Long-Term Political Balance

University of Virginia Professor Larry Sabato in his Crystal Ball blog takes a look at demographers' predictions of the political effect of the reapportionments following the censuses of 2010, 2020,and 2030. Bottom line: The Bush 2004 states will gain 17 electoral votes; the Kerry 2004 states will lose 17 electoral votes. (Sabato assumes that the District of Columbia will gain 1 electoral vote; I disagree.) According to these projections, Florida will gain 9 electoral votes, Texas 8, Arizona 5, California 3, Nevada and North Carolina 2 each. New York will lose 6 electoral votes, Ohio and Pennsylvania 4 each, Illinois 3, Massachusetts and Michigan 2 each. The lineup of electoral votes will look very different from today, and very different from what prevailed in the 1960 election (which was determined by the 1950 census), the first election I followed closely. Consider the figures below for what are projected to be the dozen largest states:

I'm puzzled by one thing: Georgia, which has been growing more rapidly than North Carolina, is projected to gain only 1 seat while North Carolina is projected to gain 2.

I would also like to add a caution. Population growth doesn't proceed along straight lines. If in 1990 you'd have extrapolated growth from the 1970-90 period, you would have California growing much more than it has. But the defense slowdown in the early 1990s cut California's growth sharply, and coastal California has had a huge outflow of internal migration since 2000 (compensated for by an inflow of international migration). Arizona and Georgia may or may not continue their very rapid growth in the 1990-2006 period. And so on. If you add up the Sun Belt and Snow Belt states in the above figures, you get:

That's an enormous shift. But it hasnt all happened yet.

HSAs IN OHIO (UPDATE)

Last November, I blogged about a proposal in the Ohio legislature to require that state and local government employees be given the option of choosing health insurance policies embodying Health Savings Accounts. Here is a report from a Columbus insurance executive who favors HSAs.

"Our bill [which mandates that all public employees (1.3M) be provided access to Heath Savings Accounts] was approved by the House in May 2006 and never made it to the Senate because nobody worked from May through November as they (the majority Republicans) indefensibly defended themselves from the liberal onslaught by very carefully doing absolutely nothing but justify the leftist charges (where is the leadership?!). After the November debacle we declined to push for Senate passage because in a very contentious lame-duck session nearly every bill passed was bastardized. Unless H.B. 506 is passed with its to be added RFP provision re competitively bid multiple provider selection process (three or more) to prevent price fixing, it is worthless.

It will be re-introduced this week, again by Rep. Lou Blessing, an experienced and respected legislator and long time advocate even before there was an HSA, with support from former Speaker Larry Householder. This time, in spite of a change of party at the state level, the Republican controlled legislature can only implement an open public records mandate (H.B. No. 9) with the savings (20-30% first year) realized by its passage. There is no other way. It is also the only way to salvage the Ohio public pensions ($150B), which have voluntarily provided healthcare to retirees (what if they decide not to?).

In Michigan, the Blues have convinced GM and Ford that their only way out is to break the UAW, get out from under the pension and healthcare burden, restructure in Michigan with the survivors and prosper anew. Delphi was a test case. It worked. The auto industry is a test case for American manufacturing, ironically with John Engler at the helm. Their goal is to have, among others, all 16 Ford and GM Ohio plants closed down and relocated to Michigan by 2010, with innumerable concessions, especially after Comerica relocated to Texas. Michigan is desperate. Unless Ohio listens to me (and hopefully, us) so will they be. Then, the rest of the nation. Ohio officials are so naive as to believe this won't occur.

From your position you have the tendency to look at problems from the top down. My less exalted view is from the middle both ways. The vast majority's is from the bottom up. All three are essential to a solution. In Michigan the Blues have bought up all the HSA providers so that they can build the requisite fat into their own HSA offerings to salvage their dominance by diluting the HSA cost savings. In Ohio, United Healthcare requires all employees to be HSA participants, yet have to be dragged kicking and screaming into selling one to a client. They and Medical Mutual dominate our market for public employees through the efforts of a single lobbyist (he, a former Taft Chief of Staff, is not a missionary).

I will break it down for you. The evil is once again greed. First: Big Insurance--Simple. If an agent goes into a building housing public officials, let's say 100, and spends an hour convincing the group that HSAs are their best alternative he nets $10/mo/employee ($1,000.00). That same agent goes into that same building spending 10 minutes asking them to renew their HMO "entitlement" plan and he nets $5,000 ($50/mo/employee). As an agent, which would you sell? As an insurance provider, which would you rather have sold?

On Thursday, March 29, Ohio H.B. 116 will begin hearings in the Ohio Government Relations and Elections Committee(?) for consideration. Republicans hold a 9-8 majority in that committee but one of the nine is the chirperson of the Ohio Retirement Study Council who adamantly opposes HSAs and resents us because we exposed her own absurd offering as a solution to healthcare costs last year as just that. We are saving the public pensions she oversees and she is our staunchest opponent. This was all quickly arranged since the bill was introduced on March 20 by the big insurance lobby and the unions, whose pensions we also save, let alone any future Ohio ties to the U.S. auto industry. Additionally, legislative leaders know that other mandates can only be funded by the savings that the implementation of our bill will generate. None of that seems to matter."

I'm obviously not an expert on Ohio health insurance law or on the developments the writer describes as occurring in Michigan. But I think the above is an interesting illustration of the workings of our healthcare finance system--or, rather, systems. For we do not have one healthcare finance system in the United States; we have many, and they are constantly changing. The decisions of employees, employers, insurers, healthcare providers, pharmaceutical companies and benefits managers, Congress and state legislatures, and CMS and state regulators are making changes constantly, with results that are hard to predict with precision. The federal government is just one of very many players, albeit an important one. Here are some of my previous blogposts on HSAs, The Wal-Mart Controversy and Health Savings Accounts, which I think will grow in popularity and importance as the years go on. One way to advance them would be for the Ohio legislature to make them available to public employees, and for legislatures in other states to follow suit.

By Michael Barone