| Morning Jolt
. . . with Jim Geraghty February 27, 2014 Why is the Obama Administration Squeezing the Home-Health-Service Industry? A couple nights ago, Jim Angle of Fox News pointed out a largely-unnoticed aspect of Obamacare: HHS Kathleen Sebelius' decision to cut the maximum amount she could from Medicare's payments for home health-care services. Home health-care services are when a professional from a Medicare-certified Home-health agency comes to an elderly person's house and provides nursing care, physical therapy, or speech-language pathology services. | | CPAC is the event where history is made, and tickets are moving fast! Register NOW at RegisterforCPAC.com. 
| | | Sebelius cut the maximum permitted by law, 3.5 percent, and declared HHS would do the same for the next three years. As Angle's report: noted, "The cuts were deep enough that officials offered a damaging prediction of the impact saying, it was estimated that approximately 40 percent of providers would have negative margins." "Negative margins" is another term for losing money. And businesses that lose money either go kaput or lay off workers. Forty percent of the firms in the industry adds up to roughly a half-million jobs. That doesn't mean that 500,000 home-health-care workers will be fired tomorrow, but it does mean that they're at serious risk for layoffs in the next three years. So we're talking about a massive job-killer in a field dedicated to treating the health problems of the elderly. Here's industry research firm IBISWorld, basically declaring that the outlook for what was, not long ago, one of the fastest-growing health-care fields looks grim: Prior to December 2013, the Home Care Providers industry was quickly becoming one of the fastest growing healthcare industries in the United States. Home care saves billions of dollars every year by allowing patients to avoid high-cost healthcare settings, such as hospitals… To help pay for other provisions of the recent healthcare legislation, the Centers for Medicare and Medicaid Services announced the implementation of a four-year 3.5% annual reduction to the Medicare base payment for home healthcare services beginning in January 2014. The National Association for Home Care and Hospice estimates that the magnitude of these reductions will likely render three-quarters of all industry operators unable to run profitably by 2017. Note: That is way more than 40 percent. According to the Partnership for Quality Home Healthcare, the industry experienced its largest job loss in more than a decade in December 2013; although the Medicare reductions were not officially implemented until 2014, CMS's announcement was enough to spur industry operators to begin cutting costs. The industry is aggressively lobbying Congress to reconsider or revoke these reductions, but unless that happens, IBISWorld expects industry revenue to decrease in the five years to 2019. Spurred by slow revenue growth in 2014, IBISWorld also anticipates significant profit losses across the industry, with average margins decreasing by 2019. So what's the administration's angle here? They never met a dollar they didn't want to spend, particularly in entitlements, so why are they suddenly putting the screws to the home-health-care industry, of all professions? Is it that the financial forecasts of Obamacare have been so wildly overoptimistic and unrealistic that they feel they've got to make a big-time cut somewhere to prevent their "bending the cost curve down" promise from becoming an even bigger joke? Or does the administration have something ideological against home health care? Is it that by having the health-care provider coming to a person's house, there's not enough of a role for the government to intervene, manage, and meddle? And why does Paul Ryan get ads depicting him throwing Granny off the cliff when Kathleen Sebelius really is cutting funding for care for the elderly right now? Colorado's Senate Race Just Got a Lot More Interesting This is not a guarantee that Senator Mark Udall, (D., Colo.), will be defeated in November. But it is good news. Weld District Attorney Ken Buck and Rep. Cory Gardner are swapping races. Buck said Wednesday he will drop his bid for U.S. Senate and instead pursue the 4th Congressional District seat, which represents Weld County. Gardner, a Republican who currently represents the 4th, will run for U.S. Senate, Buck said. "I have talked with Cory Gardner and feel that he would be a strong candidate for the United States Senate to beat Mark Udall," Buck said. "I made the decision to step down and endorse Cory for that job. I was running against Mark Udall because I think this country needed to change directions, and I still think the country needs to change directions, and I think Cory gives us the best chance to get that done." The field is cleared: State Rep. and United States Senate candidate Amy Stephens confirmed with The Gazette on Wednesday evening what had been rumored throughout the day. She will remove herself from the U.S. Senate race and throw her support behind U.S. Rep. Cory Gardner in a campaign that will pit a Republican nominee against Sen. Mark Udall, a Boulder Democrat born to a powerful political dynasty. "Cory is Colorado's great unifier," said Stephens, of Monument. "He is liked in so many circles - right, left, moderate, you name it. He is Colorado's beloved son and at the end of the day he is the candidate who can take on Mark Udall and make this happen. If we want to avoid a single-payer health system, we need Cory to win." As the Colorado Springs Gazette notes: "Colorado Republicans must never forget this selfless decision by Stephens, who could have posed a formidable threat to the incumbent Democrat. We seldom see politicians place the interests of a party or a political philosophy ahead of the self interest of winning a higher political office." Buck's not a bad candidate, but he had a golden opportunity against appointed Senator Michael Bennet back in 2010 and fell just short, 46.4 percent to 48.1 percent in what was a near-ideal issue environment for the GOP. His mouth got him in trouble with an ill-regarded off-the-cuff comment that voters should support him over his female primary opponent Jane Norton "because I do not wear high heels" -- the kind of statement easily exploited in attack ads. By shifting to the House race in Gardner's R+11 district, he becomes, barring some massive implosion, Congressman-elect Ken Buck. Cory Gardner is a top-tier candidate. You may recall him grilling witnesses about some of the more inane "got coverage?" ads running in his state. Back in 2010, Gardner was one of the "young guns" and considered one of the GOP's best shots to pick up a seat, running against Betsy Markey. Markey outspent Gardner by $1.2 million… and lost, 41 percent to 52 percent. He's young, polished, and has solid conservative credentials but is also capable of articulating that message in a way that doesn't alienate the soccer moms. Mark Udall isn't toast — yet — but his year just got a whole lot tougher. Dave Weigel: "Previously, I'd thought that Ed Gillespie's run in Virginia was the ultimate Republican bet on the power of Obamacare to win elections this year. Gardner's usurped that title. He's giving up a safe seat to challenge a Democrat, Mark Udall, who's carved out a good profile for himself (especially on NSA issues) in a state that went Democratic in 2008, 2010*, and 2012. Udall even felt safe enough to vote for Manchin-Toomey; months later, conservative activists successfully recalled two Colorado state senators who voted for gun control." Why Doesn't Harry Reid Have to Be the Least Bit Likeable? Have you noticed that certain Democrats can be extremely unlikable, with no discernable consequence to their public power or prestige? Remember this oft-analyzed statistic? The exit pollsters asked which was the most important candidate quality – vision for the future (29%), shares my values (27%), cares about people like me (21%), and strong leader (18%). Mitt Romney won three of the four qualities. Voters who selected vision opted for Romney 54%-45%. Those who picked values preferred Romney 55%-42%. Voters focused on strong leadership opted for Romney 61%-38%. Romney lost 18%-81% among voters who said "cares about people like me" to Barack Obama. Obviously, "cares about people like me" is an important element of success in American politics… unless you're the ornery, mean old cuss named Harry Reid. Apparently he can be a nasty SOB and still float along at the highest of heights in the U.S. government. About once a month or so, Harry Reid makes a statement that would be career-ending for your average Republican. He described Obama as, "a 'light-skinned' African American 'with no Negro dialect, unless he wanted to have one.'"After Hurricane Sandy, he said, "The people of New Orleans and that area, they were hurt but nothing in comparison to what happened to the people" in New York and New Jersey. He's complained about the smell of tourists coming into the Capitol building. He declared the Iraq War lost. Famously, in 2012, on multiple occasions he accused Mitt Romney of not paying taxes for ten years. And now, he's declaring that no one is getting hurt from Obamacare, anywhere, at all, in any way: Senate Majority Leader Harry Reid (D-Nev.) declared Wednesday that all of the "horror stories" being told in relation to the federal health-care law are false. "Despite all that good news, there's plenty of horror stories being told," Reid said on the Senate floor. "All of them are untrue, but they're being told all over America." Get that? All of them are untrue! There are 317 million Americans, and any single one of them saying he got a raw deal from Obamacare must be lying! Then he adds: Responding to ads being run by a Koch-backed group against Obamacare, Reid said the ads go too far and that Charles and David Koch are trying to "buy" America. "It's too bad that they're trying to buy America, and it's time that the American people spoke out against this terrible dishonesty of these two brothers who are about as un-American as anyone I can imagine." Remember McCarthyism? Remember how terrible it was when a senator was calling citizens anti-American? Hello? Is anyone paying attention? Harry Reid is deeply, intensely dislikable, but that dis-likability never seems to have any consequence for him. ADDENDUM: Fantastic news! It's been a brutal winter for stinkbugs: "'In the previous two years, natural mortality averaged about 20-25 percent,' . . . In January 2014, however, Kuhar's team discovered that the subfreezing temperatures had killed off 95 percent of the population." From Our Sponsor: THIS MARCH 6TH THROUGH 8TH AT THE GAYLORD NATIONAL RESORT AND CONVENTION CENTER, COME GATHER, COME CONNECT, COME LEARN, AND LEAVE MORE ENERGIZED THAN EVER TO FIGHT FOR OUR COUNTRY. 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