Obamacare: A Deception
The Devil is in the Details
By PAUL CRAIG ROBERTS | CounterPunch | February 5, 2013
The article below is the most comprehensive analysis available of “Obamacare” – the Patient Protection and Affordable Care Act. The author, a knowledgeable person who wishes to remain anonymous, explains how Obamacare works for the insurance companies but not for you.
Obamacare was formulated on the concept of health care as a commercial commodity and was cloaked in ideological slogans such as “shared responsibility,” “no free riders” and “ownership society.” These slogans dress the insurance industry’s raid on public resources in the cloak of a “free market” health care system.
You will learn how to purchase a subsidized plan at the Exchange, what will happen when income and family circumstances change during the year or from one year to the next, and other perils brought to you by Obamacare. It is one of the most important articles that will be posted on my website this year. Americans will be shocked to learn the extent to which they have been deceived. The legislation neither protects the patient nor are the plans affordable.
The author shows that for those Americans whose income places them between 138% and 400% of the Federal Poverty Level, the out-of-pocket cost for one of the least expensive (lower coverage) subsidized policies ranges from 2% to 9.5% of Modified Adjusted Gross Income (MAGI), a tax base larger than the Adjusted Gross Income used for calculating federal income tax.
What this means is that those Americans with the least or no disposable income are faced in effect with a substantial pay cut. The author provides an example of a 35 year-old with a MAGI of $27,925. The out-of- pocket cost to this person of a Silver level plan (second least expensive) is $187.33 per month. This cost is based on pre-tax income, that is, before income is reduced by payroll and income taxes. There goes the car payment or utility bill. The lives of millions of Americans will change drastically as they struggle with a new, large expense – particularly in an era of no jobs, low-paying jobs and rising cost of living.
The author also points out that the cost of using the mandated policies will be prohibitive because of the large deductibles and co-pays. Many Americans will find themselves not only with a policy they can’t afford, but also with one they cannot afford to use. Those who cannot afford the insurance, even with a subsidy, will be faced with a costly penalty, and in many cases, this, too, will be difficult, if not impossible, to pay. As each year’s subsidy is based on last year’s income, there will be a substantial year-end tax liability for those who must repay the subsidy in whole or part because their income increased during the year.
The stress alone from such a regressive scheme is, without a doubt, not conducive to good health and well-being.
Diets will worsen for millions of Americans as they struggle with a new large expense. Thus, the effect of Obamacare will be to worsen the health of millions. Indeed, a “glitch” in the legislation allows millions to be priced out of coverage.
Alternatively, Americans might be able to acquire health insurance coverage but have no doctors willing to treat them.
The demand that Obamacare places on household budgets in which there is no slack makes me wonder where the president’s economists were while the insurance lobby crafted the product that serves the profits of insurance companies. Two well-known economic facts are that real family income has been stagnant or declining for a number of years and Americans are over their heads in debt.
How does Obama preside over a recovery when consumer purchasing power is redirected to insurance company profits?
Obamacare not only rations health care by what a person or family can afford, but also has implications for Medicare patients. Hundreds of billions of dollars are siphoned from Medicare to help pay the cost of Obamacare. The health care provided to Medicare patients will decline with the reduced payments to care providers. Health care seems destined to be rationed according to the age and illnesses of Medicare patients. Those judged too old and too ill could be denied expensive treatments or procedures that would prolong their lives.
Obama will rue the day that his name was put on this special interest legislation, and most Americans, once they realize what has been done to them, will be angry that special interests again prevailed over the health of the nation.
OBAMACARE: THE DEVIL IS IN THE DETAILS
The Patient Protection and Affordable Care Act of 2010, commonly referred to as the ACA or Obamacare, will go into full effect in 2014. This decree mandates that all Americans must purchase and maintain government-approved health insurance or pay a penalty to the IRS. Touted as a plan to provide all Americans with access to medical care, in reality, this compulsory shakedown commands everyone to purchase insurance that for many will be too expensive, even with government subsidies – or unaffordable to use – or both.
The ACA was not selflessly designed with the intent of providing affordable and equitable medical services to those in need, but rather to acquire taxpayer money for the private insurance companies under the seemingly helpful guise of health care and the ideological excuse of personal responsibility. It takes money from ordinary people and gives it to a medical insurance industry that profits handsomely from this legally-enforced corporate welfare – all while keeping Americans locked in the same broken system that puts profit before patients. The law was essentially written by business executives from the industry so that special interests would not be upset and profits assured.
There’s a lot to digest about how the ACA works and much is buried in a complex, convoluted maze of regulations and procedures. A few websites contain explanations, but very important details have either been left out or glossed over. These details are well worth understanding so you will know what’s at stake for you and your family. This lesson is not meant to convey a political opinion. This is how the ACA works and under this law, there are no sacred cows.
In today’s lesson, you will learn why 2013 is an important year for many of you with regard to your income and the ACA. We will discuss 1) use of Modified Adjusted Gross Income, 2) tax credits (help paying for insurance), 3) your share of the premium, 4) paying back the tax credits to the IRS, 5) expansion of Medicaid and estate recovery which could affect you if you are put into that plan, 6) inadequate coverage in most subsidized plans, 7) penalties, 8) exemptions and 9) a few tidbits. We’ll also take a look at the agenda of Enroll America and the Health Insurance Exchanges, and what you can expect to hear in the very near future.
Here we go. Fasten your seat belts.
1. HEALTH INSURANCE EXCHANGE BASICS
In 2014, each state will have an Affordable Insurance Exchange where qualified individuals and families with incomes between 138 and 400 percent of the Federal Poverty Level (FPL) can shop for commercial insurance policies. Most individuals and families with incomes at or below 138 percent FPL will be put into Medicaid. You may be eligible for help paying for your insurance in the form of a tax credit. In most states, the Children’s Health Insurance Program (CHIP) will continue to cover children in families with incomes up to at least 200 percent FPL. Some states may offer a Basic Health Plan for those who earn up to 200 percent FPL and are not eligible for Medicaid. Under limited circumstances, you may also be eligible for a cost-sharing credit.
Eligibility to receive a tax credit, the amount of your tax credit and your out-of-pocket share for the insurance will be determined by your income and where you fall in the Federal Poverty Level Guidelines (FPL). This is easy to understand.
Your annual gross income determines which FPL you’re in. For example, based on 2012 FPL Guidelines, an individual with an annual income of $33,510 is at 300 percent FPL; a family of 4 with an annual income of $69,150 is at 300 percent FPL. To see where you’re at, try the handy calculator at this link. FPL Guidelines are revised every January, so the 2013 edition should be up soon.
The ACA requires use of MODIFIED ADJUSTED GROSS INCOME (MAGI) instead of Adjusted Gross Income for all determinations made by an Exchange including eligibility for Medicaid except in certain cases. So, in this lesson, we’ll refer to annual income as MAGI.
Modified Adjusted Gross Income (MAGI) is defined as Adjusted Gross Income PLUS
a) all tax exempt interest accrued or received in the taxable year;
b) the non-taxable portion of Social Security benefits provided under Title II of the Social Security Act which includes old-age benefits, disability benefits, spousal benefits, child benefits, survivor benefits and parental benefits;
c) tier 1 Railroad Retirement benefits that are not includible in gross income; and
d) the exclusion from gross income for citizens or residents living abroad.
The adoption of MAGI, created by the ACA, is defined in a new section of the IRS code.
2. DETERMINING ELIGIBILITY FOR A TAX CREDIT
The tax credit is to help you pay for insurance. The ACA says it must be based on annual income for the tax year it’s received, but since you will need help paying for your plan during that year, the ACA allows for advance payment of the tax credit.
Here’s an example of what that means: Let’s say you apply for insurance at an Exchange in 2014. Therefore, 2014 is the tax year you will receive your tax credit, and per the ACA, the amount you receive must be based on that year’s MAGI. But, that year’s MAGI won’t be available until 2015 when you file your 2014 tax return and you need help paying for your insurance plan when you buy it in 2014. So, the amount of your tax credit has to be determined on information that is available such as your prior-year (2013) tax return. Thus, the tax credit morphs into an ‘advance payment of the tax credit’ (also referred to as an advance premium assistance credit). Now you see why 2013 is an important year for many of you.
The ACA allows for limited disclosure of tax return info in order for an Exchange employee to verify your citizenship status and MAGI, and, not only to let you know how much your advance tax credit will be, but also to see if you are eligible to receive this in the first place. An Exchange can also consider using your real-time income by looking at your state’s most current quarterly wage database, or it may agree to accept paper verification (pay stubs, etc.) as a last resort or an attestation of your income with no verification. Creation of a federal ‘data services hub’ is in the works so your income information will be more readily accessible. But, no matter how this plays out, you’ll still receive an advance payment of the tax credit because your actual MAGI for 2014 will not be known by you nor can it be verified by an Exchange until you file your 2014 tax return in 2015.
Ultimately, no matter which method is used – prior year or partial current year – this advance payment of the tax credit carries with it some heavy-duty consequences which are discussed in topic 4 of this lesson.
3. TAX CREDITS AND YOUR SHARE OF THE PREMIUM
The amount of your tax credit will be based on the second lowest-cost Silver plan in the area where you live and your MAGI. Here’s how this works – it’s quite simple:
a) First, the amount you will pay out of your pocket for that Silver plan – copays and deductibles not included – will be a specific percentage of your MAGI, and you will pay this to the insurer on a monthly basis. The way this percentage will be calculated is described a few lines down.
b) Next, your share will be deducted from the cost of that Silver plan and the difference will be your tax credit which the government will pay directly to the insurer on a monthly basis when you purchase a plan.
The specific percentage you will have to pay for the second lowest-cost Silver plan will be based on your FPL using a well-greased sliding scale. As your FPL increases little by little, the percentage you will pay increases. The same percentage applies to an individual or a family. Here’s how much of your MAGI you will pay for that Silver plan:
— up to 138 % FPL: 2% for people legally present less than 5 full years and residents of states that do not expand Medicaid
— 138-150% FPL: 3 to 4%
— 150-200% FPL: 4 to 6.3%
— 200-250% FPL: 6.3 to 8.05%
— 250-300% FPL: 8.05 to 9.5%
— 300-400% FPL: 9.5% – there’s no range, but the dollar amount of your share will change because 9.5% of a lower MAGI is less than 9.5% of a higher MAGI.
Here are two examples in dollars using 2012 FPL Guidelines and an estimate for a second lowest-cost Silver plan which will vary depending where you live – actual costs are not yet available:
a) You are 35 years old and the price of the second lowest-cost Silver plan for an individual in the area where you live is $4,750 with no tax credit. If your MAGI is $33,510 ($2,792.50 per month) putting you at 300 percent FPL, your share for that Silver plan, per the chart above, would be 9.5 percent of your MAGI which comes to $3,183 ($265.25 per month). Your tax credit would be $1,567 which is the difference between the unsubsidized cost of that Silver plan and your share.
b) You are 35 years old and your MAGI is $27,925 ($2,327 per month) putting you at 250 percent FPL, so, your share of that Silver plan would be 8.05 percent of your MAGI which comes to $2,247.96 ($187.33 per month) and your tax credit would be $2,502.
If the second lowest-cost Silver plan is too expensive, you can apply your tax credit to a Bronze plan which will be cheaper but less comprehensive. If you want a better plan than the Silver, you will have to pay the full difference in the premium.
Don’t forget that your share of the monthly premium will be figured on your MAGI which is pre-tax income. So, after you deduct your income taxes and your share of an insurance plan, will you be able to cover your monthly basic living costs including paying off debt you may owe and still have some cash left to pay for medical care if you have to use your insurance? Check out topic 6 in this lesson for a rundown of plans and coverage you can expect to find at an Exchange. Hope you don’t faint.
Once you purchase a plan, your share and your tax credit won’t change until the next enrollment period unless, before that time, your income goes up or down enough to bump you into a different FPL or you get a job with insurance. You can let your Exchange know by phone or via your online account, or, your Exchange might notice while cruising the data services hub you learned about in topic 2 and notify you that you must ‘up’ your coverage or that you’ve been tossed into Medicaid if your MAGI has decreased enough to make you eligible for that plan. Exchanges will be encouraged to use as many different avenues as possible including private databases to keep tabs on your income.
Thus, you could end up bouncing from Medicaid to a subsidized plan or vice versa. By the same token, you could take some extra work to help pay the bills or to save for a vacation, and, oops, you went over 400 percent FPL and are no longer eligible for a tax credit. The Exchange may not find out about this unless you spill the beans, but, no matter how it all plays out, income changes will catch up with you when you file your tax return.
To be eligible for a tax credit you must file your tax return no later than April 15. Married taxpayers must file a joint return. Individuals who are listed as dependents on a return are ineligible for a tax credit.
If you are eligible for Medicaid, you will not be allowed to receive a tax credit or a cost-sharing credit although some states impose premium and cost-sharing charges on certain Medicaid enrollees per the Deficit Reduction Act of 2005 (DRA) and clarified in the Tax Relief and Health Care Act of 2006.
On January 22, 2013, the Centers for Medicare & Medicaid Services (CMS) proposed allowing states to further increase Medicaid premiums and out-of-pocket costs by 5 percent. The most egregious part of this proposed rule says that states may allow providers to deny services for failure to pay the required cost-sharing in certain circumstances. The Obama administration is behind this proposed rule hoping to persuade states to expand Medicaid since many have refused and others are still undecided – the expansion of Medicaid is an integral part of the ACA. Allowing states to further increase premiums and cost-sharing for the poorest segment of the population underscores the existing political bias toward low-income Americans despite rhetoric which claims otherwise.
https://www.federalregister.gov/articles/2013/01/22/2013-00659/medicaid-childrens-health-insurance-programs-and-exchanges-essen- tial-health-benefits-in-alternative#h-186 http://www.nytimes.com/2013/01/23/health/medicaid-patients-could-face-higher-fees-under-a-proposed-federal-policy.html
Affordability rates (the percentage of your MAGI the government has decided you can afford to pay for insurance) are based on boardroom formulas which don’t take particular individual needs into account such as housing costs, property taxes, debt, education, transportation, retirement savings, etc. Also, FPL Guidelines are standard across the country and do not take into consideration those who reside in a more expensive region or vice versa. They are one-size-fits-all with the exception of Alaska and Hawaii. See topic 8 in this lesson to learn about exemptions.
Check out what self-proclaimed health care expert Jonathan Gruber says about affordability and get a load of all the “formulas.” According to Mr. Gruber, you may be having too much fun in life and need to get serious, buy health insurance and live under a rock in order to pay for it. He was involved with Romneycare in Massachusetts and was also Mr. Obama’s go to man under a no-bid contract. Per a bar graph on page 6 of a report prepared by Stan Dom for the Urban Institute, subsidized plans under the ACA are estimated to cost 2 to 3 times more (give or take) than the subsidized plans under Romneycare. Per several surveys during the years that Romneycare has been in effect, many low and modest income MA residents have had difficulty paying for those plans and the out-of-pocket costs to use the insurance, particularly chronically-ill residents.
http://ebookbrowse.com/1493-gruber-will-affordable-care-act-make-hlt-ins-affordable-reform-brief-v2-pdf-d124754327
http://www.statecoverage.org/files/TheBasicHealthProgramOptionUnderHealthReform.pdf
4. PAYBACK OF TAX CREDITS TO THE IRS
Perhaps you recall hearing politicians including Mr. Obama say if you can’t afford to pay for health insurance, the government will help you. That was one of the key talking points repeated non stop. We just went over the help part – the tax credits. Now we’ll look at what Mr. Obama et al didn’t tell you which is important to understand because it could cause you some serious financial distress.
Remember the “advance payment of the tax credit” in topic 2 of this lesson? Well, essentially, that was a loan from the government which was paid in advance to the insurer on your behalf when you purchased your plan, and, as you know, loans have to be paid back. So, when you file your tax return for the year you received your “advance tax credit” (your loan), if your income has changed, you have to settle this with the IRS. Here’s the deal:
a) If your MAGI is higher and the increase puts you into a higher FPL, you may have to pay back a portion or all of the tax credit because it was based on a lower MAGI. In other words, you could have an additional tax liability on top of the income taxes you already paid (or still owe) because you received a higher tax credit than you were entitled to.
b) If your MAGI is lower and the decrease puts you into a lower FPL, a refund could be coming to you because you were eligible for a larger tax credit than the government paid to the insurer. In other words, you overpaid for your portion of the insurance premium.
c) If you earned a bit more or less, but your extra earnings or loss didn’t bump you into another FPL, you’re home free.
To figure out your payback, you will have to enter the relevant figures on the reconciliation page of the tax return. Changes in filing status such as the number of people in your household will also have an impact. For those of you who marry or divorce, the rules for the payback amount as well as the amount of the tax credit you are eligible to receive will make your head spin – the computation includes pre- and post-marriage FPL and uses the highest FPL of the two people involved. Ditto for divorce.
Here is one of the reconciliation explanations in IRS-speak: Your liability for an excess tax credit you received must be reflected on your current year income tax return subject to a limitation on the amount of such liability.
Oh! Limitation on the amount of such liability. That sounds good.
Let’s take a peek at the payback limitations on record at the time of this writing. “At the time of this writing” are the operative words because the cap has been increased twice since the ACA was signed into law. The original payback was capped at $400 for families under 400 percent FPL and $200 for individuals. We’ll skip over the first increase. The story behind the second one is that a particular revenue stream was removed from the original law, so something had to be done to compensate for this lost money. Thus, an amendment was passed that increased the cap using a sliding scale, thereby putting a huge financial burden on the backs of the very people the ACA claims to help. In other words, tag, you’re it. You are the cash cow.
Here are the current sliding-scale caps:
If the household income (expressed as a percent of poverty line) is:
less than 200 percent, the applicable dollar amount is $600
at least 200 percent but less than 300 percent, the applicable dollar amount is $1,500
at least 300 percent but less than 400 percent, the applicable dollar amount is $2,500
Effective date: the amendment made by this topic shall apply to taxable years ending after December 31, 2013. Very truly yours, House Ways and Means Committee
The name of this bloodsucker is The Comprehensive 1099 Taxpayer Protection and Repayment of Exchange Subsidy Overpayments Act of 2011.
http://www.gpo.gov/fdsys/pkg/PLAW-112publ9/html/PLAW-112publ9.htm
But wait, there’s more!
a) Update: Today (Feb. 17) (2011) the House Ways and Means Committee approved the 1099 repeal bill which requires consumers earning more than 400 percent of the poverty line to pay back the [entire] subsidy.
b) Also, per IRS final regulations: for taxable years beginning after December 31, 2014, the payback caps may be adjusted to reflect changes in the consumer price index.
Payback amounts are reduced to one-half for unmarried individuals who are not surviving spouses or filing as heads of households. There is no help if you get hit with a payback and many of you will have difficulty paying this liability.
Chances that you may have received an incorrect tax credit are not exactly slim because this poorly thought-out scheme does not take into account the unpredictable and complex financial situations that confront the low and modest income population.
Keep in mind that by ending up in a higher FPL, you may also have to pay more out of your pocket for an insurance premium. You learned how that works in topic 3. If you can’t afford a higher premium and drop your insurance, you may still owe a payback plus a penalty for being uninsured which is also MAGI-based. Penalties are discussed in topic 7. If your MAGI puts you over 400 percent FPL, you just knocked yourself into left field and are on your own paying for an insurance plan on the open market. And, you may also be required to payback the entire tax credit.
If you get a job during the current year that offers health insurance which is not more than 9.5 percent of your total salary and the coverage is not less than 60 percent, you must take that insurance or pay a penalty for being uninsured. But, you may owe a payback for the months you received a tax credit before you landed the job. How large that payback is will depend on your MAGI for the entire tax year, not just on your income during the months you received the tax credit. Or, you may lose a job during the year and have a significantly reduced income even though the amount reported on your tax return is high because you had a job for part of the year. In this case as well, your payback will be based on your MAGI for the entire tax year.
More interest income from taxable and tax-exempt savings or a year-end bonus could also contribute to an increased MAGI and the possibility of a payback as well as taking extra work to help pay the monthly bills, house and car repairs, educational aspirations or a vacation. So, whether or not you end up in payback land will depend on how close you are teetering on the edge of an FPL. Ditto for your share of the premium and the amount of your tax credit.
The payback may stop many of you from purchasing insurance at the Exchange because you know in advance you will not have the money to pay it. If this is the case, you may be allowed to negotiate a lesser tax credit by paying more out of your pocket for your monthly insurance premium in order to avoid or decrease the payback. It’s a crap shoot. Considering what you’ve learned so far in today’s lesson, many of you will find yourselves between a rock and a hard place under the ACA, and you will be forced to make untenable choices. Given the skyrocketing costs of food, heat and other basics, how will you even tread water under this set-up, never mind get ahead?
Being told you will receive help from the government if you can’t afford to purchase insurance and finding out at tax time this was really a loan and you owe the IRS a substantial debt on top of your income taxes is outright shameful. But most politicians have no shame – which brings us to the next topic.
5. MEDICAID EXPANSION AND ESTATE RECOVERY
In order to expand Medicaid, several Medicaid regulations were changed:
a) the income limit for eligibility was increased to 133 percent FPL, but since states must apply a 5 percent disregard, this effectively raises the eligibility to 138 percent FPL
b) Modified Adjusted Gross Income will be used in most cases to determine eligibility (also applies to certain CHIP applicants)
c) the age limit was increased to 64, childless adults will be eligible; and
d) the asset test was dropped except for certain groups such as the elderly and people on Social Security Disability – BINGO!
The fact that the asset test was dropped is very important, but before we look at why, you must first understand that if an Exchange determines you are eligible for Medicaid, you have no other choice. Code for Exchanges specifies, “an applicant is not eligible for advance payment of the premium tax credit (a subsidized plan) or cost-sharing reductions to the extent that he or she is eligible for other minimum essential coverage, including coverage under Medicaid and CHIP.” Therefore, you will be tossed into Medicaid unless there are specific rules as to why you would not be eligible. If you are enrolled in a private plan through an Exchange and have been receiving a tax credit, and your income decreases making you eligible for Medicaid, in you go. If you are allowed to opt out because you don’t want Medicaid, you will have to pay a penalty for being uninsured unless you can afford to purchase insurance in the open market.
Just so you’re clear on this: the ACA stipulates that the system will ensure that if any individual applying to an Exchange is found to be eligible for Medicaid or a state children’s health insurance program (CHIP), the individual will be enrolled in such a plan.
Furthermore, to increase enrollment in health coverage without requiring people to complete an application on their own, states are advised to automate enrollment whenever possible by using existing databases for social services programs such as SNAP (food stamps) to enroll people who appear eligible for Medicaid but are not currently enrolled. Therefore, you could find yourself auto-enrolled in Medicaid against your will if your state acts on this advice.
Many times over Mr. Obama et al told you that all Americans would have choice. Choice was another big talking point. Are poor and low-income Americans undeserving of choice? Is the ACA a class-based system? Maybe they meant that for this segment of the population, the choice would be between Medicaid or a penalty for remaining uninsured. This is blatant discrimination.
Here’s why dropping the asset test got the BINGO – Estate Recovery! You won’t find the following info in the ACA. It’s in the Omnibus Reconciliation Act of 1993 (OBRA 1993) – a federal statute which applies to Medicaid, and, if you are enrolled in Medicaid, it will apply to you depending on your age.
a) OBRA 1993 requires all states that receive Medicaid funding to seek recovery from the estates of deceased individuals who used Medicaid benefits at age 55 or older. It allows recovery for any items or services under the state Medicaid plan going beyond nursing homes and other long-term care institutions. In fact, The Centers for Medicare & Medicaid Services (CMS) site says that states have the option of recovering payments for all Medicaid services provided. The Department of Health and Human Services (HHS) site says at state option, recovery can be pursued for any items covered by the Medicaid state plan.
b) The HHS site has an overview of the Medicaid estate recovery mandate which also says that at a minimum, states must pursue recoveries from the “probate estate,” which includes property that passes to the heirs under state probate law, but states can expand the definition of estate to allow recovery from property that bypasses probate. This means states can use procedures for direct recovery from bank accounts and other funds.
c) Some states use recovery for RX and hospital only as required by OBRA 1993; some recover for a few additional benefits and some recover for all benefits under the state plan. Recovery provides revenue for cash-strapped states and it’s a big business.
Your estate is what you own when you die – your home and what’s in it, other real estate you may own, your bank account, annuities and so on. And even if you have a will, your heirs are chopped liver. Low-income people often have only one major asset – the home in which they live and, in some cases, this has been the family home through several generations.
So what this boils down to is: if you are put into Medicaid – congratulations – you just got a mandated collateral loan if you use Medicaid benefits at age 55 or older! States keep a running tally.
Estate recovery can be exempted or deferred in certain situations after your death, but the regulations for this are limited and complicated with multitudes of conditions. You may not have an attorney on speed dial, but with regard to this hundred pound gorilla, it sure would be handy.
Should you decide to ask your congresscritter about estate recovery, be prepared for responses such as:
— “Estate recovery doesn’t apply to you.” (Great news. Please overnight a copy of the amendment to OBRA 1993 that stipulates estate recovery is no longer required and no longer allowed. Here’s my address.)
— “Oh, estate recovery is state, I’m federal.” (Wrong – estate recovery is federally mandated although the estate recovery program itself is administered by each state.)
— “I don’t know anything about this.” (Highly unlikely because the expansion of Medicaid is an integral part of the ACA and estate recovery is not a secret.)
— “The ACA wasn’t about revamping Medicaid.” (As explained above, Medicaid regs were revised in order to expand Medicaid.)
— “I’ll look into that and get back to you.” (Don’t hold your breath – they don’t want to go there.)
If you ask about estate recovery when you contact an Exchange or speak with an outreach agency, you’ll probably run into a brick wall or be told it doesn’t apply to you – whatever. But, it doesn’t matter because what you are told is not legally binding. What is legally binding is your signature on the Medicaid application which indicates that you agree to the terms of the contract – which brings us to another item in OBRA 1993. Read on.
OBRA 1993 also contains procedural rules intended to ensure that individuals are informed about Medicaid program requirements including disclosure of estate recovery before they complete the application process and also during the annual re-determination process. Notification of estate recovery should be on the signature page of your state’s Medicaid application and is usually a one-liner: I understand that if I am aged 55 or older, (name of your state’s Medicaid plan) may be able to get back money from my estate after I die. (Use of the word ‘may’ doesn’t mean if the state feels like it – it means recovery will take place unless there are specific circumstances for exemption or deferment as mentioned above.) There are also strict recovery/repayment clauses for injury-related settlements disclosed on the signature page and a few other ditties that apply to you or a family member who is enrolled in Medicaid. All of these items must also be disclosed in your state’s Medicaid handbook.
Under the ACA and proposed federal rules for implementation, states will be required to provide a single, simple application to apply for and enroll in Exchange plans, Medicaid and CHIP, and consumers must be able to apply by phone, in person or online. The Secretary (HHS) is charged with this task and it’s in the works. This begs an answer to the following questions:
— Will Medicaid applicants be diligently informed about estate recovery and other rules that apply to Medicaid enrollees on this single application?
Failure to do so would be in non compliance with OBRA 1993 and would also be deceptive.
— Will applicants be provided with a signature page that contains appropriate disclosure of these rules so they can be reviewed before signing on the dotted line?
— How will appropriate disclosure and obtaining a signature work for those who are bumped into Medicaid due to a decrease in income or who might be auto-enrolled because they were presumed eligible through a database.
If an applicant or someone who has been bumped or auto-enrolled in Medicaid is not satisfied with the terms of the Medicaid contract, lack of another health insurance option that is in the best interest of low-income earners represents undue and unconscionable advantage being taken of this segment of the population under a law that mandates health insurance or a penalty.
Do the health insurance policies enjoyed by lawmakers on Capitol Hill and paid for by taxpayers include an estate recovery program?
Medicaid is poor, underfunded, overstretched and constantly bombarded by state budget cuts – even before an ACA expansion. It offers a low quality of care in many states, and, in general, represents inequities in care. Office-based doctors typically refuse to accept Medicaid patients, thus, millions thrust into this plan will have difficulty finding a primary-care doctor or a specialist.
A perfect example is the December 2012 federal appeals court decision that allowed California to cut reimbursements by 10 percent to doctors, pharmacies and others who serve low-income residents under the state’s Medi-Cal plan (a version of Medicaid) due to state budget issues. California was already at the bottom of the rate-reimbursement heap which made finding doctors difficult for residents in Medi-Cal. This decision will further reduce the number of health care providers willing to take new Medi-Cal patients, thus jeopardizing their access to primary and specialized care. Under the ACA’s expansion of Medicaid, state budget crises across the nation will exacerbate the ongoing problems regarding access to care for Medicaid patients, particularly in states that have a high low-income population.
http://www.sfgate.com/health/article/Medi-Cal-cuts-upheld-by-appellate-court-4116971.php
6. INSURANCE PLANS AT THE EXCHANGES
Below are the 4 plan levels that will be offered at Exchanges for people between 138 and 400 percent FPL. Each one has government- approved benefits including prescription coverage. You will be entitled to one free preventive visit each year. Per the most recent study commissioned by the Kaiser Family Foundation, several cost-sharing options were estimated for non-group (individual and family) Bronze and Silver plans. Cost-sharing is the amount you must pay to use your insurance. Your share of the premium is not part of cost-sharing.
The way this works is you will pay for all your medical care until you reach the annual deductible. Then you’ll pay the applicable percentage of coinsurance until you reach the annual out-of-pocket spending cap which will be set on a sliding scale. Annual means these amounts start again the following year, and if they change, you will find out when you re-apply for insurance. There will also be copays – an amount you will pay to the doctor for an office visit.
Here are the current estimates:
Bronze: cheapest and dry as dust with 60/40 coverage – a win-win for insurers
a) annual deductible of $4,375 for an individual (double for a family) with 20 percent coinsurance, b) annual deductible of $3,475 for an individual (double for a family) with 40 percent coinsurance
Silver: next cheapest – offers an illusion of coverage at 70/30
a) annual deductible of $2,050 for an individual (double for a family) with 20 percent coinsurance, b) annual deductible of $650 for an individual (double for a family) with 40 percent coinsurance
Gold: expensive – 80/20 – better coverage
Platinum: most expensive – 90/10 – most comprehensive coverage
A fifth plan will be available for the under-30 crowd and people who have been granted a hardship exemption. See topic 8 in this lesson. Coverage in this plan will be less comprehensive than the Bronze – it is primarily for major-medical expenses except that it has a free preventive visit. Cost-sharing for people at 138 to 200 percent FPL is estimated to be a bit less than the Bronze and Silver estimates mentioned above.
The high deductibles in all but the two most expensive plans could saddle you with mounting bills for routine care and may stop you from seeking necessary treatment for illness or injuries. Many of you will find that the promise of access to affordable health care really means access to inadequate coverage at a price the government has decided you can afford to pay.
The number of drugs in each plan at an Exchange will vary from state to state. In some states, plans will offer up to 99 percent of available drugs and others only 45 percent which means you may not have access to the specific drugs you need. Perhaps Big Pharma will change its stance on this before 2014.
The cost of plans at an Exchange will vary from state to state based on where you live and your age. The ACA allows insurers to charge older customers up to three times more for a plan, even if they are in good health, as long as the state in which an Exchange is located doesn’t have a law that caps age-rating. Some Exchanges will tuck an administrative fee of 2 to 4 percent into premiums to help cover operating expenses.
Cost-sharing tax credits will be available if you are below 250 percent FPL to protect you from high deductibles and copays – but only if you purchase a Silver plan. If you buy the cheaper Bronze plan, you won’t be eligible for these credits, which are, by the way, direct federal payouts to private health insurance companies.
Obamacare has no cost controls. There is nothing stopping the insurance companies from increasing their rates, and Washington has already estimated higher premium costs at the Exchange for 2016 which doesn’t mean that 2015 won’t have an increase. Sounds like 2014 prices will be an Introductory Offer. Get ‘em while their hot!
7. PENALTY FOR BEING UNINSURED
The ACA requires that people who have been deemed able to purchase health insurance but decide not to buy it starting in 2014 will owe a penalty (a tax) to the IRS. Here’s what this looks like:
a) In 2014, the annual penalty will be $95 per adult and $47.50 per child, up to a family maximum of $285 or 1 percent of family income, whichever is greater.
b) In 2015, the penalty will be $325 per adult and $162.50 per child, up to a family maximum of $975 or 2 percent of family income, whichever is greater.
c) In 2016, the penalty will be $695 per adult and $347.50 per child, up to a family maximum of $2,085 or 2.5 percent of family income, whichever is greater.
The IRS collects the penalty, but the ACA stipulates that taxpayers shall not be subject to any criminal prosecution or penalty, tax liens, seizure of bank accounts or garnishment of wages for failure to pay it and no accumulation of interest on the unpaid balance. So, it appears that all the IRS can do is deduct the penalty from a refund it owes you, and if you’re not due a refund, then you’ll have an outstanding tax obligation.
Keep in mind that the penalty is described in annual amounts but is really monthly. So, if you are uninsured for only part of the year, you will accrue only 1/12 of the total for each month you are uninsured unless you qualify for an exemption.
8. EXEMPTIONS FROM THE PENALTY
You may be eligible for official permission that excuses you from having to pay the penalty for being uninsured. The requirements are:
a) If the cheapest health care plan available costs more than 8 percent of your MAGI after subtracting the tax credit or employer contribution, whichever is applicable.
b) Your income is so low that you aren’t required to file federal income taxes.
c) You are between jobs and without insurance for up to three months.
d) You have a sincerely-held religious belief that prevents you from seeking and obtaining medical care.
e) You are in jail.
f) You are an undocumented immigrant.
g) You are a member of an Indian tribe or a religious group currently exempt from paying Social Security tax.
If item d) is the case, you must file a sworn statement as part of your tax return, and should you obtain care during the tax year, the exemption will no longer apply and you will have to pay a penalty for being uninsured. Per H.R. 6597, medical care is defined as acute care at a hospital emergency room, walk-in clinic or similar facilities. Medical care excludes treatment not administered or supervised by a medical doctor such as chiropractic, dental, midwifery, personal care assistance, optometry, physical exams or treatment where required by law or third parties such as an employer, and vaccinations.
If you think you can’t afford the amount the government has decided you can afford to pay for your insurance plan, and you don’t fit into any of the categories described above, you can apply for a Hardship Waiver. Details have not yet been provided regarding hardship eligibility requirements under the ACA, but, for an idea of what they might look like, let’s check out what the deal is in Massachusetts which already has a mandated health insurance law – Romneycare! In fact, Romneycare was the model for Obamacare. That’s why some people call Obamacare, Obamneycare.
To qualify for a Certificate of Exemption under Romneycare, a Massachusetts resident must demonstrate that health insurance is not affordable due to one of the following: 1) homelessness; 2) eviction or foreclosure notice; 3) domestic violence-related medical trauma; 4) major long-term illness of a child; 5) death of your spouse; 6) your house burned down; or 7) “you can establish that the expense of purchasing health insurance would cause you to experience serious deprivation of food, shelter, clothing or other necessities.”
Ya gotta luv number 7. And in Massachusetts, exemptions come with an expiration date, so you have to clean up your act in short order. Under the ACA, the Secretary of Health and Human Services will determine if, indeed, you have suffered a hardship that keeps you from being able to pay for coverage.
9. OTHER TIDBITS
There is much more in the ACA including all kinds of rules and penalties for employers, employees and the self employed as well as the Accountable Care Organization (ACO) model which will be mandated starting in 2014. The latter works as follows: under the simplest option available, a small group of doctors and hospitals – an ACO – will manage your care and be graded and paid based on the outcome of all patients who seek treatment with that ACO. The ACO will also be rewarded with a share of the savings in health costs it achieves by following best treatment practices and reaching specific benchmarks set by CMS. The second option, “shared savings plus risk,” is for larger ACOs. Providers will receive a lump-sum payment to treat their patients and assume a portion of the risk for above target spending but are eligible to keep a greater portion of the savings.
Either of these options reduce patient care to numbers and paperwork because doctors are essentially controlled and incentivized by an administrator in some far-flung office. The ACO model is the insurance industry’s version of “budgeting” the cost of health care which ultimately benefits insurers at the expense of doctors and their patients.
Doctors say that basing their pay on treatment outcomes creates an incentive for them to avoid tough cases whose outcomes could “kill my numbers.” “Paradoxically,” writes Dr. G. Keith Smith, “doctors who are doing sham surgery will be the ones with the best outcomes, as their patients, many of whom don’t need surgery in the first place, will exhibit great, basically perfect outcomes. Physicians who don’t do unnecessary surgery will be pushed to do so to improve their ‘scores.’ ‘Pay for performance’ trends in medicine are not a good idea in my opinion. Paying based on patient outcomes will have perverse effects, not the least of which will be the complete denial of care to the very sick.”
The ACA also requires Health Insurance Exchanges to establish a navigator program to inform the uninsured about the availability of government-approved subsidized plans at an Exchange and to facilitate enrollment in these plans, but it leaves the design of the program up to each Exchange.
Depending how an Exchange sets up its program, some Navigators will sell plans offered by an Exchange while others will be responsible for maintaining the existing market but may also be allowed to sell Exchange plans. All seller Navigators will be compensated either by Exchanges or insurance carriers for the plans they sell. Many options are being considered by Exchanges including using insurance agents. Hopefully, Navigators and insurance agents will not be knocking on your door or contacting you by phone. That would be over the top. Here’s a link to read what the California Exchange is pondering with regard to its Navigation program.
10. ENROLL AMERICA, HERNDON ALLIANCE & THE EXCHANGES – MASTERS OF SPIN
Since many Americans don’t know about the ACA, somehow the word has to get out and people must be encouraged to purchase health insurance either in the open market or at an Exchange. And who better to do this?
Enter “Enroll America” – a nonprofit 501(c)3, financially backed by Aetna, Blue Cross Blue Shield, UnitedHealth, America’s Health Insurance Plans, hospitals, associations that represent drug manufacturers and nonprofits with vested interests. For insurers and pharma, the ACA is manna from heaven – scratch that – manna from Capitol Hill – and the dollar signs in their eyes are on fire! These profit seekers and connected nonprofits will be using every avenue possible to maximize their bottom lines.
The mission of Enroll America per its website is to “ensure that all Americans are enrolled in and retain health coverage.” It’s Board of Directors and Advisory Council reads like a Who’s Who in the Medical Industry Cartel – CEOs, presidents, vice presidents and directors of such entities as the American Hospital Association, Express Scripts, Medicaid Health Plans of America, Kaiser Permanente and many others – the list is long. If you would like to donate to these mega-profit vultures, you can do so on the Enroll America home- page. The goal is $100 million by 2014.
In its publication, “Ten Ways to Make Health Coverage Enrollment and Renewal Easy,” Enroll America has recommended availability of web-based applications to increase the places where people can enroll in coverage: at home, at grocery stores, community health centers, state fairs, sporting events, places of worship, and more. Gee, you can apply for insurance while you pray. How thoughtful.
The strategy for insurers and state Exchanges to persuade you to purchase insurance and warn you about the penalties includes using ads, social media, blogs, YouTube, Flickr, Twitter, hospitals, health centers, McDonald’s, in-store radio announcements, ballparks, county fairs, libraries, laundromats, community events, libraries, county fairs and drugstores – you name it. Blue Cross Blue Shield has partnered with H & R Block. Health insurers are already setting up shop inside some supermarkets so they can answer your questions and sign you up for coverage while you do your grocery shopping. They will likely be showing up in shopping malls – maybe even in parking lots, on street corners and at church fairs. And, their aim is to recreate themselves from the bloodsucking leeches that they are to your new, cool-dude friends.
We’ll be living in Occupied Territory.
Let’s connect some dots. The executive director of Enroll America is Ron Pollack, also president of Families USA – a nonprofit and friend of the industry. On its website, Families USA bills itself as “a national non-partisan organization dedicated to the achievement of high quality, affordable health care for all Americans.” Philippe Villers and Robert Crittenden, M.D. are on Families USA Board of Directors. Mr. Villers is also on the BOD of Herndon Alliance, Bob Crittenden is a Herndon staff member and Ron Pollack is a Herndon founder.
Herndon Alliance is an influential health care spinmeister creating messaging to change public opinion and tweaking each message to reach particular groups.
Herndon has close ties to Capitol Hill and helped market the ACA providing words politicians and supporters should use to promote the bill. For example, during the national health care debacle a few years ago, you heard Mr. Obama et al continually talk about ‘choice,’ ‘we need a uniquely American solution,’ ‘fair rules,’ ‘investing in America’s future’ and ‘high-quality, affordable healthcare.’ That last one is used in Families USA mission statement. The Council for Affordable Health Insurance, a frontgroup for the industry, gets right to the point – its name. Ron Pollack worked with the Obama administration to help reshape public opinion of Mr. Obama’s unpopular health care bill. Leading up to 2014 when the Exchanges are scheduled to open, there will most likely be a blitz of TV ads in which you will hear many of these same nebulous, feel-good words. And, you’ll undoubtedly read or hear plenty of Herndon spin from your Exchange and throughout your state in the immediate future.
In the interest of coming up with messaging, Enroll America held a few focus groups and commissioned a nationwide survey in fall 2012. Research was provided by Celinda Lake from Lake Research Partners, a national public opinion and political strategy research firm. One takeaway was when a monthly premium cost was given, the majority of people polled thought that it was too expensive and the ACA would not provide affordable and comprehensive coverage even with the government tax credits (subsidies). So, Lake Research Partners advised Enroll America not to mention specific costs but to use the phrase ‘free or low-cost plans.’
Herndon has been working on messaging various parts of the ACA that will be used by outreach partners, insurers and state Exchanges. Its messaging is not based on truth or evidence – Herndon actually stays away from any mention of facts as you read above regarding the cost of plans. Instead, its messaging is designed to mislead an uninformed public.
A few of Herndon’s target populations include voters, people of color, red states, skeptical audiences, and you’ll love this one – Elevator Language with a list of succinct scripts to use based on the person you’re speaking to during the ride. You must check out Herndon’s website and read the many instructions of what to say and what not to say. You’ll either get very annoyed or laugh yourself silly.
http://herndonalliance.org/resources/research/communications-tips-exchange-talking-with-voters.html
http://herndonalliance.org/resources/implementation-basics/communications-tips-to-use-with-skeptical-audiences.html
Here are some examples of Herndon spin regarding the ACA:
— Use “family values” when talking to the public about the expansion of Medicaid. Is estate recovery a family value?
— When talking about the ACA’s required Accountable Care Organization (ACO) model that will pay doctors according to patient outcomes and reward them for savings they achieve, Herndon says to call this “Coordinated Patient Care” and “do not connect pricing with rewards or incentives for doctors” or “with lump-sum payments for medical care” and do not mention “payment based on positive patient outcomes.” Why not? The three do-nots are how ACOs work. (ACOs are described in topic 9.)
http://herndonalliance.org/resources/system-change/payment-reform-quality-care-pricing.html http://herndonalliance.org/resources/system-change/coordinated-patient-care.html
— Here’s an award winner: “Members of Congress will purchase their insurance at the Exchange. If members of Congress are part of the marketplace then it’s got to offer quality plans and protections.”
http://herndonalliance.org/resources/research/communications-tips-exchange-talking-with-voters.html
— Stressing that under the ACA insurers won’t be able to deny coverage for pre-existing diseases is a Herndon biggie. In fact, you heard this many times over from Mr. Obama and other politicians. But a loophole in the law allows insurers to rescind (cancel) your policy if you intentionally put false or incomplete information on your application. The ACA says you must be given at least 30 days’ notice before your coverage can be rescinded, giving you time to appeal the decision or find new coverage. So, if your care becomes costly for the insurer and you didn’t mention you had a rash on your arm when you were 15, that will work. How can you prove if leaving this out was intentional or not? It’s them against you.
Enroll America’s Best Practices Institute is publishing a series of briefs on the best way to write and design websites and marketing materials, no doubt, using Herndon messaging. PR and marketing firms are helping various state Exchanges come up with appealing branding such as using a name everyone will like and spiffy logos with cool type styles in colors that will appeal to all audiences. Branding lessons include advising Exchanges which words to ‘embrace’ such as emphasizing choice, control, transparency and competition. Other messaging includes, “the Exchange should be viewed as an educator, not an enforcer” and using the word ‘marketplace’ instead of Exchange is a must. Tennessee Health Care Campaign will be telling potential customers “. . . the exchange offers us more choices, greater control over our health care, and more competition to control costs.” It’s all Herndon’s handywork in one form or another.
http://dhmh.maryland.gov/exchange/pdf/Brand_Recommd_may182012_final.pdf http://www.thcc2.org/PDFs/rtm_exchange_talking_point.pdf
More choice means choice of insurance companies, not choice of doctors and hospitals. In rural areas, there may be only one insurer offering plans which means one network and doctors may not be taking new patients. This happened in MA under Romneycare, and on top of that, many doctors would not accept people in the subsidized plans because of time-consuming red tape and low reimbursement rates. Under the ACA, insurers are planning to limit networks in the cheaper plans at the Exchanges. Having too few doctors in a network is a means of suppressing the use of health care which increases an insurer’s profits. Further on in this lesson, you’ll learn that the Maryland Exchange has been advised to ignore negative problems such as not enough doctors to serve the newly insured.
Choice is definitely a non starter for people found eligible for Medicaid – the ACA allows no other choice for this segment of the population and many doctors do not accept Medicaid. As for giving you greater control, considering all the rules about income and FPL, not to mention the data-mining to monitor your income during the year and those nasty tax credit paybacks, it’s you who is being controlled. And competition? Read this stunning op-ed by Nomi Prins: “Real Danger of “Obamacare” Insurance Company Takeover of Health Care.”
In Enroll America’s January 15, 2013 press release, Executive Director Rachel Klein says the ACA offers the promise of “access to comprehensive, affordable health coverage.” That is a false promise. As you learned in this lesson, coverage in the plans that will be offered at the Exchanges, with the exception of the two most expensive, is anything but comprehensive – the cheaper plans are unaffordable to use. Furthermore, how can she claim that the cost of the plans are affordable? Ms. Klein should be well aware of the nationwide survey Enroll America commissioned in which the majority of people polled said that the plans are too expensive.
http://files.www.enrollamerica.org/news-room/press-releases/Enroll_America_Plans_Major_Affordable_Care_Act_Enrollment_Campaign_1-15-13.pdf
http://www.nytimes.com/2012/12/20/us/officials-confront-skepticism-over-health-law.html?ref=us&_r=0&pagewanted=all
Currently PR firms are working with some state Exchanges to develop effective communications plans and advertising campaigns. Names include Mintz & Hoke, Hill & Company Communications and Weber Shandwick just to name a few. Ask the Massachusetts Health Insurance Connector – the prototype of an Exchange in the land of Romneycare – how much it spent on PR contracts over the years. In 2007, board members signed off on a two-year contract with Weber Shandwick for $1.85 million the first year with nearly $3 million for advertising – commission on media buys not included. And, by the way, the MA Connector upper management boasts six-figure salaries. Former MA Connector Executive Director Jon Kingsdale’s salary in 2007 was $225,000 and increased in 2008 to $231,750. In 2007, Deputy Director Rosemary Day alternated between a four-day and five-day work week to the tune of $175,000. These are only two examples of the many high-flying salaries at the MA Connector, an operation run by politicians and unelected political appointees and influenced by executives from the private insurance industry,
http://www.wickedlocal.com/cambridge/news/x497793387/Connector-re-ups-contract-with-Cambridge-based-Weber-Shandwick http://www.boston.com/yourlife/health/other/articles/2007/01/27/6_figure_pay_for_care_plan_overseers/?page=full http://www.highbeam.com/doc/1G1-166773095.html
Add up pay scales like that for every Exchange in the country, throw in some bennies, a PR contract for each Exchange, campaign costs and compensation paid by Exchanges to Navigators for plans they sell – a grand and costly effort to push more people into America’s for-profit health care system. Your tax dollars at work and mega bucks that could be used for actual hands-on medical care.
The Maryland Exchange has three campaign funding levels – Basic, Plus and Full-Scale – with a total for year one, two and three. Basic funding for year one is $2,450,000, Plus is $4,000,000 and Full-Scale is $6,300,000. See p.137 at this link for years two and three.
http://www.dhmh.maryland.gov/exchange/pdf/FinalAdvertisingReportWeber.pdf
The following, from the maryland link above, gives you an idea of some of the strategies that will be in play, most likely in all states. The Maryland Exchange has been advised by Weber Shandwick to “establish a system to monitor newspaper, radio, TV and online conversations about the Exchange and the program and to establish procedures and priorities for responding to negative media stories, op-eds, blogs and reports.” You can find this in the Risk Management and Responses section of Maryland’s strategic marketing plan.
In the Earned Media/Public Relations section, advice includes “ . . . putting out stories on the first effective enrollees, enrollment number milestones, and enrollee testimonials. Each of these becomes the focus for positive, brand-reinforcing stories. There will also be the risk of negative stories, including potential topics such as enrollment snafus, delays in issuing insurance cards, the cost of Qualified Health Plans [government-approved plans], claims of ‘shoddy’ Bronze coverage, incidents of physicians refusing to accept enough new patients to serve the uninsured and other negative topics.” “While coverage is bound to include some level of criticism it can be success- fully countered by putting a human face on heatlh reform.”
The Social and Digital Media section advises an invasion of the Internet including social media to market health insurance by “delivering the right messages to the right audience at the right time,” (probably using Herndon spin) to “help drive enrollment in the Exchange,” and also flooding newspapers with op-eds to contradict reported adverse effects of the ACA.
More details can be found at the Maryland pdf link below. It’s worth looking at this presentation to grasp the big business approach of Exchanges which is clearly profit-driven. The Maryland Exchange strategy is just one example. The goal of Exchanges is sell, sell, sell.
http://www.dhmh.maryland.gov/exchange/pdf/FinalAdvertisingReportWeber.pdf
Exchanges certainly have a lofty goal – promote success stories only and be ready to contradict and cover up the bad stuff as quickly as possible. Massachusetts residents have been there. The Connector and state politicians including the governor made sure that anyone being harmed by Romneycare would not be heard in spite of statewide survey reports put together by outreach agencies advising state legislators and power-players that low-income people were not faring well under this law. Various issues were spelled out and testimonials were included, but residents’ concerns about the adverse effects of Romneycare were ignored. MA national legislators also went along with this agenda as did the mainstream media.
When $130 million was needed in 2009 to balance the Massachusetts state budget, the Connector – with the blessing of MA Gov. Deval Patrick and the MA legislature – removed about 28,000 legal immigrants – working people paying taxes – from their insurance plans. Another 8,000 or so were barred from enrolling in insurance plans because the MA legislature voted to cap enrollment in the subsidized plans. This took place at the same time Mr. Obama was trying to sell the ACA to the nation, so, under pressure from Washington, the MA legislature restored some of the money, and the Connector dumped these people, without their consent, into an out-of-state plan with higher copays, less comprehensive coverage and next to no doctors or safety net hospitals in its network.
http://www.huffingtonpost.com/iyah-romm/lessons-from-massachusett_b_380718.html
This has huge implications for the ACA. If legal immigrants can be removed from their plans and others denied enrollment when a state budget is squeezed, which vulnerable segment of the population is next in line? The good news is these legal immigrants in MA sued the Connector and its then-Executive Director, Jon Kingsdale, and the Massachusetts Supreme Judicial Court ruled unanimously that the state could not violate their right to equal protection under the state and federal constitutions and fiscal considerations alone can not justify a state’s invidious discrimination against them. As a result of this decision, the state had to come up with some bucks, and the Connector was forced to put the plaintiffs back into their original plans.
Getting back to Enroll America, Herndon Alliance and some of the less-than-honorable Exchange strategies – it’s one thing to inform Americans about the ACA and Exchanges that offer the possibility of either purchasing high-deductible or catastrophic coverage with a loan from the government to help pay for it or being tossed into expanded Medicaid – but, mounting a costly, massive campaign to purposely deceive and manipulate the public with the unstated goal of more profit for the already extremely lucrative health insurance industry is disgraceful.
———————————————-
Is the ACA a fair law if it helps only one small segment of the population but hurts and exploits a larger number to do so? The way this law works is fundamentally unfair and will not bring medical care to the many, but, instead will progress to greater personal debt for individuals and families who can’t afford the “affordable” insurance as well as those who must keep an eye on their income to avoid the many traps and false ends this law creates. At their expense, the forced purchase of health insurance will bring increased revenue to the industry, not to mention more kickbacks to Congress, and in the very near future, the health insurance industry will be “too big to fail.”
The ACA is most definitely a “uniquely American solution” which has little to do with reforming this country’s barbaric health care system. It merely controls peoples’ finances and choices while leaving insurance companies in charge and does virtually nothing to end their abuses. It will leave many millions of Americans uninsured and millions more underinsured at a staggering cost to taxpayers.
Politicians, health care policy wonks and vested interests will brush aside the ACA’s adverse effects. You’ll hear that some have fallen through the cracks of health care reform but the problems can be easily tweaked. You will also witness the usual dog-and-pony show on Capitol Hill in which the two parties play the blame game. The bought-and-paid-for mainstream media will regurgitate whatever Washington feeds it, and TV talking heads will chime in, inviting their “experts” to analyze the situation while real people in the real world struggle to get by under this law or fall by the wayside.
Good luck everyone and watch out for the folding chairs.
addendum:
Obamacare architect leaves White House for pharmaceutical industry job
http://www.guardian.co.uk/commentisfree/2012/dec/05/obamacare-fowler-lobbyist-industry1
Paul Craig Roberts is a former Assistant Secretary of the US Treasury and Associate Editor of the Wall Street Journal. His latest book, Wirtschaft am Abgrund (Economies In Collapse) has just been published.
UK nuclear site shutdown totals $160bln amid cost overruns
RT | February 4, 2013
Decommissioning one of the “most hazardous” nuclear sites in Europe has already cost Britain $106 billion, and further expenses are expected, officials have said. Sellafield chiefs have come under fire for missed deadlines and inflated salaries.
Sellafield, the nuclear reprocessing site in Cumbria, northwest England, stores 82 tons of plutonium waste. A plant director called one of the plant’s buildings, B30, “the most hazardous industrial building in Western Europe.”
The closure was announced in June 2012, following concerns over terrorist threats and environmental damage.
The total lifetime cost of decommissioning and clean-up has hit £67.5 billion ($106 billion), the Public Accounts Committee said in a new report – two-thirds the total amount the UK spent on the National Health Service in the years 2011 and 2012, and nine times the spending on the Teacher Pension Scheme in the same time period, Guardian Data reported in its annual audit of UK government spending.
The report, published on Monday, highlighted “critical problems” with both the clean-up attempt and the costs of removing hazardous radioactive waste. The Sellafield clean-up was severely criticized by a Commons Select Committee, which commented on the PAC report.
“An enormous legacy of nuclear waste has been allowed to build up on the Sellafield site. [And] there’s no indication of when that cost will stop rising,” Chair of the Committee of Public Accounts Margaret Hodge MP said in a statement released along with Monday’s report.
Hodge added that 12 of 14 major projects at the plant were behind schedule, and five are over budget, posing severe risks to both people in the area and the environment. “Basic project management failings continue to cause delays and increase costs,” the Commons Select Committee said.
The ‘Prospect’ trade union called for closer scrutiny of Sellafield’s owners. The report said that nuclear executives from private companies have received a “reward for failure”, and are being paid “huge salaries”, averaging £690,000. One director was paid just over £1.2 million, according to the report.
“We need more evidence that the salaries paid to NMP senior directors match their actual performance within the company. Closer scrutiny would ensure that the public is actually paying for expertise that brings added value to the clean-up operation and not just bolsters NMP Ltd’s reputation,” Mike Graham, Prospect’s national secretary, said in a press release.
The report came the same week that court action was taken against Sellafield over its illegal dumping of nuclear waste in a local landfill. On Thursday, a court case will open in which the nuclear operator will be accused of breaching environmental permits when it dumped four bags of nuclear waste in a landfill at nearby Lillyhall, without any authorization.
“Furthermore, now that Cumbria county council has ruled out West Cumbria as the site of the proposed geological disposal facility, a solution to the problem of long-term storage of the waste is as far away as ever,” the committee said.
Related article
- Sellafield shambles to cost £67bn (morningstaronline.co.uk)
Eighth Annual Citgo-Venezuela Heating Oil Program Launched
Venezuelanalysis | February 4, 2013
Last Thursday, at the Night of Peace Family Shelter in Baltimore, CITGO Petroleum Corporation President and CEO Alejandro Granado and Citizens Energy Corporation Chairman Joseph P. Kennedy II launched the eighth annual CITGO-Venezuela Heating Oil Program with the first heating oil delivery of this winter’s initiative.
The program, which began as a single donation in 2005 in response to the high prices of heating oil resulting from hurricanes Katrina and Rita, has grown well beyond its original scope. Today, it has become a humanitarian symbol of unity between the people of Venezuela and those in need in the United States.
This year, the program has a heightened sentiment as it comes at a time when Venezuelans and many in the world send their wishes for the health and prompt recuperation of President Hugo Chávez, who has supported this initiative since its creation eight years ago.
“The CITGO-Venezuela Heating Oil Program has been one of the most important energy assistance efforts in the United States. This year, as families across the Eastern Seaboard struggle to recover from the losses caused by Hurricane Sandy, this donation becomes even more significant,” said Granado. “This energy assistance program is an integral example of the humanitarian principles endorsed by the CITGO ultimate shareholder, Petróleos de Venezuela, S.A. (PDVSA), the national oil company of the Bolivarian Republic of Venezuela.”
Over the years, the program has helped more than 1.7 million people stay warm during the coldest months of winter by donating more than 200 million gallons of heating oil worth more than $400 million. It is estimated that this year the program will help more than 100,000 families in 25 states plus the District of Columbia, including members of more than 240 Native American communities and more than 200 homeless shelters.
“CITGO invests relatively more than any other major oil company in social responsibility projects. As a matter of fact, our percent of revenue spent in social programs has been five times more than those of other much larger, vertically-integrated competing global brands. It is a core principle of our business to use the strength of our resources to help people in need,” Granado said.
Since the program’s creation, CITGO has partnered with Citizens Energy Corporation, a non-profit organization created in 1979 by former U.S. Rep. Joseph P. Kennedy II. Citizens Energy Corporation, which has used successful ventures in the energy and health care industries to finance charitable programs in the U.S. and abroad, has provided energy assistance to families in need for more than 30 years.
“We are so grateful for this generous donation from the people of Venezuela and CITGO Petroleum Corporation. After eight years and more than 200 million gallons of heating oil distributed within the U.S., the burden of another difficult winter threatens the livelihood and safety of senior citizens and low-income families,” Kennedy said. “It is critical that we continue to support American families through this program. Thanks to this partnership, we will help more than 400,000 people stay warm and safe this winter.”
Kennedy emphasized the commitment CITGO has made to American communities. He said that he has approached major U.S. oil companies and oil-producing nations to ask them to assist the poor in bearing the burden of rising energy costs. “They all said no,” he said, “except for CITGO, President Chávez and the people of Venezuela.”
Congressman Elijah Cummings (MD), who also spoke during the event, reiterated the importance of helping those in need. “I commend CITGO and Citizens Energy Corporation for launching the Heating Oil Program this year. This program is literally life-saving for so many whose resources are already stretched thin in tough economic times. I stand with the many Baltimore and Washington recipients who thank both CITGO and Citizens for their commitment to helping our communities,” he said.
Echoing those sentiments, Claudia Salerno Caldera, Venezuela’s Vice Minister of Foreign Affairs for North America, addressed the plight of poor people and why humanitarian assistance is so vital. “The vision of social responsibility in the energy policy of the Bolivarian Republic of Venezuela has allowed us to assure that our profits benefit the neediest people in our country. Just as the government of President Hugo Chávez has made significant efforts in the fight against poverty and in the promotion of social justice in Venezuela, this program demonstrates that our commitment to the poor transcends all boundaries, ideological and geographical,” Salerno said.
Families struggling to pay for home heating oil can call Citizens Energy Corporation at 1-877-JOE-4-OIL (1-877-563-4645), to see if they are eligible for heating oil assistance. Once approved, the household will receive an authorization letter with details for arranging a one-time delivery of 100 free gallons of oil.
For more information about the program, click here.
Edited by Venezuelanalysis.com
CITGO, based in Houston, is a refiner, transporter and marketer of transportation fuels, lubricants, petrochemicals and other industrial products. The company is owned by PDV America, Inc., an indirect wholly owned subsidiary of Petróleos de Venezuela, S.A., the national oil company of the Bolivarian Republic of Venezuela. For more information visit www.citgo.com.
Beginning in 1979 with oil-trading ventures in Latin America and Africa, Citizens Energy has used revenues from commercial enterprises to channel millions of dollars into charitable programs in the U.S. and abroad. Whether heating the homes of the elderly and the poor, lowering the cost of prescription drugs for millions of Americans, or starting solar heating projects in Jamaica and Venezuela, Citizens Energy creates social ventures as innovative as the businesses that finance them. For more information, visit www.citizensenergy.com.
On Paper, China Looks Very Good
By David Macaray | Dissident Voice | February 4th, 2013
Without much fanfare, and without many people even aware of it, in 2009, China has overtaken the U.S. as the world’s leading papermaker. Moreover, they did it in much the same way that they became the world’s premiere manufacturing beast: with innovative engineering, a smart game plan, a vast reservoir of cheap labor, and massive government subsidies.
As for reaching the top of the papermaking ladder, it’s the innovative engineering aspect that’s mind-boggling. China has managed to develop a genetically altered hardwood eucalyptus tree (which begins in the lab as a tissue sample inside a petri dish) that requires only four to six years to reach full height. That’s approximately one-tenth the time it takes “natural” trees in North America (which are abundant) to reach maturity. Eucalyptus is a favored furnish in papermaking because of its soft fiber.
Each year Chinese labs clone 190 million of these “test-tube” eucalyptus sprigs, which are planted on 790,000 acres spread over several Chinese provinces. Wending Huang, Asia Pulp & Paper’s chief forester in China, calls these bad boys “Yao Mings” (referring to a famous and very tall Chinese basketball player). Wisconsin is the leading papermaking state in the U.S. Maine is second. China can now match the yearly output of Wisconsin in just three weeks.
But genetically engineered trees aren’t the whole story. In addition to new woodlands, China has established itself as the world’s leading recycler of paper. Indeed, its recycling, de-inking, re-pulping operation is staggering. China buys about 54 billion pounds a year of scrap paper and cardboard from all over the world, and uses this recycled material to produce about two-thirds of its own paper and cardboard.
As for its own paper production, according to the McClatchy News Service, China has 20 mega-sized paper mills spread across the country, and the automated machines in these state-of-the-art mills are capable of producing a mile of glossy publishing-grade paper per minute. A mile a minute. That’s 5,280 feet per minute (fpm) of a glossy, high-quality base sheet. That’s amazing.
Not to give away any trade secrets, but Machine #1 at Kimberly-Clark’s Fullerton, California, paper mill produces a 172-inch wide sheet, at 4,600 fpm. That’s a pretty good operating speed for a less-than-new machine that runs 24 hours a day, 360 days a year. But this wadding is used exclusively for Kleenex and bath tissue, and doesn’t approach the quality of “publishing-grade” paper. A high-quality, glossy base sheet is a whole other deal.
It should also be noted that China still imports the overwhelming majority of its raw timber and processed (chemically treated) pulp. It gets its timber from all over the world (e.g., Indonesia, Russia, Vietnam, Brazil). In 2011 alone, it imported 14.5 million tons of it (29 billion pounds), l.6 million tons of which came from the U.S., where sawmills, logging and pulp operations have closed down, leaving timber businesses looking for new customers.
While environmental groups have strongly objected to China’s aggressive demand for wood pulp, claiming that it’s destroying the world’s forests, American companies and Wisconsin politicians have their own reasons to complain. They accuse the Chinese government of subsidizing the country’s paper mills and “dumping” unfairly priced (too cheap to compete with) paper on the American market. Japan was accused of the same practice with its cars.
According to McClatchey, “the Washington-based Economic Policy Institute estimates the Chinese government doled out at least $33 billion in subsidies to its paper industry from 2002 to 2009—the period that coincides with its stunning growth. That’s more than $4 billion a year, a number that is growing.”
So we have U.S. paper mills being squeezed not only by foreign competitors but by foreign governments subsidizing those competitors. It must be nice having your own government as partner and benefactor. One of the obvious advantages is that the government can print all the money it wants. That can be very helpful.
The third complaint—along with environmental concerns and “dumping”—is reserved for labor unions. They blame the unions for wanting decent wages and benefits. Attacking working people, those at the very bottom, should come as no surprise. It’s Newton’s First Law of Fecal Gravitation on an Inclined Plane (Shit rolls downhill).
~
David Macaray, a Los Angeles playwright and author (It’s Never Been Easy: Essays on Modern Labor), was a former union rep. He can be reached at: dmacaray@earthlink.net.
Related article
US may have broken own sanctions by buying Tehran’s oil
RT | February 2, 2013
There is a high probability that US sanctions against Iran have been violated by its own army. Part of the $1.55 billion in fuel the US bought from Turkmenistan for the Afghan army in the last five years may have originated in Iran.
A report by the Special Inspector General for Afghanistan Reconstruction (SIGAR) suggested that “despite actions taken by DOD to prevent the purchase of Iranian fuel with US funds, risks remain that US economic sanctions could [have been] violated” from 2007 to 2012.
Most of the fuel for domestic Afghan consumption comes from neighboring Iran. Because of the US sanctions on Tehran restricting the trade of Iranian oil and petroleum products, the ISAF has been required to abide by the regulations and buy petrol from eight Afghan-owned companies that deliver petroleum from Turkmenistan, which borders both Iran and Afghanistan.
The SIGAR report also acknowledged there are no plausible oversight mechanisms to make sure Iranian petroleum products are not included in future fuel purchases.
Turkmenistan is a major regional oil producer, which also trades for petroleum products made in Kazakhstan, Uzbekistan, Russia and Iran. Petrol vendors in Turkmenistan use flexible supply schemes, meaning that fuel of various origins could potentially be blended together.
In response to a draft of SIGAR report, the US Embassy in Kabul stated that “it is possible that if blending is taking place in Turkmenistan it could contain some Iranian fuel,” but refused to admit that fuel imported from Russia could also be blended with Iranian fuel prior to its import into Afghanistan.
“All fuel imports carry a ‘verified Fuel Passport’ from the refinery, which provides information on the origin, quantity, quality, and specifications of the fuel,” the embassy explained.
“Suppliers are unlikely to blend Iranian fuel, or any other product, with other sourced fuel because of the potential that blending could cause product deviation from specification standards and potentially cause a rejection of the entire shipment,” the embassy said.
In 2012, the Pentagon reportedly spent over $800 million on imports from Turkmenistan, most likely for fuel purchases.
The Economics of the Cuban Embargo
By SAUL LANDAU and NELSON P. VALDES | CounterPunch | January 29, 2013
The time has come and almost gone for Washington to repair its broken relations with Cuba. For 53 years the White House has maintained a punishing embargo on trade with Cuba. Its proponents, with the goal of removing Cuba’s revolutionary government, still plead: “give it time.”
In 2001 President George W. Bush allowed for an exception permitting US companies to sell agricultural products to Cuba for immediate payment, although imports from Cuba remained off limits. Other economic sectors received no benefits.
Cuban Americans particularly from south Florida now export goods and remittances to relatives and friends while importing profits from sales made to fellow Cubans in Cuba, giving them an advantage denied to the rest of the country.
Washington pundits attribute superhuman strength to the anti-Castro lobby; thus no President would attempt to lift the trade and travel embargoes on the island. Yet, Cuban Americans trade with and travel to Cuba freely on a daily basis. The “embargo” applies to everyone except Cuban Americans.
This growing international trade, disguised as sending goods to needy family members in Cuba, now includes filling the hulls on 10 or more daily charter flights from US cities to Cuba. Cuban Americans send goods, often with “mules,” to provide family members in Cuba, needing supplies for their businesses. The “mules” return with cash, derived from sales of these goods. Some of the new Cuban stores and restaurants supplied by Miami-based Cubans make substantial profits, some of which get spent in Cuba, and ends up in Cuba’s central bank.
Miami, the United States’ poorest large city, derives income because it provides jobs involved in buying and selling the goods sent to Cuba. Jobs also arise from routine tasks created around the daily charter flights to and from Cuba, and the fees collected from take offs and landings. Add to this, the work for accountants, book-keepers and others.
Some unemployed Cuban Americans get jobs as mules transporting the goods and money from one country to the other. Miami banks also benefit.
In Cuba, this trade also creates jobs and wealth. Mercedes runs a paladar [private restaurant]in Havana’s Vedado neighborhood, “because we draw tourists who like good food, which I serve at my paladar.”
Some paladar customers flew to Havana from Miami. These Cuban Americans come to visit relatives and maybe check on their new investments in Havana family-run businesses. “Relatives in Florida supply me with food I can’t get easily in Cuba,” Mercedes said, “like some spices, and packaged goods. I send them money for these products. They make a profit, and so do I. The government makes money from taxes I pay, and jobs grow in Cuba’s tourist industry.”
US-based charter flights have full hulls, even those with few passengers. One charter flight company manager told us: “Passengers don’t matter that much. The hull is totally full.”
Much of the Cuba trade flows through the Miami International Airport, meaning capital moves from the US to Cuba; most of the luggage contents, however, remain in Cuba. The boon to Miami airport services means jobs, fees and taxes, which remain as capital in south Florida. The goods purchased in south Florida by Cubans (relatives, mules, etc) benefit local businesses.
This trade multiplies jobs throughout the area — as well as it does for Cuba: In Miami sales emanate from stores and lead to jobs in transportation, parking, hotel facilities, restaurants, and luggage-handling. Count the businesses providing services to the people traveling to Cuba and sending goods there. Don’t omit the expanded police force, and extra officials required in immigration, and customs; nor fail to consider jobs servicing air planes, and their jetways, and additional personnel needed for landings and take offs, and extra jobs in airport administration and maintenance created by expanded travel. Think of Miami’s increased tax revenues.
South Florida represents a Cuban settler state within the United States. It counters its interests against those of the dominant society, with the society’s ignorant acquiescence. The Miami-based Cuban Americans and their Cuba-based families have used US-Cuba policy, the embargo representing the power of the nation for their own self-interest, and in order to attain a comparative advantage vis a vis the rest of the American population.
Since 1960, commitment to overthrow of the Cuban government has functioned as US foreign policy on Cuba, a policy now controlled informally by south Florida Cuban-Americans. The Cuban American ethnic enclave assumed the political power needed to turn south Florida into an autonomous Cuban settler state inside US boundaries, so that the embargo does not get applied to the Cuban American enclave. The enclave barons use the embargo to secure, for themselves, a protection of the Cuba trade monopoly. This challenges stated US national interests.
Camouflaged by ubiquitous anti-Castro rhetoric, the Cuban American entrepreneurs have manufactured a lucrative business with the island, regulated by the very government they pretend to hate. The rightwing congressional representatives pretend to fight for every law to punish the “Castro regime” while in practice turn a dead eye to the growing trade that helps Florida’s and Cuba’s economy. Preserve the embargo, but make an exception for Cuban Americans.
By recognizing the facts about this trade, the White House might become inspired to lift the embargo – a move to benefit all Americans. US government revenue would grow from opening trade and travel with Cuba. In the process we might also regain a missing piece of US sovereignty!
Saul Landau, Professor Emeritus, California State University, Pomona, produced FIDEL and WILL THE REAL TERRORIST PLEASE STAND UP, available on dvd.
Nelson P. Valdes is Professor Emeritus, University of New Mexico.
World Bank and IMF Forecasts Follow Predictable Pattern for Haiti, Venezuela
By Arthur Phillips and Stephan Lefebvre | CEPR Americas Blog | January 28, 2013
The World Bank has joined the “doom and gloom” chorus on Venezuela’s economy. And in Haiti, the Washington-based institution again appears overly optimistic.
On Tuesday, January 15, the World Bank released its latest global economic forecast, which projects 2013 global GDP growth at 3.4%, up 0.4% from its preliminary estimate for 2012 and down a half a percentage point from its previous forecast in June. The Bank emphasized that the low rates were largely a result of sluggish growth in the U.S. and Europe. As for Latin America and the Caribbean, the regional predicted growth for 2013 is listed at 3.6%, up more than half a point from the estimated figure for 2012.
As with many media commentators over the past few years, the World Bank predicts that Venezuela’s economic recovery from the global recession cannot hold up. The Bank forecasts 1.8% growth in 2013, a sharp drop from an estimated 5.2% last year. Since the Venezuelan economy is not slowing, there is no obvious reason to predict a collapse in economic growth.
Furthermore, we can see that the projection numbers follow a trend. Both the World Bank and the IMF have been consistently underestimating growth projections in Venezuela.
Meanwhile, in Haiti the Bank predicts a sharp jump in GDP growth, from 2.2 to 6.0 percent, while the IMF has forecast growth at 6.5%. When we compare these numbers to those of previous years, we can see the opposite trend of that in Venezuela. All the projections for 2012 overestimated growth by well over 5 percentage points.
It is unclear why both the IMF and the World Bank have projected such high growth for Haiti considering the many severe challenges facing the country in the wake of the 2010 earthquake. As we have noted on an ongoing basis over the past three years, major international donor funding has been slow to materialize, progress on housing, water, sanitation and other infrastructure has been minimal, and there have been few examples of improvements that would suggest an upsurge in growth is on its way. There has been even more bad news in the wake of Hurricane Sandy at the end of October, which devastated crops and left 2.1 million people “food insecure.” The World Bank and IMF’s projections of 6 percent or higher GDP growth in 2013 seem unfounded.
The IMF’s pessimistic growth projections for Venezuela fit a pattern going back several years. GDP growth forecasts for Argentina were off by 5.0, 5.2, and 4.3 percentage points for the years 2004-2006, and for Venezuela they were off bya gigantic 10.6, 6.8 and 5.8 percentage points in the same years. These patterns suggest a politicization of the IMF’s projections for certain countries, since the Fund was consistently overly optimistic on Argentina’s growth in the years that the Argentine government was still following the IMF’s policy recommendations.
Related articles
Iran engineers capable of building refineries abroad
Press TV – January 27, 2013
A senior Iranian oil industry official says Iranian engineers are capable of building refineries in other countries.
Managing Director of National Iranian Oil Engineering and Construction Company (NIOEC) Farhad Ahmadi said after building the Shazand Oil Refinery near the central city of Arak, Iran has gained necessary experience to build refineries abroad.
He added that NIOEC has been flooded with demands from refining companies in neighboring countries.
“With the implementation of this giant refining project [in Arak], we have acquired the know-how to construct a fully Iranian refinery, and also achieved the capability to export technical and engineering services related to refining projects.”
Shazand’s Imam Khomeini Refinery, due to be inaugurated in the coming days, is to enhance the country’s premium gasoline production by eight million liters per day (lpd).
The treatment facility produces gasoline, liquefied gas, propylene, kerosene, gasoil as well as fuel oil and tar.
The refinery has undergone development with an investment of USD3.3 billion by NIOEC.
Iran plans to inaugurate three mega-projects at Shazand, Lavan and Abadan refineries by the end of the current Persian calendar year (ending March 20, 2013) to enhance production of the country’s premium gasoline from 12 million lpd to 25 million lpd.
The projects will increase Iran’s total gasoline output to 70 million lpd, enabling the country to become a long-term exporter of gasoline.
Iran attained self-sufficiency in fuel production after its international suppliers stopped selling gasoline to Tehran under US pressure.
Related articles
- China defying sanctions imposed on Iran (alethonews.wordpress.com)
- Iran self-sufficient in building gas turbo-compressors: Official (alethonews.wordpress.com)
China defying sanctions imposed on Iran
By Shabbir Kazmi | January 26, 2013
The recently released data shows Iran’s crude oil exports to China soared to the second highest level in December 2012, despite US-led sanctions against the Islamic Republic’s energy sector.
According to a Reuters report China imported nearly 593,390 barrels per day (bpd) of crude from Iran in December last year, up 3.6 per cent from the preceding year and up 39 per cent from November. For the full year 2012, the highest level of China’s crude imports from Iran stood at 633,000 bpd.
Industry officials in China attributed the enhancement in Iran’s crude oil exports to improvement in shipment. The problems that used to cause delays have been overcome recently. The period of delay has become shorter and overall, less frequent.
Iran is currently China’s third largest supplier of crude, providing Beijing with roughly 12 percent of its total annual oil consumption.
At the beginning of 2012, the United States and the European Union had imposed new sanctions on Iran’s oil and financial sectors with the goal of preventing other countries from purchasing Iranian oil and conducting transactions with the Central Bank of Iran.
On October 15, 2012, the EU foreign ministers reached an agreement on another round of sanctions against Iran.
Iran terms these impositions illegal and insists that US-engineered sanctions were imposed based on the unfounded accusation that Iran is pursuing non-civilian objectives in its nuclear energy program.
According to another news report China will soon start importing polyethylene made in Iran, which became possible after the Islamic Republic partially lifted a ban on the export of petrochemicals late last year.
Lately, China-based market sources said that an estimated 100,000-150,000 metric tons of high density polyethylene (HDPE) and low density polyethylene (LDPE) from Iran is expected to arrive in China within a month aboard five vessels. The sources added that the Iranian tanker Touska will shortly discharge HDPE and LDPE at Shanghai port.
On November 6, 2012, Iranian Deputy Oil Minister Abdolhossein Bayat announced that the Oil Ministry had lifted the ban on the export of seven petrochemicals; benzene, styrene monomer, caustic soda, linear alkyl benzene (LAB), melamine crystal, premature ventricular contraction (PVC), and polyethylene.
Related articles
- US probes Swiss medicine giant for trade with Iran (alethonews.wordpress.com)
- Israel may rely on US ‘scalpels’ to contain Iran – defense minister (alethonews.wordpress.com)
- US exempts 9 countries from sanctions on Iranian oil industry (alethonews.wordpress.com)
Germany, France and nine other EU countries approved tax on financial transactions
MercoPress | January 25th 2013
France, Germany and nine other European Union states side-stepped British opposition this week and won approval for a tax on financial transactions, it emerged on Wednesday.
EU Taxation Commissioner Semeta said the tax, strongly rejected by the UK could yield up to 57 billion Euros a year EU Taxation Commissioner Semeta said the tax, strongly rejected by the UK could yield up to 57 billion Euros a year
The Times reported that EU finance ministers gave their blessing to the scheme, which will apply to anyone in the 11 countries who makes a bond or share trade or bets on the market using derivatives.
The two big Euro states were able to bypass opposition from Britain and other states under an EU procedure known as enhanced co-operation. The system has been used previously for divorce law and in the field of patents.
Algirdas Semeta, the European Taxation Commissioner, called the decision a “major milestone for EU tax policies”. He had no immediate estimate of how much revenue the tax would generate, but noted that the Commission previously had calculated that such a tax across the 27-nation bloc could yield €57 billion a year.
The 11 nations, representing about two thirds of the EU economy, are Austria, Belgium, Estonia, France, Germany, Greece, Italy, Portugal, Slovakia, Slovenia and Spain. The Netherlands, where a Government was elected in the autumn, may participate. The states now need the Commission to draft legislation enacting a tax.
Related articles
- Finance tax given go ahead as Ireland and UK opt out (independent.ie)
- EU approves financial transaction tax for 11 eurozone countries (guardian.co.uk)
- Giant Victory in Europe on Taxing Financial Speculation (ips-dc.org)
Featured Video
Did the 9/11 Hijackers Really Fly the Planes?
or go to
Aletho News Archives – Video-Images
From the Archives
Aaron Siri’s Book: Vaccines, Amen
By Maryanne DemasiMaryanne Demasi | Brownstone Institute | June 15, 2026
For decades, vaccines have been treated as the sacred cow of modern medicine. I was taught that they were the holy grail. To question them was heresy. To raise concerns about safety was to risk professional exile.
Aaron Siri makes it clear in Vaccines, Amen: The Religion of Vaccines that the story we’ve been told about vaccine science rests far more on belief than proof.
“No child should be sacrificed on the altar of the religion of vaccines,” Siri writes, as he turns his focus to America’s overcrowded childhood immunisation schedule.
I assumed little in this book would surprise me. I’ve spent years reporting on drug safety, regulatory capture, and the corruption of science. But Siri showed me how wrong I was.
Siri is not a doctor or a scientist. He is an attorney, and this, he says, is his advantage. In court, rhetoric won’t save you. Evidence does. As he puts it, he doesn’t get to say “trust me” the way many doctors do. “I need to prove claims with real data.”
And he does. … continue
Blog Roll
Aletho News- Biden’s Closed Circle on Russia
- Lebanon Accuses Israel Of Violating The Chemical Weapons Convention By Spraying Toxic Herbicide Over Farmland
- Did the 9/11 Hijackers Really Fly the Planes?
- ‘Jewish lobby’ deceived Putin – Lukashenko
- The UK Joins the Pirates
- Israeli government plans to fund extremist occupier group in occupied West Bank with $1.89M: Report
- Press TV reporter wounded in Israeli drone strike on southern Lebanon
- Time for Trump to Tell Benjamin Netanyahu to Go Away!
- Israeli officials: ‘Security zones’ to remain in Lebanon, Syria, Gaza
- Israel Fails to Sabotage Islamabad Accord… At Least for Now
- If Americans Knew
- Jared Kushner’s Israel-linked island, and other dubious projects
- Why Are Crypto Billionaires and AIPAC Spending $8+ Million to Elect Adrian Boafo?
- Why the Mainstream Media Should Stop Using the ADL as Their Go-To Antisemitism Source
- Censorship and Thuggery Won’t Save Israel’s Reputation
- Israel Searches for a Red Sea Foothold in Somaliland
- They Weren’t Convicted of Terrorism, But These Palestine Activists Got Sentenced as Terrorists Anyway
- “Ceasefire” is not in Israel’s vocabulary – Daily Update
- Did Trump just threaten a nuclear attack on Iran? Another merger for Israel-Firster David Ellison –Daily Update
- Israeli Firm Accused of Launching Smear Campaigns During US, European Elections
- As World Cup kicks off, Gaza amputee girls chase football dreams
- No Tricks Zone
- Climate Alarmists Now Using Natural Phenomena To Support Their Claims
- New Study: Significant CO2 Fluxes From Non-Volcanic Sources Are Largely Neglected In Carbon Budgets
- Women Climate Scientists Being Harassed, Insulted By Skeptics, Claims Berkeley Earth Researcher
- Germany’s Longterm Spring Climate Data Show “No Climate Trend”
- New Study: Solar Photovoltaic, Wind Power Fail To Meet Annual Energy Demands 62% Of The Time
- Germany’s Die Welt: “Too Much Is Too Much” … Green Energies Are Cannabalizing Each Other!
- Germany’s Ecological Holocaust… Once Fairy Tale Forests Getting Cleared For Wind Turbines
- A Grand Solar Minimum Has Arrived…Global Cooling Of At Least 1°C Is Expected By The 2030s, 2040s
- European “Expert Commission” Urges COVID-19-Like Global Climate State Of Energency!
- Real-World Observations Do Not Support The Position That Climate Change Is Human-Caused
Aletho News 