The Senate Committee on Health, Education, Labor and Pensions is considering the nomination of David Weil to head the Department of Labor’s Wage & Hour Division. Seems like a random bureaucrat that won’t make much difference in the grand scheme of things. Not exactly. Weil is a re-tread from the Obama administration who has supported onerous labor market regulations Dr. Weil would greatly narrow the definition of “independent contractor” to force millions to accept a status they do not want or need. During his first go-around at the DOL, Weil opted to define “independent contractor” to exclude the vast majority of workers despite their preferences or industry realities. This would crush the gig economy. We put together some infographics here ([link removed]) to show just how bad it would be for a variety of workers if Weil is confirmed.
Budget Reconciliation Blues
The Senate Democrats released their “infrastructure” bill earlier this week and it’s a doozy. The price tag comes in at $3.5 trillion. According to The Washington Post, “It also would clear the way for hundreds of billions of dollars — and possibly close to $1 trillion — in climate-related legislation, including clean energy tax credits and more funding for electric vehicles.” The plan includes funding for “elder care, home care, child care, prekindergarten, paid family and medical leave, housing programs, and other education and safety-net programs.” Adding injury to insult (yes, I wrote it that way on purpose) is the fact that the Democrats have also proposed massive tax increases to pay for the bill. For example, the proposal is to raise the top marginal income tax rate, increase the corporate tax rate, and make changes to the international tax system. There is also talk of raising the capital gains tax which could lead to a double death tax. One death tax is one too many. There
has also been talk of giving the Internal Revenue Service (IRS) more money for enforcement. After the leak of sensitive tax information a couple of weeks ago, the last thing we should be doing is giving the IRS more power.
Democrats are doing everything possible to destroy an economy that is struggling to recover from the pandemic. Between President Biden’s sweeping pen-and-phone competition order released last week, and now this massive $3.5 trillion tax and spend deal, the uncertainty of the pandemic will shift to uncertainty from Washington in ossifying private-sector investment. What taxpayers and businesses need most now is stability and time to heal, not more bloated government spending and massive tax increases. This bill won’t be popular with many folks. On one hand you have (hopefully) all Republicans who will reject it because of the tax increases and the massive spending and progressives might reject it because it doesn’t spend enough. In fact, Sen. Bernie Sanders (I-Vt.) said that he would have preferred a bill that starts at $6 trillion.
So, if you’re keeping score… Congress may be considering a $3.5 trillion infrastructure bill (that isn’t really infrastructure) + $4 trillion in regular annual spending. That is nearly $7 trillion in spending. That’s $2 trillion MORE than the GDP of Japan, the third largest economy in the world. And, lastly, the expiration of the federal debt ceiling is on July 31. Yep, quite a bit going on, and not a lot of good news for taxpayers.
More Telehealth
To millions of Americans requiring medical treatment during the coronavirus pandemic, telehealth services provided a safe and affordable alternative to the status-quo of in-person appointments. In fact, in the early weeks and months of COVID-19 lockdowns, some health systems reported that non-urgent virtual care visits surged more than 4,000 percent. These numbers have come down quite a bit since then but remain far higher than pre-pandemic norms. When the coronavirus pandemic first forced everyone inside, officials across the country rushed to roll back rules getting in the way of patients’ healthcare. From Massachusetts to Florida, states quickly stepped up and allowed out-of-state doctors to offer telehealth services to state residents without having to go through normal state licensure requirements. The Department of Health and Human Services followed suit, granting healthcare providers wider latitude to treat Medicare and Medicaid patients across state lines and use popular
applications to deliver telehealth without fear of complicated rules. But, as things gradually slide back to “normal,” there are some early signs of a regulatory reversal. After Alabama ended its COVID-spurred state of emergency, residents suddenly found themselves unable to access out-of-state virtual care. This sudden change in the rules has led to unfortunate situations where families relying on far-away medical specialists have had to travel across the country to receive continued care. Renewed restrictions also don’t bode well for taxpayers who have to dole out tens of millions of dollars to maintain telehealth access across underserved communities. More red tape means that those dollars will stretch less far in helping vulnerable patients get the care they need.
Other state-level changes are more encouraging, yet still create a specter of uncertainty for millions of patients. For example, New York’s Medicaid program is continuing to cover virtual health services even after the state has rolled back its emergency waiver of telehealth funding rules. This coverage continuation not only gives low-income residents more healthcare options but will likely save Empire State taxpayers billions of dollars because telehealth tends to be less expensive than ordinary care. By some estimates, telehealth costs are nearly 50 percent lower than in-person visits. However, this sustained coverage and resulting cost savings will only last for the duration of the federal Public Health Emergency. There remains the disturbing prospect that patients could suddenly find themselves without virtual medical access once the federal government declares the emergency over. Rules at the federal level are also complicating patient access to telehealth. Even though healthcare
researchers have recommended a hybrid model of in-person and virtual visits for Medicare home health beneficiaries, the federal government has still not allowed these patients to access telehealth services. Medicare has bolstered the scope of reimbursable telehealth services, but billing changes are centered around rural patients already in medical facilities. A broader-based reimbursement system for telehealth can deliver substantial savings for taxpayers and patients over the long-term.
Clearly, it will take a while for the federal government and states to figure out exactly which services should be permitted and reimbursable by taxpayer-funded insurance programs. Policymakers should keep an open mind and commit to innovative technologies that can lead to better, more affordable care. With the right policies, the healthcare system can finally pivot toward the digital domain and make lifesaving services accessible to millions of Americans.
BLOGS:
Monday: TPA Letter Urges Baltimore City Oversight Panel to Keep Politics out of the Inspector General Office ([link removed])
Tuesday: With Right Policies, Patients Can Continue to Rely on the Digital Domain ([link removed])
Wednesday: Senators Must Stop David Weil ([link removed])
Friday: Watchdog Slams White House for Attempts to Stifle Speech on Social Media ([link removed])
MEDIA:
July 8, 2021: Politics406.com ran TPA’s op-ed, “The Debt Ceiling Debate Is Just Another Opportunity to Tax Future Generations.”
July 8, 2021: Righthalert.com ran TPA’s op-ed, “The Debt Ceiling Debate Is Just Another Opportunity to Tax Future Generations.”
July 9, 2021: The Center Square ran TPA’s op-ed, “Critics worry BRIDGE Act could result in broadband overbuilds and widen digital divide.”
July 9, 2021: Townhall.com ran TPA’s op-ed, “The Debt Ceiling Debate Is Just Another Opportunity to Tax Future Generations”
July 9, 2021: WBFF Fox45 (Baltimore, Md.) quoted TPA in their story, “Illegal dumping piles up for decades behind West Baltimore rowhomes: 'It's not okay'.”
July 10, 2021: The Galion Inquirer (Mt. Gilead, Ohio) ran TPA’s op-ed, “Critics decry BRIDGE Act’s effect on states.”
July 10, 2021: The Center Square ran TPA’s op-ed, “BRIDGE Act’s broadband mapping approach will delay closing the digital divide.”
July 11, 2021: The Sentinel and Enterprise (Fitchburg, Mass.) ran TPA’s op-ed, “Pro-needle exchange but anti-vaping? The hypocrisy of American healthcare policy.”
July 11, 2021: The Sun ran TPA’s op-ed, “Pro-needle exchange but anti-vaping? The hypocrisy of American healthcare policy.”
July 11, 2021: Fitness Health 4 ran TPA’s op-ed, “Pro-needle exchange but anti-vaping? The hypocrisy of American healthcare policy.”
July 11, 2021: Vapors,org ran TPA’s op-ed, “Pro-Needle Exchange but Anti-Vaping?”
July 11, 2021: Mcutimes.com ([link removed]) ran TPA’s op-ed, “Pro-needle exchange but anti-vaping? The Hypocrisy of American Health Care Policy.”
July 11, 2021: The Daily Advent ran TPA’s op-ed, “The Debt Ceiling Debate Is Just Another Opportunity to Tax Future Generations.”
July 12, 2021: WBFF Fox45 (Baltimore, Md.) interviewed me about the proposed door to door outreach forvaccines.
July 13, 2021: The Center Square ran TPA’s op-ed, “With right policies, patients can continue to rely on the digital domain.”
July 13, 2021: The West Side Journal (Port Allen, La.) ran TPA’s op-ed, “Critics decry effort to promote government broadband networks.”
July 14, 2021: RealClearPolicy ran an op-ed by TPA’s Johnny Kampis, “Perdues Built System of Protectionism for Georgia Growers During Trump Administration”
July 15, 2021: WBFF Fox45 (Baltimore, Md.) interviewed me about slow mail delivery in Baltimore.
July 15, 2021: The Radio America Network interviewed me about the new $3.5 trillion budget plan.
July 15, 2021: I appeared on WBOB 600 AM (Jacksonville, Fla.) to talk about budget reconciliation and oil prices.
July 15, 2021: Issues & Insights ran TPA’s op-ed, “Time For A New, Private Space Race.”
July 15, 2021: The Livingston Parish News (Denham Springs, La.) ran TPA’s op-ed, “Critics decry BRIDGE Act’s effort to promote government broadband networks.”
July 15, 2021: I appeared on Rush to Reason on KLZ 560AM (Denver, Col.) to talk about the Democrats $3.5 trillion spending bill.
July 15, 2021: VP of Policy Patrick Hedger appeared on the Trevor Carey Show on CA/Power Talk (Fresno, Ca.) to discuss the Biden administration’s pressure on social media companies.
July 16, 2021: I appeared on the Chris Stigall Show on 990 AM (Philadelphia, Pa.) to talk about the Democrats $3.5 trillion spending bill.
Have a great weekend!
Best,
David Williams
President
Taxpayers Protection Alliance
1401 K Street, NW
Suite 502
Washington, D.C. xxxxxx
www.protectingtaxpayers.org ([link removed])
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