Sunday, August 31, 2014
When Congress passed the Affordable Care Act, it required health insurers, hospitals, device makers and pharmaceutical companies to share in the cost because they would get a windfall of new, paying customers.
But with an $8 billion tax on insurers due Sept. 30 — the first time the new tax is being collected — the industry is getting help from an unlikely source: taxpayers.
States and the federal government will spend at least $700 million this year to pay the tax for their Medicaid health plans. The three dozen states that use Medicaid managed-care plans will give those insurers more money to cover the new expense. Many of those states — such as Florida, Louisiana and Tennessee — did not expand Medicaid as the law allows, and in the process turned down billions in new federal dollars.
Other insurers are getting some help paying the tax as well. Private insurers are passing the tax onto policyholders in the form of higher premiums. Medicare health plans are getting the tax covered by the federal government via higher reimbursement.
State Medicaid agencies say they have little choice but to pay the tax for health plans they hire to insure their poorest residents. That's because the tax is part of the health plans' costs of doing business. Federal law requires states to pay the companies adequate rates.
"This situation results in the federal government taxing itself and taxing state governments to fund the higher Medicaid managed care payments required to fund the ACA health insurer fee," said a report by Medicaid Health Plans of America, a trade group.
Meanwhile, many Medicaid managed-care companies have seen their share prices — and profits — soar this year as they gained thousands of new customers through the health law in states that expanded Medicaid. More than half of the 66 million people on Medicaid are enrolled in managed-care plans.
STEEP COSTS FOR STATES
A KHN survey of some large state Medicaid programs found the tax will be costly this year. The estimates are based in part on the number of Medicaid health plan enrollees in each state and how much they are paid in premiums. States split the cost of Medicaid with the federal government, with the federal government paying, on average, about 57%.
• Florida anticipates the tax will cost $100 million, with the state picking up $40 million and the federal government, $60 million.
• Texas estimates the tax at $220 million, with the state paying $90 million and the federal government, $130 million.
• Tennessee anticipates it will owe $160 million, with the state paying $50 million and the federal government, $110 million.
• California budgeted $88 million, with the state paying $40 million and the federal government, $48 million.
• Georgia estimates the tax on its plans at $90 million, with the state paying $29 million and the federal government, $61 million.
• Pennsylvania predicts the tax will cost $139 million, with the state paying $64 million and the federal government, $75 million.
• Louisiana estimates the tax will cost $27 million, with the state paying $10 million and the federal government, $17 million.
Texas is believed to be the only state that has not yet agreed to cover the tax for its health plans, according to state Medicaid and health plan officials. "The premium tax is just another way that the costs of the Affordable Care Act are pushed down to states and families," said Stephanie Goodman, spokeswoman for the Texas Medicaid program.
Medicaid officials in other states complain that paying the tax reduces money they could have spent on covering more services or paying providers.
"I do not feel I am getting anything in return for this," said Tennessee Medicaid Director Darin Gordon.
Officials won't know exactly how much states owe until the Internal Revenue Service sends bills to insurers at the end of August and the Medicaid plans submit those to states.
The health insurer tax is estimated to bring in at least $100 billion over the next decade from all insurers, government auditors estimate.
Most non-profit Medicaid health plans are exempt from the tax, which the trade group says gives the non-profits a competitive edge vying for state contracts. "We consider this tax so badly construed that it should be reconsidered because it makes no public policy sense," said Jeff Myers, CEO of Medicaid Health Plans of America.
The trade group, which represents both non-profit and for-profit Medicaid plans, also opposes the tax because it takes money from Medicaid programs that could be used to pay plans to improve care, he said.
The Centers for Medicare & Medicaid Services declined to comment on how states and the federal government are covering part of the tax.
Timothy Jost, a consumer advocate and law professor at Washington & Lee University in Virginia, said the lawmakers intended to cover the costs of the law by including as many groups paying in as possible.
While it may be unusual for the federal government to essentially tax itself, Jost said, the situation is no different from the federal government paying a contractor to provide a service, then having that contractor use some of those dollars to pay state sales tax or federal income tax.
"This tax should not have surprised anyone, and it should have been worked into contract prices," he said.
Paul Van de Water, senior fellow with the left-leaning Center for Budget and Policy Priorities, said neither health plans nor states should be complaining about the taxes because both are benefiting from the law.
"States are benefiting from the Affordable Care Act because with more people getting insured, it is driving down their uncompensated care costs," he said. He noted that is true even in states that did not expand Medicaid under the health law.
"People always like to get a benefit and not have to pay for it," he said. "If we did not have this tax, we would have had to raise the money somewhere else."
Kaiser Health News is an editorially independent program of the Kaiser Family Foundation
Myth of arctic meltdown: Stunning satellite images show summer ice cap is thicker and covers 1.7million square kilometres MORE than 2 years ago...despite Al Gore's prediction it would be ICE-FREE by now
- Seven years after former US Vice-President Al Gore's warning, Arctic ice cap has expanded for second year in row
- An area twice the size of Alaska - America's biggest state - was open water two years ago and is now covered in ice
- These satellite images taken from University of Illinois's Cryosphere project show ice has become more concentrated
The speech by former US Vice-President Al Gore was apocalyptic. ‘The North Polar ice cap is falling off a cliff,’ he said. ‘It could be completely gone in summer in as little as seven years. Seven years from now.’
Those comments came in 2007 as Mr Gore accepted the Nobel Peace Prize for his campaigning on climate change.
But seven years after his warning, The Mail on Sunday can reveal that, far from vanishing, the Arctic ice cap has expanded for the second year in succession – with a surge, depending on how you measure it, of between 43 and 63 per cent since 2012.
Scroll down for video
To put it another way, an area the size of Alaska, America’s biggest state, was open water two years ago, but is again now covered by ice.
The most widely used measurements of Arctic ice extent are the daily satellite readings issued by the US National Snow and Ice Data Center, which is co-funded by Nasa. These reveal that – while the long-term trend still shows a decline – last Monday, August 25, the area of the Arctic Ocean with at least 15 per cent ice cover was 5.62 million square kilometres.
This was the highest level recorded on that date since 2006 (see graph, right), and represents an increase of 1.71 million square kilometres over the past two years – an impressive 43 per cent.
Other figures from the Danish Meteorological Institute suggest that the growth has been even more dramatic. Using a different measure, the area with at least 30 per cent ice cover, these reveal a 63 per cent rise – from 2.7 million to 4.4 million square kilometres.
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The satellite images published here are taken from a further authoritative source, the University of Illinois’s Cryosphere project.
They show that as well as becoming more extensive, the ice has grown more concentrated, with the purple areas – denoting regions where the ice pack is most dense – increasing markedly.
Crucially, the ice is also thicker, and therefore more resilient to future melting. Professor Andrew Shepherd, of Leeds University, an expert in climate satellite monitoring, said yesterday: ‘It is clear from the measurements we have collected that the Arctic sea ice has experienced a significant recovery in thickness over the past year.
‘It seems that an unusually cool summer in 2013 allowed more ice to survive through to last winter. This means that the Arctic sea ice pack is thicker and stronger than usual, and this should be taken into account when making predictions of its future extent.’
The speech by former US Vice-President Al Gore (above) was apocalyptic. He said that the North Polar ice cap is falling off a cliff and could be gone in seven years
Yet for years, many have been claiming that the Arctic is in an ‘irrevocable death spiral’, with imminent ice-free summers bound to trigger further disasters. These include gigantic releases of methane into the atmosphere from frozen Arctic deposits, and accelerated global warming caused by the fact that heat from the sun will no longer be reflected back by the ice into space.
Judith Curry, professor of earth and atmospheric sciences at Georgia Institute of Technology in Atlanta, said last night: ‘The Arctic sea ice spiral of death seems to have reversed.’
Those who just a few years ago were warning of ice-free summers by 2014 included US Secretary of State John Kerry, who made the same bogus prediction in 2009, while Mr Gore has repeated it numerous times – notably in a speech to world leaders at the UN climate conference in Copenhagen in 2009, in an effort to persuade them to agree a new emissions treaty.
Mr Gore – whose office yesterday failed to respond to a request for comment – insisted then: ‘There is a 75 per cent chance that the entire polar ice cap during some of the summer months could be completely ice-free within five to seven years.’
Misleading as such forecasts are, some people continue to make them. Only last month, while giving evidence to a House of Lords Select Committee inquiry on the Arctic, Cambridge University’s Professor Peter Wadhams claimed that although the Arctic is not ice-free this year, it will be by September 2015.
Asked about this yesterday, he said: ‘I still think that it is very likely that by mid-September 2015, the ice area will be less than one million square kilometres – the official designation of ice-free, implying only a fringe of floes around the coastlines. That is where the trend is taking us.’
For that prediction to come true it would require by far the fastest loss of ice in history. It would also fly in the face of a report last year by the UN Intergovernmental Panel on Climate Change (IPCC), which stated with ‘medium confidence’ that ice levels would ‘likely’ fall below one million square kilometres by 2050.
Politicians such as Al Gore have often insisted that climate science is ‘settled’ and have accused those who question their forecasts of being climate change ‘deniers’.
However, while few scientists doubt that carbon-dioxide emissions cause global warming, and that this has caused Arctic ice to decline, there remains much uncertainty about the speed of melting and how much of it is due to human activity. But outside the scientific community, the more pessimistic views have attracted most attention. For example, Prof Wadhams’s forecasts have been cited widely by newspapers and the BBC. But many reject them.
An area twice the size of Alaska was open water two years ago and is now covered in ice after the arctic ice cap has expanded for the second year in a row
Yesterday Dr Ed Hawkins, who leads an Arctic ice research team at Reading University, said: ‘Peter Wadhams’s views are quite extreme compared to the views of many other climate scientists, and also compared to what the IPCC report says.’
Dr Hawkins warned against reading too much into ice increase over the past two years on the grounds that 2012 was an ‘extreme low’, triggered by freak weather.
‘I’m uncomfortable with the idea of people saying the ice has bounced back,’ he said.
However, Dr Hawkins added that the decline seen in recent years was not caused only by global warming. It was, he said, intensified by ‘natural variability’ – shifts in factors such as the temperature of the oceans. This, he said, has happened before, such as in the 1920s and 1930s, when ‘there was likely some sea ice retreat’.
Dr Hawkins said: ‘There is undoubtedly some natural variability on top of the long-term downwards trend caused by the overall warming. This variability has probably contributed somewhat to the post-2000 steep declining trend, although the human-caused component still dominates.’
Like many scientists, Dr Hawkins said these natural processes may be cyclical. If and when they go into reverse, they will cool, not warm, the Arctic, in which case, he said, ‘a decade with no declining trend’ in ice cover would be ‘entirely plausible’.
Peer-reviewed research suggests that at least until 2005, natural variability was responsible for half the ice decline. But exactly how big its influence is remains an open question – and as both Dr Hawkins and Prof Curry agreed, establishing this is critical to making predictions about the Arctic’s future.
Prof Curry said: ‘I suspect that the portion of the decline in the sea ice attributable to natural variability could be even larger than half.
‘I think the natural variability component of Arctic sea ice extent is in the process of bottoming out, with a reversal to start within the next decade. And when it does, the reversal period could last for several decades.’
This led her to believe that the IPCC forecast, like Al Gore’s, was too pessimistic.
‘Ice-free in 2050 is a possible scenario, but I don’t think it is a likely scenario,’ she concluded.
GOOD NEWS FOR POLAR BEARS...
Saturday, August 30, 2014
- Scientists have finally solved the mystery of how rocks can move across the flat ground of a dry lake bed in Death Valley, California
Visitors have long been puzzled by the sight of boulder tracks criss-crossing a dusty bowl known as the Racetrack Playa in Death Valley National Park. But two researchers now say the rocks - which can sometimes be heavy and large - are propelled along by thin, clear sheets of ice on breezy, sunny days. They call it "ice shove". "I'm amazed by the irony of it all," paleobiologist James Norris tells the LA Times. "In a place where rainfall averages two inches a year, rocks are being shoved around by mechanisms typically seen in arctic climes."
The findings are based on a lucky accident by James Norris and his cousin Richard Norris - while they were studying the sliding rock phenomenon. They actually witnessed the boulders moving in December when they went to check their time-lapse cameras in the valley. "There was a pop-pop-crackle all over the place in front of us and I said to my cousin, 'This is it'," Richard Norris says in the science journal Nature. They watched some 60 rocks sail slowly by, leaving the well-known snaking trails in the ground. "A baby can get going a lot faster than your average rock," Norris notes. The rocks also don't slide around very often - scientists estimate only a few minutes out of a million - which is why the event has not been noticed before.
Continue reading the main story
Philippine peacekeepers trapped by rebels in the Syrian Golan Heights are "under attack", Philippine Defence Minister Voltaire Gazmin says.
He said the assault had started early on Saturday, but gave no details on any casualties.
In recent days the Syrian rebels have taken 44 Fijian peacekeepers hostage in the area and surrounded 75 Filipinos manning two separate UN posts.
The rebels have also seized a crossing point into the Israeli-occupied Golan.
They are believed to include members of the al-Nusra Front, al-Qaeda's affiliate in Syria.
Mr Guzman told reporters that 40 Philippine soldiers trapped at one post had come under attack on Saturday.
Thirty-five others based at the other camp have been "extricated", he said.Worsening security
The Fijian members of the UN Disengagement Observer Force (Undof) were detained on Wednesday near Quneitra, during fighting between rebels and government forces.
Last week the Philippine government said it would bring home its 331 peacekeeping forces from the Golan Heights in October, amid deteriorating security there.
Israel seized most of the Golan Heights, a strategic plateau in south-western Syria, during the 1967 Six-Day War.
The two countries signed an armistice in 1974, after which Undof was put in place to monitor the demilitarised zone.
It has 1,224 lightly-armed military personnel from Fiji, India, Ireland, Nepal, the Netherlands and the Philippines.