Cup-a-Joe

AHCA, a.k.a. Obamacare is front in center with the Republican presidential candidates.  ”I will repeal Obamacare.  I’ll grant a waiver on Day One to get that started,” says Romney. Governor Perry says, “I will use an executive order to get rid of as much of Obamacare as I can on Day One.”  And not to be outdone,  candidate Cain, states, “Obamacare must be replaced because it is a disaster.”  So, what’s really going to happen? read more »

I just can’t resist returning to health care — or The Affordable Health Care Act (AHCA/Obamacare) as that wonderful piece of legislation is known.  It’s such an oxymoron, I can’t resist.

I had my interest piqued the other day by a notice I received on AHCA — it was a notification from the Department of Health and Human Services on the development of standards for the Affordable Insurance Exchanges (45 CFR Parts 155 and 157 for you geeky types).  These are the state run exchanges which “will provide competitive marketplaces for individuals and small employers to directly compare available private health insurance options on the basis of price, quality, and other factors.”

I don’t know what I was thinking (or was I?), but I started reading the 35 pages of details in the Federal Register — and rapidly determined that the Exchanges (as they are known) are going to make Homeland Security seem like a micro agency.  The scope of detail which will be monitored and regulated by the Exchanges is very broad and will necessitate a very large bureaucracy.  The exchanges will be responsible to make sure that individuals have valid social security numbers; that they qualify for appropriate discounts (which means they’ll have to interface with the IRS and/or employers);  coordinate with Medicare/Medicaid/CHIP to ensure that the individuals don’t qualify for those plans — and these rules didn’t even mention how the Exchanges are going to work with insurance carriers to make sure that the coverage is “affordable.”

I’m amazed at how our government has determined that the “initial” cost of the exchanges will be expensive, but long term costs will be reduced because of the “use of efficient systems.”  Hmm.  Government and efficient systems — another oxymoron.  In my opinion, this solution is not going to be affordable — in the short-run or long-run.  But it sounds like a pretty creative way to reduce unemployment.

As I noted in my previous blog, the EPA took control of permitting of major sources from the State of Texas.  If one carefully reads the Dallas Morning News article on December 24^th’s front page, you’ll note that the fight is over carbon dioxide emissions – which Texas and a variety of other states have sued EPA’s right regulate.  But it was only Texas which had the cojones (a great Mex-Tex phrase) to refuse setting up the permitting program.  The state’s regulators (TCEQ) don’t agree with the science which the EPA is using (and this is not the first time); so, it’s not just a bunch of oil guys in an uproar.  The end result of this will be more paperwork and hoops to jump through, with no real results.  This takes me to my next point.

Round 1, which Texas lost, was the fight over the process Texas used to allow quick permitting – which by the way still takes months and thousands of dollars of consulting and air modeling.  The end result of that fight will be the EPA making the process more “transparent,” which in my mind means “politically correct,” not necessarily ending up in cleaner air.

Just as an aside comment – one of full disclosure.  Much of what I write about in this area is not created from a vacuum.  I have the privilege to co-chair a committee which represents the interests of small businesses and local governments to the TCEQ.  Consequently, over the years I had the opportunity to meet with many directors and staff members of the TCEQ, as well as their scientists.  Thus, I have a good understanding of the dilemma which the agency finds itself in trying to serve the people of Texas in providing a safe environment without hamstringing the ability of business to provide livelihood for the state’s citizens.

Just finished meeting with our Clean Air Committee to discuss the upcoming regulations which impact our industry in Dallas/Fort Worth and Houston next year.  The industry if facing some significant changes next year and I’m always amazed how much willingness there is for the industry to try to do the right thing.  The challenge is trying to get the regulators to understand that documentation for documentation’s sake is not the solution.

Our biggest issue is not the requirements to use chemistry that helps reduce ozone — which has a dramatic impact on a company’s productivity/profitability.  It’s the regulatory hoops which must be jumped so the regulating community can “document” that the “rules” were followed.   It’s one of the major frustrations between the regulated community and the regulators.  If it’s not documented, it didn’t happen.  Yet, if one makes the rules so onerous — businesses are less willing to comply.  It’s a fine balancing act.  It’s also an argument at the heart of the recent litigation between Texas and the EPA.  Ah, such a tangled weave.

If you’re a small business owner or manager in North Texas, I’m sure the recent Dallas/Fort Worth article in the Business Section titled, “9 North Texas Employers Unite to Collect Data for Health Plans,” intrigued you. I was intrigued – and quickly became upset.

For us insurance geeks, the article made it painfully obvious that large employers get to play in a different sandbox than the rest of us.  If these large employers can get together to determine “how they manage benefits and purchasing only the most needed health options to keep workers healthy and out of doctor offices,” which in turn will help them reduce their premiums – why can’t small businesses do the same?  The answer is yes we could (as an single Association or several associations), but the carriers really don’t want to deal with small business in that manner – and existing state and federal laws almost make it impossible.  The end result will be that large companies will be able to find ways to mitigate any cost increases in health care while small business will continue to see the double digit increases which have plagued us for the past decade – and the foreseeable future.

The recent legislation (Affordable Health Care) does NOT address the issue of costs for small business.  In fact when one really looks at the net effect, employers will find it much more economical to pay the penalties of not offering health insurance and forcing their employees to pay for their own insurance from the “pools.”  Given that mandated coverages will be “richer” than what many small employers presently offer, many are going to be rudely shocked at the personal costs of “Obamacare.” Many individuals have been led to believe that the legislation will make health care easier to obtain and much more affordable. This may be true for some individuals, but the folks in small business and their employees (who were supposedly the target of this legislation) may pay a very steep price.   I will close by quoting an old, and probably over used, axiom – “There is no free lunch.”

On Tuesday, the “Show Me’ state just said “We’ll Show You” with the passing of Proposition C. The measure was aimed at nullifying the new federal health care law, and Missouri became the first state in the nation where individuals voiced their concern regarding mandated insurance.

Although it remains to be seen how all of this will play out, given what’s going on in Arizona with its immigration laws, we’re in for an interesting ride of state vs. federal rights.  Alexander Hamilton and Thomas Jefferson were arguing these same issues over 225 years ago.  The more things change, the more they remain the same.

For the past month or so, I have been watching the ongoing Texas vs. Feds fight.  The gloves are now starting to come off as Governor Perry is playing a role in the disagreement between the Feds (EPA) and Texas regarding “polluting” companies.  The spin from EPA’s Regional Administrator Al Armendariz is that they’re protecting the public from polluting companies, which have been given a free pass from the Texans.  Granted, my experience is strictly with small businesses – but the Texas Commission on Environmental Quality’s (TCEQ) requirements are far from “easy” on business. read more »

If you have not been paying attention to Clean Air issues — you better start!  As an industry, offset lithography has been a target for good reasons.  We use volatile organic compounds, which are precursors to low level ozone which can create health issues, and print producers tend to do business in heavily populated areas.  These areas are continuously having the EPA crank down on the restrictions.  This summer the EPA will set new ozone standards which will adversely affect many cities such as Austin, Oklahoma City, Wichita, Tulsa, and East Texas within the next few years.  Although some digital technologies may remove the target from the industry’s back, that reality is many years into the future, and the regulations are impacting today’s industry in the midst of the most sever economic downturn in its history. read more »