Leftist Incompetence Update: Yet Another Obamacare Health Co-Op Ends In Utter Failure

Another Obamacare Health Co-Op Ends In Failure – Daily Caller

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Bleeding cash, the Louisiana Department of Insurance (LDI) announced Friday that Louisiana’s Obamacare health insurance co-op will be closing its doors by the end of 2015.

It will be the second collapse of an Obamacare health care co-op this year and the third since the Obama administration rolled them out in 2012 as a competitor to commercial health insurance companies.

From the beginning, the Louisiana co-op was fraught with high-paid consultants who were not even from Louisiana, but Georgia. It also suffered from an apparent conflict of interest. George Cromer, its CEO, simultaneously served the Louisiana House of Representatives as chairman of that legislative body’s insurance committee.

Roughly 18 months into its existence, in September 2012, the Louisiana co-op received $66 million from the U.S. Centers for Medicare and Medicaid Services. By 2014, the National Association of Insurance Commissioners reported that the co-op had burned through half of its cash and suffered a net operating loss of $23 million.

The co-op had only enrolled 17,000 paid subscribers out of a total state population of 4.6 million, according to state census data.

AM Best, the insurance rating company, reported in the third quarter of 2014 that the Louisiana co-op’s indebtedness was 198 percent, among the worst performing Obamacare nonprofits in the nation.

“The onerous burdens of Obamacare have shocked health insurance markets and caused instability in pricing and predictability, and as a result, we’ve seen premiums spike upward,” Louisiana Insurance Commissioner Jim Donelon wrote in a press statement July 24 when he announced closure plans for the co-op.

“Start-ups in insurance, especially health insurance, are always a tough row to hoe. Obamacare has made that even more difficult,” the commissioner noted in a press release.

The LDI’s Office of Financial Solvency will be examining the financial issues that led to its decision to close, and the commissioner has said that the department is “on-site at the co-op.”

The Louisiana Health co-op began with controversy over Terry Shilling, its first CEO. Shilling arranged a lavish contract with his own Atlanta-based consulting firm, Beam Partners, LLC, an arrangement approved by federal Obamacare CMS officials.

Federal officials also approved Shilling as original founder and “interim CEO” for the co-op, even though in 1998, the Securities and Exchange Commission sanctioned him for insider trading as a health executive. Shilling’s consulting firm received more than $3 million from the co-op in 2013 for “health plan development,” according to its IRS Form 990 filing.

Louisiana insurance documents obtained by the Washington Examiner in August 2013 showed that Beam would receive a separate $4 million contract from the start-up co-op. On top of the contract, the Atlanta firm would receive a 20 percent “performance fee,” according to the documents. Finally, Beam additionally reaped a “benefit payment services” that began at $66,667 per month in 2013, culminating in $72,917 in 2016, according to Louisiana co-op insurance filing documents.

Separate from the preferential contract with Shilling, the co-op represented a potential political conflict of interest. After Shilling’s relationship with the co-op went public, the Atlanta businessman stepped down as interim CEO, to be replaced by Louisiana Rep. George Cromer.

Cromer, a Republican, also was the chairman of the Louisiana House committee on health insurance. He did not step down from the position after assuming the co-op post.

The Daily Caller News Foundation reached out to Cromer’s office, but has yet to receive a response.

The Louisiana co-op is not the first to fold.

In February, the Iowa Insurance Department assumed receivership and closed the doors of Co-Opportunity Health, an Obamacare co-op that served more than 100,000 customers in Iowa and Nebraska. Co-Opportunity had a loss ratio of 140, which meant that for every dollar it received in premiums, it had to pay out $1.40 in benefits.

The first failure occurred in 2013, when the Vermont Insurance Commissioner refused to grant a license to a new Obamacare health co-op.

The Commissioner refused to license the co-op because the president had steered as much as $500,000 of the co-op’s money to his own firm. CMS had approved the loan to the Vermont co-op despite the conflict of interest.

She also said the co-op’s math was inadequate and failed to meet the state’s financial standards.

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Obamacare: Now With 34% Fewer Providers!

Report: Obamacare Plans Have 34% Fewer Providers – Weasel Zippers

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But you can keep your doctor!

Via Newsmax:

Thirty-four percent fewer healthcare providers are available to Obamacare patients – backing up “anecdotal reports that exchange networks contain fewer providers than traditional commercial plans,” a new report says.

According to an analysis by Avalere Health, the Washington-based advisory firm, the Obamacare networks offer an average of 42 percent fewer heart and cancer doctors – along with 24 percent fewer hospitals and 32 percent fewer primary care physicians for patients to choose from.

But most importantly, the Affordable Care Act’s restrictions on out-of-pocket costs by patients do not apply to healthcare services outside the plan’s network.

Keep reading

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Leftist Nightmare Update: IRS Might Not Refund $38M In Overpaid ObamaCare Fines

IRS Might Not Refund $38M Overpaid ObamaCare Fines – Sweetness & Light

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Fines? What fines? Those are ‘shared responsibility payments.’

From the Washington Free Beacon:

300,000 Taxpayers Overpaid Obamacare Fine by $38 Million, IRS May Not Return Money

By Morgan Chalfant | July 15, 2015

Approximately 6.6 million U.S. taxpayers paid a penalty for not having health insurance imposed this year under Obamacare, and hundreds of thousands of them overpaid the fine.

Bloomberg reported Wednesday that the number of taxpayers paying the fine, which was put in place to encourage Americans to enroll in health coverage, exceeded the Obama administration’s initial estimate by 10 percent.

Funny how all of the ‘bad stuff’ about Obama-Care was underestimated. What are the odds?

According to a new report from the National Taxpayer Advocate, an independent organization within the Internal Revenue Service (IRS), the average fine paid by taxpayers was $190. The penalty, however, can reach up to 1 percent of one’s income.

The report also discovered that about 300,000 taxpayers, most of whom should have been deemed exempt because of low income, overpaid the fine by $35 million. The average amount overpaid by each individual was $110.

So Obama-Care even fined the poor. What a surprise.

The IRS has yet to decide whether or not it will return the funds to those who overpaid…

According to the report, approximately 10.7 million U.S. taxpayers filed for exemption from the penalty…

And never mind that most of these people getting exemptions are the very people Obama-Care was supposed to get to pay their ‘shared responsibility.’

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Ready For Another Obamacare Price Hike? (David Catron)

Ready For Another Obamacare Price Hike? – David Catron

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In July of 2009, as the Obamacare debate was heating up, Gallup published a survey indicating that 83 percent of Americans wanted health care reform to make their health insurance more affordable. Now, more than five years after the President’s “signature domestic achievement” was passed, health insurance premiums are higher than ever. And it’s obvious that Obamacare is a major driver of the increase. The Wall Street Journal reports that insurers are proposing rate increases ranging from 25 to 51 percent for 2016. Why? “All of them cite high medical costs incurred by people newly enrolled under the Affordable Care Act.”

Obamacare apologists suggest different causes, of course. Jonathan Cohn writes, “One reason could be the normal and predictable competition among insurance plans jostling for market share.” Cohn’s grasp of economics is so tenuous that he doesn’t know insurers compete for market share by reducing premiums. He also connects the increases to anxiety about that bête noire of Obamacarians everywhere, King v. Burwell: “If the court rules in favor of the plaintiffs… millions will drop their coverage because they will no longer be able to afford it.” Cohn evidently thinks insurers will respond by making insurance even less affordable.

The real reason for the proposed increases is that insurers now have real data on real Obamacare enrollees rather than implausible projections from the Obama administration. And this new information makes it clear that they’ll lose their shirts if they sell coverage at anything resembling 2015 rates. Many young, healthy individuals have refused to buy pricy Obamacare coverage, leaving insurance carriers with sluggish premium streams out of which to pay the large dollar claims coming in from seriously ill patients willing to buy coverage regardless of cost. This dynamic has already caused a number of health insurers to incur huge losses.

Obviously, not even an evil insurance company can stay in business if it consistently loses large amounts of money. Earlier this month, Assurant Health announced that losses related to Obamacare are causing it to close its doors. Western Journalism reports, “The company and industry watchers blamed its losses directly on the impact of Obamacare… Assurant lost $63.7 million in 2014. The insurer raised its rates by 20 percent in 2015, in hopes of returning to profitability, but lost between $80 to $90 million during the first quarter of this year.” The company has been in business for 123 years and provides coverage for 1 million people.

Assurant is based in Wisconsin, but insurers all across the country are attempting to survive the same perverse incentives that finally undid that venerable company. The Journal lists proposed increases by companies offering plans through exchanges in Connecticut, Indiana, Maryland, Michigan, New Mexico, Oregon, Tennessee, Vermont, Virginia, and Washington state. And many of these companies are already losing huge amounts of money: “BlueCross BlueShield of Tennessee… lost $141 million from exchange-sold plans, stemming largely from a small number of sick enrollees.” It is asking for a 36.3 percent rate increase.

All of which suggests that the “premium stabilization” safeguards ostensibly meant to prevent Obamacare from sending the health insurance industry into a death spiral aren’t working. The “reinsurance program,” as Philip Klein explains at the Washington Examiner, “slaps fees on insurance policies and uses the revenue to funnel payments to insurers to compensate them for taking on individuals with a high-risk profile.” “Risk corridors” are a corporate redistribution scheme whereby the government uses the profits of some insurers to offset the losses of others. But, as Klein points out, both programs will be gone after 2016.

If disasters like Assurant and BlueCross BlueShield of Tennessee are occurring while these programs remain in place, what will happen when they’re gone? Well, we’ll have more insurers proposing hair-raising rate increases in order to avoid the fate of Assurant. But, not to worry, says Charles Gaba at HealthInsurance.org, upon whom the erstwhile “Citizen Cohn” rather desperately relies upon as the voice of reason: “These requested rate changes are being submitted to the state insurance commissioner’s office… and in most states either the commissioner or some other regulatory body has to either approve the requests or deny them.”

In other words, some state bureaucrat may simply deny the insurance company’s rate request and impose a more “appropriate” premium. This means that, in New Mexico, Health Care Service Corp. may get a mere 25 percent increase rather than the 51 percent it has proposed. In Tennessee, Blue Cross may get only 20 percent rather than the requested 36.3 percent increase. In Maryland, the state bureaucrats may decide that, instead of a 30.4 percent increase, Blue Shield may only get 18 percent. All of these outcomes have one thing in common: The rate goes up by double digits. That means you pay a higher premium no matter how it turns out.

In other words, in the best case scenario, the your health insurance premiums are going up. And this is not simply because Obamacare has been unable to accomplish the main thing most Americans wanted from health reform in first place – more affordable medical care. Barack Obama’s “signature domestic achievement” is actually making health care less affordable. Good job, Mr. President. Please use the rest of your term perfecting your chip shot.

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Thanks Barack… U.S. Welfare Rolls Explode Under Obamacare

U.S. Welfare Rolls Explode Under Obamacare – WorldNetDaily

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The Affordable Care Act, or Obamacare, has created more dependency on government and perverted the capitalist foundations of America, according to a top surgeon.

“You just can’t keep giving everything away to people without them working for it,” said Dr. Lee Hieb, former president of the Association of American Physicians and Surgeons. “It’s not capitalism when you let people who are able-bodied not contribute to society but take the spoils. I mean, that’s just not capitalism. We have too many people that don’t work to eat.”

Obamacare appears to be worsening America’s dependency issue. The Associated Press reported food-stamp enrollment increased in 11 states between January 2013 and the end of 2014, the period during which Obamacare went into effect.

Ten of those 11 states expanded Medicaid under the ACA, and six of them used new online enrollment systems that made it easy for customers to sign up for both Medicaid and food stamps at the same time. Such streamlined application systems were built specifically for the health-care overhaul.

In total, nearly 632,000 people were added to the food-stamp rolls in those 11 states during that period, at an estimated cost of almost $79 million a month to the Supplemental Nutrition Assistance Program, the food-stamp program also known as SNAP. This came at a time when the national economy was improving and food-stamp enrollment declined nationwide.

Dr. Jane Orient, executive director of the Association of American Physicians and Surgeons, sees the phenomenon as part of a government attempt to place more Americans under its thumb.

“Self-reliant Americans are being crushed by taxation and regulation, directly and indirectly, and turned into government dependents,” Orient said. “How can you resist if government can cut off your food and medicine?”

In almost all of the 16 states that didn’t expand Medicaid, food-stamp rolls have been decreasing as the economy improves.

Hieb, author of “Surviving the Medical Meltdown: Your Guide to Living Through the Disaster of Obamacare,” said Obamacare’s Medicaid expansion damaged the American medical system by dropping people from their private insurance and putting them on Medicaid.

“People think that all these people getting on Medicaid through Obamacare were uninsured,” Hieb said. “That’s not true. A number of those people had private insurance, but now, because they qualify under these new guidelines, why not have somebody else pay for your health insurance? So instead of paying for health insurance, they’re taking Medicaid.”

She continued, “So you’ve turned paying patients into nonpaying patients. It’s absolutely, clearly a failing economic model, and I don’t understand how smart people believe it. I just don’t understand how they do not see that point.”

Hieb, an orthopedic surgeon, has observed firsthand the damage Medicaid expansion has done to hospitals. She recently reached the end of a contract to perform surgery two-and-a-half days a week at a small hospital, and she is now looking for a similar arrangement. However, she says she’s found hospitals are running scared from orthopedic surgeons like her because they fear they won’t make enough money to pay the surgeons’ salaries.

According to Hieb, the hospitals are struggling to bring in money because of the increase in Medicaid patients and corresponding decrease in private-pay patients. Medicaid does not reimburse hospitals as much as private insurance does. Hospitals have also struggled to cope with Medicare provider payment cuts and increased administrative paperwork.

But while Medicaid expansion has hurt hospitals, it has been a boon to health-care consumers. In states that expand Medicaid, adults with incomes up to 138 percent of the federal poverty level must qualify, and states are allowed to set even higher thresholds. Before the ACA took effect, the median Medicaid eligibility limit for parents was 106 percent of the federal poverty level. Medicaid expansion also made adults without dependent children eligible for the first time.

Hieb said she believes Americans are smart enough to act in their own financial self-interest, and, for many who hover just above the poverty level, that involves taking advantage of the welfare system. Hieb lives among the patients she serves in rural Iowa, and she says they know how to look out for themselves.

“It’s a mistake to think that all these poor people are children who cannot navigate this very complex medical system,” Hieb asserted. “These are the people who have figured out if you don’t make $35,000 a year working, it’s not worth working because you can do that well if you know how to work the system of welfare.”

If people can cobble together enough disability payments, unemployment payments and food stamps to earn a halfway decent living, Hieb argued, they are smart enough to hitch themselves to Medicaid, even if they might be able to afford health insurance on their own.

“People act in their own economic self-interest,” Hieb said. “If you can get things for free, why pay for them?”

She answered her own question: “One, because that’s ethical, and two, medical providers cannot be in business unless somebody actually pays the bill.”

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Leftist Nightmare Update: Hawaii Shutting Down $205 Million Obamacare Exchange (Video)

Hawaii’s $205 Million Obamacare Exchange Shutting Down – TPNN

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Hawaii’s state legislature rejected legislation giving a $28-million cash infusion to its troubled Obamacare insurance exchange, making it impossible for the website to operate after this year.

The exchange will stop taking new enrollees on Friday.

Hawaii’s Connector Exchange released a statement saying:

“Now that it is clear that the state will not provide sufficient support for the Hawaii Health Connector’s operations through fiscal year 2016 (ending June 30, 2016), the Connector can no longer operate in a manner that would cause it to incur additional debts or other obligations for which it is unable to pay.”

“Staff reductions will commence immediately, with the executive director ( Jeff Kissel) exiting once the bulk of operational activities end.” The statement continued saying: “If the state cannot facilitate an orderly transition, the Connector’s operations will abruptly end, as the Connector does not have the resources to continue operations.”

According to Americanthinker, more states, including: Minnesota, Maryland, Massachusetts, Vermont, and Oregon – are having massive problems with their Obamacare websites, and are expected to close also. The cost? Almost a Billion dollars more of our money flushed down the drain.

Can any state exchanges continue to exist? With 36 states refusing to open their own exchanges and the Supreme Court ready to deal the death blow to subsidies, the future of the Obamacare exchanges appears uncertain at best.

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How Rand Paul And A Few Other RINO Douchebags Let Congress Keep Its Fraudulent Obamacare Subsidies

How Five Republicans Let Congress Keep Its Fraudulent Obamacare Subsidies – National Review

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The rumors began trickling in about a week before the scheduled vote on April 23: Republican leadership was quietly pushing senators to pull support for subpoenaing Congress’s fraudulent application to the District of Columbia’s health exchange – the document that facilitated Congress’s “exemption” from Obamacare by allowing lawmakers and staffers to keep their employer subsidies.

The application said Congress employed just 45 people. Names were faked; one employee was listed as “First Last,” another simply as “Congress.” To Small Business Committee chairman David Vitter, who has fought for years against the Obamacare exemption, it was clear that someone in Congress had falsified the document in order to make lawmakers and their staff eligible for taxpayer subsidies provided under the exchange for small-business employees.

But until Vitter got a green light from the Small Business Committee to subpoena the unredacted application from the District of Columbia health exchange, it would be impossible to determine who in Congress gave it a stamp of approval. When Vitter asked Republicans on his committee to approve the subpoena, however, he was unexpectedly stonewalled.

With nine Democrats on the committee lined up against the proposal, the chairman needed the support of all ten Republicans to issue the subpoena. But, though it seems an issue tailor-made for the tea-party star and Republican presidential candidate, Senator Rand Paul (R., Ky.) refused to lend his support. And when the Louisiana senator set a public vote for April 23, Majority Leader Mitch McConnell and his allies got involved.

“For whatever reason, leadership decided they wanted that vote to be 5-5, all Republicans, to give Senator Paul cover,” one high-ranking committee staffer tells National Review. “So they worked at a member level to change the votes of otherwise supportive senators.” Four Republicans – senators Mike Enzi, James Risch, Kelly Ayotte, and Deb Fischer – had promised to support Vitter, but that would soon change.

Senate staffers, according to a top committee aide, reported seeing Missouri senator Roy Blunt make calls to at least two Republican committee members, lobbying them, at McConnell’s behest, to vote no on subpoenaing the exchange. By the time the committee was called to quorum, Enzi, Risch, Ayotte, and Fischer voted no.

To many observers, it was curious that any Republican would move to put the brakes on an investigation into Obamacare fraud, and particularly curious that they would pull back in an instance where the federal government was actually defrauding itself, one that so clearly illustrates Obamacare’s flaws by exposing the bureaucratic jujitsu and outright dishonesty required of federal employees themselves to navigate the law.

Conservative health-care experts can’t understand the reasoning behind the GOP senators’ opposition. They see politics and self-interest at play, and they allege that Republican leaders are as invested as their Democratic counterparts in maintaining their subsidies, fraudulently obtained, while avoiding scrutiny from an overwhelmingly disapproving American public.

“We deserve to know who signed that application, because they are robbing taxpayers,” says Michael Cannon, director of health-policy studies at the libertarian Cato Institute. The staffers who signed the fraudulent application, he says, “know who was directing them to do this. And so we have to follow the trail of breadcrumbs. This is the next breadcrumb, and whoever is farther up the trail wants to stop Vitter right here.”

The story of the ill-fated subpoena can be traced back to the debate over the Affordable Care Act, when Senator Chuck Grassley (R., Iowa) insisted that lawmakers and congressional staff join a health-care exchange set up under the bill. For government employees, that meant giving up government-subsidized health-care contributions of between $5,000 and $10,000 per person. The White House scrambled to find a way to allow congressional employees to keep those subsidies. In Washington, D.C., only the small-business exchange allowed them to do so. After secret meetings with House speaker John Boehner in 2013, President Obama instructed the Office of Personnel Management to allow Congress to file for classification as a small business, despite the fact that the law defines a small business as having no more than 50 employees and the House and Senate together employ tens of thousands.

When Vitter’s staffers tracked down the application and discovered obvious signs of fraud, Vitter requested approval to subpoena an unredacted copy of the application. The value of that document, says Cannon, is that it would reveal the name of the person who filed it. “Now you’ve got someone to call to testify,” he says, predicting that testimony would precipitate a congressional vote on whether to end the congressional exemption altogether.

“I think it makes sense to find out what happened,” says Yuval Levin, the editor of National Affairs, a noted conservative health-care voice and a National Review contributor. “It would be pretty interesting to see whose name is on the forms,” he says. “It has to go beyond mid-level staffers.”

But some congressional Republicans, it seems, are also resistant to getting to the bottom of the mystery – or, at the very least, they are content to let sleeping dogs lie.

Committee rules for a subpoena require either the consent of the ranking member or a majority of the group’s 19 senators. Because Democrats quickly made their opposition clear, Vitter needed the approval of all ten Republicans. Nine of them quickly consented via e-mail; one senator was strangely unresponsive.

Senior committee aides say that Rand Paul’s staff didn’t immediately reply to an e-mail requesting the senator’s consent and, when they did, they refused to provide it. When Vitter attempted to set up a member-to-member meeting, his overtures were ignored or put off. Paul’s policy staff refused to take a meeting. When Vitter tried to confront Paul on the Senate floor, they say, the Kentucky senator skirted the issue.

It wasn’t until after the vote that Paul shared his reasoning. “Senator Paul opposes allowing Congress to exempt themselves from any legislation,” an aide told the Conservative Review. “To that end, yesterday, he reintroduced his proposed constitutional amendment to prohibit Congress from passing any law that exempts themselves. Senator Paul prefers this option over a partisan cross-examination of Congressional staff.”

But a constitutional amendment is a longshot that would take years, and it hardly precluded an investigation of congressional corruption here and now.

“That’s absurd,” says Robert Moffit, the director of the Center for Health Policy Studies at the conservative Heritage Foundation. “You don’t need a constitutional amendment to get a subpoena… I don’t know where he’s coming from.”

“The answers he has given do not make sense,” Cannon says of Paul. “And when someone with his principles does something that is so obviously against his principles, and does not give an adequate explanation, you begin to think that politics is afoot. It would have to be someone very powerful that made him a powerful pitch – or threat – to keep him from doing this.”

Paul’s press secretary tells National Review that the senator “examines every opportunity to [oppose Obamacare] individually, and does not base his vote on requests made by other senators, including the majority leader.”

Asked whether McConnell pushed Paul or any other senator on the subpoena, a spokesman for McConnell says the majority leader “didn’t make any announcements when that committee voted.”

The flip-flopping Republicans justified their change of heart. Risch said in the April 23 committee meeting that legal wrangling with the D.C. exchange could take time away from the committee’s small-business work. Enzi said he saw little wrong with the application as is.

“Each of us has our own budget, each of us has our own staff,” he said. “I don’t know about everybody else, but I’m way under 50 [employees]. So my staff qualifies as a small business.”

Enzi was one of the original sponsors of Vitter’s 2013 amendment to end the congressional Obamacare exemption, but his press secretary tells National Review he felt the probe “could inadvertently target staff who simply completed paperwork as part of their job.” He insists that Enzi “made up his own mind.” Risch, Ayotte, and Fischer declined to comment.

A spokesman for South Carolina senator Tim Scott, who voted for the subpoena, says that nobody lobbied him one way or the other, while a spokesman for Florida senator Marco Rubio, who also voted in favor of the measure, declined to comment.

Health-care experts dismiss Enzi’s claim that each member’s office is its own small business, and not just because the health exchange application was filed for Congress as a whole. “These congressional offices that think they’re small businesses, are they LLCs?” Cannon asks. “Are they S-Corps? Are they shareholder-owned? Are they privately held? What is the ownership structure of this small business that you’re running, senator? It’s just utterly ridiculous.”

“They’re transparently absurd,” says Moffit of Senate Republicans claiming small-business status. “Who made the determination that Congress is a small business and is therefore eligible for subsidies that do not legally exist? How did that happen?”

No one quite knows what’s behind leadership’s apparent push to kill the subpoena. The move baffled some committee staffers. “The amount of blood that McConnell and Paul spilled to prevent [the subpoena] from happening makes me wonder [if] maybe that isn’t all that there is to it,” the high-ranking staffer says. “Maybe other people signed it… They’re clearly afraid of something bigger than a person’s name getting out there.”

Others, however, think the motives behind GOP leadership’s apparent obfuscation are clear. “If there’s one thing that absolutely drives Americans fundamentally crazy, it’s the idea that Congress can set one set of rules for themselves and another for everybody else,” says Moffit. “That’s political poison, and that’s why they have been so desperate to avoid the issue.”

“The most powerful interest group in Washington D.C., is not the Chamber or the unions or anyone else,” Cannon says. “It is members of Congress and their staffs. And when it comes to their benefits, they are all members of the same party.”

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