The Fighting 29th

All about New York's 29th Congressional District

Congressional Quarterly reports that House Minority Leader John Boehner's leadership PAC has begun to make maximum contributions to Republicans who are in danger of losing their seats. In contrast, Majority Leader Steny Hoyer's PAC is making contributions to Democratic challengers. Randy Kuhl recently received the $10,000 maximum from Boehner's PAC.

Exile at Rochesterturning notes that these defensive buys put the lie to the notion that low Congressional approval ratings might lead to a Republican resurgence. I agree. Those interested in the source of the low approval ratings might want to read what Glenn Greenwald has to say about them -- the bottom line is that low approval is being driven by Democrats' discontent with the Democratic Congress.

As fundraising shifts into high gear, it will be interesting to see if another factor is at play: "live by the corporate PAC, die by the corporate PAC". Randy Kuhl received big donations from corporate-financed PACs that want to pass legislation agreeable to the corporations who pay their bills. A Member of Congress who is part of the minority party, and on the edge of losing his seat, isn't an automatic investment for those PACs. It will be interesting to see whether Kuhl can attract funds from them again, or if he'll have a shortfall that can't be shored up by a few donations from House leaders.<?p>

Yesterday's court appearance by anti-war activists, who entered a plea of not guilty and will represent themselves in court, was widely covered in local media. Reader Elmer sends the Corning Leader front-page coverage (here [pdf] and here [pdf]). The Elmira Star-Gazette story was reprinted in the Rochester Democrat and Chronicle. And Syracuse News 10 has video of the accompanying demonstration.

Rochesterturning reports that a conservative group, headed by former Bush press secretary Ari Fleischer, may be airing ads in the Rochester market. Freedomswatch.org is making a $15 million national buy, and according to Americablog, $187,235 will be spent on ads in the Rochester market. Four ads have been produced, and can be viewed on YouTube. Freedomswatch disputes the buy information.

US News and World Report has an in-depth story on Americans Against Escalation in Iraq (AAEI), the group sponsoring some of the ads and protests in the 29th. It includes some details on the internal debates of the group, which is trying to engage rather than just protest. One of the tactics considered (and apparently discarded) was to have protesters wear flak jackets and helmets after Kuhl's "packing" comment.

The State Children's Health Insurance Program (S-CHIP) saga keeps getting more complex, with the llatest news that the White House wants to keep states like New York from raising the eligibility ceiling for the program. Though the White House thinks that S-CHIP is a problem because it may replace private insurance for some, that's not Randy Kuhl's position.

The last post on the (S-CHIP) dealt with Randy Kuhl's charge that it will cut Medicare benefits. Kuhl also says that the bill will "increase taxes on private health insurance policies, and make it easier for illegal aliens to get government-funded healthcare." Like the Medicare charge, there's a grain of truth in that spin, but it's fundamentally wrong.

The tax increase that Kuhl crticizes amounts to roughly $1/year for each insured person. That dollar will be used to fund research into the effectiveness of drugs, devices and treatments. Even the private insurers agree that the research is a good idea - they just argue about how to fund it.

The concern over illegals getting Medicaid is a result of S-CHIP's repeal of the requirement for documented proof of citizenship for all Medicaid recipients. Again, there's more here than meets the eye.

Before the Deficit Reduction Act (DRA) of 2005, states weren't required to collect documented proof of citizenship for Medicaid recipients. In the run-up to the DRA, the Health and Human Services Inspector General recommended [pdf] some common-sense methods for states to better document the immigration status of Medicaid recipients. In the DRA, Congress went far beyond those recommendations. It mandated the use of hard-to-get documents, and made that requirement an up-front one.

The result was a mess. A report study in one state (Virginia) [pdf] showed that the requirement mainly caused more cost in the program and delays in getting health care. Most important: emergency room visits, the most expensive way to provide care, went up after the DRA requirements were enacted. Administration costs for Medicaid also went up, because applicants needed help getting documents like certified copies of birth certificates, which cost $25-50.

In the DRA, Congress didn't do its homework before writing legislation. New York is the only state in the nation that's had a long-term policy of verifying citizenship status for Medicaid recipients. The Kaiser Family Foundation has issued a report [pdf] showing how New York is able to do a decent job of verifying citizenship while still getting people enrolled. To pick one glaring example, New York automatically enrolls newborns without further checks, since a baby born on US soil is a US citizen.

The DRA requirements are a classic example of "sounds good" legislation that doesn't work. If the S-CHIP repeal of those requirements is signed into law, Congress needs to go back to the drawing board to find a practical, workable solution to the issue of illegals getting Medicare.

Of course, this lengthy explanation is a lot harder to understand than the one-liners in Kuhl's press release. Kuhl is facing the accusation that he doesn't want to insure children. His spin -- he's protecting seniors, keeping taxes on insurance down, and keeping illegal immigrants from getting benefits -- sounds good, but doesn't hold up under scrutiny.

Today's Democrat and Chronicle carries and op-ed by a member of the group that occupied Randy Kuhl's Fairport office.

In Bath, a "vigil" will be held at 110 Liberty Street at 4 p.m. Wednesday while those arrested in the Bath protest meet with the Bath district attorney.

Over at Rochesterturning, poster Exile asks whether the recent McClatchy investigation into the politicization of the grant-making process has any relevance to the 29th. The McClatchy reporters showed that grant announcements from agencies, and public appearances with cabinet secretaries, were correlated with "GOP Interests". The report concentrates on the Commerce and Treasury departments.

Under the Hatch Act, agencies aren't allowed to provide grants in order to help candidates. But meeting with Members of Congress, and attending political briefings, are allowed. It's going to be hard to prove causation, but there's definitely some correlation between grant announcements and GOP political needs in the 29th. Exile points to this Kuhl press release, where a $2.6 Energy Department grant was announced two weeks before the election, accompanied by fulsome praise of Kuhl from the Energy Secretary. Earlier in 2006, Kuhl also received great credit from the Commerce Secretary for an Infotonics grant.

Since these grants were vetted by career civil servants who are protected by whistleblower legislation, I doubt that any of them were purely politically motivated. But there is persuasive evidence that the current White House went far beyond previous administrations in raising political awareness of cabinet agencies, and Randy Kuhl sure got a lot of attaboys from cabinet secretaries in 2006.

Update: Today's Washington Post has a front-page story on the same topic.

Randy Kuhl's press release on HR 3162, the State Children's Health Insurance Program (S-CHIP), is headlined "Kuhl Votes Against Measure That Cuts Senior's Medicare Benefits". Since this bill is likely to become a campaign issue, it's worth seeing why that headline is a little right and a lot wrong.

S-CHIP reauthorization increases the number of children covered by the bill, so costs will rise. One way the bill pays for itself is cuts to the Medicare Advantage program, which is a subsidy paid to HMOs and other insurance programs.

Medicare Advantage began as a program to allow private insurance programs and HMOs to provide coverage to Medicare patients. When those programs were first allowed to be part of Medicare, they received 5% less than fee-for-service providers, since they were supposed to be more efficient. After 25 years of lobbying, the "more efficient" private sector providers are paid 12% more than regular providers, which amounts to an additional $1,000 per Medicare recipient.

The extra money paid to Medicare Advantage HMOs leads to three things: additional benefits for seniors in Medicare Advantage, higher profits for HMOs, and increased fraud:

Senate investigators released to Congress interviews and documents that indicate sales agents in at least 39 states have used unethical or illegal practices. Such practices have included the enrollment of dead or mentally incompetent Medicare beneficiaries, the impersonation of Medicare representatives and the use of personal information stolen from federal records...

Even if Medicare Advantage led to no fraud and no extra profits for HMOs, the fact remains that it unfairly rewards about 20% of Medicare recipients. Cutting the Medicare Advantage subsidy to fund S-CHIP makes good fiscal sense and it is fundamentally fair.

So, Randy Kuhl's press release is technically right about Medicare. A small minority of seniors will lose benefits because of this bill. S-CHIP also means one less gravy train for HMOs, and one less source of Medicare fraud.

Kuhl's press release makes two other claims, about higher taxes and immigration. I'll deal with them in a later posting.

Yesterday's Messenger-Post followup story on the VA Hospital in Canandaigua did mention Randy Kuhl, taking a quote from his press release. The M-P cut off the first sentence -- here's the full quote from the release:

I am pleased that my effort to bring Sec. Nicholson to the Canandaigua VA campus played an important role in this process. I have fought to ensure that funding and resources were not taken away from our veterans. This is the best option to serve our veterans because it will provide new and updated, state of the art facilities, on the current footprint of the campus.

The Steuben Courier, a free newspaper in Bath, also covered Thursday's Bath press conference or protest by Americans Against Escalation in Iraq.

I've been hard on the protesters lately, so I want to be sure that I acknowledge that the latest protest by Americans Against Escalation in Iraq was about as well-run as any protest I've seen in the last year.

AAEI's protest was more of a press conference, but it managed to avoid a number of the pitfalls of the last event in Bath. First, the organizers emphasized that all the participants were from the 29th district. Second, their press conference/protest occurred after AAEI tried to get a meeting with Kuhl through proper channels. It was only after Kuhl wrote back to AAEI saying that he was unable to meet with them that they decided to hold the press conference.

The effectiveness of the latest protest was also clear from the weakness of the response from Kuhl's office. The best Kuhl's spokesman could manage was that the protesters should call the office for a meeting -- in other words, they should do what they've already done.

The inability of Kuhl's spokesperson to respond with anything but a non sequitur shows that AAEI gave Kuhl's office no room to quibble. This protest gave AAEI a media window that was almost entirely sympathetic, and they did so without anyone getting arrested. AAEI showed that you don't have to re-live the 1960's to get your point across.