Saturday, November 23, 2013

Healthcare.gov Untransparent Metrics

November 23, 2013

Latest Studies: 46 new items, including reports from the National Center for Policy Analysis on how states can reform Medicaid, and a Texas Public Policy Foundation report on how big government hurts the economy
Notes on the Week: Healthcare.gov’s new metrics will tell us nothing, Louisiana school choice lives for now, this month in liberal condescension, and more
To Do: Be thankful
Healthcare.gov’s new metrics won’t tell us anything. The Obama administration says Healthcare.gov will be a success “if 80 percent of users can buy health-care plans online,” report Amy Goldstein and Juliet Eilperin:
According to a government official familiar with the new target, the 20 percent who are unlikely to be able to enroll online are expected to fall into three groups: people whose family circumstances are so complicated that the Web site cannot determine their eligibility for subsidies to help pay for health plans; people uncomfortable buying insurance on a computer; and people who encounter technical problems on the Web site. [Washington Post, November 16]
But what does “80 percent of users can buy health-care plans online” mean? The new metrics are as clear as mud, says Megan McArdle:
The [Post] article says that the administration has related metrics for things such as lag time and the error rates in delivering pages, which imply that the answer is “80 percent of attempts will succeed.”
But then why would you lump “people who are uncomfortable buying insurance on a computer” into the group of people who won’t succeed? Presumably, something close to none of the attempts to use the website to buy insurance will be made by people who are uncomfortable buying insurance on a website.
“Eighty percent of total enrollees having gone through the site” is a pretty useless metric; the administration could theoretically satisfy this metric by getting five people enrolled: four on the exchanges and one through a paper application. […]
[I]t’s unlikely that the administration is measuring this directly; rather, they’d be constructing a model based on lower-level metrics such as ... lag times and page-delivery errors. The nice thing about models is, of course, that they can be tweaked. All of which is to say that if the administration does not want to fail this metric, it won’t. [Bloomberg, November 18]

Another rough week for the ObamaCare rollout. Here are some highlights:
• In a Rose Garden address last month, President Obama cited Jessica Sanford as an example of an ObamaCare success story. However, the state of Washington recently told her it had miscalculated her tax credit eligibility and that her monthly premiums would increase from $198 to $280. She has decided she cannot afford the coverage. “It was a huge disappointment, and especially since my story had been shared by the president,” said Sanford. [CNN, November 19]
• On Tuesday, Secretary of Health and Human Service Kathleen Sebelius visited some health care navigators in Miami, Fla. Local media were on hand to record the visit, and as Secretary Sebelius spoke with a couple in the middle of signing up, Healthcare.gov crashed. Someone said: “Uh oh.” How could she have not figured that might happen? [Washington Post, November 20]
• Oregon, a state that leans to the progressive side of the political spectrum, has so far enrolled nobody through its state exchange. That’s because its online portal isn’t ready at all. The state is now scrambling to process the 18,000 paper applications (19 pages each) it has received. [RealClearPolitics.com, November 20]
• Coloradan Shane Smith got a letter informing him that his dog Baxter had been enrolled in coverage through the state’s health insurance exchange. Smith says he has no idea how his dog got enrolled, though he did provide his dog’s name as the answer to a security question when he logged on to create his own account. [Fox News, November 21]
• On Friday, the Obama administration announced another ObamaCare delay. The open enrollment period has been pushed back—for 2015. The start of the period will now be November 15, 2014, instead of October 1, 2014. Curious timing, that—right after the 2014 elections. Could it be the administration is worried about something enrollees might discover were they to re-enroll on October 1? Laura Trueman points out that the cost of plans next year is likely to spike since “current enrollment in the exchanges is drawing older people, as young adults discover they can’t afford the Cadillac plans mandated by Obamacare. The 2015 plans will be priced based on the experiences of the older than expected population.” [The Foundry, November 22]

In Louisiana, school choices lives—for now. The Department of Justice has backed off of its efforts to keep kids in failing schools in order to preserve what it deems to be the right racial balance—at least temporarily. In a motion filed in August, the Department had claimed that Louisiana’s school voucher program would upset the racial balance in the 34 Louisiana school districts governed by court-supervised desegregation plans.
On Monday, a federal district judge issued a procedural ruling that describes the DOJ’s position as having shifted from seeking to require federal pre-approval for any voucher issued to a student in those school districts to seeking the creation of a notice procedure. The DOJ now wants Louisiana to give it information on the assignment of students to voucher schools 45 days before assignments are finalized and the parents notified.
A big problem for the DOJ’s initial motion seems to have been that there is no evidence that school choice makes segregation worse. A literature review conducted by Greg Forster earlier this year finds that many studies measuring segregation are flawed because they compare the racial composition of individual schools to the racial composition within the school district, a method that effectively masks any segregation caused by school district boundaries themselves. Among studies that do not have that flaw, Forster reports:
Seven of these studies find that school choice moves students into less racially segregated classrooms. The remaining study finds that school choice has no net impact on racial segregation. None find that choice increases racial segregation.
This result should not be surprising says Forster: “Public schools are intractably segregated by race because students are assigned to schools based on where they live, and school choice has the potential to break down these residential barriers.” [“A Win-Win Solution: The Empirical Evidence on School Choice,” by Greg Forster, Friedman Foundation for Educational Choice, April 2013]
Two recent studies have examined the Louisiana Scholarship Program specifically. Anna J. Egalite and Jonathan N. Mills, graduate students at the University of Arkansas, find:
In the school districts under federal desegregation orders, which are the focus of the Department of Justice litigation, LSP transfers improve integration in both the sending schools and the private schools that participating students attend (receiving schools). […] For sending schools, 74 percent of the moves improve integration, while just 26 percent have a negative impact. In receiving schools, 56 percent of total transfers improve integration. Again, when we break out our results by race, we find that nearly 90 percent of African American transfers improve desegregation in their sending schools. [Education Next, Winter 2014]
And Boston University political science professor Christine Rossell also finds that vouchers improve desegregation. As described by Politico’s Caitlin Emma, Rossell’s study finds:
[I]n all but four of the districts – some of which are majority white, some majority black and some more evenly split – vouchers improved or had no effect on racial imbalance. And in the districts where racial imbalance worsened, the effects were “miniscule.” [Politico, November 8] [H/t: Jason Bedrick at Cato at Liberty, November 12]
The court is scheduled to hear arguments on the Department of Justice’s new request on Friday, November 22.

Forgoing growth: Most of the fiscal “austerity” accomplished during 2013 was composed of tax increases not spending cuts, reports Salim Furth:
Several tax increases took effect in January 2013: new Obamacare taxes, the expiration of the payroll tax, and “fiscal cliff” tax increases. During the fiscal year (which ended on September 30), those together increased taxes by $188 billion.
The spending cuts (i.e., sequestration) took effect in March 2013. Sequestration reduced fiscal year (FY) 2013 budget authority by $85 billion, but only $42 billion of the cuts took effect during FY 2013.
But what would have happened if we had traded $188 billion of tax increases for the same amount of spending cuts? Here are the estimates produced by four different economic models:

[The Heritage Foundation, November 14]

Taxpayers are paying for pro-tax advocacy. The Small Business Administration, a government agency established to support small businesses and entrepreneurs, has weighed in on the side of more taxes—and used taxpayer funds to do so, of course. The agency commissioned an $80,000 study on how an Internet sales tax would affect small businesses by longtime advocates of an Internet sales tax. Not surprisingly, as John Berlau reports, Donald Bruce and William F. Fox of the University of Tennessee’s Center for Business and Economic Research reached a conclusion favorable to an Internet sales tax—specifically that the so-called Marketplace Fairness Act would affect only 1,817 online retailers.
Berlau notes that the study is based on a survey of 1,000 companies by Internet Retailer magazine, which may not be representative of the many retailers who sell online. [OpenMarket.org, November 20]

Some First Amendment plaintiffs the ACLU likes; some it doesn’t. On November 8, Elaine Huguenin asked the U.S. Supreme Court to hear her appeal of the New Mexico Supreme Court’s ruling that her photography business cannot refuse on moral grounds to provide wedding photography services to same-sex couples.
The American Civil Liberties Union has filed a brief in this case. Can you guess which side the ACLU has taken? Here is the ACLU talking about one episode in its history:
One of the most noted moments in the ACLU’s history occurred in 1978 when the ACLU defended a Nazi group that wanted to march through the Chicago suburb of Skokie, Illinois where many Holocaust survivors lived. The ACLU persuaded a federal court to strike down three ordinances that placed significant restrictions on the Nazis’ First Amendment right to march and express their views. The decision to take the case was a demonstration of the ACLU’s commitment to the principle that constitutional rights must apply to even the most unpopular groups if they’re going to be preserved for everyone. Many now consider this one of the ACLU’s finest hours.
If Nazi’s can march through the neighborhoods of Holocaust survivors, shouldn’t photographers be able to walk away from a same-sex wedding? Aren’t they both engaged in forms of expression? Nope, that’s not what the ACLU thinks. Adam Liptak got an explanation of the ACLU’s position from one of its lawyers, Louise Melling:
Ms. Melling said the evaluation had required difficult choices. Photography is expression protected by the Constitution, she said, and Ms. Huguenin acted from “heartfelt convictions.”
But the equal treatment of gay couples is more important than the free speech rights of commercial photographers, she said, explaining why the A.C.L.U. filed a brief in the New Mexico Supreme Court supporting the couple.
“This is a business,” Ms. Melling said. “At the end of the day, it sells services for photographing weddings. This is like putting up a sign that says ‘Heterosexual Couples Only.’” [New York Times, November 18] [H/t: Jacob Sullum, Reason, November 19]
Meanwhile, the folks who make a living producing not images but sentences and paragraphs still earn some sympathy from the ACLU. Mark Steyn reports that the ACLU has filed a brief supporting Steyn and National Review against a defamation lawsuit filed by global warming proponent Michael Mann. Steyn writes:
And they’re very strong on a couple of key points — that what they call “the value protecting of free speech on issues of public interest” is paramount, and that in suits like these the litigant’s goal is not to win or lose but “to intimidate the advocate ‘into silence.’” [National Review, November 14]
If the ACLU wanted to be consistent, it would support the free expression rights of both Mark Steyn and Elaine Huguenin. We’re pretty sure that Steyn, like Huegenin, makes a living plying his trade.

It pays to be a broker in government largess. At least one region of the country is doing rather well. A Washington Post special report from Greg Jaffe and Jim Tankersley finds that affluence has been on the rise in Washington, D.C.
During the past decade, the region added 21,000 households in the nation’s top 1 percent. No other metro area came close […] big companies realized that a few million spent shaping legislation could produce windfall profits. They nearly doubled the cash they poured into the capital.
The signs of the new Washington are everywhere — from the Tiffany store that Fairfax County (Va.) development officials boast is the most profitable in the country to the new Tesla dealership in Tysons Corner. Every morning on the Beltway, contractors, lobbyists and some of the country’s highest-paid lawyers sit in the nation’s worst traffic. […] Essentially, Washington has been the beneficiary of a decade-long, taxpayer-funded stimulus package. […] It’s hard to say exactly how many of Washington’s households in the top 1 percent draw their incomes from the broad business of serving, supplying or influencing the government. But an analysis of tax data by the Economic Policy Institute shows that the area’s 1-percenters are most likely to be lawyers and executives. […] Nearly 1 in 10 of those households is headed by a government worker. […]
Government relations has become so important to the bottom line of a modern company, Becker said, that it should be a required course at business school. The numbers suggest she’s right. Companies spent about $3.5 billion annually on lobbying at the end of the last decade, a nearly 90 percent increase from 1999 after adjusting for inflation, political scientist Lee Drutman notes in a forthcoming book, “The Business of America Is Lobbying.” […] The more companies spend on influence, the lower their effective tax rates and the higher their stock returns compared with competitors’, according to recent research. A company called Strategas has built an index to track the stock performance of the 50 companies that lobby the most; last year, that index outperformed the rest of the market by 30 percent. [“Capital gains: Spending on contracts and lobbying propels a wave of new wealth in D.C.” by Greg Jaffe and Jim Tankersley, Washington Post, November 17]
Who needs Kyoto? China and India both signed the Kyoto protocol on greenhouse gas emissions in 1997. The United States did not. From James Taylor, here’s a snapshot on how that has worked out:
U.S. carbon dioxide emissions declined by 3.7 percent in 2013, the Tyndall Centre for Climate Change Research at the University of East Anglia (UK) reports. The decline in U.S. emissions continues a dramatic drop in U.S. emissions this century, even as global emissions rapidly rise. […]
Global emissions will rise by 2.1 percent during 2013, powered mainly by a 5.9 percent increase in China and a 7.7 percent increase in India.
U.S. emissions have declined 14 percent since the year 2000. The decline is even more dramatic since 2007, with U.S. emissions down 16 percent in that short time.
Global emissions continue to rise despite the ongoing decline in U.S. emissions. Global emissions are up 45 percent since 2000, and up 16 percent since 2007.
China now emits approximately double the emissions of the second largest emitter, with China accounting for 27 percent of global emissions and the United States accounting for 14 percent of global emissions. Since the year 2000, China alone is responsible for two-thirds of the global increase in carbon dioxide emissions. [Heartland Institute, November 19]
What to remember about November 22: Sure, the assassination of John F. Kennedy 50 years ago Friday is a big deal historywise, but did you know that Aldous Huxley and C.S. Lewis also died on that same day in 1963? Dan Hannan remembered:
Both men wrote dystopian novels. Huxley’s Brave New World foresaw a time when reproduction would be industrialised and the population drugged. Lewis’s That Hideous Strength tells of Britain being taken over by an apparently benign, but in fact diabolical, bureaucracy. Art often anticipates life and, deliciously, the bureaucracy is known by the acronym NICE.
Lewis’s work now seems the more relevant. Regular readers will know that what I call the EU’s hideous strength – its ability to make good people do bad things – has been one of the long-running themes of this blog for the past six years. What stays in my mind from Brave New World, by contrast, is not the science fiction, but the way the main character comes to see that, in a plastic society, reality is reached through Shakespeare, “that other world of truer-than-truth”. [The Telegraph, November 22]
This month in liberal condescension:
“It’s fascinating to me that some of the pushback is coming from, sort of, white suburban moms who—all of a sudden—their child isn’t as brilliant as they thought they were and their school isn’t quite as good as they thought they were […] . Do we want more for our kids, or do we want less? Do we want higher standards or not?”
—Arne Duncan, trying to explain why some people oppose national Common Core education standards. [Politico, November 18]
“Well, it really wasn’t any fun. I did not enjoy having to answer to the voters. I didn’t like the idea that someone could stop you on the street and fill your ear full for 30 minutes just because they voted for you. I got to where I couldn’t stand the voters. And when you’re a politician, that’s a bad place to be.”
—John Grisham, remembering his short stint as a Mississippi state representative in the 1980s. [Los Angeles Times, November 16]
“Just shop around in the new marketplace. You’re going to get a better deal. […] Remember, before the Affordable Care Act, these bad-apple insurers had free rein every single year to limit the care that you received, or used minor pre-existing conditions to jack up your premiums, or bill you into bankruptcy.”
—President Barack Obama, advising voters who don’t like the fact their health insurance plans are being cancelled for not complying with ObamaCare’s insurance regulations. [Reuters, October 30]
Politicians never think their ideas are wrong; they think the people just don’t know what’s good for them. And maybe they’re right. Think of how much better life could be if weren’t for the fact that it’s really hard to give people stuff they don’t want: Right now you could be driving a DeLorean on your way home from watching a USFL game, looking forward to watching your kids play lawn darts; then you could record the fun for later viewing on your Polaroid Polavision Home Movie System—while sipping a New Coke, of course. But unless we can go back to the future that people didn’t want, you’re out of luck.
• Celebrate Thanksgiving, and if you happen to be in the neighborhood of Plymouth, Mass., on November 23, you can celebrate a little early. Plymouth is the location of the colony formed by the Pilgrims after they disembarked from the Mayflower in 1620. The Pilgrims held the first Thanksgiving in 1621. Plymouth’s Thanksgiving parade this year will celebrate heroes from throughout America’s history, including Squanto, Abraham Lincoln, and the first responders to the Boston Marathon bombing. Attendees are encouraged to bring non-perishable food items for a local food bank.
• Discover how economic liberty can improve life in the Middle East. The Fraser Institute, the International Research Foundation, and the Friedrich Naumann Foundation will host the 8th Annual Economic Freedom of the Arab World Conference in Muscat, Oman, on November 25 and 26.
Learn about the problematic science and failed predictions of anthropogenic climate change. Professor Michael Beenstock will speak at the Institute of Economic Affairs in London. His lecture will begin at 6 p.m. on November 27.
• If you have a nonprofit in the Washington, D.C., area and it excels in the areas of fiscal management, communication, organizational and resource development, planning, human resources, risk management, or use of technology, then you should consider applying for the Washington Post Award for Excellence in Nonprofit Management. Your nonprofit might win $10,000. Applications are now open for the 2014 award; the application deadline is January 6, 2014.

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