The rule of law, or the rule of men (women)?

by on September 10, 2010 at 10:21 am in Law, Medicine, Political Science | Permalink

The Obama administration on Thursday told health insurers that it will track those who enact "unjustified" rate increases linked to the health overhaul and may block those companies from a new marketplace for insurance coverage.

Kathleen Sebelius, secretary of Health and Human Services, issued the warning in a letter to Karen Ignagni, the insurance industry's top lobbyist.

Ms. Sebelius said some insurers were notifying enrollees that their insurance premiums will increase next year as a result of the law's new benefits.

…"There will be zero tolerance for this type of misinformation and unjustified rate increases," Ms. Sebelius wrote. "We will not stand idly by as insurers blame their premium hikes and increased profits on the requirement that they provide consumers with basic protections."

Nowhere is it stated that these rate hikes are against the law (even if you think they should be), nor can this "misinformation" be against the law.  Here is further information, including a copy of the letter, which is worse than I had been expecting.

Bill September 10, 2010 at 10:36 am

Consumer misinformation is against the law. It’s called unfair and deceptive practices.

If carriers have a rate increase due to changes in the law, they will have to document it for approval by their state insurance regulator or they won’t get it. That’s the reference in Sebelius’s statement to “unjustified rate increases.”

Sebelius’s statement simply states the law–you can’t get rate approval for something that isn’t and she’s saying that if there is something that isn’t, you don’t get approval for it.

I have not been tracking some of the state insurance commissioner’s investigation in California regarding inaccurate filings, so perhaps someone can fill in the gaps on this, as it is relevant to this statement.

raja_r September 10, 2010 at 10:49 am

Bill -

Then why threaten them? If it is “unfair” then it won’t get approved, right? And if it gets approved, then it is not unfair?

So, again, where is the need to threaten them?

Andrew September 10, 2010 at 11:05 am

Law is but the tyrant’s will…and laws are sooo last millenium.

rojiani September 10, 2010 at 11:24 am

Which is worse for welfare: Price discrimination or price intimidation?

dave September 10, 2010 at 11:34 am

from an actuary:

State insurance departments approve rate increases not based on whether they are justified, but whether politicians want them or not. In many states you can have perfectly good reasons to raise rates and it will be denied simply to score cheap political points.

Bernard Guerrero September 10, 2010 at 11:41 am

To generalize the above:

[X governmental] departments approve [Y actions] not based on whether they are justified, but whether politicians want them or not. In many [z political subdivisions] you can have perfectly good reasons to [Y actions] and it will be denied simply to score cheap political points.

Philo September 10, 2010 at 11:47 am

Maybe Sibelius meant that *the Federal Government* will not “stand idly by” while the state regulators–cat’s paws of the insurance industry–approve rate hikes.

Thomas September 10, 2010 at 12:03 pm

This is the 2nd time that HHS has threatened health insurers who publicly opposed the administration’s plans. That’s totally unacceptable behavior, and Sebelius should be out of work because of it.

Bill September 10, 2010 at 12:37 pm

Andrew, Yes, I am a lawyer,

so let’s go to the text of the letter:

1. “It has come to my attention that several health insurer carriers are sending letters to their enrollees falsely blaming premium increases for 2011 on the patient protections in the Affordable Care Act.” Lead in, no problem with that–her assertion is that premium increases are based, not on the Act, but other things or are intended to misrepresent. No problem–her assertion, her burden to prove it in the letter, so let’s see what she offers as evidence.

2. “According to our analysis and those of some industry and academic experts, any potential premium impact from the new consumer protections and increased quality provisions under the Affordable Care Act will be minimal.” Her position of fact; you can dispute or not, but the bottom line is that rates increases have to be justified, and her analysis says that claims of high future rate increases wouldn’t be justified. OK. So, she’s telling them: we’re watching, we don’t agree, and you’d better be prepared both to prove it and support your claims to others.

3. “We estimate that that the effect will be no more than one to two percent. This is consistent with estimates from the Urban Institute (1 to 2 percent) and Mercer consultants (2.3 percent) as well as some insurers’ estimates. Pennsylvania’s Highmark, for example, estimates the effect of the legislation on premiums from 1.14 to 2 percent.” Factual support for her claim.

4. Bottom line: “Given the importance of the new protections and the facts about their impact on costs, I ask for your help in stopping misinformation and scare tactics about the Affordable Care Act. Moreover, I want AHIP’s members to be put on notice: the Administration, in partnership with states, will not tolerate unjustified rate hikes in the name of consumer protections.” Whoopty do. Tell them not to misrepresent facts when they have not even made a filing that can be examined or let them know that false filings are subject to rejection.

5. Threatened action: we will assist states in reviewing filings (contained in the HealthCare Act); we will write regulations within our authority and assist states in writing theirs, also contained in the act or subject to state insurance regulations or statutes; and we will design the exchanges (as authorized in the act):

“Already, my Department has provided 46 states with resources to strengthen the review and transparency of proposed premiums. Later this fall, we will issue a regulation that will require state or federal review of all potentially unreasonable rate increases filed by health insurers, with the justification for increases posted publicly for consumers and employers. We will also keep track of insurers with a record of unjustified rate increases: those plans may be excluded from health insurance Exchanges in 2014″

The article states that HHS might write regulations — and, by the way, you have to have legislative authority for the regulations — so, what. If you have the authority, so what. If they don’t have authority, the industry will challenge the regulations. And, if they don’t have authority, no one is intimidated. The article doesn’t discuss the scope of authority–I don’t know how a journalist can say “it’s not clear to me that the federal government will have the authority to decide which insurers will be allowed into the exchanges” but if the journalist is right or wrong, the regulations will be subject to judicial review–which will turn on the statute.

When I read this article, my reaction was: some lobbyist or PR firm got to this journalist. I don’t know what her legal expertise is. Just a PR piece. Don’t worry, Andrew, if someone writes a regulation that is not supported by the law, it is challenged and not enforced. But, I doubt Sebelius is writing without a knowledge of the law, and bet the journalist is.

odinbearded September 10, 2010 at 1:14 pm

So Bill, what happens in the time between the unlawful regulations and the time of their appeal? This isn’t some game where we can sit back and change the rules just to see what happens.

If an insurer is marked by HHS it doesn’t matter that the regulations will be overturned in a year. In the meantime, the company, marred by bad press and demonized by the government’s bully pulpit, will fold.

liberty September 10, 2010 at 1:47 pm

How can the government know whether FOR THE FIRM this law raises their EXPECTED costs more than THE GOVERNMENT decided the law would raise them?

GregS September 10, 2010 at 1:51 pm

I’m also an actuary. I can vouch for the claim that state insurance departments approve or disapprove rate increases based on political claims. Our studies often indicate that we need to take a 20-30 % rate increase. Management decisions often drop this back to more like a 5 – 10 % increase. And the increase still doesn’t get approved.

This is the game insurance departments play: “If I deny a rate increase this year, people in my state will be happy, and I’ll get fewer phone calls complaining about rate jacking. The insurer writes in all 50 states, so it can make up for losses in my state by taking rate increases in other states.” This is dangerously destructive if all 50 states play this game.

This process in and of itself makes insurance more expensive. We need to hire teams of lawyers and teams of regulatory analysts to deal with the legal morass. We also have to have more underwriters and actuaries to do normal work, because a lot of our jobs is dealing with either existing regulation or the prospect of future regulations. Does anyone think these costs don’t fall on the consumer? Insurers SHOULD be identifying where regulatory/government costs are coming from, and charging more to states that impose larger regulatory expenses on them.

Another consideration for insurers deciding a rate increase: “We would increase rates on short order if we could, but the red tape will take months or a year to cut through. We’ll be suffering losses in that time, so we have to make up for those losses after the rate increase is approved, or risk insolvency.” This wait can make an indicated 10% rate increase jump to a 15 or 20% rate increase.

Something always surprises me in discussions like this one. This is a discussion about what policy OUGHT to be, and how government officials OUGHT to behave. Someone always makes an inane comment like “The government has to do this, because it’s the law.” That adds absolutely nothing to the discussion. Maybe the law gives Sebelius a reason to make legal threats against businesses. There is also a higher law restricting agents of government from regulating speech. What we really should be discussing is whether it’s a good idea for Sebelius to behave this way, and what the consequences will be. You add nothing by reminding us what the law (as you know it) happens to be.

Andrew September 10, 2010 at 2:03 pm

Bill, I was being facetious of course, but isn’t the first thing a law firm does when it is threatening someone is send them a letter describing their interpretation of the law, favorable to themselives, not so much for the recipient?

Josh September 10, 2010 at 2:07 pm

Come on, I don’t WANT to reinforce my bias about this administration’s anti-business dogma… it’s just so hard when the facts keep getting in the way.

Bill September 10, 2010 at 2:11 pm

@Odinbeard, In answer to your question about what happens while the regs are appealed: Nothing happens. The regulations do not go into effect.

@GregS, I do appreciate your comments, and for lines line workers comp, some states either were slow to approve, or disagreed with carriers interpretations as well. I am also familiar with insurance companies filing for a rate and hoping it will be approved because no one has the time to review it; and, when challenged, withdrawing and saying, Oops, we made an error. Many states have file and use rules, and the regulatory never scrutinizes the filing other than perfunctorily.

DanC September 10, 2010 at 2:47 pm

Like all socialist governments, first Obama wants to regulate economic activity then, if you question him, he seeks to destroy you. Welcome to the new America.

And Bill applauds political extortion, even claims that it is perfectly legal as long as the politburo has given them a fig leaf of legal justification.

By Bill’s definition a bad law that gives regulatory agencies extreme powers to extort compliance and stifle political dissent is a good thing. Who needs economic or political freedom?

Bill must have studied law under Stalin.

Out of all the crazy comments that Bill has made, this really shows who he is. One wonders if he would define all administrative laws as a blank check for regulatory agencies to strip us all of liberties if we get in the way of the social planners.

Fight for your freedoms people, before people like Bill and Obama take them away.

DanC September 10, 2010 at 2:56 pm

Correction

By Bill’s definition a law that gives regulatory agencies extreme powers to extort compliance and stifle political dissent is a good thing, because the law was created as a way to destroy private companies who dissent. i.e. Because the law destroys private companies, which was the objective of many who wrote the law, the law is a good law. A bad law becomes a good law because it gives the state the power to redefine what good is. Welcome to Orwell World. Who needs economic or political freedom?

Brad_sk September 10, 2010 at 3:23 pm


DaveyNYC said
So Sebelius wants justified rate increases? Fair enough:

Rates have to go up to accommodate the removal of lifetime caps.
Rates have to go up to accommodate removal of pre-existing condition exemptions.
Rates have to go up to hire staff needed to serve an additional 31 million customers.
Rates have to go up to cover costs associated with keeping kids under parent’s plans until age 26.

Rates will go down because everyone is insured.

So the pool of healthy people will be paying minimal amount which will decrease cost. Walmart model – more numbers, less price.

Brad_sk September 10, 2010 at 3:30 pm


This is the 2nd time that HHS has threatened health insurers who publicly opposed the administration’s plans. That’s totally unacceptable behavior, and Sebelius should be out of work because of it.

Posted by: Thomas at Sep 10, 2010 12:03:36 PM

Lets see…Company claims “Buy my car and get 100mpg”. In reality its not true…FDA/SEC/ rightly investigates and fines them. People applaud.

Do you complain on price fixing too…Say Pepsi/ Coke/Dr Pepper all get together and increase price of soda can by 40c each on same day. You are ok with it because its private business, right?

Insurance company claims “Rate increased because of health care law” – No explanation given on exactly why. Govt investigates and you complain?

Bill September 10, 2010 at 3:42 pm

DanC, Give me a break with your statement: “By Bill’s definition a law that gives regulatory agencies extreme powers to extort compliance and stifle political dissent is a good thing….” You imagine too much. Rhetoric aside, do you HONESTLY think that the health care legislation that was ground through the legislative process gave “regulatory agencies extreme powers to extort compliance from those who dissent…” Come on, who are you kidding with that language. And, by the way, the straw man you set up (By Bill’s definition…) was not my statement but yours. Good try on the rhetorical swoosh.

Dan * September 10, 2010 at 3:56 pm

Is it just libertarian idealism that most here seem to be assuming that the rate hikes are due purely to market forces? I’m not suggesting it isn’t, but my understanding of the situation is that mandatory coverage covers the other issues. As a healthy mid-20s dude with a plan, I knew I was already subsidizing the old fart’s insurance. Yes, I’m an Obama guy, I like to err on his side, so maybe I’m being too lenient. But the deal behind the doors with the insurance agencies (ie Ms Ignagni) was that rates wouldn’t be greatly affected with the bill. Everyone (even people here) have stated that the insurance companies made off like bandits.

So isn’t Sebelius effectively in the right? Or are corporate lobbyists as impotent as the politicians they deal with? Has health insurance been held to anything like market forces in a long time? I will not accept that any of this will negatively affect the insurance industry’s image. It is not a free flowing market. Few like them, but most who can afford purchase their wares. That is probably the best indicator of a failed market in my head.

anonymoose September 10, 2010 at 3:59 pm

Come on Brad_sk, you can do better than that. Rates will go down because everyone is insured? You do realize that that doesn’t happen until 2014 right? And with everyone insured, there will be increased demand for services. You did think about that right? Maybe you should look at an example, say the Massachusettes model, to see what happens when everyone is insured before you start making such claims. Just a thought

“Some insurers say the Massachusetts law mandating coverage has added to the cost burdens on the health system. At least initially, they said, it encouraged newly enrolled members to flood the offices of primary care physicians and specialists to receive physicals and other exams.”

http://www.boston.com/business/healthcare/articles/2009/09/16/health_insurers_plan_10_rise_in_rates/

mulp September 10, 2010 at 4:27 pm

I’m also an actuary. I can vouch for the claim that state insurance departments approve or disapprove rate increases based on political claims. Our studies often indicate that we need to take a 20-30 % rate increase. Management decisions often drop this back to more like a 5 – 10 % increase. And the increase still doesn’t get approved.

Year after year insurers need premium increases that are 15-25% higher than inflation, so the average increases of only 5-8% above inflation is insufficient to meet the rising costs of health care which is rising at 15%-25% above inflation?

Doesn’t that demonstrate the private for-profit health insurance sector is incapable of limiting the unsustainable increases in costs of health care? If the problem is Congress increasing insurer costs, then Republicans are a big part of the problem given their record of driving up insurer costs from 1999 through 2006.

mulp September 10, 2010 at 4:43 pm

Rates will go down because everyone is insured.

So the pool of healthy people will be paying minimal amount which will decrease cost. Walmart model – more numbers, less price. — Brad_sk

No one talking in favor of health reform who is knowledgeable of the topic ever says costs/prices will go down.

In fact, “bending the cost curve” is code for “costs/prices will continue to go up, but slower”, and those working in the field expect getting health care cost increases limited to inflation will take decades.

If the health care cost increases are under inflation plus economic growth/productivity, then health care’s share of consumption goes down, even as prices increase more rapidly than inflation.

GregS September 10, 2010 at 4:58 pm

mulp,
Year after year, indicated rate increases get blocked, so the pattern is not surprising. I should say, I’m a property and casualty actuary and not a health or life actuary, but the principle is the same:
Premium = Expected Losses + Business Costs + Profit.

Government interference has without question raised the “Expected Losses” and “Business Cost” terms, while trying to artificially hold down the “Premium” term. Overall, the “Profit” term is quite small. You would not cut the cost of insurance by much if you simply did away with it (also, you CAN’T do away with it without killing innovation). If anyone is attempting to argue that government management can keep the “Business Cost” term low, I urge you to start up a company and implement the super-efficient model of the government bureaucracy, which every other health insurer is inexplicably failing to use.

I’m not sure what point you’re making about the Republicans. If you’re arguing that the problems I’ve described exist and have existed independent of who is in power, I agree with you. If you’re arguing that parties aren’t responsible for the costs of their particular policies, I don’t agree with you.

Bill September 10, 2010 at 5:53 pm

@Beefcake, Apparently you can’t make an argument other than an ad hominem.

Jon September 10, 2010 at 9:05 pm

The govermment is about to become the biggest purchaser (indirectly) of health insurance. It is well within its rights, just like any other consumer, to object to prices it considers too high, and to take its business elsewhere. Indeed, isn’t this how markets are spposed to work, and if this can help slow medical inflation how is that not a good thing?

kingfish September 10, 2010 at 10:38 pm

Prof. Cowen, I think your speed reading went a little bit too far.

The sequence of the events based on the HHS letter:
1. Insurers are sending out letters informing others that premiums will SUBSTANTIALLY increase all due to the new health care law;
2. Based on multiple analysis gathered by HHS, the new law should only bring moderate increase;
3. HHS then threatens.

So what did Ms. Sebelius do wrong? Even if insurers’ claim is fully substantiated, should they compare notes with HHS first before hanging up HHS to dry?

MPO September 11, 2010 at 2:25 am

Bill,

It is not at all difficult to predict your “future actions” based on your extensive posting history. While you may not be the most ideological regular on MR, you are certainly one of the most blatantly partisan. Surely you can understand how that behavior on your part poisons your contributions.

Bill September 11, 2010 at 9:47 am

mPO, I’m sorry that but I don’t drink the cool-aid that is served to me, I think for myself, and people should react to the substance of a comment and not the person, if they are rational and not partisan themselves. (and, even if they are, what you call partisan, they should be able to respond with facts and not engage in ad hominem arguments) I have, by the way, voted for, and even advised, moderate Republicans, and independents, so if you think you may know my views, perhaps you should think about where your own views may lie. I like the website when it focuses on microecomic issues, but when it gets into anything related to politics, too often some of the cryptic responses look like slogans. Adding what I think are substantive facts (ie, law regarding regulatory proccess, for example) may be discomfiting to those who don’t care about facts or other information, or even other views, but who cares about them anyway.

Bill September 11, 2010 at 10:25 am

@Dan C, Rather than posting the Fox News summary of the GAO report, here is the link to the GAO report written to the minority members of the committee: http://republicans.waysandmeans.house.gov/UploadedFiles/GAO_Mailer.pdf

From the GAO report:

1. “Although the HHS brochure contains
instances in which HHS presented abbreviated information and a positive view of
PPACA that is not universally shared, nothing in the brochure constitutes
communications that are purely partisan, self-aggrandizing, or covert. In addition, we
point out some overstatements in the brochure of PPACA’s benefits, such as where
the brochure suggests that PPACA increases the number of primary care providers,
when PPACA only provides incentives for such increases.”

2. “Here, the 2010 HHS brochure focuses on the benefits of PPACA, and there are
references in the brochure that assert that PPACA “preserves and strengthens
Medicare,” makes “improvements,” and creates “new benefits.” Although some may
view such statements as an attempt to persuade the public to the Administration’s
point ofview, we do not find them to be purely partisan in nature. While the
brochure contains statements describing the benefits of PPACA, we cannot say that
such statements are completely political in nature.”

3. “The brochure does not provide beneficiaries with a comprehensive summary of
changes to Medicare that will be implemented as a result of PPACA, and in several
instances it provides abbreviated information that leaves out details about PPACA.
For example, the brochure states that “[i]nsurance companies will be prohibited from
denying coverage due to a pre~existing condition for children starting in September,
and for adults in 2014,” but does not explain that this provision of PPACA, although
broad, does not apply to all health plans. A subset of health plans-grandfathered
individual health insurance plans-are exempt. HHS Brochure, at 3; see Pub. L. No.
111-148, § 1201(2) (redesignating section 2701 of the Public Health Service Act as
section 2704 and amending it) (to be codjfjedat42 U.S.C. § 300gg-3); InteIim FYnal
Rules for Group Health Plans andHealth Insurance Coverage Relatjng to Status as a
Page 8 B-319834
GrandfatheredHealth Plan Under the Patjent Protectjon andAffordable Care Act, 75
Fed. Reg. 34,538, 34,542 (June 17,2010).

There is limited space in a brochure, and we would not, therefore, expect a brochure
to contain comprehensive information on the provisions of PPACA. A brochure,
generally, is expected to present a brief overview of or introduction to information of
interest to the recipient. The HHS brochure does provide a brief overview of PPACA
by identifying programs to which PPACA made changes, providing some information
on the details of those changes, and noting dates when many of the changes will take
effect. Additionally, the brochure refers beneficiaries to other sources for further
information, such as the Medicare Web site and toll-free telephone number. HHS
Brochure, at 4. In our 2004 opinion, we found that although the flyer omitted some
information regarding the impact of legislation on Medicare beneficiaries’ coverage
and costs and may have highlighted some of the positive aspects of Medicare
changes, the flyer was not purely partisan. B-302504, at 10-11. Likewise, the
information in the 2010 HHS brochure, while not comprehensive, does not amount to
a violation of the publicity or propaganda prohibition.
In our view, the brochure presents a picture of PPACA that is not universally shared.
For example, two government analyses have determined that PPACA reductions in
funding for Medicare Advantage may decrease enrollment and result in less generous
benefit packages.11 In addition, one of those analyses and the 2010 Medicare Trustees
Report acknowledge that while the financial outlook for the Medicare program is
substantially improved as a result of PPACA, the feasibility of long-range
improvements is still uncertain, and significant increases in premiums for some
beneficiaries may be necessary.12 The brochure focuses on the improvements to the
financial outlook for Medicare in the section entitled “Keeps Medicare Strong and
Solvent.” See HHS Brochure, at 4. In its discussion of “Improvements to Medicare
Advantage,” the brochure focuses on the more immediate effects of the provisions
related to Medicare Advantage rather than the projected impact over the next 10 or
more years, and does not mention the government analyses. See jd} at 2.
We noticed, also, that the brochure overstates some of PPACA’s benefits. For
example, it states that PPACA “increases the number of primary care doctors, nurses,
and physician assistants,” when PPACA, in fact, only provides incentives for suchincreases. HHS Brochure, at 3; see Pub. L. No. 111-148, §§ 5205, 5501-5509
(provisions providing incentives for primary care services, including an Allied Health
Loan Forgiveness Program, incentive payments, training, and demonstration projects
to assess health professions workforce needs). The brochure also states that PPACA
will “ensure accountability throughout the health care system.” HHS Brochure, at 1.
While PPACA may help to increase accountability, it does not guarantee it. See, e.g.,
Pub. L. No. 111-148, §§ 6102, 10303 (accountability requirements for nursing homes
and provisions for developing outcome measures that address accountability issues).
Similarly, the brochure notes that PPACA “reduces payment errors, waste, fraud, and
abuse.” HHS Brochure, at 4. PPACA enacted requirements for increased oversight of
payment to providers and suppliers and for reporting and returning overpayments
and appropriated funding to the Health Care Fraud and Abuse Account and the
Medicaid Integrity Program. See, e.g., Pub. L. No. 111-148, §§ 6401-6411 (Medicare,
Medicaid, and CHIP program integrity provisions); Pub. L. No. 111-152, § 1303
(appropriating funding to fight fraud, waste, and abuse). Also, the brochure mentions
that “guaranteed Medicare benefits won’t change-whether you get them through
Original Medicare or a Medicare Advantage plan” and contains similar statements on
other pages. HHS Brochure, at 1. Beneficiaries who participate in Medicare
Advantage are guaranteed original Medicare benefits, but the specific benefits beyond
original Medicare offered by Medicare Advantage plans are not guaranteed and could
change at a plan’s discretion. 42 U.S.C. § 1395w-22(a).
The positive tone of the brochure, however, does not make the brochure purely
partisan. The publicity or propaganda prohibition does not bar materials that support
a particular view or justify the agency’s policies. B-302504, at 12. Indeed, it is
important for the public to understand the philosophical underpinnings of the
policies advanced by elected officials and their staff in order for the public to
evaluate and form opinions on those policies. In that regard, the public may find it
important to know of the Administration’s views-whether the public agrees with
them or not. Notwithstanding the brochure’s lack of detail and its positive tone, the
content of the brochure does not constitute a purely partisan message. HHS has
established a nexus to its responsibility to inform the public, and the content of the
brochure is not solely political. HHS also has directed readers to additional sources
of information for more details about the program.”

Bill September 11, 2010 at 12:16 pm

If you read the letter, you will see the GAO was providing an opinion on, in the GAO’s words,

“… whether HHS’s use of appropriated funds to pay for the brochure constitutes
a violation of the publicity or propaganda prohibition in the Consolidated
Appropriations Act, 2010, Pub. L. No. 111-117, div. C, title VII, § 720, 123 Stat. 3034,
3210 (Dec. 16,2009).4 The prohibition states that “[n]o part of any appropriation contained in this or any other Act shall be used directly or indirectly, including by private contractor, for publicity or propaganda purposes within the United States not
heretofore authorized by the Congress.” Pub. L. No. 111-117, § 720.”

The text of the letter, quoted above, does not state that HHS made misleading statements. (By the way, I challenge you to quote any part of the GAO letter which specifically says the pamphlet was misleading.) Applying the standards it has applied to other matters, it concluded: “Although the HHS brochure contains instances in which HHS presented abbreviated information and a positive view of
PPACA that is not universally shared, nothing in the brochure constitutes communications that are purely partisan, self-aggrandizing, or covert.”

Rather than reading the Fox News blurb, everyone should read the letter. Become a primary source addict and critically think for yourself and don’t rely on the Fox News excissions. You’ll see that one of the issues is how much detail needs to be presented in a short brochure, for example, or whether the agency has to present the floor debate in a brochure, or whether it “can present materials that supporta particular view or justify the agency’s policies. B-302504, at 12″, or whether it has to go into long term issues where a pamphlet focuses on short term matters, and so on.

The world is complicated. Live in it. Read the primary source document.

Bill September 11, 2010 at 1:26 pm

@DanC, First, the fact that views are not universally shared does not make them misleading.

Second, the GAO report does not state that the HHS pamphlet says, in your words, “as fact things that other government reports have found to be false”. The sentence you are referring to refers to their statement that PPCA would improve the financial outlook of Medicare, and the GAO came back with a report which GAO said says : “In addition, one of those analyses and the 2010 Medicare Trustees Report acknowledge that while the financial outlook for the Medicare program is substantially improved as a result of PPACA, the feasibility of long-range improvements is still uncertain, and significant increases in premiums for some beneficiaries may be necessary.”

Third, regarding your claim of partisanship, the GAO report concludes: “The positive tone of the brochure, however, does not make the brochure purelypartisan. The publicity or propaganda prohibition does not bar materials that support
a particular view or justify the agency’s policies. B-302504, at 12. Indeed, it is
important for the public to understand the philosophical underpinnings of the
policies advanced by elected officials and their staff in order for the public to
evaluate and form opinions on those policies. In that regard, the public may find it
important to know of the Administration’s views-whether the public agrees with
them or not. Notwithstanding the brochure’s lack of detail and its positive tone, the
content of the brochure does not constitute a purely partisan message. HHS has
established a nexus to its responsibility to inform the public, and the content of the
brochure is not solely political. HHS also has directed readers to additional sources
of information for more details about the program.”

Fourth, you might want to double check anything you get from Fox News and go to the primary source document first.

Usef Ulli Diots September 14, 2010 at 9:44 am

I wonder, would this have been a good time to reflect with contrition on shilling for Obama throughout the 2008 electoral campaign?

Doc Merlin September 15, 2010 at 2:48 am

Government price setting is a bad idea. Regardless… we warned you about this Tyler. Here the Obama administration is engaging in government price fixing.

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