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Washington Update: What’s Really Going on in Washington Wisconsin AAHAM May 9, 2014.

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Presentation on theme: "Washington Update: What’s Really Going on in Washington Wisconsin AAHAM May 9, 2014."— Presentation transcript:

1 Washington Update: What’s Really Going on in Washington Wisconsin AAHAM May 9, 2014

2 How Government Really Works Throw out all preconceived notions you have about government and how it is “supposed” to work. In reality, it works nothing like what you learned in school or read about in books. Not so sure it works anymore

3 What A Ride! Maybe this is the new norm

4 What Congress Has Been Up To


6 What Congress Has Been Up To

7 913 178 Can anyone tell me what these numbers represent?

8 913 Days Until the 2016 Presidential Elections 178 Days Until the 2014 Congressional Elections

9 2016 Here We Come!!!! Rep. Paul Ryan Gov. Scott Walker Sen. Marco Rubio Jeb Bush Gov. Chris Christie Sen. Rand Paul Rick SantorumGov. Rick PerrySen. Ted Cruz Gov. Susana Martinez Scott Brown

10 Bridge Gate Governor Christie went from top tier 2016 Presidential candidate to struggling to stay afloat these days. When it goes wrong it goes wrong and may be hard to recover from.

11 Tornado Ted Cruz Tornado Ted’s brand has put Republicans in a very tough spot and has forced business community to now disavow those they helped get elected in 2010 His government shutdown sideshow has made him stronger within the Tea Party, but has made him an outcast among most of his other colleagues.

12 Tornado Ted

13 You said you wanted a third party. Democratic Party Republican Party Tea Party

14 * Started in 2010 and really caught on * Won large number of seats in 2010 elections * Failed to nominate Tea Party candidate for WH in 2012 * Other than Sen. Cruz they have really not faired well on national stage (losses in DE and NV in 2010, losses in MO and IN in 2012) * Big blows to Tea Party from fallout over government shutdown State of the Tea Party

15 * King of the Tea Party loses race for Governor in VA * Biggest sign of change for me was the special election in Alabama * Alabama businessman Bradley Byrne defeated Tea Party candidate Dean Young in Republican primary * Business community now disavowing Tea Party candidates State of the Tea Party

16 If you are a Democrat here is your choice in 2016

17 Others who want to run and still may even with Clinton running VP ”Smokin” Joe Biden Gov. Martin O’Malley Sen. Elizabeth Warren Gov. John Hickenlooper

18 Before we get to 2016 we need to get through 2013 President really has to be asking himself “Can I catch a break here!” *Another game of chicken with shutting government down *Increased debt limit * Republican(s) efforts to defund ACA * President has to put off key pieces of ACA/Rollout of ACA/Website/You can keep your insurance * Syria * Finally got a spine and stood up to Republicans * IRS Scandal * Benghazi * Have people asking the question:

19 Miss Me Yet?

20 How About Me

21 Probably Not Me (But I may not go down as worst President ever)

22 Or Me

23 Before we get to 2016 we need to get through 2013 Republicans have to asking what are we doing!” * Party may be learning lessons from 2012 (Debt ceiling vote beginning) *Becoming more polarizing (reverse effect – far right getting primaried by moderates – MI is perfect example) *Republican leadership in tough spot *Having the 2010 crop of Freshman not so energizing now for party’s future * Becoming the Democrats of the 1990’s * Like you today hate you tomorrow mentality (Sen. Marco Rubio) * Gay marriage and race issues * Fight to defund ACA – even most Republicans see as a losing issue * Shutting government down * Syria * 2014 debt ceiling

24 2014 elections critical to Republican’s future 2014: Senate Democrats have to defend 25 seats Senate Republicans have to defend 16 Redistricting in the House makes taking control difficult for Democrats – Really only 17 seats that one would consider truly competitive.

25 Why Republicans Can’t Win Key Elections Republican U.S. Senate candidate Rep. Todd Akin (R-MO), who stated that pregnancy rarely occurs as a result of what he called "legitimate rape.“ Republican Senate candidate Richard Murdock (R-IN), who said that life was "something that God intended", even if the pregnancy was due to rape. Rep. Steve King (R-IA) - For every one who's a valedictorian, there's another 100 out there who weigh 130 pounds -- and they've got calves the size of cantaloupes because they've been hauling 75 pounds of marijuana across the desert. Mitt Romney - “There are 47 percent of the people who will vote for the president no matter what. All right, there are 47 percent who are with him, who are dependent upon government, who believe that they are victims, who believe that government has a responsibility to care for them, who believe that they are entitled to health care, to food, to housing, to you name it… And they will vote for this president no matter what…

26 “Super Republicans” Rise Within GOP’s Ranks House Republicans by Partisan Voter Index (PVI)*, 1995-1996 and 2013-2014 (236 Members) (231 Members) The percentage of House GOP Members with a PVI score of R+5 or greater jumped from 56% to 78% As a result of redistricting and a huge sorting-out of voters and seats, the share of House “Super Republicans”— Republicans from districts with a PVI score of R+5 or higher—has grown nearly fourfold since ‘95/’96 The “Super Republican” majority means that House Republicans today are likelier to play to a primary audience than be bullied into submission by Democrats

27 Redistricting Whitewashes Republican Districts Non-Hispanic White Share of the Average House District White share of district, pre-redistricting (2010) White share of district, post-redistricting (2012) * * Non-Hispanic White Share of Select GOP Districts Analysis After 2010 redistricting, the white share of the average GOP House district increased by 2 percentage points, while the white share of the average Democratic district decreased by 1 percentage point In Tea Party and other Republican districts across the country the increase in the share of white voters was sharper, often completely altering the demographics in the district such that they bore no resemblance to national demographics The higher share of white voters gives many Republicans a competitive advantage; for example Rep. Farenthold won his 2010 election by fewer than 100 votes, but after redistricting the white share of the district increased by 21% and he won handily

28 Democrats Have Their Own Challenges President Obama Approval Rating Hoverin in the mid 40% range 33% of voters vote in November will be to oppose President (his agenda) 56% of voters oppose ACA Democrats lose key special election in FL Lobbyist David Jolly defeated Alex Sink True Swing District Sink strong Democratic candidate Jolly was not top choice of Republican party – poor candidate, poorly run campaign and ran around the district with his 26-year old girlfriend Big problem for national Democrats worried about November




32 1-800-318-2596 (F1UCKYO) Cruel Joke by someone

33 California Exchange “Welcome to America’s hottest talk line. Ladies, to talk to interesting and exciting guys free, press one now. Guys, hot ladies are waiting to talk to you. Press two to connect free now.” What deaf Obamacare customers were greeted with after being mistakenly directed to a sex chat number instead of insurance line

34 Mo Money Mo Money Please President’s FY’15 budget requests more money for the implementation of the ACA WH needs $630 million more to operate the exchanges ACA law did not provide funding for federally run exchanges

35 . Website “Glitches”

36 Roughly 22,000 people who have signed-up for the ACA have filed appeals with the government trying to get mistakes corrected. Problem is the website not equipped to handle appeals so these 22,000 appeals are sitting there untouched. This could be a real problem when people need to use the insurance and find they may not have the coverage they thought or tried to get. 2 Companies in MN paid their premiums for all their employees and federal government cashed the check, but now has told them they do not have coverage. Class-action lawsuits are next.

37 An then… that line you wish you could take back President Obama: You can keep your healthcare

38 * This statement has the President floundering and Democrats a very bit concerned – especially Senate Democrats up for re-election. * The unified Democratic base shown during government shutdown showing cracks over this issue. Loss in FL special will cause more cracks leading up to November. * Members on both sides of the aisle introduce legislation allowing people to keep their insurance as promised. 39 Democrats vote with R’s to allow you to keep healthcare – go against President. * President had to come out on tv and admit the failures and has his own plan to allow people to keep their plan – pure political move to protect Democrats up for re-election – state not sure if they can do this. * Presidents poll numbers hover around mid-40% range * Rasmussen poll claims over 50% of Americans want ACA repealed. * President say’s he didn’t have any idea these problems existed prior to rollout. * Former President Bill Clinton throws President Obama under the bus.

39 YOU’RE FIRED! (Technically she resigned) Had to be done – she was becoming a bigger liability and would be the poster child for failure closer to 2014 mid term elections. Sylvia Burwell new HHS Secretary appointee. Comes over from OMB. Limited health experience, but strong manager.

40 Real Marketing of ACA


42 Calling All Young People! The ACA really only works if: 1) the young people sign up and they are not; and If the young people don’t sign up, you could see this program blow up due to costs exploding next year. 33% - 55-64 age group 22% - 45-54 age group 15% - 35-44 age group 15% - 26-34 age group 6% Under 18 age group 2) People actually pay their premium – signs-up do not equal paid.

43 Calling All Young People! Gender Breakdown for enrollment: 46% Males 54% Females 21% of ALL enrollments do not qualify for subsidy 79% of all enrollments eligible for subsidy (Ehealth Data shows big premium spikes for individuals not eligible for subsidies) * HHS.Gov data

44 States Role WH may get kinks in website all worked out, but one of the keys to long-term success is how the states handle the ACA rollout and enrollment. Rollout in states will or could become political tool and its success could depend on how those political forces are able to do damage to the ACA in those particular states. This battle is far from over.

45 Uninsured Main thrust of the ACA was to get uninsured people insurance According to governments own data only 1 in 10 uninsured people are enrolled in the exchange Reasons being state is they don’t believe they can afford the plans McKinsey Survey 2014

46 Unions Unions were the biggest advocates for the ACA Switched their tune late in the game once they realized their plans (Cadillac plans) would be taxed by the ACA Unions have now become one of the most outspoken critics of the ACA Unions have been pressing the White House for an exemption, which he has resisted up until this point

47 Do members of Congress have to use the exchanges?

48 President comes out and agrees to continue paying 75% monthly premium for MOC and their staffs. This has been a much debated topic and we finally have the answer: Yes, but with a twist. MOC and their staff have 75% of their monthly healthcare costs paid for. ACA would have eliminated that benefit. Earlier this summer MOC were complaining on the impacts such a move would have on their ability to earn a living. MOC and staff are required to purchase insurance through the exchange. Senator David Vitter (R-LA) and Sen. Mike Enzi (R-WY) trying to strip this provision.

49 Employer Mandate * For a second time the President announced another delay in the employer mandate. * Very large employers are required to offer health care coverage to their full-time employees or pay a penalty to the federal government beginning January 1, 2015. * Under the final regulations released by the U.S. Department of Treasury (Treasury Department) on February 10, 2014, however, employers with fewer than 100 full- time employees will have an extra year to plan for and implement the employer mandate (2016). * Former Obama advisor Robert Gibbs recently said on Meet the Press he doesn’t believe employer mandate will ever kick in.

50 Medicaid Expansion of Medicaid meant that roughly 6.3 million people would be able to sign up for coverage. Between 1-2 million have signed-up. The problem with the new Medicaid expansion means that it will create new headaches for states, health plans, and patients Because the income of these individuals will fluctuate meaning they will find themselves in and out of the Medicaid expansion efforts. This would mean some would find themselves with gaps I their coverage due to the income fluctuation. Income bumps could leave these people without insurance because they cannot afford in private market.

51 40-Hour Work Week Under ACA the work week is defined as anyone working 30 hours per week. Has caused businesses to drop hours for employees. New legislation pending in Congress changing the definition of work week back to 40 hours per week. I’d see this as an election year move by Republicans. Is getting some traction with Democrats. Rep. Lipinski is (D-IL) first Democrat to co-sponsor

52 Full-Time Employee Careveouts Fewer and fewer employees fit into the neat definition of full-time employees. Poses real challenges for the IRS. IRS say’s it needs carveouts and exemptions to various industries to make this law work effectively. In the category of carveouts include: Flight Attendants and Pilots; Cruise Ship Workers (because they do work outside the US on these ships would this affect their employers requirement to offer healthcare?) Adjunct Faculty On-Call Employees Temp Firm Employees (some work full-time)

53 Third Party Payments of Marketplace Health Plan Premiums Interim Final Rule sitting over at OMB Just days after the federal Department of Health and Human Services (“DHHS”) issued a letter which seemed to sanction third-party premium subsidies for patients who purchase insurance through a health care exchange under the Affordable Care Act (“ACA”), DHHS released new guidance cautioning against that practice. As a result, any hospital or health care provider that seeks to provide premium assistance to patients who purchase insurance through an exchange risks investigation or sanction by the federal government. The government’s position may also mean that issuers of such plans will not accept premium payments from third parties (other than the government).

54 Paul A. Miller (703) 383-1330 – office (703) 930-7790 – cell phone @mwcapitol – Twitter @mwceo – Twitter

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