’t be making news, much less getting the very-top-of-the-front-page treatment from the Providence Journal:

A big study of older patients hospitalized for common illnesses raises that provocative possibility — and also lots of questions. Patients who got most of their care from women doctors were more likely to leave the hospital alive than those treated by men.

If reversed results were reported, the story would be the flaws in the methodology.  As it is, the results are printed to make them seem more significant.  Saying that 11.5% of elderly patients die when treated by men, versus 11.0% treated by women, seems like a bigger deal than saying that 88.5% survive with men and 89.0% with women.  In the first case, 4.5% more patients die with male doctors; in the second, merely 0.6% more survive with women.

That small difference could be sheer coincidence or methodological flaws, and no news reporter is going to dig through the research to double-check whether every relevant factor (e.g., the average ages or specialties of the doctors) is adequately adjusted.  Similarly, what does it mean to get “most” of your care from women?

One might even file this story as “fake news,” and going forward, we shouldn’t expect that if the results from a future iteration of this report are different the public record will be corrected with the same visibly.  Actually, one might predict that the stories printed at that time will insinuate sexist recidivism, as if it’s a “setback for women.”

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ObamaCare Repeal Plan Exposes Government Plantation

Even if he fails in office, President-elect Donald Trump — merely by promising to behave as if it’s possible for the people to push back against the government-expansionist march — will do much to expose the workings of the government plantation.  Consider comments from Democrat Governor Gina Raimondo in an article by Lynn Arditi of the Providence Journal:

Gov. Gina Raimondo said Tuesday during a meeting at The Providence Journal that she “loses sleep” over the prospect of a hasty unrolling of the Affordable Care Act and its Medicaid payment system. “It could be devastating for us,” she said.

Such a change would mostly be “devastating” if it portends a new pattern in which the federal government stops paying state governments to provide services. That is increasingly the business model of Rhode Island’s true major industry, government.

The Beast needs customers for its services, and it needs a mechanism to make other people pay the bill.  The federal government is critical in that transaction because it’s able to take money in so many ways and without people’s having a clear view of what it’s paying for or a straightforward way to decline the bill year after year.

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Monthly Tracking Will Be Welfare Boom

Pay attention to this tidbit from a Providence Journal article by Alisha Pina:

The majority, said Cindy Machado, chief human service policy and system specialist, were here because they want to know why their benefits were cut. Of the 97,000 receiving food assistance, 3,000 have been deemed ineligible or didn’t give the required paperwork in time to keep getting help.

Another 500 people on Thursday had their state health insurance cut for similar reasons. UHIP has a program that allows the state to check monthly if residents are still eligible for the insurance. Notices were sent to those in question, and time was given before benefits were ended. Officials had hoped that the program would save about $16 million this fiscal year, but delaying the launch by two months decreased the projected savings by $2.4 million.

Right now, it sounds like a money saver that 3,500 welfare beneficiaries were found to be ineligible, but we’re on an economic upswing, and all of the state’s welfare programs aren’t fully integrated, yet.  When the upswing stops and, more importantly, when all government programs are linked for this month-to-month assessment, UHIP will become a way to maximize payments, not minimize them.

Through a creepily invasive “program” that keeps a monthly profile of all Rhode Island residents — at least those below some income threshold that we might call the “dependence line” — the plan is for the government to actively sign up new “clients” as they become eligible, sucking a maximum number of people into the system.  Again, we’re all either potential produce or tax-money laborers for the government plantation.

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What a Democrat Governor Can Do to Medicaid

Ted Nesi has changed his Saturday quick-hit column back to “Nesi’s Notes.” I wonder if one of the items on his list in today’s edition was the inspiration.  Writing of Democrat Governor Gina Raimondo’s proclaimed savings from Medicaid initiatives:

The governor’s office frequently touts roughly $70 million in state-level savings from her Medicaid initiatives in 2015-16. But most of that money didn’t come from changing how care is provided; $19 million was from lower payment rates to hospitals and nursing homes, $13 million was from higher taxes on hospitals, $9 million was from cuts to managed care, $7 million was from maximizing federal funding, and so on. There were plenty of other 2015-16 initiatives, some of which achieved their promised savings and some of which didn’t, but that’s where the big money was saved.

As I noted last February, Raimondo’s “Reinventing Medicaid” seems to have a clear news-coverage advantage over the reforms championed by Republican Governor Don Carcieri (with help from the Bush administration), to which it bears a marked similarity.  The main difference was on emphasis, with the Republican looking for accountability from consumers while the Democrat has turned more to increasing revenue and shifting costs to private insurance, where the government is less likely to take any heat.

Or maybe the difference in how the program is treated isn’t so much a partisan thing as simply a better name…

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Raimondo Admin’s Dodgy Non-Response to ProJo’s APRA Request

So as you probably know, Rhode Island’s new computer system (UHIP) for qualifying applicants and disbursing social program benefits is a mess. The problems have been well publicized to the point of infamy: a backlog of applications; benefit payments delayed; nursing homes (who have no easy way to stop their expenses) wracking up serious amounts of uncompensated care; even a security “glitch” that could have exposed the personal information of 200-1,000 customers.

It has gotten to the point that the feds were compelled to step in again – this time, breathing fire.

The agency continued to warn that the DHS could soon lose federal funding for administrative costs because of the system’s “failure to meet FNS statutory and regulatory requirements.”

And a Rhode Island House committee held its second hearing into the matter on Monday.

The question is, who is responsible for all of this? Was this a failure by the vendor setting up the new system, Deloitte Consulting? Or did the Raimondo administration force a transition to the new system from the old too quickly? (This, in fact, was a blunt warning by the feds to the Raimondo administration in early September.) If so, why?

In order to shed some light on the matter, the Providence Journal’s ace reporter Kathy Gregg sent the Raimondo administration an APRA request on September 7 for

all correspondence between the state and the company that designed it: Deloitte Consulting.

We pause here to go back, review and note that the subject of Gregg’s request was “correspondence”.

Gregg reports in yesterday’s Providence Journal that six weeks later – on the night before Thanksgiving, to be precise – the Raimondo administration gave her a thumb drive that purported to respond to the request. It contained only reports from Deloitte – and those only through September 6. Critically, the thumb drive contained no correspondence whatsoever between the Raimondo administration and Deloitte.

To reiterate: Gregg asked for correspondence. What she got was reports. (In the same way, Gregg might ask a Raimondo-operated fruit stand for a bag of oranges and receive, instead, a small bag of turnips.)

This non-responsive response by the Raimondo administration would appear to conform to neither the letter nor the spirit of Rhode Island’s APRA law. Nor is it the action of a Governor who, in an interview with Rhode Island Public Radio thirteen months ago, claimed to be “deeply committed to transparency”.

I asked the CEO of the Rhode Island Center for Freedom and Prosperity (full disclosure: I work with the Center), Mike Stenhouse, if he had a reaction to this. He responded,

A curious, honest, and relentless free-press is vital to preserving democracy in our free society and in holding elected officials accountable to the people. In this case, the administration’s pitiful non-response certainly makes it appear as if they have something to hide.

When a reporter like Kathy Gregg asks questions, she isn’t just asking for herself and her newspaper, she makes the request on behalf of all Rhode Islanders. Something went wrong with the launch of a major new state computer system – a system, remember, that has come in at over triple the originally budgeted cost. We are all minimally owed answers about the why and how of all of this. It is time to move from the dodgy non-responses to the straight answers and transparency to which the Governor herself has indicated that she is “deeply committed”.

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HealthSource and Defrauding of Taxpayers

Ted Nesi reports that HealthSource RI — the state’s ObamaCare health benefits exchange — wouldn’t accept two lower-cost plans from Neighborhood Health.  Even on its surface the decision is an outrageous scam:

A Kaiser Family Foundation analysis, which originally included the two Neighborhood plans rejected by HealthSource, suggested they would have lowered the average premium for HealthSource’s second-cheapest mid-tier plan by 14% in 2017. Instead that number will only decrease by 0.5%, according to HealthSource.

But HealthSource officials said their decision was driven by the federal formula for premium subsidies, which are provided to about 90% of the Rhode Islanders who buy insurance through the marketplace.

In other words, Rhode Island officials didn’t want prices to go down too much because they want to force federal taxpayers (ultimately through debt) to pay $17 million more for Rhode Islanders’ health care than they ought to.  The openness with which “HealthSource officials” admit this shows they believe Rhode Islanders are happy to have their government stealing on their behalf, but some of us aren’t so immoral.  As a side benefit to local government agents, the after-tax cost of the exchange’s average health plan would have gone up 42% if they didn’t rig the market, making the exchange look even worse in the public eye.

And that’s not all.  Earlier this month, we learned that Neighborhood initially set its prices too high because its inexperience in the market left the organization no good basis by which to set prices.  So, they ended up refunding $2 million to members, probably with much of it simply a transfer of money taken from taxpayers as subsidies.

In summary, Neighborhood Health, which was arguably more like a quasi-public welfare agency before ObamaCare, overcharged its customers from the start, which forced us all to pay more in subsidies in our capacity as United States citizens.  It then refunded a chunk of the excess to its members, none to taxpayers.

Now, state government officials have refused to allow Neighborhood to charge less for plans in order to steal more money from taxpayers.  This action may very well result in another big transfer of wealth to Neighborhood members through another refund next year.

And on it will go.  If a private organization behaved like this, politicians and pundits would be declaring it scandalous.

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