Massachusetts Health Stats

RomneyCare by PowerPoint: How the Democratic-Party Insurers Work the Poltical System

The Massachusetts health care insurance market -- both before and after RomneyCare -- is primarily an extension of the Democratic Party. It works kind of the way the Chinese and Iranian armies run big companies in their respective one-party states.

Here's a simplistic view of the three major ways your money moves between you and healthcare providers, with the Democratic Party siphoning off some money all along the way.

For "pure" Romneycare itself, the flow is even more complex:

 - Dennis Byron

RomneyCare/Obamacare Feature "Premium Support;" Why Not Medicare?

In all the publicity about the Massachusetts Supreme Court re-instating the right of legal immigrants to buy Commonwealth Care (nee RomneyCare) after that right had been outlawed in 2009 to save $150,000,000 in the Massachusetts budget, one glaring fact never gets mentioned. 

What's the $150,000,000 for? 

The answer is:

Tax-funded premium support for legal immigrants to buy healthcare insurance from a list of a half dozen or so "private" (by the left's definition) healthcare insurance companies. 

According to all the related stories, the federal Patient Protection and Affordable Care Act (PPACA) works the same way.  And PPACA will also chip in half the cost of the legal immigrants tax-funded premium support to the state of Massachusetts budget starting in 2014 (thanks America).

So how come tax-funded premium support is OK for RomneyCare and ObamaCare but bad for Medicare?  It's just another way left-wing politicians such as John Kerry try to screw us seniors.  (Where's AARP when you need it?  Actually, it spends all its resources trying to sell you non-premium-supported insurance.)

There's another worse example of senior screwing brewing: Kerry and other senators of both parties and Independent Lieberman want to take away senior's right to buy the Medigap supplement policy they want. As with the irony of the politicians saying it's OK for those under 65 to have premium support but it's not OK for those of us over 65, PPACA is going to force those under 65 to buy insurance they don't want while an amendment to it is going to prohibit seniors from buying insurance they do want.

(By the way, as a former legal immigrant in a foreign country, who was allowed to participate in its healthcare insurance system, I have no problem with the Supreme Court decision itself.)

-- Dennis Byron

The Boston Herald "Medicare Victim" Story on Enbrel: Dozens of Teachable Moments

On November 3, the Boston Herald ran one of those typical healthcare-insurance-companies-suck sob stories written by its "house lefty." But this healthcare-insurance-company-sucks sob story had a twist. The healthcare-insurance company in the Herald story was not one of the usual for-profit Republican bad guys but the good old Democratic-party bureaucracy, the Centers for Medicare/Medicaid Services.

The alleged "Medicare victim" is a former pressman (I'm guessing that's someone that worked in newspaper publishing back when it used presses) with rheumatoid arthritis (RA). In the story, the victim is of an age not specified, and has been on Medicare of a “part” not specified, for a length of time not specified.  The Herald story did say where the Herald’s victim lived in Massachusetts (Millis) and that he needed Enbrel, the drug of Phil-Mikelson-pro-golfer fame, to control the RA. Supposedly it used to cost the Herald's "Medicare victim" $42 a month under Medicare back in some time period unspecified and now – starting in July 2011 -- it began to cost him $600 a month instead.

We'll probably never know the whole story about the Herald's "Medicare victim" unless he wants to go public. But the Herald did a disservice to seniors by publishing a story that made no sense to anyone that studies Medicare drug coverage. And unneccesarily scared the shit out of hundreds or more seniors who use it.

Thankfully, as inaccurate and as misleading as the Herald story is (kind of like former Illinois Senator Obama claiming that a healthcare insurer denied his mother cancer-care coverage), the Herald article provides a teachable moment.  Lefties love teachable moments. The potential teachable-moment statements in the Herald article are underlined both above and below. I will follow up with detail on each in future blog posts as appropriate and if I feel like participating in a teachable moment.   But in summary

1. The Herald said:

"(The victim) says Medicare has changed its deal for covering... (Enbrel)"

Medicare did not change "its deal" for covering Enbrel or any other drug.  (Note how the Herald says the victim said this.  That way, the Herald is not responsible for the inaccuracy.)

2. The Herald said:

"(Enbrel) kept him working for 10 years with increasingly severe rheumatoid arthritis."

This calls into question the story line of the Herald "house lefty" that something that Medicare had been supporting for 10 years (a low co pay) was then recently and abruptly changed drastically "by Medicare." Medicare has only had Part D drug coverage for five years.  Worse in terms of the teachable moment, we don't know what 10 years the Herald house lefty is talking about.

3. The Herald says in a November 4 follow-up article that its Medicare victim is on an unnamed Tufts Medicare Preferred plan. It does not appear that either Tufts (the actual insurer) or Medicare (the accused insurer that is actually only a payer, just like EMC or Raytheon or probably the Herald) changed anything for the Medicare victim assuming he is the guy from Millis that turned 65 in 2010, that he was not disabled by the RA (the story implies he was working fairly recently), and that he used Tufts.

4. The Herald said

"Enbrel used to cost him a $42 per month co-pay." 

My guess is that the "Medicare victim" received some bad insurance advice, possibly from Tufts. Good advice would not have changed his cost situation but it could have better prepared him and possibly helped him find assistance if he qualified.  (I can think of at least one other scenario. Possibly he was disabled by the RA when he was in his early 60s, went on Medicare two years later but before he turned 65, and belonged to some Tufts health plan before 2010 -- like a Medicare Part C HMO -- that covered Enbrel better than Tufts' 2010-2012 Medicare plan lineup covers it.)

5. The Herald said

"Now it costs him $600 a month."

"Now" is the clinker in this claim. The monthly average under the likely Tufts plan for 2011 would have been around $400 a month (assuming he is using a local CVS or Rite-Aid), not $600. There are less expensive Medicare Part D plans in Millis that would have lowered his cost to about $330 a month on average. That lower price from other insurers will be about the same in 2012.  But maybe there was another good reason to be on Tufts.  

Enbrel is expensive medicine. Every case is different but, on an annual basis, the typical Enbrel Medicare user gets $22,000 worth of the recommended dosage of Enbrel for as little as $4,000.

• That's pretty good especially compared to before 2006 when there was no Medicare prescription coverage.
• That’s better proportionately than you getting your annual fix of brand-name blood pressure or chloresterol medicine on Medicare, retailing at $4000 but costing you $1000 out of pocket (a monthly $50 co-pay until you fall into a little bit of the donut hole and pay 50% of the drug's cost).
• And -- at least in Massachusetts -- there was and is a state program that helps substantially mitigate even the $4000  (or $1000) for senior-citizen couples making as much as $36,000 a year. With no asset test or spend down required.   

6. The Herald said:

"So ("the victim") stopped taking Enbrel four months ago."

This statement is the one that really makes no sense to people that research such things because June/July 2011 was when the Herald's "Medicare victim" would have been coming out of the donut hole and have been eligible to buy Enbrel for only $95 a month for the rest of 2011. 

I'm not defending the donut hole mind you but its effect is

• to keep annual drug costs very low for most seniors without specialty drug needs, and
• to provide benefits almost immediately after the policy begins without high up-front out of pocket expense 

7. The Herald said:

"... he is far from alone. At a recent (Massachusetts) State House hearing, doctors, patients advocates and patients themselves told lawmakers that not only is Medicare changing prescription drug rules, private insurers also have demanded high patient payment for some of the more expensive drugs treating cancer, heart disease, HIV/AIDS, hemophilia and multiple sclerosis." 

Again, Medicare is not "changing" and has not changed anything.  IF anything related to the victim's Medicare drug coverage changed, and I cannot find that it did, it was one insurer that changed something.

Nor does a private insurer "demand payment" of anyone. That's not the way insurance works. (And most healthare insurance programs including Medicare are run by private insurers, despite the Democratic-party-line dig at "private insurers.")  

And I don't think the Massachusetts legislature can do anything about Medicare drug coverage so it is grossly unfair of the Herald to imply the pols could help to its Medicare victim and other seniors.  That just victimizes him twice, to use a favorite expression of the left.

I also don't think the Massachusetts state legislature can pass a law that would have an effect on those with employer sponsored insurance where the employer is self insured. Counting all Massachusetts residents where Medicare and self-insured employers are the payers, 75% of the people in Massachusetts are unaffected by anything the state legislature does when it comes to healthcare insurance. 

The Herald sure packed a lot of teachable moments into a small article.

-- Dennis Byron

UPDATE: Washington Post Fact Checker Digs RomneyCare Fact-Check Hole Deeper

Isn't there some saying that goes

"When you've dug yourself into a hole, the first rule is to stop digging?"

Apparently the Washington Post (WaPo) fact checker didn't get the memo.

A few days ago I pointed out all the errors in the WaPo fact check of a Mitt Romney claim about the RomneyCare, the so-called health care reform we're saddled with here in Massachusetts. WaPo's fixed a few of the errors so you can no longer see what I was originally commenting on. 

In fact, and I've never seen this before on the web, WaPo changed the blog post without making any note or giving any notices that the current article at that link is not what was originally posted. That's bad blogging etiquette. But I don't care since I agreed with WaPo's point.  I just simply wanted to point out that the WaPo supporting facts were wrong, way wrong... little-kid-who-didn't-do-his-homework wrong.

On the other hand, Brian Rosman of HealthCare for All doesn't agree with the WaPo opinion and he's also found all kind of factual errors with the latest WaPo posting.  When WaPo can't please a far lefty from HCFA, something's really wrong.

My only comments on the latest version, now that WaPo has removed the errors about

• MassHealth/Medicaid
• the percentage of people uninsured or on government insurance (not counting Medicare)
• and -- I think -- the double counting the Health Safety Net and the uncompensated care pool

is that the data he uses to "prove" that RomneyCare stopped "free riding" is five years old and not statistically significant.  It doesn't seem to recognize the special circumstance here in Massachusetts in 2005/2006 known as the "merged market." I also don't agree with his definition of "free rider" but that's what blogging is for. 

In summary, if I had read the current post -- as opposed to the original post -- I wouldn't have wasted my time on these latest two blog entries.

But as Brian Rosman says, "who's watching the watchmen?"

-- Dennis Byron

WaPo Fact Check on RomneyCare Needs Heavy Fact Checking

You won't find any argument from me that former Massachusetts Governor Mitt Romney is incredibly intellectually dishonest about Romneycare.  But the Washington Post fact check column about Romney's dishonesty itself includes some very large errors of fact.

It says:

"A report from the Urban Institute showed that the number of higher-income Massachusetts residents without insurance — the so-called “free riders” — fell from 5.2 percent before RomneyCare was enacted to 1 percent in 2008."

It's kind of hard to follow WaPo's trail here because the link it provides goes to a Commonwealth Fund document rather than an Urban Institute document.  But the numbers cited refer to statistics commonly (and incorrectly) used to represent all the uninsured in Massachusetts, not uninsured higher income Massachusetts residents. 

The years cited appear to be off as well; the 1% number refers to 2010, not 2008.  And the Urban Institute did the research only related to the 1% number, not the 5.2% number. That out-of-state left wing organization was hired by current Massachusetts Governor Deval Patrick to do research in 2009 and 2010 when initial state research conducted by another research organization found no reduction in the overall uninsured between 2006 and 2008. 

Most importantly, high income Massachusetts residents without insurance represented a very small percentage of the uninsured in Massachusetts prior to the so-called Massachusetts healthcare reform.  Most of the uninsured pre-RomneyCare were eligible for Medicaid and simply had not signed up. A large percentage were illegal aliens and not eligible for healthcare insurance under any programs proposed then or in effect now... in any state (see Romney's presentation of Medicaid Commission in January 2006 and many other research documents from that period). 

This of course is the same situation with the current national statistics (see recent book about PPACA by key Kennedy aide, McDonough).

WaPo says:

"The study concluded there was no evidence of residents using state-subsidized insurance when they could afford their own plans...

In Romney's defense, that wasn't his point.  He wasn't talking about the period post the so-called reform but pre.

WaPo says:

"But these numbers gloss over an important fact: the number of Massachusetts residents using private insurance has remained roughly unchanged..."

Actually it is down by over one hundred thousand.  This is net of over 150,000 that have lost employer sponsored insurance due to crowd out, countered by about 50,000 that re-entered the individual insurance market because of changes unrelated to RomneyCare (or possibly related if they were reacting to the mandate).

WaPo says:

"In 2010, 18.5 percent of state residents were either uninsured or using public insurance plans..."

No idea what the source is for this statement.  I assume it refers to Medicaid alone although it sounds a little low. Free or subsidized insurance outside of Medicaid includes another 3% (this is the number of so-called actual RomneyCare subscribers, around 150,000 people on a program called Commonwealth Care). And of course there is still some percentage uninsured no matter whose statistics you use.  So the correct number in the WaPo sentence should at least be 24%.

WaPo says:

"Romney’s plan instead shifted much of the free-rider costs to.. newly formed government agencies called MassHealth and Commonwealth Care..."

MassHealth is not newly formed.  It is the name for Medicaid in Massachusetts and has been in existence for decades.  Commonwealth Care is the insurance mentioned above.  The new agency, run by the much quoted MIT Professor Gruber, is called the Connector Authority. It is a useless political hack organization that runs the non-Medicaid free and subsidized insurance program. But all recipients still have to go through Masshealth so the Connector really has no function other than to employ nieces and nephews of legislators and all the out-of-state consultants it hires (e.g., Dell/Perot of Texas does the information technology).

WaPo says:

“Health centers experienced a significant reduction in the number of uninsured patients..."

Actually the reduction was not significant in any statistical sense.

WaPo says:

"... their source of financing shifted from uncompensated care funding to patient-related revenue.”

Maybe but this doesn't make sense because the budged for uncompesated care funding is rising dramatically since the full implementation of RomneyCare in 2008. Of course that makes the Romney's spokeswoman's statement ludicrous but that is the job of Romney spokespeople.

WaPo says:

"The Boston Globe projected that the price tag for Commonwealth Care alone would reach $1.35 billion by 2011, up from just $158 million in 2007."

That is an unfair comparison because RomneyCare was not really implemented until 2008. 

WaPo says:

"Add that to the $475 million the state spent on its Health Safety Net program..."

This is the uncompensated care funding WaPo referred to earlier.  They are one and the same.  And that amount is only what the state "spent" two years ago  It owes another $60 million for that year that the legislature did not appropriate and even more for the last year. And the bill keeps rising. 

The whole big idea behind RomneyCare was to take this "free care pool" money and -- instead of giving it to charity hospitals to help care for the needy -- Romney gave it to politically connected insurance companies to give it to politically connected teaching hospitals to care for the needy.  But no one told the needy to get out of the ghetto and go to the fancy part of town where the teaching hospitals are.

AND MOST IMPORTANT, THERE WERE AND ARE VERY FEW FREE RIDERS, HIGHER INCOME PEOPLE FROM "NICE NEIGHBORHOODS" WHO COULD AFFORD INSURANCE AND DIDN'T TAKE IT AND THEN SHOWED UP AT CLINICS AND HOSPITALS  IN GHETTOS LOOKING FOR CARE.

-- Dennis Byron

Obama Defunding RomneyCare According to Globe, Herald

I find it hard to believe but according to both the Globe and the Herald today, October 31, the federal waiver that underlies (or is it underlays?) RomneyCare is in serious trouble.  Supposedly the Obama administration seriously wants to cut back on the federal money with which the state of Massachusetts pays for much of the incremental insurance that everyone from Mitt Romney to Deval Patrick to President Obama himself wets their pants over on a daily basis.

This recent post explains the waiver in wonk talk. But the nickle version is as follows: 

•  
  • (Which has always been almost everyone of us here in Massachusetts.  Healthcare insurance was invented here in 1850. We love it.)
• If you're familiar with the proven business concept of eliminating the middleman, RomneyCare works just the opposite.
• Massachusetts used to pay mostly public charity hospitals to take care of the needy using mostly a tax on those of us that used the Massachusetts-based non-profit healthcare insurers.
• A large group of religous charity hospitals in Massachusetts also helped the needy the old fashioned way
  • (You probably think I mean via charitable giving. There was some of that but the basic method of the religous approach to helping the needy was to pay workers poorly, ironically making them 'needy.')
• So the state went hat in hand to Bill Clinton and a Medicaid waiver was granted in 1997 to use some Medicaid money to help the charity hospitals to help the needy. 
• The 'outside the box' thinking behind RomneyCare in 2006 -- the second time the waiver came up for renewal -- was to take that Federal money and
  • give it to politically connected insurance companies instead
  • they, in turn, would give it to politically connected teaching hospitals to take care of the needy.
• But no one told the needy.  They keep going to the public charity hospitals.
  • (The needy can't go to the religous charity hospitals any more because they were put out of business by this so-called reform. That puts more stress on the remaining public charity hospitals.)

Last week, the proponents of single payer healthcare insurance for Massachusetts, a group called Mass-Care, spelled all this out in great detail in a 100-page document. 

Or you can work your way back through my blog posts, reading every other post (in the posts not about the failure of RomneyCare, I tend to write about the failure of Medicare).

-- Dennis Byron

Massachusetts Blue Cross: Please Pass a Law to Make Us Stop Wasting Money... and Beat Wellpoint

Blue Cross of Massachusetts will hold a conference October 21

• at an expensive Boston hotel
• to present expensive Harvard research findings
• paid for by Blue Cross 

The research finds that Massachusetts residents want the state

• to pass laws
• to stop Blue Cross from spending money
  • at expensive Boston hotels
  • for expensive and obvious Harvard research (link pending release of research results by Blue Cross).

The canned research by some Harvard professor in the bag to Blue Cross finds that Massachusetts residents want the state rather than payers or providers to control costs.  The research is part of the fourth wave of propaganda -- which included the Tuesday October 18 New York Times article -- to try to jumpstart Governor Deval Patrick's failed proposal to force Massachusetts state employees into HMOs.

Those would mostly be Blue Cross HMOs, of course.  Today, most state employee health insurance is fee for service and administered by Wellpoint (WLP). Deval Patrick passed a law in summer 2011 to force many munincipal employees to Wellpoint as well (by abrogating collective bargaining rights but you never read that in the liberal media).

-- Dennis Byron

Feds Screw Seniors with 2012 Social Security Increase

Headline after headline today screams some variation of:

"Feds Screw Seniors with 2012 Social Security Increase...

At least that's the impression I get from hundreds and hundreds of news articles October 20 that couple the breathless news that the first Social Security increase in three years will be accompanied by the first Medicare Part B premium increase in three years. 

Duh!. That's the way it's supposed to work.

An exception to the cockeyed media twist is this MSNBC headline: "Social Security goes up, but so do Medicare premiums." That's accurate. And the story behind it is accurate.

But I saw one website that linked to the MSNBC story with a lede that said the social security increase will be "largely taken up" by Medicare Part B premium increases. I don't see anything in the linked article that even implies that. Because I respect the blogger who wrote it -- who is probably neither Social Security (SS) or Medicare age -- he must have just assumed from all the media twisting of this news that "largely taken up" was the case. Otherwise I can't imagine where he got the idea.

Simplistically the average person on SS is going to get a $35 raise in income a month and a $10 raise in part B premium. Depending on the Part C or D choices they make over the next 6 weeks of Medicare Open Enrollment, they could "cut their loss," which is how the cockeyed press seems to be looking at this news.

It does look like about 3% of the SS population may have it all "taken up" but -- assuming the rumored $10 montly increase is accurate for those that have been paying $96.xx the last three years for Medicare Part B -- such a SS recipient would be someone only receiving $300 a month currently (as opposed to the average of around $1100). I think that would mean they put very little into SS over the years. Maybe they're mostly retirees on a government pension back when -- still true some places maybe? -- government employees didn't contribute to SS.  

But there's also 2,000,000 of us baby boomers that are apparently going to get a Part B premium decrease.  Because -- as noted above -- while everyone that signed up for Medicare in 2009 or before has had their premium frozen at $96.xx a month for the last three years, those of us that signed up in 2010 and 2011 have been paying $110.xx and $115.xx a month, respectively, to make up for the difference. Our premiums will go down to the new rumored $106 (or whatever it turns out to be). 

Seniors that make over $85,000 a year have also been paying more than $96.xx, a lot more, and their premiums will go down as well.

Thanks for the inflation, Barry, especially for the environmental regulations and wars that have driven up oil prices.

-- Dennis Byron

DukakaCare... RomneyCare... Obamacare... PatrickCare? What the Left Up to?

What's with all the old news this week?

• The NPR and Politifact stories about the 2006 RomneyCare Massachusetts health insurance law being like the 2010 Patient Protection and Affordable Care Act (PPACA), known as Obamacare, are getting tiring.
• And the New York Times' breathless October 18, 2011 report that Governor Deval Patrick of Massachusetts is going to put the people whose healthcare Massachusetts directly funds (25% of the state's population -- those on Commonwealth Care -- AKA RomneyCare, Medicaid, and state employees but not retirees) into HMOs was old news on March 18, 2011. (Oh by the way, about half of them are already in HMOs.)

So what this left's angle? I can only assume it has something to do with Republican presidential politics. I think it's some backasswards way of attacking Romney. I can't believe we have to put up with another year of this crap. But -- whatever -- the left is just as wrong on this subject as the Mittmaniac Romney supporters I wrote about back in August. 

Using NPR and Politifact's logic, except for the late lamented CLASS Act, there is no difference at all between PPACA and RomneyCare:

• 1st So-called Difference: Yes, RomneyCare WAS about containing costs. It is no different than PPACA on those grounds. See Romney's letter to the Boston Globe dated November 21, 2004 (but get it fast; everything in the Globe's archives, costs money starting October 19) and many similar articles and presentations about/by Romney at the time. To say RomneyCare was not about containing costs is a Deval Patrick lie to introduce socialized medicine in Massachusetts as described above. Romney now plays along because it helps his current political persona).
• 2cnd So-called Difference: Despite what Politifact and NPR say, RomneyCare contained no patient bill of rights because Massachusetts effectively already had one, after DukakaCare
• 4th So-called Difference: NPR and Politifact says PPACA covers more types of people whereas RomneyCare only covered children. No idea where the lefties came up with that one. RomneyCare covered all these people.  That was what RomneyCare was all about. 
  • If a person does not qualify for Medicaid but is below 150% of FPL they get free $450 a month Cadillac insurance. 
  • From 150% to 300% of FPL they get a $450/month Cadillac policy for from $45 to $115 a month depending on where they fall on the FPL-Plus scale (this information is an average individual situation; similar deals for families with up to $88K in income depending on size of family).
  • Strangely, although this is supposedly a huge problem both in Massachusetts and throughout the U.S., only 44,000 people (out of 6,500,000 people) are covered by the subsidized insurance and only about 100,000 (out of 6,500,000 people) are covered by the free insurance
• 5th So-called Difference: NPR claims RomneyCare did not raise taxes. RomneyCare dramatically raised Massachusetts taxes.  It introduced - of course  - a tax for not buying insurance... plus a tax on smokers, increased the taxes on healthcare insurers, added many more fees and most dramatically forced the legislature to raise sales taxes 20%.  The latter happened after Romney jetted out of town but is just as much a part of RomneyCare because it is part and parcel of all the budget cuts on city, town and school aid, parks, cops and courts and even public health that the state has faced because of RomneyCare 

It's hard to believe either the left, with the convicted felon ex-House Speaker always smiling down on Romney in those photos the left loves to run, or Romney himself is proud of this disaster.  But that's politics, I guess.

-- Dennis Byron

Obama Administration Realizes RomneyCare Did Not Work.

Poltico writes on October 11:

"Medicaid waiver entangled in safety net in Massachusetts – The extension of the Medicaid waiver that allows Massachusetts to operate its landmark health care reform has hit a roadblock over funding for “safety net” providers, who are facing a growing demand for care even though the state’s coverage expansion was supposed to limit their burden of caring for the poor."

There is no entaglement here. The headline would be clearer and more revealing IF the Politico headline simply stated the reality. 

"Even Obama Administration Realizes RomneyCare Did Not Work."

Depending on your politics or perspective, maybe it seemed like a good idea at the time to take away the free care pool money from the charity hospitals (now cutely called "heatlh safety net" hospitals) and give it to the politically connected insurance companies who could give it back to the charity hospitals (and maybe to the politically connected teaching hospitals too?). And that was all that RomneyCare was about, an accounting gimmick. All the Massachusetts Medicaid waiver information on HHS.gov explains how it is supposed to be revenue neutral.
 
But it didn't work. The free care pool was supposed to go virtually to zero but instead it's back over a half a billion and is still not fully funded by the legislature. 

The Massachusetts lefties do not want to accept the fact of RomneyCare's failure when they see data that all the newly insured are getting free or highly subsidized insurance. So they blame the failure on George Bush's recession. They don't want to face the failure when some politically correct place finds increasing use of ERs and CHCs. So they blame it on lack of public transportation. The lefties don't want to accept failure even when the left-wing Blue Cross Foundation shows how RomneyCare has eaten away at other state programs, including public health. So they blame it on Scott Brown.

Maybe the Massachusetts left will accept the failure of RomneyCare now that the left-wing Obama administration is finding RomneyCare a failure and holding up Massachusetts' Medicaid waiver extension.

-- Dennis Byron