Sunday, March 11, 2018
Medicare drug benefit is weakened by congressional budget deal
Congress has undermined the Medicare drug benefit
that millions of older Americans depend on – one of the few federal
health-care programs that's working well.
The two-year federal budget deal
passed recently shifts more of the program's costs onto drug
manufacturers starting in 2020. In the process, the change eliminates
one of the key features that has made the program – known as Part D –
successful for over a decade.
If the change stays in place, Part D could soon become
just another budget-busting entitlement with little hope of long-term
sustainability.Medicare Part D provides private, federally subsidized prescription drug coverage to 42 million senior citizens. And since being implemented in 2006, the program has served beneficiaries extraordinarily well. In one recent survey, 87 percent of enrollees reported being satisfied with their Part D coverage.
Such positive attitudes are largely the result of Part D's market-based structure, which provides patients with a wide array of coverage options. This year, the average enrollee had 23 stand-alone plans to pick from. This setup forces insurers to compete with one another for seniors' business by offering the highest-quality, lowest-cost plans possible.
The program has also proven surprisingly affordable for taxpayers. A recent analysis from the American Action Forum found that the program's 2016 costs were less than half what was projected when the law was first implemented.
That's an unheard of feat for a federal program. One of the main reasons costs have remained so low? Plan providers are encouraged to keep patient drug expenses under control.
Under the standard benefit model, enrollees pay for the full price of their drugs until they reach a deductible of $405. After that, they're responsible for only a quarter of drug costs up to a certain limit – $3,750 this year.
It's at this point that beneficiaries enter a gap in coverage known as the "donut hole" in which they will pay 35 percent of a brand name medicine's cost in 2018. Once drug spending reaches about $5,000, patients are in the catastrophic phase of coverage, and cost-sharing drops off once again.
ObamaCare established a plan to phase out this donut hole by 2020 so that seniors would only have to pay 25 percent of brand-name drug costs after meeting their deductible. The remaining 75 percent of the cost would be split between pharmaceutical companies – which would discount drugs by 50 percent – and insurers that would cover the other 25 percent.
By making plan providers responsible for such a significant share of donut hole spending, the reform gives these companies a powerful incentive to keep as many patients as possible out of the donut hole. After all, once patients reach the donut hole, insurers see their costs soar. It's for this reason that three in four Part D enrollees never enter the coverage gap.
The budget deal effectively obliterates that incentive – and thus threatens the program's long-term sustainability. It does this by shifting the vast majority of donut hole spending onto drug companies and letting insurers almost entirely off the hook. As of 2020, plan providers will only be responsible for 5 percent of a brand-name drug's cost in the coverage gap, while pharmaceutical makers will have to pay for 70 percent.
The consequences for Part D could be catastrophic. Insurers will actually have an incentive to drive patient drug spending over the donut-hole threshold as quickly as possible by, for instance, encouraging patients to rely on costly brand-name drugs instead of more affordable generics. Once patients enter the coverage gap, insurer costs would plummet.
What's remarkable about this change is that it's a far better deal for insurance companies than for patients or taxpayers. A recent analysis by the consulting firm Avalere estimates that the government will save $7 billion over the next decade thanks to these changes. The average Part D beneficiary will save $20 a year. Insurers, meanwhile, will save a whopping $40 billion.
Insurance companies don't deserve another government handout. And Americans don't deserve another unsustainable entitlement program. Lawmakers need to roll back these misguided changes and rescue Part D from its impending fiscal ruin.
Former Obama officials form anti-Trump national security think tank
A group of about 50
former Obama administration officials recently formed a think tank
called National Security Action to attack the Trump administration's
national security policies.
The mission statement
of the group is anything but subtle: “National Security Action is
dedicated to advancing American global leadership and opposing the
reckless policies of the Trump administration that endanger our national
security and undermine U.S. strength in the world.”
National Security Action plans to
pursue typical liberal foreign policy themes such as climate change,
challenging President Trump's leadership, immigration and allegations of
corruption between the president and foreign powers.This organization uses the acronym NSA, which is ironic. Three of its founding members – Ben Rhodes, Susan Rice and Samantha Power – likely were involved in abusing intelligence from the federal NSA (National Security Agency) to unmask the names of Trump campaign staff from intelligence reports and to leak NSA intercepts to the media to hurt Donald Trump politically. This included a leak to the media of an NSA transcript in February 2017 of former National Security Adviser Michael Flynn's discussion with Russian Ambassador to the U.S. Sergei Kislyak. No one has been prosecuted for this leak.
Given the likely involvement of Rhodes, Rice and Power to weaponize intelligence against the Trump presidential campaign, will their anti-Trump NSA issue an apology for these abuses?
It is interesting that the new anti-Trump group says nothing in its mandate about protecting the privacy of Americans from illegal surveillance, preventing the politicization of U.S. intelligence agencies or promoting aggressive intelligence oversight. Maybe this is because the founders plan to abuse U.S. intelligence agencies to spy on Republican lawmakers and candidates if they join a future Democratic administration.
It takes a lot of chutzpah for this group of former Obama officials, who were part of the worst U.S. foreign policy in history, to condemn the current president's successful international leadership and foreign policy.
After all, ISIS was born on President Obama's watch because of his mismanagement of the U.S. withdrawal from Iraq and his "leading from behind" Middle East policy. The Syrian civil war spun out of control because of the incompetence of President Obama and his national security team.
This was a team that provided false information to the American people about the 2012 terrorist attack on the U.S. consulate in Benghazi and the nuclear deal with Iran. I wonder if the anti-Trump NSA will include videos on its website of former National Security Adviser Susan Rice falsely claiming on five Sunday morning news shows in September 2012 that the attack on the Benghazi consulate was "spontaneous" and in response to an anti-Muslim video.
And of course there's the North Korean nuclear and missile programs that surged during the Obama years due to the administration’s "Strategic Patience" policy, an approach designed to kick this problem down the road to the next president. Because of President Obama's incompetence, North Korean dictator Kim Jong Un may have an H-bomb that he soon will be able to load onto an intercontinental ballistic missile to attack the United States.
It must appall this group of former Obama national security officials that President Trump is succeeding as he undoes everything they worked on.
ISIS will soon control no territory in Iraq or Syria because of the Trump administration's intensified attacks on it and arming of Kurdish militias.
In sharp contrast to President Obama, President Trump drew a chemical weapons red line in Syria and enforced it.
North Korea is pushing for talks with the U.S. in response to strong United Nations sanctions the U.S. worked to obtain in 2017. And compliance with the new sanctions has been significantly improved, especially by China, as the result of President Trump’s actions.
President Trump repaired the damage done to U.S.-Israel relations by President Obama and has recognized Jerusalem as the capital of Israel – something several previous presidents promised but failed to do.
Iranian harassment of U.S. ships in the Persian Gulf stopped in 2017, likely due to the more assertive Iran policy of President Trump. This includes the president's successful effort to build a stronger U.S. relationship with Saudi Arabia.
President Trump is right when he says he inherited a mess on national security from the Obama administration. This is because President Obama and his national security team undermined U.S. credibility and left President Trump a much more dangerous world. I doubt the new anti-Trump National Security Action think tank will succeed in convincing Americans otherwise.
Fred Fleitz a former CIA analyst, is senior vice president for policy and programs with the Center for Security Policy,
a national security think tank. His new book is “The Coming North Korea
Nuclear Nightmare: What Trump Must Do to Reverse Obama’s ‘Strategic
Patience.” Follow him on Twitter @FredFleitz.
Pelosi: Democratic Caucus divide ahead of primaries is 'exhilarating'
Washington Democrats continue to take a Wild West
approach to their 2018 congressional primaries -- endorsing
challengers, attacking at least one incumbent and totally avoiding
California’s testy Senate contest -- all of which appears OK with House
Minority Leader Nancy Pelosi.
“Welcome to the Democratic Party,”
the California Democrat said Thursday, when asked whether a lack of
party unity could help Republicans.
“It is the most exhilarating thrill to be a leader in a
party that has that kind of diversity of opinion. It’s our
strength. We’re not a rubber stamp. … It certainly can work to our
advantage. So I don’t see it as an obstacle.”Washington Democrats have been split this year in several races, as they focus on winning a total 24 House seats to take control of the chamber. But the situation is most glaring in a Texas congressional race.
The Democratic Congressional Campaign Committee, whose mission is to elect and reelect party members to the chamber, has openly opposed candidate Laura Moser, one of a handful of Democrats who ran in this week’s 7th Congressional District Democratic primary.
Sen. Bernie Sanders, a Vermont Independent who caucuses with Democrats, told NBC News on Friday that such tactics are “unacceptable.”
In 2016, Sanders ran for president on the Democratic ticket but lost in the primary to Hillary Clinton, who appeared to have some advantages from the Democratic National Committee, according to leaked emails.
Moser already has support from Our Revolution -- the political group continuing the so-called “Sanders Movement.”
But Sanders, who’s campaigning this weekend in Texas, is so far noncommittal about whether he’ll help Moser, saying, “We’ll take a look at the race.”
Sanders told The Hill on Friday that he’s staying out of the California Senate race in which his backers and the Democratic Party’s far left wing are leading efforts to deny moderate Democratic Sen. Dianne Feinstein a sixth term.
At the state party convention last month, delegates gave Feinstein just 37 percent of the vote, compared with 57 percent for state Senate leader Kevin de Leon.
De Leon, a favorite of the state party’s progressive wing, didn’t get the endorsement because neither he nor Feinstein got the required 60 percent of the vote. But the situation was another example of a divided party and a possible threat to Feinstein’s reelection bid, despite her having a double-digit primary lead over de Leon and millions more in campaign money.
Sanders this week joined a handful of Washington Democrats in endorsing Marie Newman, the primary challenger in moderate Illinois Democratic Rep. Dan Lipinski’s bid for an eighth term.
The others backing first-time candidate Newman include New York Democratic Sen. Kirsten Gillibrand and Illinois Democratic Reps. Luis Gutierrez and Jan Schakowsky, who is part of the DCCC leadership team, while Pelosi is backing Lipinski.
In another example, so many Democrats have entered congressional primaries in Southern California, where the DCCC is trying to win several GOP-held seats en route to 24 , that fears of splitting or diluting the vote has led to some candidates being asked to drop out, a source recently told Fox News.
As bullets fly, Chicago police boss blasts civilian oversight plans
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| Chicago Police Superintendent Eddie Johnson, left, with Mayor Rahm Emanuel, says the city is making "real progress" in fighting crime since a high of 771 murders in 2016. |
Chicago's police superintendent on Saturday blasted efforts for greater civilian oversight of the department, citing "real progress" in fighting crime -- just hours after at least eight people were reportedly wounded in overnight shootings.
Hours later, two men were slain on the city's South Side, the Chicago Tribune reported.
Proposals by the city's leading community organizations
call for greater oversight by a seven-member civilian board called the
Commission for Public Safety and Accountability, the Chicago Tribune reported.But Chicago police Superintendent Eddie Johnson said no one consulted him or anyone in the CPD for the year and a half it was conceptualized.
“We're in the middle of a serious crime fight, and we're finally making real progress, so I don’t know how you can turn over crime strategy and every policing decision to some group of people who have absolutely no law enforcement experience,” Johnson said.
In January, Fox News reported that murders had declined in the city in 2017 compared with 2016, dropping to 650 kilings from a two-per-day total of 771. Police credited so-called ShotSpotter technology -- consisting of cameras and detection radars deployed in neighborhoods -- for helping to reduce crime."(W)e're finally making real progress, so I don’t know how you can turn over crime strategy and every policing decision to some group of people who have absolutely no law enforcement experience."
This year, shooting deaths have included the Feb. 13 slaying of Chicago police Commander Paul Bauer, who was shot multiple times while pursuing a suspect.
However, expanded use of camera surveillance has raised privacy concerns, Fox News reported.
Still, police reform has been a contentious subject in Chicago since November 2015, when a judge ordered the release of video footage showing Laquan McDonald, a black teen, being shot 16 times.
Under the new reforms, the commission would name a superintendent by selecting three candidates for the mayor to consider. The mayor would share joint-authority to fire or remove the superintendent “for cause.”
The reforms were modeled off others major cities like Los Angeles and Seattle, which have civilian oversight boards to monitor police.
The new proposals will be introduced at a City Council meeting later this month.
Saturday, March 10, 2018
The U.S. is Making ‘Zero Concessions’ Before Talks with North Korea, According to the White House
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| White House press secretary Sarah Huckabee Sanders speaks to the media during the daily briefing in the Brady Press Briefing Room of the White House, Friday, March 9, 2018. |
The White House says North Korea must take “concrete and verifiable” steps before President Trump’s meeting with Kim Jong Un.
During Friday’s briefing, Sarah Sanders said a time and place have not yet been determined for the meeting, and the president is hopeful the U.S. can make continued progress.
She also said the U.S. will make “zero concessions” before talks.
Sanders announced the president’s pardon of Kristian Saucier, who was sentenced to one year in prison for taking pictures inside a nuclear submarine.
The case was a major talking point during the 2016 elections as the president said Saucier was ruined for doing nothing compared to Hillary Clinton.
Trump's North Korea meeting sure beats a military attack
If President Trump goes ahead with
announced plans to meet with North Korean dictator Kim Jong Un, he would
open the door to potentially solving our nuclear dispute with the
Communist nation short of war. This is a far better course that
listening to the calls from some to give up on diplomacy and use
military force against the North.
Former U.S. Ambassador to the United Nations John Bolton, for example, recently put forth an argument
– echoed by a number of establishment foreign policy members – that
America was legally justified in conducting a preventive military strike
on North Korea.
But the case that a military attack on the North is
necessary and would be effective is both flawed and wrong. Such a
drastic and costly course of action should only be taken as an absolute
last resort to forestall an imminent attack by North Korea.Bolton claimed that those who oppose striking in the absence of a North Korean attack “argue that action is not justified because Pyongyang does not constitute an ‘imminent threat.’ They are wrong. The threat is imminent.”
Bolton added that the U.S. “should not wait until the very last minute.” Otherwise, he continued, we “risk striking after the North has deliverable nuclear weapons, a much more dangerous situation.”
If such a U.S. strike were ordered, it would have catastrophic consequences for us. Far from ensuring our safety, it would impose egregious levels of casualties on U.S. forces and American civilians, and harm – not help – our security and our prosperity.
Also critical is the fact that only Congress can authorize such a strike. Subsection 2(c) of the War Powers Resolution of 1973 expressly limits the president’s ability to use military force abroad under only three conditions: First, when Congress has declared war; second, when Congress has specifically authorized such action; or third, during a national emergency “created by (an) attack upon the United States, its territories or possessions, or its armed forces.”
There is nothing in the law that authorizes the president to use lethal military force against an adversary merely because it possess a capability to attack us. Absent an actual or imminent attack, such use would violate U.S. and international law.
Though the Constitution prevents the president from taking such unlawful actions, there is also a very practical reason for refusing to do so: It isn’t necessary to keep us safe.
David Kang, a North Korea expert and professor of international relations at the University of Southern California, argues that – contrary to some alarmist claims – the North Korean regime isn’t “crazy,” but is in fact very predictable.
“There are exactly zero examples of a time North Korea caved in to pressure,” he wrote in The Washington Post. “North Korea won’t attack first,” he continued, “because to do so would be regime suicide. But it will fight back if attacked.”
Moreover, should the U.S. launch a war on the Korean Peninsula, the cost to the troops would be astronomically high.
As The New York Times reported: “Roughly 10,000 Americans could be wounded” or killed in combat “in the opening days alone.”
Army Chief of Staff Gen. Mark A. Milley added: “The brutality of this will be beyond the experience of any living soldier.”
It is important to recognize what should be the core objective of U.S. policy on North Korea: to use the most efficient and effective means possible to ensure the North never uses its nuclear weapons.
While a war might eventually eliminate the North Korean military threat, the cost in lives of doing so could be measured in the millions.
Nuclear weapons might be used against American citizens, and egregious damage would be done to the Asian economy, which would have a direct and negative effect on the United States.
Such casualties need never be suffered, however. There are far superior ways to ensure America’s core interests are protected short of preventive military strikes leading to war.
“Deterrence has worked for 65 years, and it can continue to do so indefinitely,” Kang explains. Evidence and logic strongly endorse his analysis. President Trump’s diplomatic opening is a move in the right direction and immediately lowers the danger of war.
Much work remains. Kim has worked for many years to reach the stage where he has an operational missile that can reach the U.S. mainland. He will not give up his only domestic deterrence cheaply and will almost certainly make major demands of the U.S.
Talks are a great beginning but reaching the goal of denuclearization will likely take a lot of painful back-and-forth negotiations. Kim must eventually take concrete, verifiable action to prove his intentions. President Trump is not likely to repeat diplomatic mistakes of the past and will require tangible evidence of compliance.
President Trump has been right to resist those advocating the use of military force to solve the North Korean crisis. Time will tell if Kim is sincere in his claim to work towards full denuclearization. But as has been the case for the past 65 years, even during negotiations, deterrence will continue to keep America safe.
Daniel L. Davis is a senior fellow for Defense Priorities and a former lieutenant colonel in the U.S. Army who retired in 2015 after 21 years, including four combat deployments and an assignment as an adviser to the South Korean Army. Follow him @DanielLDavis1.
President Trump to talk tax cuts, economy at Boeing in St. Louis
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| President Trump is expected to visit St. Louis to discuss the benefits of his Tax Cuts and Jobs Act on Wednesday. |
Wednesday's scheduled trip will be his third to the Show Me State since taking office — and first since passage of the Tax Cuts and Jobs Act, the St. Louis Post-Dispatch reported.
This is what #taxreform means to Missourians ⬇️ pic.twitter.com/oUKME9Cf5P— Senator Roy Blunt (@RoyBlunt) March 1, 2018
According to Friday’s jobs report, U.S. employers added 313,000 jobs in February, more than forecast, and saw moderate wage growth and continued low unemployment.
Trump’s trip to the Boeing facility follows an informal agreement between the two parties on a fixed contract for the new Air Force One program.
“Thanks to the president’s negotiations, the contract will save the taxpayers more than $1.4 billion,” deputy White House press secretary Hogan Gidley said.
Boeing is building a brand new 747 Air Force One for future presidents, but costs are out of control, more than $4 billion. Cancel order!— Donald J. Trump (@realDonaldTrump) December 6, 2016
The new deal will be valued at $3.9 billion, down from the original estimate of more than $5 billion for two 747 jets, which will serve as presidential aircraft, and a development program.
Joining Trump in the roundtable discussion will be Missouri state Attorney General Josh Hawley and other Republicans, FOX2 St. Louis said. Hawley is vying to replace Democratic incumbent U.S. Sen. Claire McCaskill in November's election.
President Trump to visit St. Louis Wednesday for economic roundtable https://t.co/K196FFOQyu pic.twitter.com/Ycj5mVuh7b— FOX2now (@FOX2now) March 10, 2018
Wednesday's event is billed as “invitation only,” though it will be open to media.
The president’s two previous Missouri visits were to Springfield in August and St. Charles in November while promoting his tax-reform plan, the Post-Dispatch reported.
NRA files lawsuit saying Florida gun bill approved by Gov. Scott violates 2nd Amendment
News of the lawsuit came just hours after Florida
Gov. Rick Scott publicly went against allies in the NRA in signing a gun
control bill that was drafted in response to the fatal school shooting
in Parkland, Fla., on Feb. 14. Seventeen people were killed in that gun
attack, attributed to a 19-year-old named Nokolas Cruz.
Chris Cox, executive director of the NRA’s Institute
for Legislative Acton, has matainted that the bill “punished punishes
law-abiding gun owners for the criminal acts of a deranged individual."The lawsuit is asking a federal judge to block the new age restriction from taking effect.
The bill signed by Governor Scott raises the minimum age to buy rifles from 18 to 21, extends a three-day waiting period for handgun purchases to include long guns and bans bump stocks, attachments that enable semiautomatic rifles to approximate the firing speed of fully automatic ones. Such bump stocks were used in the recent gun massacre in Las Vegas in which several dozen people died. The bill did appeal to Republicans with the inclusion of a provision that enables teachers and other school employees to carry handguns, something President Trump was passionate about immediately following the Valentine's Day shooting at Marjory Stoneman Douglas High in Parkland.
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Trump: Indiana Senate GOP 'Should Be Ashamed of Themselves'
President Donald Trump lashed out again at the Indiana Senate's rejection of House-passed redistricting, ...
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How many times do we need to say this? If you’re here illegally and get caught, you’re going back. It’s the la...














