OBAMA OFFICIAL DELETED OBAMACARE EMAILS SOUGHT BY CONGRESS

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Administrator of Centers for Medicare and Medicaid Services deleted some of her emails

Patrick Howley
Political Reporter

The administrator of the Centers for Medicare and Medicaid Services (CMS) deleted some of her emails and may not be able to cooperate with a congressional investigation into the flawed Obamacare rollout, CMS has warned Congress.

Marilyn Tavenner, who was appointed by President Obama to take over CMS within the Department of Health and human Services in 2013 — prior to the Obamacare rollout — deleted some of her emails and did not save hard copies as the Federal Records Act requires her to do, MSNBC reported Thursday.

Though Tavenner’s computer did not crash like ex-IRS official Lois Lerner’s computer allegedly did, Tavenner may be unable to cooperate with House Oversight and Government Reform Committee subpoenas.

“During her entire tenure at CMS, Ms. Tavenner’s CMS email address, which is accessible to both colleagues and the public, has been subject to write-in campaigns involving thousands of emails from the public,” according to a letter CMS sent Wednesday to the National Archives and Records Administration. “Therefore, she receives an extremely high volume of emails that she manages daily. To keep an orderly email box and to stay within the agency’s email system capacity limits, the Administrator generally copied or forwarded emails to immediate staff for retention and retrieval, and did not maintain her own copies.”

CMS noted that this practice of not keeping emails “continued until November 2013,” just one month after the Obamacare website launched.

“It is possible that some emails may not be available to HHS,” the letter stated.

Read more: http://dailycaller.com/2014/08/07/obama-official-deleted-obamacare-emails-sought-by-congress/#ixzz3A8BGXosj

Obama Official Deleted Obamacare Emails Sought By Congress

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Patrick Howley

The administrator of the Centers for Medicare and Medicaid Services (CMS) deleted some of her emails and may not be able to cooperate with a congressional investigation into the flawed Obamacare rollout, CMS has warned Congress.

Marilyn Tavenner, who was appointed by President Obama to take over CMS within the Department of Health and human Services in 2013 — prior to the Obamacare rollout — deleted some of her emails and did not save hard copies as the Federal Records Act requires her to do, MSNBC reported Thursday.

Though Tavenner’s computer did not crash like ex-IRS official Lois Lerner’s computer allegedly did, Tavenner may be unable to cooperate with House Oversight and Government Reform Committee subpoenas.

“During her entire tenure at CMS, Ms. Tavenner’s CMS email address, which is accessible to both colleagues and the public, has been subject to write-in campaigns involving thousands of emails from the public,” according to a letter CMS sent Wednesday to the National Archives and Records Administration. “Therefore, she receives an extremely high volume of emails that she manages daily. To keep an orderly email box and to stay within the agency’s email system capacity limits, the Administrator generally copied or forwarded emails to immediate staff for retention and retrieval, and did not maintain her own copies.”

CMS noted that this practice of not keeping emails “continued until November 2013,” just one month after the Obamacare website launched.

“It is possible that some emails may not be available to HHS,” the letter stated.

Read more: http://dailycaller.com/2014/08/07/obama-official-deleted-obamacare-emails-sought-by-congress/#ixzz39jyOTeVF

Doctors Begin To Refuse Obamacare Patients

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Sarah Hurtubise

Obamacare plans have shrunk payments to physicians so much that some doctors say they won’t be able to afford to accept Obamacare coverage, NPR reports.

Many of the eight million sign-ups in Obamacare exchanges nationwide already face more limited choices for physicians and hospitals than those in the private insurance market. But with low physician reimbursement rates, the problem could get even worse.

For a typical quick patient visit, Dr. Doug Gerard, a Connecticut internist, told NPR a private insurer would pay $100 while Medicare would pay around $80. But Obamacare plans are more likely to pay closer to $80, which Gerard says is unsustainable for his practice.

“I cannot accept a plan [in which] potentially commercial-type reimbursement rates were now going to be reimbursed at Medicare rates,” Dr. Gerard told NPR. ”You have to maintain a certain mix in private practice between the low reimbursers and the high reimbursers to be able to keep the lights on.”

Narrow networks have become a hallmark of many Obamacare exchange plans, as one of few options left to insurance companies that allows them to save money by lowering reimbursement rates and covering fewer providers. In the health-care law’s first year, 70 percent of all Obamacare plan networks were either narrow or ultra-narrow, according to an analysis from consulting firm McKinsey.

But doctors are feeling even more financial pressure due to the changes and many believe there’s a risk that Obamacare insurance will go the way of Medicaid, where patients still struggle to find a doctor after low reimbursement rates led many physicians to stop accepting it.

“I don’t think most physicians know what they’re being reimbursed,” Gerard said. “Only when they start seeing some of those rates come through will they realize how low the rates are they agreed to.”

If Obamacare coverage continues on its current track, exchange customers could face a lower level of care than those who buy coverage in the private market.

“I think it could lead potentially to this kind of distinction that there are these different tiers of quality of care,” Connecticut Obamacare chief Kevin Counihan told NPR. ”That’s been something, at least in our state, that we’re trying to work against. And the carriers are, as well.”

The problem is especially bad for private practices like Gerard’s, where physicians’ income is directly tied to reimbursements. But hospitals — especially top-tier ones that treat the most difficult diseases — are also increasingly rejecting the low reimbursement rates. The nation’s best cancer treatment centers are often covered by very few exchange plans in their states; if Obamacare customers end up with a difficult-to-treat cancer, they’re likely to face a lower quality of care right off the bat.

“You get what you pay for,” said Connecticut State Medical Society president-elect Bob Russo. “If you can’t convince [doctors] that they’re not losing money doing their job, then it’s a problem. And they haven’t been able to convince people of that.”

Read more: http://dailycaller.com/2014/08/04/doctors-begin-to-refuse-obamacare-patients/#ixzz39TNjuopb

THE ROT WITHIN, PART I: OUR PONZI ECONOMY

Dependent on inflating bubbles to evince “economic strength”

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by CHARLES HUGH-SMITH |ZERO HEDGE | JULY 22, 2014

Depending on blowing the next bubble to temporarily prop up the economy is the height of foolhardy shortsightedness.

All the conventional policy fixes proposed by Demopublican politicos, technocrats and the vast army of academic/think-tank apparatchiks are the equivalent of slapping a coat of paint on a fragile facade riddled with dryrot. All these fake-fixes share a few key characteristics:

1. They focus on effects and symptoms rather than address the underlying causes, i.e. the dryrot at the heart of our government, society and economy.

2. They maintain and protect the Status Quo Powers That Be–no vested interests, protected fiefdoms or Financial Elites ever lose power as a result of these policy tweaks.

3. They are politically expedient, meaning they assuage the demands of vested interests rather than tackle the rot undermining the nation.

4. They ignore the perverse incentives built into current systems and the incentives of complicity, i.e. to cheer another coat of paint on the dryrot rather than face the costs of real reform.

The financial underpinnings of the economy and society are rotting from within:finance, higher education, defense, healthcare, law, governance, you name it.

This week I want to highlight a few key causes of this pervasive and eventually fatal systemic rot.

Let’s start with Our Ponzi Economy. There are three primary examples of our Ponzi Economy: pay-as-you-go social programs (Social Security, Medicare, Medicaid, etc.); housing and the stock market. All are examples of financial Ponzi schemes.

All Ponzi schemes rely on an ever-expanding pool of greater fools who buy into the scheme and pay the interest/gains due the previous pool of greater fools. Ponzi schemes fail because the pool of greater fools is finite, but the scheme demands an ever-expanding pool of participants to function.

All Ponzi schemes eventually fail, though each is declared financially soundbecause this time it’s different. The number of greater fools required to keep the scheme going eventually exceeds the working population of the nation.

Here’s why Pay-As-You-Go Social Programs are all Ponzi schemes:

1 retiree consumes the taxes paid by 5 workers.

Those 5 workers when they retire consume the taxes paid by 25 workers.

Those 25 workers when they retire consume the taxes paid by 125 workers.

Those 125 workers when they retire consume the taxes paid by 625 workers.

Those 625 workers when they retire consume the taxes paid by 3,125 workers.

You see where this goes: very quickly, the number of workers required to keep the Ponzi scheme afloat exceeds the entire workforce.

The only way to keep the Ponzi scheme going is to keep raising payroll taxes on the remaining workers, which is precisely what welfare states (i.e. every developed economy on the planet) has done.

But raising taxes merely extends the Ponzi scheme one cycle. Eventually, taxes are so high that the remaining workers are impoverished. Right now, the U.S. has reached a ratio of 2 full-time workers for every retiree. As the number of retirees rises by thousands every day and the number of full-time jobs stagnates, the ratio will slide toward 1-to-1:

The Problem with Pay-As-You-Go Social Programs: They’re Ponzi Schemes (November 5, 2013)

Estimates are even worse in other developed nations. In Europe, the ratio of retirees over 65 to those between 20 and 64 will soon reach 50%–and that’s of the population, not of people with full-time jobs paying taxes to fund social welfare programs. (source: Foreign Affairs, July/August 2014, page 130)

As the percentage of the working-age populace with full-time jobs declines, the worker-retiree ratio will become increasingly unsustainable. The taxes paid by each worker are nowhere enough to fund the generous pension and healthcare benefits promised to every retiree.

In the U.S., the number of people of working age who are jobless is 92 million; the number of full-time jobs is 118 million. This chart of labor participation includes almost 30 million part-time employees who don’t earn enough to pay substantial taxes and millions of self-employed people making poverty-level net incomes.

Courtesy of STA Wealth Management, here is a chart that shows full-time workers are less than half the labor force:

Housing is also a classic Ponzi scheme: prices can only go up if there is an ever-expanding pool of greater fools willing and able to pay even more for a house than the previous pool of greater fools.

As I have explained many times, the only way the Status Quo has been able to expand the pool of greater fools is to lower interest rates to near-zero, drop down payments to 3% and loosen previously-prudent lending standards.

The Housing “Recovery” in Four Charts (May 27, 2014)

These tricks extend the Ponzi for a cycle by artifically expanding the pool of greater fools, but that pool is not infinite. (Foreign buyers are currently enlarging the pool, but their participation is dependent on the Ponzi schemes in their home economies not blowing up.)

The stock market has been made the official metric of the nation’s economic health; too bad it’s a Ponzi scheme. Financial bubbles are what economist Robert Shiller calls “naturally occurring Ponzis” because the psychology of ever-rising prices and profits fuels an inflow of greater fools that sustains the bubble until all available greater fools have sunk their cash and credit into the bubble.

Here is what a market that is increasingly dominated by Ponzi bubbles looks like: this is the S&P 500 (SPX):

(source: Gordon T. Long, Macro Analytics)

Depending on blowing the next bubble to temporarily prop up the economy is the height of foolhardy shortsightedness. Yet that’s our Status Quo, increasingly dependent on inflating bubbles to evince “economic strength” when the Ponzi paint will soon peel off the rotten wood of the real economy.

Chicago Faces $67 Million Shortfall After Obamacare’s Medicaid Expansion Busts Budget

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Sarah Hurtubise

Chicago’s public health system is facing a massive $67 million shortfall after an early adoption of Obamacare’s Medicaid expansion cost much more than expected, Crain’s Chicago Business reports.

Cook County, which encompasses Chicago and its surrounding suburbs, made a deal with the Obama administration to get an early start on the health care law’s Medicaid expansion in 2012.

But the resulting program, CountyCare, is costing millions more than original projections. The prototype Medicaid expansion lost Cook County $21 million in the first six months of operation — that’s expected to balloon to $63.5 million by November 30, according to the Chicago Tribune.

CountyCare was expected to pad the city’s coffers. In 2013, state officials projected that the new system would bring in at least $28 million by November, Crain’s reported. The cost of caring for the influx of Medicaid patients has busted projections partially because the newly insured are seeking pricier medical care than expected.

While the program has already failed to meet budget projections this year, the problem is likely to get worse in 2015. Medicaid expansion patients are required to use only CountyCare medical facilities for the first year — meaning the county will end up reimbursing itself for much of its spending on CountyCare coverage.

In January, however, CountyCare patients will be allowed to access other health plans and medical providers. That could leave the expanded Medicaid program to cover patients with the most expensive health problems, along with the least ability to pay. If the public health system loses more inexpensive patients next year, the budget crunch will get even worse.

Dr. John Jay Shannon, promoted to the top position at the Cook County Health and Hospitals System just weeks ago, is charged with finding $67 million in savings from the program by November. If he’s unable to, Cook County taxpayers will have to pony up to pay for the program.

Shannon told Crain’s that the county had “unrealistic expectations” that CountyCare would be “some kind of profit center” for the public health system. But Cook County officials were far from alone in thinking the federal funding would boost.

Advocates of the Medicaid expansion nationwide regularly castigate states that have decided against expanding the welfare program. The White House recently released a report attempting to shame states for refusing $88 billion in “free” federal taxpayer funding to expand Medicaid — but Cook County’s experience suggests states may not be able to count on the programs remaining free. (RELATED: White House: Red States Have Saved Federal Taxpayers $88 Billion By Rejecting Medicaid Expansion)

Read more: http://dailycaller.com/2014/07/14/chicago-faces-67-million-shortfall-after-obamacares-medicaid-expansion-busts-budget/#ixzz37eXEcEYQ

Number Of California Doctors Accepting Medicaid Plummets After Obamacare

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Sarah Hurtubise

The number of doctors accepting Medicaid patients in California dropped by a quarter from 2013, at the same time that two million new Obamacare expansion patients are joining the rolls.

In spring 2013, close to 109,000 physicians were enrolled to accept patients with Medi-Cal coverage, California’s version of Medicaid, California Health report writes. But after a purge of the lists this spring, just 82,605 doctors are now available, according to the state Department of Health Care Services.

Many doctors have chosen not to continue providing for Medicaid patients in the state after Obamacare forced an update of provider requirements, according to Medi-Cal spokesman Anthony Cava. The updated requirements “have strengthened the department’s ability to deny or terminate providers who do not comply with application requirements,” Cava said.

Others were dropped from the list of participating physicians because they hadn’t accepted a Medicaid patient in the past 12 months, Cava said.

“This has not resulted in a decrease in access to care,” Cava insisted, according to California Health Report.

But Medicaid patients nationwide already struggle to find doctors that accept the coverage, which typically has the lowest physician reimbursements of any federal program. Earlier this year, a Merritt Hawkins survey of physicians in top cities across the country found that just 45 percent of physicians in the 15 biggest cities in the country take Medicaid patients. (RELATED: Less Than Half Of Doctors In Nation’s Largest Cities Are Accepting Medicaid)

In Los Angeles, just 44 percent of cardiologist accepted Medicaid in 2013, along with 36 percent of obstetricians and gynecologists; seven percent of dermatologists; 35 percent of orthopedic surgeons; and 53 percent of family practice physicians. According to the state’s data, those numbers will now fall even further.

The drastic drop couldn’t come at a worse time for low-income customers in California, which has signed up more new Medicaid customers than any other state as part of the health-care law’s Medicaid expansion. California has two million more Medicaid sign-ups from the expansion, bringing its grand total to 10.5 million Medi-Cal customers statewide.

State officials are already struggling with the large influx. California was one of six states to be called out by the federal Obamacare and Medicaid administrator, Centers for Medicare and Medicaid Services (CMS), for failing to address its staggering backlog of Medicaid applications. The state owed CMS a plan on how to address its 600,000 application backlog last Monday.

Read more: http://dailycaller.com/2014/07/15/number-of-california-doctors-accepting-medicaid-plummets-after-obamacare/#ixzz37a5tgY6k

This State Won $7M from Taxpayers … for Wasting $48M

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Marianela Toledo / / July 09, 2014 /

 

Photo: Clementine Gallot

MIAMI — Florida once again is getting a hefty bonus from federal officials for “saving” taxpayers money.

This year, the state’s Department of Children and Families misspent $47.8 million in food stamp benefits.

However. that’s out of almost $6 billion the federal government gave to Florida.

So, Florida’s error rate of .81 percent is the second-lowest in the nation — and only a slight dip from the previous year when the state received $8 million for having the lowest error rate at 0.7 percent.

As a result, Florida receives a $7 million bonus for its welfare assistance programs.

Vermont had the highest waste rate at 9.66 percent. The national average was 3.2 percent.

SNAP, known as food stamps, is meant to give individuals and families a helping hand when they need it most.

>>> The Great Society 50 Years Later: How We’re Failing America’s Poor

Although data verifying the effectiveness of the program is in short supply, participants are not. In 2013, about 3,556,500 signed up for SNAP, an increase of more than 200,000 from the year before.

Rachel Sheffield, a policy analyst at The Heritage Foundation who focuses on welfare policy, said that adding work training or a work requirement to the food stamp program would help reduce misuse of the federal program.

Back in Florida, though, officials are pretty excited.

“We are pleased Florida is again being recognized as a leader for quality and accuracy in processing food assistance applications,” Mike Carroll, Florida’s interim DCF secretary, said. Carroll added:

The department is committed to helping individuals in crisis, and being able to quickly assist families and individuals in need of these resources is one of our principal functions. This is the seventh year in a row that DCF’s improvements and accuracy in correctly processing food assistance applications has received accolades and bonus money from the federal government, totaling more than $54 million.

The U.S. Department of Agriculture rewards states for keeping error rates to a minimum.

State agencies such as the one in Florida determine eligibility for Medicaid, food assistance, and temporary cash assistance based on federal guidelines.

Read more on Watchdog.org.

HHS Spent $62 Billion On Improper Payments In Health-Care Programs Last Year

Sarah Hurtubise

The federal government’s health-care programs made over $62 billion in improper or fraudulent payments last year, according to a Senate report out Wednesday, and the sum is likely to rise in the future as the federal government’s role in health care is expanding drastically.

Medicare, Medicare Advantage and Medicaid alone accounted for $62.2 billion of the federal government’s improper payments in 2013, the last full year of former Health and Human Services Secretary Kathleen Sebelius’ tenure, according to the Senate Special Committee on Aging report.

While improper payments across the entire federal government have dropped from a record-high $121 billion in 2010 to $105 billion total last year, incorrect payouts from federal health-care programs are growing.

In 2012, 8.5 percent of all Medicare payments were considered incorrect, but last year the rate grew to 10.1 percent. Medicare has hired more auditors to provide higher levels of oversight to the Medicare and Medicaid payment processes, but so far they’ve failed to actually prevent the improper payouts from happening.

“Medicare just isn’t getting the job done when it comes to preventing payments errors,” said committee chairman Sen. Bill Nelson. “Medicare must change the way it pays its providers so that the cheats are getting caught and the honest providers are getting paid.”

Ranking member of the committee Maine Republican Sen. Susan Collins pointed out that the auditors aren’t helping.

“The increase in audits has not translated into a reduction in improper payments,” Collins said. “In fact, Medicare is currently experiencing its highest improper payment rate in five years.”

The bipartisan report focused on the growing rate of Medicare and Medicaid fraud and even honest mistakes, emphasizing that the health care programs administrator, the Centers for Medicare and Medicaid Services (CMS), must shift from documenting improper payments that have already occurred and attempt to prevent the faulty payments from happening in the first place.

Absent any drastic changes in the federal government’s practices, however, improper health care payments are, if anything, likely to increase over the next several years. CMS administers Medicare, Medicaid and beginning this year, Obamacare as well — creating yet another opportunity for taxpayers to be hit billions in improper payments.

The risk for improper taxpayer spending through the Affordable Care Act is well-documented. Because CMS failed to build an income verification system in time for Obamacare’s launch, the Obama administration is belatedly sending out millions of letters to customers asking them to provide further proof of their eligibility for premium subsidies through Obamacare exchanges.

Read more: http://dailycaller.com/2014/07/09/hhs-spent-62-billion-on-improper-payments-in-health-care-programs-last-year/#ixzz3719Sze50

It’s Not True that 20 Million Americans Gained Coverage Under Obamacare

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Alyene Senger

@AlyeneSenger

Alyene Senger focuses her research and writing at The Heritage Foundation on the intricacies of health policy as research associate in the Center for Health Policy Studies.

A new report from the Commonwealth Fund claims 20 million Americans “gained coverage under the Affordable Care Act as of May 1.” But a closer look at that number reveals it’s not all it’s cracked up to be.

First, the authors, Dr. David Blumenthal, president of Commonwealth, and Vice President Sara Collins, get to the 20 million by adding together 1 million young adults who gained coverage under a parent’s policy, 8 million consumers who selected a marketplace plan, 5 million who purchased directly from an insurer, and 6 million who enrolled in Medicaid or the Children’s Health Insurance Program.

Also, the authors admit the 20 million figure does not distinguish between those who were previously insured and those who were not – even though the previously insured would not be “gaining” coverage but merely replacing one form of coverage with another.

And what about those 5 million who purchased coverage outside the exchanges? Is it fair to say they “gained” coverage because of the ACA? The authors site a Congressional Budget Office April 2014 report. Indeed, the CBO said, “[R]oughly 5 million people will enroll in ACA-compliant plans outside of the exchanges each year from 2014-2024.” (Page 9)

However, in the following paragraph, the CBO writes, “In the absence of the ACA, 9 million to 10 million people would have enrolled in nongroup coverage each year from 2014 through 2024, CBO and [the Joint Committee on Taxation] estimate. With roughly 5 million people expected to enroll in nongroup plans in years after 2015 under the ACA (excluding those people who purchase policies in the exchanges), that number will be 4 million to 5 million lower under the ACA than the number projected in the absence of the law.” (Emphasis added)

CBO is clearly projecting that net enrollment in the non-exchange individual market will decline (presumably because CBO believes that a portion of current individual market enrollees will seek subsidized replacement coverage in the exchanges as a result of the law). Therefore, here again, those 5 million projected enrollees do not represent a “gain” in coverage.

The 20 million figure sounds like a breakthrough, but the truth is the gains in coverage are not as strong as they are portrayed.

Supreme Court Deals Blow To Unions

Supreme Court Deals Blow To Unions

Chuck Ross

The U.S. Supreme Court sided with an Illinois mother in a ruling Monday that will severely limit public sector unions’ ability to force home health and personal care workers to pay union dues.

In Harris v. Quinn, the court voted 5-4 in favor of Pam Harris, a suburban Chicago mother, who sued Illinois Gov. Pat Quinn for a 2009 executive decision he issued forcing personal care assistants to pay dues to public unions.

The Harris family receives around $25,000 per year from Medicaid to help care for their adult son, Josh, who suffers from Rubinstein-Taybi Syndrome. Home care is an alternatives to placing him in a state institution.

Harris claimed that being forced to give dues to a public union violated her First Amendment rights.

In its decision, the court drew a line between workers like Harris and other public sector employees.

“In the case of full-fledged public employees, the State establishes all of the duties imposed on each employee, as well as all of the qualifications needed for each position,” wrote Justice Samuel Alito, who authored the majority opinion.

He was joined by Chief Justice John Roberts and Justices Antonin Scalia, Clarence Thomas and Anthony Kennedy. Justices Ruth Bader Ginsberg, Sonya Sotomayor, Elena Kagan, and Stephen Breyer dissented.

“So if a personal assistant steals from a customer, neglects a customer, or abuses a customer, the state washes its hands,” reads the opinion.

Because of Quinn’s 2009 decision, unions like the Service Employees International Union were allowed to collect dues from the Medicaid payments going to the Harris family.

SEIU has unionized 20,000 such individuals, and collects an estimated $10 million in dues annually.

Monday’s decision will severely hamper their ability to draw money from such workers, the number of which are growing considerably and were seen by unions as a major source of new funds.

While the decision was unfavorable to public unions, it did not go as far as some of their opponents had hoped. An ultimate win for public union opponents would have been a reversal of the 1977 ruling Abood v. Detroit Board of Education.

While he abstained from deciding on the precedent, Alito did call it “questionable,” leaving open the possibility that it could be revisited.

Nevertheless, Harris’s supporters praised the decision.

“The court looked at the situation and saw that Pamela Harris clearly was not a paid government employee,” Paul Kersey, director of labor policy at the free-market Illinois Policy Institute, told The Daily Caller.

“She does not have to worry about them interfering with her family. She doesn’t have to worry about the aid she gets from the state being redirected to unions,” said Kersey.

The Illinois Policy Institute filed an amicus brief on behalf of the Illinois mother.

“There are 20,000 people in Illinois who have been forced to pay dues to a union that they may not support, and they can look forward to being free of having any of their benefits directed to the SEIU,” said Kersey.

Kersey said that had Quinn’s executive decision been allowed to stand, it would have opened the door to unionizing anyone who does business with the government, including doctors who provide care to Medicaid and Medicare patients and small grocers who sell goods to customers on food stamps.

Read more: http://dailycaller.com/2014/06/30/supreme-court-deals-blow-to-unions/#ixzz368mTlJ3Y

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