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Tuesday Respite: A Story Just Begging For A Story

Balloon Juice - Tue, 06/22/2021 - 12:31

Every now and then I run across a bit of news that cries out for use in fiction. The latest came last week while I was perusing the less prominent, more interesting parts of the Washington Post. Powerball mystery: Someone in this tiny town won $731 million. Now everyone wants a piece of it:

LONACONING, MD. — There haven’t been a lot of big wins in this little town tucked between gentle green mountains in Maryland’s far western reaches. Coal brought work, then took it away. The railroad meant prosperity, then stopped running. They made glass here, and then they didn’t.

These days, the line of cars at the First Assembly of God food giveaway is so long that the volunteers split each box into two smaller portions to feed more families.

But over the past few weeks, Lonaconing — the locals call it “Coney” — has acquired a new shine, a glint of gold in iron country. Sometime in late January, someone bought a Powerball lottery ticket at the Coney Market, and that ticket’s six numbers won the big one — $731 million, the biggest jackpot ever in Maryland and the fifth-richest payout in U.S. history.

That someone lives in Lonaconing, according to the owner of the market. But because Maryland is one of seven states that allow lottery winners to remain anonymous, and because the winner is no fool, the identity of that someone isn’t public.

The fact that someone in this town of 1,200 people (just 400 families, actually, down by half over the past 50 years) is suddenly Midas-rich has caused some strange things to happen.

(Apparently lottery winners can’t be anonymous in most states–why is that? Is it an anti-corruption thing?)

People from around the country are writing to, and even visiting, the store owner, begging him to forward requests for money to the winners. People are making the winding drive into town just to buy tickets with the winning numbers. Townies are impatient for the winner to donate money to help the struggling town. Its businesses are struggling; its seniors have insufficient fixed incomes; “mine water” sometimes befouls its sinks.

And the question remains on everybody’s minds: who won? Anonymous letters are circulating naming various people. Things are perhaps getting a little tense.

There’s a joke that you can improve any story by adding a five-word sentence in after the first one, and that’s exactly where my fiction-addled mind went. That sentence? And then the murders began. Obviously I don’t want this to actually happen, but you know what? I’d watch that show.

Open thread! Let’s try to keep it respiteful.

The post Tuesday Respite: A Story Just Begging For A Story appeared first on Balloon Juice.

Categories: Politics

Yes, He Wanted FCC To Go After SNL

Crooks and Liars - Tue, 06/22/2021 - 12:31

It's true. The former so-called president wanted "his" Federal Communications Commission to find a way to sanction Saturday Night Live for their satire of his administration.

What a stupid snowflake abuse of power move. If you thought it was just the tweets...

trump tweet snl 3

trump tweet snl

trump tweet snl 2 wasn't.

The Daily Beast quotes one Trump legal adviser:

...when they briefly discussed this with Trump more than two years ago, they made a point of saying that the Justice Department, in particular, doesn’t handle these matters, anyway. Trump seemed disappointed to hear that there was no actual legal recourse or anything that the FCC or DOJ could do to punish late-night, anti-Trump comedy.

“Can something else be done about it?” Trump replied, according to this source, to which they responded with some version of “I’ll look into it.” (This person says that to this day, they have not, in fact, “looked into it.”)

Categories: Politics

Trump Wanted To Send COVID Infected Americans To Guantánamo: New Book

Crooks and Liars - Tue, 06/22/2021 - 12:05

A new book called Nightmare Scenario: Inside the Trump Administration's Response to the Pandemic That Changed History contains a mind-numbing revelation about Trump's response to Americans on the Diamond Princess cruise ship infected with the coronavirus.

“Don’t we have an island that we own?” the president reportedly asked those assembled in the Situation Room in February 2020, before the U.S. outbreak would explode. “What about Guantánamo?”

“We import goods,” Trump specified, lecturing his staff. “We are not going to import a virus.”

Like sports team owners who treat players like cattle or grocery store inventory, Traitor Trump equates American citizens infected with a virus as disposable imported goods.

In the new book they write that Trump wanted to fire a senior State Department official who allowed 14 coronavirus-infected Americans on the Diamond Princess cruise ship to return home. The decision “doubles my numbers overnight,” the president complained to Azar, as the number of official U.S. coronavirus cases rose to 28.

In this appearance on Fox News on March 6, 2020 you can see how Trump was more worried about "the numbers" than those infected on the cruise ship with COVID.

"I like the numbers being where they are. I don't need to have the numbers double because of one ship."

read more

Categories: Politics

Trump Former Bodyguard, Matthew Calamari, Under Criminal Investigation

Crooks and Liars - Tue, 06/22/2021 - 12:00

The Wall Street Journal is reporting that Trump's former bodyguard (and current Trump org Chief Operating Officer) is under criminal investigation in New York himself! The walls keep closing in on those closest to Donald Trump as New York prosecutors keep chipping away at folks until they get enough people to flip or give up information on Trump and his family.

The WSJ reports that prosecutors are looking into whether Calamari "received tax-free fringe benefits" and then knowingly "avoided paying taxes on such perks" which is illegal. Calamari has worked for Donald Trump for roughy 40 years, starting as a bodyguard and then working his way up to COO. The probe is looking into whether Trump and the Trump Org gave "perks" to it's staff in the form of cars, apartments, private school tuition, etc. Accepting these benefits and not paying taxes is a crime, although it is rare that prosecutors bring cases based just on these charges alone. It could be part of a larger scale case or used as a means to get people to flip.

read more

Categories: Politics

Colbert Hammers US Catholic Bishops Over Biden Communion

Crooks and Liars - Tue, 06/22/2021 - 11:58

Stephen Colbert is Catholic.

But, as the CBS late night host noted in Monday's monologue, President Joe Biden is REALLY Catholic.

"Now, listen. People know this, I'm Catholic," said Colbert. "But Biden is sooo Catholic. He's the only guest I've ever spent time with backstage talking about the consolations of God and the need for daily rosary — so far! Ball's in your court, Andrew Garfield!"

Members of the U.S. Conference of Catholic Bishops, in contradiction to the Vatican's wishes (yeah) want to deny President Biden communion over his pro-choice, NOT pro-abortion, political stance. "Yep, they're Holy Ghosting him," said Colbert.

Then Stephen went for the kill and twisted the comedy knife -- ouch.

"I'm not sure how serious the bishops are here — if they really wanted to punish Biden, they'd move him to a different parish and not tell anyone why they did it."

"That joke is based on a true story." Colbert noted.

He closed out the bit with a nod to presidential history: "This is a big deal for a lot of reasons, one of which is that Biden is only the second Catholic to occupy the White House, after John Kennedy. But JFK was never denied communion, because he always went to confession after banging Marilyn Monroe."

Categories: Politics

Testimonials reveal Biden administration still has more work to do to protect unaccompanied children

Daily Kos - Tue, 06/22/2021 - 11:55

While the Biden administration has made significant steps in getting unaccompanied minors out of dangerous Customs and Border Protection (CBP) facilities and to Health and Human Services (HHS) custody to be placed with a U.S. sponsor, 17 court testimonials submitted by children held at so-called emergency influx facilities show the administration still has significantly more work to do.

Children sent to these unlicensed sites “described crowded living conditions, spoiled food, lack of clean clothes and struggles with depression,” Reuters reported. "A lot of the girls here cry a lot," a 17-year-old girl said according to the report. She was being held at Fort Bliss in Texas, the site of a former World War II internment camp for Japanese Americans. "A lot of them end up having to talk to someone because they have thoughts of cutting themselves."

Categories: Politics

Senator Schumer Tells the World What Is Going To Happen Today and This Week: SPOILER!!! It Is Not Voting On The For the People Act!

Balloon Juice - Tue, 06/22/2021 - 11:21

Senator Schumer made remarks on the Senate floor yesterday afternoon. In those remarks he explained what business he would bring before the Senate this week (emphasis mine):

But tomorrow—tomorrow—the Senate will also take a crucial vote tomorrow on whether to start debate on major voting rights legislation.

I want to say that again. Tomorrow, the Senate will take a vote on whether to start debate on legislation to protect Americans’ voting rights. It is not a vote on any particular policy. It is not a vote on this bill or that bill. It is a vote on whether the Senate should simply debate the issue about voting rights, the crucial issue of voting rights, in this country.

Senator Schumer has now explained to the world what is happening this week. And IT IS NOT a vote on Senate Bill 1, the Senate’s version of The For the People Act.

Stacey Abrams call to action is based on an inaccurate presentation of the strategic environment in the US Senate. You cannot operate effectively based on an inaccurate strategic premise. You cannot achieve your strategic objectives by doing so.

Senate Bill 1 is not going to be debated this week. It is not going to be voted on this week. It is not even going to be brought to the floor of the Senate because of a deal cut between the parties on what happens if a Senate committee should tie on voting out a bill. What is going to be introduced today by Senator Schumer, what he has put on the calendar under his authority as the majority leader who controls the Senate calendar, is a motion to allow the Senate to move to consider – debate and then vote on – Senate Bill 1. Schumer was never going to bring Senate Bill 1 to the floor this week. He was never going to bring Senate Bill 1 up for a vote this week. And he is NEVER GOING TO BRING Senate Bill 1 up for a vote this week.

Recognizing this reality isn’t defeatist. Recognizing this reality is dealing with the reality of the strategic environment as it exists. Not as you would prefer it to be!

Calling your senators to lobby for something that is not happening and is not going to happen isn’t effective political action. It isn’t effective anything.

Calling your Democratic senators to tell them to work on getting Senators Manchin, Sinema, and Feinstein to agree to at least reform the filibuster is something that may be effective political action if they can pull it off. If you’re a West Virginian, an Arizonan, or a Californian, calling Senators Manchin, Sinema, and Feinstein and telling them that when Senator Schumer’s efforts this week reach their inevitable results, which is that Senate Bill 1 will not be debated let alone voted on, that you expect them to agree to at least reform the filibuster may be effective political action if enough of their constituents make the attempt.

Until or unless Senators Manchin, Sinema, and Feinstein commit to at least reforming the filibuster calling to register your support for bills that will never, ever, under any circumstance be debated let alone voted on because there IS NO ONE WEIRD TRICK up Schumer’s sleeve to make that happen absent filibuster reform is a waste of your time and energy and waste of your senator’s staff’s time and energy.

The objective right now is reform of the filibuster. That’s the strategic objective. That means aligning appropriate ways and means to achieve that end. If your ways and means are focused on passing Senate Bill 1 this week, then your ways and means are misaligned with the actual potentially achievable ends.

If filibuster reform is accomplished, then the strategic objective shifts to actually passing Senate Bill 1 or the Manchin compromise or something related. And then focusing your ways and means on voting for one or more of those bills is an appropriate strategy to undertake.

Please feel free to reach out to Senator Schumer and explain to him why what he’s told you will happen this week is wrong because he clearly does not understand what Senator Schumer is actually doing, nor how the Senate rules actually work, nor what he can and cannot do under those rules. His contact information can be found at this link.

Edited to Add:

Senator Schumer actually has a strategy, which is based on a realistic and accurate assessment and understanding of the strategic environment he is operating in. It is, specifically, a strategy to change that strategic environment. It has the following components:

  1. Very publicly attempt to achieve the 60 vote cloture threshold on today’s and this week’s motions to debate Senate Bill 1, as well as several other bills on this and other important topics.
  2. Use this very public attempt to force the Senate Republicans to actually take on the record votes opposing even proceeding to debate these bills, let alone vote on them or for them.
  3. By forcing at least 41 Senate Republicans to vote against proceeding to debate, he is creating a record that can be used against them, or at least attempt to be used against them because you can’t shame the shameless, during the 2022 midterm elections.
  4. Gauge whether Senator Manchin really will not, as Senator Manchin has publicly stated he will not, vote for Senate Bill 1, the Senate version of The For the People Act.
  5. By doing so, Senator Schumer is attempting to determine out in public how much of what Senator Manchin has been doing is political gamesmanship and how much of it is sincere, for lack of a better term. That is why the Manchin compromise bill is not part of the motion that Senator Schumer will be bringing to the floor on the several bills that Senator Schumer is asking the Senate for permission to open debate on.

Senator Schumer has a strategy. It is a strategy that is appropriate for and tailored to the actual strategic environment. His ways and means this week is to use the motion to open debate, specifically its failure, to demonstrate to Senators Manchin, Sinema, and Feinstein that it is not possible to even get enough Republican senators to allow debate of these bills on their merits, let alone an actual vote on them. This then allows him to try to achieve his real and immediate strategic objective, which is reforming the filibuster so these bills can actually be debated and then voted on, rather than just prevented from ever actually coming to the Senate floor for any action. If, and only if, he is able to achieve this strategic objective will he move on to his ultimate strategic objective, which is passing Senate Bill 1, or the Manchin compromise bill, or other related bills.

Senator Schumer has told us what his strategy is. He has told us what the strategic objective is. If you’re going to engage in political action this week you can either help him do so or you can do something else. The former might be effective. The latter will not.

Open thread!

The post Senator Schumer Tells the World What Is Going To Happen Today and This Week: SPOILER!!! It Is Not Voting On The For the People Act! appeared first on Balloon Juice.

Categories: Politics

Senate Republicans set to filibuster voting rights bill

Daily Kos - Tue, 06/22/2021 - 11:18

The Senate is set to vote Tuesday on the For the People Act, but, with Republicans already enacting one vicious voter suppression bill after another in the states, a federal voting rights bill will fall to the filibuster. If Democratic Sen. Joe Manchin decides to vote for it—after proposing changes last week which other Democrats largely embraced—Republicans will nonetheless be able to block the bill using the filibuster as a tool of minority rule.

Former President Barack Obama endorsed Manchin’s proposal Monday, and hammered home the importance of the legislation, saying on a call with supporters, “We can't wait until the next election because if we have the same kinds of shenanigans that brought about Jan. 6, if we have that for a couple more election cycles, we're going to have real problems in terms of our democracy long-term.”

Categories: Politics

OUTRAGE: Trump-Appointed Judge Dismisses Lafayette Square Claims Against Trump, Barr

Crooks and Liars - Tue, 06/22/2021 - 10:53

The ACLU reacted with outrage—and warned of potentially major implications for the right to protest—after a Trump-appointed federal judge on Monday largely dismissed lawsuits accusing the former president and his attorney general of illegally authorizing a violent assault on peaceful demonstrators in the nation's capital last year.

read more

Categories: Politics

Coronavirus Growth in Western Countries: June 21 Update

Kevin Drumm - Tue, 06/22/2021 - 10:44

Here’s the officially reported coronavirus death toll through June 21. The raw data from Johns Hopkins is here.

Categories: Politics

An incoherent Sinema defends her unprincipled decision to let Mitch McConnell rule the nation

Daily Kos - Tue, 06/22/2021 - 10:39

Sen. Kyrsten Sinema, the Arizona Democrat—who apparently has decided that securing the legacy of mavericky John McCain for herself is … doing Sen. Mitch McConnell's work?—chose the eve of the procedural vote on the most consequential legislation for restoring our democracy to double down on her support for the Jim Crow filibuster with an op-ed in The Washington Post. In it she exposes just how unserious she is about this job she has taken on, ignoring history, oblivious to reality, and yet glibly triumphant in declaring principles that are absolute bunk.

It mostly boils down to one idea: Democrats shouldn’t pass things because Republicans might rescind them. What that translates into in practice with the For the People Act is that the rights of the Senate minority are more important than the voting rights of millions of Americans. The Senate will vote on a motion to proceed to debate on the bill Tuesday afternoon.

"Arizonans expect me to do what I promised when I ran for the House and the Senate: to be independent—like Arizona—and to work with anyone to achieve lasting results," she writes. (They probably also expected her to look out for their economic interests, but look where that got them.) "Lasting results," she continues, "rather than temporary victories, destined to be reversed, undermining the certainty that America’s families and employers depend on." The way to achieve "lasting results," she apparently believes, is gridlock. "The filibuster compels moderation and helps protect the country from wild swings between opposing policy poles," she says.

Categories: Politics

Coming to a Hospital Near You

Balloon Juice - Tue, 06/22/2021 - 09:40

Sometimes I feel like the entire nation as adult onset ADHD:

Low vaccination rates are dangerous when combined with the spread of variants like Delta, which is believed to be more transmissible and cause more serious illness. Steve Edwards, CEO of CoxHealth, a healthcare system in Springfield, Missouri, told CNN the combination is to blame for a six-fold increase in hospitalizations in his system.

“I think it is the Delta variant and there is a lot of kindling with low vaccination rates, so it’s spreading very rapidly,” Edwards said. “Almost all of our cases are unvaccinated people that, in my opinion, have put themselves in harm’s way during this pandemic.”

Fortunately, Plescia said, there are tactics underway to encourage vaccinations that have seen success. Some states, such as Colorado, are making a final push by calling unvaccinated people directly to provide them with information and help schedule appointments. Incentives — from the big ones like million-dollar lotteries to free tickets to the zoo or food coupons — have also worked, Plescia said.

The pandemic is not over. We’re acting like it is for a variety of dumb reasons. We got bored with it. We want to go back to our beautiful lives. We don’t like masks or washing our hands. We’re a very stupid people who don’t believe scientists and refuse to get vaccinated. We have terrible political leadership. We’re American and can never think past next week. There’s money to be made promoting coronavirus lies. And, of course, corporate America wants to go back to “normal” and pay people pittances to clean grease traps at shitty fast food restaurants. So there are a lot of reasons why we are pretending the pandemic is over, but none of them are any good or have anything to do with the actual pandemic being over. Collectively, we’re the little kid playing hide and seek standing behind a tree with their entire body visible, but they have blocked their vision and can’t see us, so they think they’re hidden.

And because the unvaccinated are in large part in poorer areas with a population that has less access to health care, weaker healthcare infrastructure, and a wider prevalence of pre-existing conditions, we’re probably going to lose a couple hundred thousand more people do to variants. We’re not even close to herd immunity, so even if you have been vaccinated, the smart play is to limit contact with people you do not know, where a mask in public, avoid unnecessary exposure (trips to the ballpark, the bar, etc.), and keep washing your hands you filthy animals.

Or don’t. Honestly not going to shed a whole helluva lot of tears if this cuts through a large swath of Trump dead-enders and vaccine truthers in Alabama and Mississippi.

The post Coming to a Hospital Near You appeared first on Balloon Juice.

Categories: Politics

Donald Trump really, really hates it when you laugh at him

Daily Kos - Tue, 06/22/2021 - 09:26

There was a point, in the later years of the Emperor Tiberius, when making a joke about the emperor could get someone killed. So could laughing at a joke about the emperor. So could failing to turn in someone who laughed at a joke about the emperor. So could … in any case, the point is that the emperor tended not to have a great deal of tolerance when it came to being made an object of derision. 

Not every aspect of Roman Empire maps neatly onto modern events (for example, Americans don’t generally store their safety deposit boxes with a collection of sacred virgins). But if there is one thing that has been true across the ages, it’s that demagogues and dictators rarely have anything that looks like a sense of humor, especially as it applies to themselves. Someone whose psychological makeup is evenly divided between ego and paranoia, is just extremely unlikely to sit through a roast without taking down names.

So it shouldn’t be surprising to find that when it comes to his portrayal on Saturday Night Live, Donald Trump was not amused. Even so, it may be surprising to find that, as The Daily Beast reports, Trump tried to get the FCC and the Department of Justice to shut down sketch comedy.

Categories: Politics

Joe Lieberman, of all people, is showing up for D.C. statehood at Senate committee hearing

Daily Kos - Tue, 06/22/2021 - 09:23

Statehood for Washington, D.C., is getting a Senate committee hearing on Tuesday, two months after the House passed the legislation on a party line vote. And the hearing at the Senate Homeland Security and Governmental Affairs Committee will include a very surprising advocate for statehood: former committee chair Joe Lieberman.

In addition to testifying before the committee, Lieberman will personally appeal to Republicans and conservative Democrats, trading on his own history as “somebody who worked very hard across party lines—and sometimes to my detriment in my own party,” as he told Roll Call. That’s one way to put it.

Categories: Politics

Pride parade attendee killed after another attendee accidentally drove into crowd

Daily Kos - Tue, 06/22/2021 - 09:02

Stories of drivers ramming into pedestrians at peaceful protests and parades have been all too common since 2020’s Black Lives Matter protests. While in most cases the drivers had malicious intent to discourage participants from expressing their views, in a recent incident a man unintentionally drove a pickup truck into a crowd of parade-goers, CNN reported. The Saturday accident left at least one person dead and another injured. While the driver was taken into custody, police officials confirmed no charges were filed.

At first, speculation arose that the incident was a hate crime against the LGBTQ community. However after investigations into the incident, authorities found that the man who drove his truck into a Pride parade in Florida acted did so accidentally.

Categories: Politics

Meghan McCain Is Very, Very Concerned About Joe Biden's Soul

Crooks and Liars - Tue, 06/22/2021 - 08:39

Where, oh where to begin?

Yesterday, Meghan McCain accused Joe Biden of "doing grave spiritual harm to himself and harm to this country" over his support for abortion rights.

"He’s going to have to ultimately talk to his creator when the time comes as we all do, and reconcile his politics with his personal faith," she intoned.

She said it’s like saying, “I’m personally opposed to murder but if you want to murder a little bit, it’s fine with me.” You know, like when she so fervently defends guns?

She also claims abortion as a cardinal sin is "a doctrine as old as the Catholic Church itself."

Um, wrong again, Meghan!

read more

Categories: Politics

Group insurance and scream minimization

Balloon Juice - Tue, 06/22/2021 - 08:00

The majority of insured Americans are insured through an employer based benefit arrangement. Commercial health insurance tends to pay clinicians significantly more per service provided than Medicare. This leads to very expensive insurance premiums that come out of employee’s cash compensation.

Group insurance is purchased through two channels. There are fully insured plans where a group sends an insurer a big check every year to take on all cost risk after cost-sharing is paid. This fully insured model is how the ACA individual market works. The other model is the self-insured model where an employer group contracts with an insurer to run the logistics of paying for health care for their employees, but the group holds financial risk of really expensive claims. Self-insurance is very common for large employers (500+ covered lives) and not uncommon for medium sized groups (100-500 covered lives). Small employers can provide insurance through either route.

Medicare and Medicaid keep their per-unit costs relatively low by engaging in administrative pricing with take it or leave it offers. Almost every doc and hospital will take Medicare pricing and payment. Many docs and hospitals will take Medicaid pricing and payment policies (although new research has done a nice job of modeling the hassle costs of Medicaid payment policy as a deterrent to broad networks!). ACA plans use narrow networks to sometimes extract low provider pricing from clinicians.

So why does commercial group insurance cost so much?

I call it the scream minimization function of HR acting as a poor agent for the principal.

We can think of the purchasing decision for health insurance of a large insurer to be done by the HR department acting as agents for the company as a whole. The HR department has a strong budget constraint. The can’t spend more than X for healthcare for a given group of employees. They engage with brokers/agents/consultants to search for bids that satisfy this budget constraint. Once they get a menu of plausible options that satisfy the budget constraint, we can think of HR engaging in locally motivated behavior. One of these behaviors may be a strong desire to not get screamed at (literally, figuratively or bureaucratically) by employees. And while most people would prefer not to piss off other people, there is probably a strong preference to avoid getting into conflicts with high prestige and power individuals while individuals/groups with low power/prestige can be ignored or minimized. This means making sure that the network is attractive to individuals with high power and prestige. Individuals with high power and prestige may earn well above median income in the group. Individuals with higher income are less deterred by cost-sharing and are likely to have a higher willingness to pay.

From this perspective, lets think about two plans that cost the company the same. The first choice has a narrow network and relatively low cost-sharing while the second choice has a broad network and twice the cost-sharing. There is a trade-off if we hold premiums constant — cost-sharing vs. network. If we think that there is a strong likelihood that the second, broad network with more cost sharing minimizes the power weighted push-back on the health plan choice, we should expect HR to choose the big network and pay a high per unit price for the privilege.

There is a recent working paper by Nicholas Tilipman at UIC that maths this up a lot:

In this paper, I study the determinants of health plan offerings among large employers and whether these plan choices reflect preferences that are aligned with that of employees. This is an important market to study this issue: employer-sponsored insurance (ESI) is a significant part of the healthcare landscape (ESI), representing approximately 30% of health expenditures. Moreover, costs in the employer market have been rising rapidly in recent years. Per-enrollee expenditures in the private ESI market have increased about 46% between 2008 and 2018, compared with an approximate 21% increase in Medicare per-enrollee spending over the same period.2 This paper sheds light on the whether a portion of these rising costs can be attributed to mismatch between employer and employee preferences.
I focus my analysis on employer decisions over health plan provider networks and, in particular, the decision of whether to offer “narrow-network” benefit designs as part of their plan menus. Health insurers and employers have increasingly started offering these insurance plans as a means of containing spending and offering consumers low-cost options.3 Despite the increasing popularity of narrow-network plans on the health insurance Exchanges, however, employers have been slower to adopt, design, and offer such products. In 2016, only 7% of employers nationally offered a narrow network as part of their plan menu (Hall and Fronstin, 2016) …

This leaves the question of why employers exhibit this behavior in menu choice. I explore several candidate possibilities: (a) inability to alter co-premiums or benefits (by virtue of the employer I study being a public rather than private employer); (b) employer mistakes or misperceptions; and (c) heterogeneity in the types of employees the employer values most when designing benefits. While I am not able to fully separate these channels, I find substantial evidence for (c). Specifically, about 30% of the estimated employer-employee mismatch can be attributed to employers placing a higher weight on the network references of the oldest workers in the distribution, while as much as 80% of the mismatch can be explained by employers emphasizing the preferences of employees in certain geographic regions. These regions tend to be ones that are less dense, have fewer competition among health care providers, and are situated close to the state border. As such, households in these regions stand to lose the most utility from a loss of a notable provider….

What he finds is that employers choose networks, that, on average, are bigger than the networks individual employees would prefer. And these big networks are expensive relative to optimal networks.

He comes to a different conclusion than my toy mental model but the finding is that employers buy bigger than optimal networks.

One of the few intriguing and potentially enduring aspects of the Trump administration health policy legacy is the creation of Individual Contribution Health Reimbursement Accounts (ICHRA). These accounts allow for employers to give a defined business group of employees an age adjusted sum of money to spend on ACA individual market plans. These ICHRA plans are likely attractive to individuals with locally below average expected medical costs and system interactions. These individuals are more likely to either buy a narrow network with high actuarial value and spend the entire employer subsidy, or buy a narrow network, low actuarial value plan and use some of the employer subsidy to pay some cost-sharing. Individuals with expensive prospective healthcare spending are likely to be worse off as the broader network ACA plans are likely significantly more expensive than the skinniest network plans on the marketplace.

These are two very long ways to get to the point that most of the time, most people are mostly indifferent to their health insurance, but the problem is the not knowing when indifference transitions to top of mind prioritization.

The post Group insurance and scream minimization appeared first on Balloon Juice.

Categories: Politics

Morning Digest: Why we won't know the winner of New York's mayoral primaries for weeks

Daily Kos - Tue, 06/22/2021 - 08:00

The Daily Kos Elections Morning Digest is compiled by David Nir, Jeff Singer, Carolyn Fiddler, and Matt Booker, with additional contributions from David Jarman, Steve Singiser, Daniel Donner, James Lambert, David Beard, and Arjun Jaikumar.

Leading Off

New York City, NY Mayor: A final poll from Ipsos ahead of Tuesday's instant-runoff Democratic primary in New York City shows Brooklyn Borough President Eric Adams in a strong position to secure his party's nomination, in contrast with other recent polls that have shown one of his top rivals, former city Sanitation Commissioner Kathryn Garcia, prevailing in the end. But regardless of who's leading, it may not be until mid-July until we know who's actually won—more on that in a bit.

First, the new survey, which gives Adams the lead with 28% when it comes to voters' first-choice preferences, while 2020 presidential candidate Andrew Yang edges out Garcia 20-15 for second. This is the strongest performance in some time for Yang, the one-time frontrunner, but it's not good enough: Ipsos shows Adams beating him by a wide 56-44 spread in the seventh and final round of ranked-choice tabulations.

Categories: Politics

Cheers and Jeers: Tuesday

Daily Kos - Tue, 06/22/2021 - 07:50

Tuesday with George

Hard to believe it was thirteen years ago when we got the news that Philosopher of Comedy George Carlin had died too young  at 71.  Seems appropriate to remember him with some of his brain droppings…

"Remember, kids, Mr. Policeman is your friend. Always cooperate with him. Mr. Policeman wants to help you, so you must help Mr. Policeman. Don't forget, if you refuse to cooperate, Mr. Policeman will beat you to death. Especially if you're not white."

“Hansel and Gretel discovered the ginger bread house about 45 minutes after they discovered the mushrooms."

"Unbelievably, a goldfish can kill a gorilla. However, it does require a substantial element of surprise."


Categories: Politics

Cartoon: How to relax this summer

Daily Kos - Tue, 06/22/2021 - 07:50

If you are able, please consider joining the Sorensen Subscription Service!

Follow me on Twitter at @JenSorensen

Categories: Politics