Last week, the Arizona Senate passed Medicaid expansion. Sadly, the proponents were not satisfied with merely passing a program expansion we can’t afford; they actively worked together to kill a series of common sense amendments that would have prevented extra expense and abuse.
One amendment would have activated the circuit breaker if the federal government ever dropped its share of the cost below the promised 90 percent, but every senate Democrat and five Republicans voted the amendment down, signaling that the Feds should feel free to increase Arizona's costs.
Another amendment would have required an independent audit to ensure hospitals don’t pass the provider tax on to patients. Expansion proponents voted the amendment down, making it easier for hospitals to illegally pass the cost along without fear of being caught.
An amendment was offered to require an annual report on the quality of care provided by AHCCCS, Arizona’s Medicaid program. Although taxpayers have a right to know whether their money is being put to good use, these same senators voted the amendment down. Without this transparency, proponents can continue to assert how well the program works without risking evidence to the contrary.
This coalition also voted down amendments designed to curtail non-emergency use of emergency rooms and ambulances, which result in high, unnecessary costs to the state. Likewise, they voted down amendments to require health professionals and pharmacists to check the prescription monitoring database before authorizing or filling a member’s prescription for a controlled substance such as Oxycodone, Percocet, or Vicodin. These amendments would have saved taxpayers from paying for and enabling addictions to these medications.
While the Medicaid expansion is a costly and misguided policy, these amendments were not poison pills but sensible ways to mitigate some of the costs and prevent abuse. The proponents, however, made a bad bill much worse by rejecting these amendments. Thankfully, the Senate does not have the last word. While we hope the House declines the Medicaid expansion, at a minimum, we hope it supports some common sense amendments that will help protect taxpayers.
Have you ever squeezed a balloon and had parts of it squeeze out between your fingers? Unless you pop the balloon with a pin, it will reemerge somewhere else when you squeeze it. Public employee pensions have become balloons, and abuse of public pension systems keeps oozing despite attempts to put the squeeze on it.
In 2011, after the Arizona Republic published a series of articles exposing pension abuses, a number of reforms to prevent costly abuses were put into place. One reform restricted what could be considered income for someone near retirement. Before the 2011 reforms, the pension amount was set based in part on the last three years of income. So a common abuse was to boost income during the last three years by counting income not part of one’s regular salary, including overtime and payouts for unused overtime and sick leave. Padding one’s income in this way set a higher pension level.
It turns out the practice is still alive and well – it has just emerged in a new place. The City of Phoenix is padding retirees’ pensions by counting compensation for unused vacation and sick time as income. The loophole is that Phoenix pays this compensation over time instead of in one big check, making the practice harder to discover. This is so lucrative that one retired employee is making more retired than when he showed up for work.
Lest you snicker at the cleverness of it all, keep in mind that all four of the state’s public employee pension systems are in financial trouble and taxpayers are paying more into the system to keep them afloat. Pension contributions have increased six times faster than the state GDP. We are paying more taxes and giving up services to fund lucrative retirements.
Pension plans will always be gamed. One loophole closed today will turn into another loophole tomorrow. There is just too much temptation in giant, multi-billion dollar funds for someone not to think of ways to loot them. Phoenix officials should be prosecuted for violating the law, but the only long-term solution for taxpayers is to pop the pension balloon and move public employees to defined contribution (410(k)-style) retirement benefits.
Goldwater Institute: Defusing the Pension Bomb: Making Retirement Plans Solvent for All Public Workers
Arizona Republic: Phoenix pension spiking is a slap to taxpayers
Arizona Republic: Legality of boosting Phoenix pensions in question
In upholding the federal health care law’s individual mandate as a tax, Chief Justice John Roberts reiterated Justice Oliver Wendell Holmes’ promise that “[t]he power to tax is not the power to destroy while this Court sits.” With the IRS’ recent targeted investigations of tea parties, balanced budget advocates, and constitutional study groups across the nation, the Chief Justice may soon have the opportunity to keep his promise.
The IRS is the chief enforcer of the federal health care law. In deciding when to impose the individual mandate penalty, the IRS will have to determine whether taxpayers have “qualifying health insurance coverage,” whether employers should be penalized for failing to provide such insurance to their employees, and if various exemptions apply. In the wrong hands or subject to the wrong directives, this immense power could all-too-easily result in the IRS rooting through private medical records and billings. The federal Health Insurance Portability and Accountability Act already authorizes your physician, hospital and insurance company—and their business associates—to disclose your personal medical information, history and records to government agencies for law enforcement and regulatory purposes without your consent.
Ever since the McCarthy era of the 1950s, courts have established that the taxing power may not be wielded to punish political enemies. The Court of that era probably never foresaw the day when its rulings would be applied to protect those who believe in constitutionally limited government, as opposed to those who sought to overthrow it. But there is no more important time than the present to revitalize and apply such limitations on the federal government’s power to tax.
In a twist that is almost unbelievable, news agencies reported last week that the same person who oversaw the targeting of conservative groups seeking tax exempt status will be responsible for overseeing the IRS’ enforcement of the federal health care law. We should all shudder at the thought.
Uncle Sam thinks he knows what’s right for your health, and he’s using your hard-earned money to teach you that lesson. Two years ago, the Goldwater Institute reported that the Centers for Disease Control and Prevention (CDC) gave Pima County, Arizona nearly $16 million through its Communities Putting Prevention to Work program to reduce obesity and promote healthy lifestyles. Our friends at Cause of Action, a watchdog organization that reports on government waste, have released a report detailing how Pima and other counties have been spending your tax money.
In Pima County, the money is funding a contract with the University of Arizona to develop restrictive zoning codes for “green-space development” and government programs that will encourage people to make “informed dietary choices.”
The Cause of Action report also gives us a peek at what could be on the horizon if the CDC continues to push its paternalism. Alabama, Georgia, and California have all used Communities Putting Prevention to Work money to lobby for new taxes on unhealthy activities, such as drinking soda and using tobacco products. This advocacy, which is part of the CDC’s long-declared proclivity for encouraging local governments to “control the food environment,” may even violate federal laws that prohibit lobbying with taxpayer dollars.
The government has no business using our money to dictate what we eat. Local governments like Pima County should stop selling out our freedom to win the federal pork wars.
Cause of Action: CPPW: Putting Politics to Work
Goldwater Institute: Pima County has super-sized plan for starving private property rights
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