Call this the world edition of Storeylines, where the International Date Line isn't just a global version of Tinder (rim shot).
Anyway, you might have missed this first little nugget over all the court rulings lately, but maybe that was the point. If you think your state had it bad when it came time to open up the exchanges – here's looking at you, Oregon – try running one from an island.
Or, more specifically, one of this country's stepchildren we call territories. Not that you've seen it on the evening news, but officials in American Samoa, Guam, the Northern Mariana Islands, Puerto Rico and the U.S. Virgin Islands have been begging for help from the feds for months amid concerns the Patient Protection and Affordable Care Act was "undermining the stability of the territories' health insurance markets."
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Well, that stony silence the territories received as a reply up until now cracked last week when CMS's Marilyn Tanner fired off a letter to Commissioner Gregory R. Francis from the Lieutenant Governor's office of St. Croix (presumably among others). In it, Tanner essentially waved the administration's magic wand and made nearly all of those pesky PPACA provisions go away.
"…HHS has determined that the new provisions of the PHS Act enacted in title I are appropriately governed by the definition of 'state' set forth in that title, and therefore that these new provisions do not apply to the territories. This means that the following Affordable Care Act requirements will not apply to individual or group health insurance issuers in the U.S. territories: guaranteed availability (PHSAct section 2702), community rating (PHS Act section 2701), single risk pool (Affordable Care Act section 1312(c)), rate review (PHS Act section 2794), medical loss ratio (PHS Act Section 2718), and essential health benefits (PHS Act section 2707)."
So while the administration fights for its subsidies back home, its handing out free passes abroad. Nothing like standing on principal. Kinda makes running off to a tropical paradise like Tom Cruise in "Cocktail" look even more appealing.
In other international news, tax inversion strategies, as they're spun, are finally starting to make the news.
(For the uninitiated, these burgeoning corporate workarounds entail a domestic company, such as Walgreens, merging with, say, a Swiss-based drug store chain, then relocating its headquarters there. The point is to cut its tax burden, since the United States boasts one of the highest corporate tax rates – at more than 39 percent – in the world.)
They're gaining traction as a clever way to dodge American taxes while otherwise operating normally since these new "headquarters" are little more than P.O boxes. And you can't blame these CEOs; they're only doing what they're paid to do: maximize shareholder value by cutting overhead, whether it's in terms of labor costs or its tax burden. As the tax reform talks heats up on Capitol Hill (almost certainly after the midterms) revisiting the corporate tax structure in this country is a critical component that needs to be addressed. Close the loopholes, lower the rate. Pretty simple math, even for a journalist.
In the meantime, I'd take away the cake they're trying to eat, and ban lobbying efforts, campaign contributions or any other actions to which a U.S. citizen is otherwise entitled, even if that citizen is a corporation per Citizens United. I'm sorry, but you can't have it both ways. If a company such as Walgreens is going to pull something like $4 billion out of our economy, while still milking Medicare payments, then there has to be some kind of sacrifice.
Though he's a little far left for me, former Labor Secretary (and bumbling economist) Robert Reich makes a good case for this.
Point is, I can see this trend accelerating if Congress does nothing to address it. As if we needed one more reason to reform our tax code.
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