Chartered Health Plan settles with District

Chartered Health Plan settles with District

By Rachel Weiner, Washington Post, Published: August 21

The District of Columbia has reached a settlement with a health-care company that was once the city’s largest contractor and whose former owner is at the center of a federal investigation into political corruption.

District officials have agreed to pay $48 million to settle the accounts of D.C. Chartered Health Plan, the Medicaid contracting firm that unraveled over the past year amid financial stresses and allegations concerning its owner’s involvement in the 2010 mayoral election.

The settlement, between the company’s receiver and city health-care finance officials, awaits the approval of federal Medicaid officials. But when a Superior Court judge signed off on the deal Wednesday, it marked a significant step toward releasing funds to health-care providers who say they have not been paid for $56.5 million in services delivered to Chartered members.

“We’re very, very, very happy,” said Maria Gomez, the president and chief executive of Mary’s Center. Chartered owes the family-focused nonprofit group more than $300,000, Gomez said, and the center is behind on its rent and payments to vendors as a result.

Gomez added: “It’s money that has been due to us for so long now. . . . If we don’t get paid, we can’t continue to see these patients.”

Chartered’s founder and former owner, Jeffrey E. Thompson, is under investigation by a federal grand jury because of allegations that he financed a “shadow campaign” of unreported expenditures on behalf of Democrat Vincent C. Gray’s successful run for mayor three years ago.

Thompson’s attorney, Brendan V. Sullivan, has repeatedly declined to comment on the campaign allegations, and Gray has denied any wrongdoing.

Much was at stake in the election for Thompson and Chartered, which did more than $300 million a year in city business at its peak.

The company, which served more than 100,000 low-income District residents, came under increasing scrutiny in the years leading up to 2010. An audit found that Chartered had overpaid firms owned in whole or part by Thompson, identifying $7.7 million in payments to Thompson-owned companies as “excessive.” The city sued, and Thompson paid $12 million to settle.

After Gray’s election, Chartered’s position improved, with the new administration agreeing to pay Chartered $7.5 million to settle another contract dispute.

Wednesday’s ruling by Superior Court Judge Melvin Wright brings Chartered’s business dealings with the District — and the company’s existence — closer to an end. Less clear is whether Chartered’s problems and the disruptions they caused will have a chilling effect on providers’ willingness to serve lower-income District residents.

“This sends a clear message to our providers that they are not only important to the beneficiaries they serve but that they are considered an integral part in the system that contributes to the health and well-being of the District’s most vulnerable population,” said Wayne Turnage, director of the city’s Department of Health Care Finance.

Gomez, of Mary’s Center, said that letting the obligations go unmet for so long hurt the city’s entire health-care system. “We always get a bad rap in the city, that people don’t want to do business in the city because they don’t get paid,” she said. “So this is very smart, to get this money out.”

Chartered came under the scrutiny of insurance regulators last year as prosecutors investigated Thompson’s alleged campaign activities and fought a legal battle with him over materials seized from his home and office.

The scrutiny culminated in a government takeover of the firm in October and the sale in April of its most valuable assets to AmeriHealth Mercy.

According to Wednesday’s agreement, providers will be paid in two installments: first from a portion of the settlement to be distributed by Chartered; and second from a portion to be distributed directly by the District. The receiver in charge of Chartered anticipated that providers will receive 90 percent of what they are owed; money recovered from Chartered’s parent company could make possible further payments.

“We’re in the home stretch,” said William P. White, commissioner of the District’s Department of Insurance, Securities and Banking and Chartered’s court-appointed rehabilitator, to whom the receiver reports. “We still have a lot of work, but at least the providers will know they’ll be paid the lion’s share of what they’re owed. We’ve come a long way since October.”

Some city officials, including D.C. Council member David A. Catania (I-At Large), have pushed for the city to hold Thompson personally liable for unpaid claims.

Wednesday’s settlement could be politically risky for Gray because of his association with Thompson and the investigation of his mayoral campaign.

Gray wants the District to pay most of the settlement out of its contingency fund. Those funds can be disbursed without approval from the D.C. Council but must be paid back within two fiscal years.

The settlement does not eliminate all of Thompson’s potential liabilities. Receiver Daniel L. Watkins is suing Thompson for $17 million, alleging that he siphoned cash out of the business, which could help fill the gap between the settlement and the money owed.

Attorneys for D.C. Healthcare Systems, Chartered’s corporate parent, wanted to delay the settlement and introduced evidence that they said would show that the District owes the company far more money. Thompson has contended in contract appeals that the city underpaid Chartered by more than $60 million.

“Our argument is that they’re paying pennies when they owe hundreds,” said David Killalea, an attorney for the parent company.

The judge rejected that argument, ruling that the parent company did not have standing in the dispute. Even if it did, Wright said, “I would have overruled your objection anyway.”

Meanwhile, city officials continued to deny all Chartered’s claims of underpayment, saying Thompson bore the risk that the per-member rates paid by the city might not cover Chartered’s costs. Although the settlement provides some compensation for such underpayments, the city admits no liability.

A status hearing on the distribution of settlement funds is scheduled for Oct. 17.

Mike DeBonis contributed to this report.


Ex-Gray adviser Vernon Hawkins charged with lying in ‘shadow campaign’ probe

Ex-Gray adviser Vernon Hawkins charged with lying in ‘shadow campaign’ probe

By Ann E. Marimow, Mike DeBonis and Nikita Stewart, Monday, August 12, 11:35 AM

A D.C. political operative who allegedly worked on a secret campaign to elect Mayor Vincent C. Gray was charged Monday with lying to federal authorities.

Vernon E. Hawkins, a longtime adviser to Gray (D), is accused of lying about trying to impede a federal investigation into an alleged off-the-books $653,000 campaign funded by a D.C. businessman in 2010.

The one-count charge against Hawkins signals that a plea agreement has been reached and a hearing is scheduled for Tuesday morning. He is the latest in a series of people charged with connections to businessman Jeffrey E. Thompson, the alleged financier of what has become known as the “shadow campaign.”

The charge against Hawkins carries a maximum sentence of five years in prison, but he is likely to face far less time under sentencing guidelines. His attorney, William E. Lawler III, could not immediately be reached for comment.

According to the three-page charging document, Hawkins paid off another person involved with the off-the-books effort to encourage the campaign worker to leave town to avoid speaking with FBI agents.

A fixture in District government and politics since the Marion Barry era, Hawkins rose from being a Department of Corrections worker to leading the Department of Human Services. He was a paid consultant on Gray’s D.C. Council campaign in 2004 and a volunteer adviser for Gray’s successful bid for council chairman in 2006.

In 2010, Hawkins was among the 100 people who went with Gray as he filed paperwork to launch his campaign that March. Internal campaign documents obtained by The Washington Post identified Hawkins as a “special adviser.”

But several campaign staffers pushed Gray to distance himself from Hawkins, fearing that the rival campaign of incumbent mayor Adrian Fenty would use Hawkins’s presence to tie Gray to the city’s old guard, according to several people privy to the discussions about Hawkins’s role in the official campaign.

Although Hawkins continued to be seen at Gray campaign headquarters directing canvassers, his name was dropped from internal documents. Campaign staffers were often confused by Hawkins’s workers vs. official Gray campaign workers.

Through the 21 / 2 year federal investigation, campaign workers would later learn that those canvassers worked for the “shadow campaign.”

The court documents filed in Hawkins’s case Monday describe a business executive matching Thompson, who was for years one of the city’s largest contractors. Thompson has not been charged.

One of Thompson’s longtime associates, Jeanne Clarke Harris, pleaded guilty last year to funneling Thompson’s money through companies she owned to fund the off-the-books effort for Gray.

In 2010, according to the court documents, Harris gave Hawkins money to try to persuade another campaign worker identified as “Person One” to “leave town for an extended period of time, so that Person One would be unavailable to speak with federal agents.”

Person One is Lamont Mitchell, according to people with knowledge of the investigation. He owns a catering business, Imani Catering, and coordinated transportation for Thompson’s get-out-the-vote effort. Campaign finance filings for Gray’s official campaign list a $1,800 payment to Mitchell’s catering company.

Mitchell has also provided catering for several other local candidates and D.C. Council members for breakfast meetings.

Mitchell could not be immediately reached for a comment.

Mike DeBonis contributed to this report.

Hundreds in D.C. lost Medicaid assistance without cause, attorneys say

Hundreds in D.C. lost Medicaid assistance without cause, attorneys say

By Alexia Campbell, Washington Post, Published: August 11

After a spinal condition paralyzed her legs six years ago, Joyce McWain-Gray crawled to her second-floor bedroom in a LeDroit Park rowhouse and holed up for nearly a year.

For her weekly medical appointments, the 56-year-old relied on District firefighters to carry her down the 12 steps from her room.

McWain-Gray grew hopeless, she said, until a social worker told her about the District’s Elderly and Persons with Physical Disabilities Waiver Program.

The Medicaid program sent an aide to her house for 16 hours a day to help her bathe, dress, cook and clean. She got a motorized wheelchair and learned to ride the bus.

Then one day her freedom ended.

The District would no longer pay for her care during evening hours, she learned in a letter from her home health agency. Then, three days later, the aide left a stack of adult diapers and a cooler of food next to McWain-Gray’s bed and left.

“They helped me with everything, and then all of a sudden it was gone,” said McWain-Gray, who lives on $710 a month in Social Security benefits. “I can’t even go to the bathroom by myself.”

McWain-Gray was illegally dropped from the program, her attorneys say, along with hundreds of other elderly or disabled people in the District — a move that attorneys who work for the city concede might have been improper.

The Washington Post found that the District cut 366 people from all or some of the services they may have been eligible to receive in the nine months ended March 2012, according to records on file at the D.C. Attorney General’s Office. About a third of those people died, the office said. The District doesn’t know how they died because the program doesn’t get copies of death certificates, officials said.

“These are absolutely critical services. The safety net falls and we look at dire consequences,” said Rebekah Mason, a staff attorney for the AARP’s Legal Counsel for the Elderly, which has represented about a dozen people facing termination from the District’s Medicaid waiver program.

Reinstatement possible

Officials with the District’s Department of Health Care Finance, which runs the waiver program, deny wrongfully cutting anyone from home health services. They said many participants lose their spots when contract case managers submit incomplete or late annual paperwork required by federal law. They said people can request an administrative hearing to fight the terminations and get back into the program if they are eligible. In the past two years, the District reinstated about 600 people, said Yvonne Iscandari, program director for the department’s Division of Long Term Care.

“You are not going to have a perfect system,” said Iscandari, who oversees the waiver program. “You are going to have instances where somewhere in the process somebody’s eligibility was not updated.”

But even home health agencies that contract with the District — and take some of the blame — worry that the District’s bureaucracy puts vulnerable people in peril.

“We’re not totally innocent in this, but some of the processes they’ve implemented have put some of the patients at risk and the agencies at risk,” said Linda Davis, owner of Premium Select Home Care, which serves about 100 Medicaid recipients in the District.

About two dozen licensed home health-care agencies contract with the District to serve about 3,000 people in the program. The District created the program in 1999, six years after Congress allowed Medicaid money to cover basic home help that doesn’t require a nurse. People must make less than $2,130 a month to qualify. The District funds 30 percent of the program and the federal government covers the rest.

The popular program reached its cap in 2011, creating a waiting list of more than 1,000 people. That triggered a paperwork backlog for contract case managers, who must get doctors to approve the level of care for each client every year. If they file it late or at the last minute, the District might not have time to authorize the continued care before the federal deadline, District officials said. That’s when the system ends the aid.

Legal guidance

Many of those people cut from the program got help from a handful of organizations that provide free legal services to seniors and people with disabilities. Attorneys for University Legal Services said they have taken up 30 to 40 termination cases in the past year and half. In some of those cases, people returned home from a brief hospital stay to discover that their aide and spot in the program were gone.

McWain-Gray is one of the people that University Legal Services helped.

She was still wearing a neck brace from a recent spinal surgery when she called for help in January 2012.

McWain-Gray said she remembers trying to change her diaper in bed in the evenings. She could not sit up. Widowed with no children, she says she had no one to turn to.

McWain-Gray’s attorney requested a hearing in front of an administrative judge, arguing that the District broke the law by not giving the woman enough notice of the pending termination.

Ending the Medicaid benefits of people who are eligible for them is illegal, said her attorney, Marjorie Rifkin. Within a few days of ending services, the District placed McWain-Gray back in the program and restored the 16 hours of daily home care.

Some clients receive vague notices that they will soon lose their home care. Others never get a notice. The practice is forcing people into nursing homes or leaving them to fend for themselves, Rifkin said. That led her and four other attorneys to write a complaint to D.C. Mayor Vincent C. Gray (D) in February 2012, threatening to sue the city if it didn’t make changes.

“We urge you to intervene to stop this practice and remediate the harm to those who need EPD Waiver services and supports to remain in their homes and the community,” read the complaint from the National Senior Citizens Law Center and University Legal Services.

Various outcomes

Attorneys who work for the city responded a few months later, saying that more than 300 people might have been improperly terminated from the program. Staff from Health Care Finance tracked down those people and found that 133 had died and 37 had entered nursing homes or other long-term care facilities, according to the letter. An additional 95 placed on the basic state Medicaid plan said they were satisfied with it. The District also took 69 people back into the waiver program at their request, the letter said.

The bureaucratic mess almost left one Northeast Washington man without anyone to care for his 89-year-old mother, who has dementia. Dwayne Hughes, 52, said he reached out for legal help after the woman’s home health-care agency kept calling to say that the District wasn’t paying. In November, Legal Counsel for the Elderly got Hughes’s mother back into the program.

“I made a commitment that I would take care of my mom. I’m going to keep her in the home as long as possible,” said Hughes, who arranged for 12 hours of daily care for his mother while he works evenings at a telecommunications company in McLean. “This is a good program, but there needs to be more oversight.”

Health Care Finance officials point to steps the District has taken to prevent people from losing the waiver benefits. District staff held mandatory training sessions for all case managers last year, focusing on the need to complete annual recertification on time, Iscandari said. Health Care Finance also began mailing notices to participants 90 days and 30 days ahead of their yearly recertification deadline. And all 1,397 people on the waiting list have received notice of available slots, she said.

The 30-day termination notices, which tell participants that they can request a hearing, help ensure that everyone who is eligible for home aid will continue to get it, Iscandari said. The program does not track how many people are terminated, when or why.

More to be done

Attorneys and advocates for Medicaid recipients say the District hasn’t done enough. People who don’t request a hearing can still lose their services because of the District’s administrative errors, Rifkin said.

“We don’t think the problem has been solved,” she said. “They’ve failed to manage the process.”

More D.C. campaigns allegedly received secret funding from Thompson

More D.C. campaigns allegedly received secret funding from Thompson

By Ann E. Marimow, Mike DeBonis and Nikita Stewart, Washington Post, Published: August 11

Years before prosecutors say he illegally financed an election effort for Mayor Vincent C. Gray, a local businessman allegedly secretly spent hundreds of thousands of dollars on behalf of at least seven other candidates for mayor and the D.C. Council, according to several people familiar with the payments.

Jeffrey E. Thompson, who is under federal investigation for allegedly financing a $653,000 secret campaign for Gray in 2010, allegedly made similar expenditures dating back to at least 2006, according to two people with direct knowledge of the payments who spoke on the condition of anonymity because the investigation is ongoing.

Thompson boosted the mayoral campaign of Linda W. Cropp, a Democrat, seven years ago with more than $100,000 in alleged illegal spending, the people said. He allegedly spent smaller amounts on behalf of former council member Michael A. Brown and the insurgent council candidacies of Patrick D. Mara, a Republican, and Mark H. Long, an independent, in 2008. And he allegedly spent still more in 2010 for council hopefuls Jeff Smith and Kelvin Robinson, both Democrats, and in 2011 for council member Vincent B. Orange (D-At Large).

Though the sums of money were significantly smaller than the amount that went into what has become known as the “shadow campaign” for Gray in 2010, such expenditures could reveal a pattern in which Thompson appears to have wielded vast influence for years over the District’s political process.

Cropp and Mara denied any knowledge of the payments, as Gray has done regarding the alleged secret effort to help him in 2010. The other candidates either couldn’t be reached or, through attorneys, declined to comment.

That keeps the focus of a
21 / 2-year investigation into political corruption in the District, for now, on Thompson.

Prosecutors appear to be methodically building a case against Thompson, who was for years one of the District’s largest contractors and who, court records suggest, is the subject of a grand jury investigation.

An individual matching Thompson’s description has been mentioned on numerous occasions in court documents as allegedly funding the “shadow campaign” for Gray (D) as well as arranging illegal “straw” donations made with his own money but disclosed as coming from employees and other associates.

While declining to comment on any particular allegations of wrongdoing, Bill Miller, a spokesman for the U.S. attorney’s office, issued a statement Friday that said: “It is clear from our office’s public corruption prosecutions over the past several years that we will not excuse criminal activity as business as usual. We plan to continue vigorously investigating and prosecuting crimes that deprive D.C. voters of the fair and transparent elections that they deserve.”

Most recently, Thompson secretly paid for T-shirts, campaign signs and field workers in 2011 to help return Orange to office, the individuals asserted. In that campaign, Orange relied on some of the same players implicated in the parallel campaign for Gray the prior year.

One of those people, veteran field organizer Vernon E. Hawkins, recently has been in talks with federal prosecutors about entering a possible plea agreement in connection with his work on the Gray shadow campaign, according to several people familiar with the negotiations who, like others, spoke on the condition of anonymity because the investigation continues.

The deal, which will not be final until a judge accepts it, is expected to be made public as soon as this week, according to two people with knowledge of the investigation. If charges are filed, Hawkins would become the latest in a series of Thompson associates to be implicated in the scandal.

William E. Lawler III, Hawkins’s attorney, declined to comment on the allegations that his client was involved in unreported expenditures for other campaigns. He also declined to comment on whether Hawkins has signed a plea agreement with federal prosecutors or whether there are any plans to do so.

Thompson’s alleged activities were often, but not always, coordinated with his longtime associate Jeanne Clarke Harris, a public relations consultant who admitted in federal court last year to participating in the shadow campaign for Gray by funneling Thompson’s money through companies she owned.

Brendan V. Sullivan Jr., an attorney for Thompson, could not be reached and generally does not comment on his cases. Harris attorney Mark H. Tuohey III did not respond to an e-mailed request for comment.

City campaign finance laws impose limits on donations and spending and require political committees to report their activities even if they are not officially coordinated with a campaign.

In recent months, prosecutors have obtained guilty pleas from two other Thompson associates who admitted being a part of what U.S. Attorney Ronald C. Machen Jr. called an “assembly line” for donations run out of Thompson’s firm.

Brown, the former council member who had been a Democrat but ran as an independent in 2008 and 2012, also admitted to secretly accepting money from Thompson. He told prosecutors that Thompson provided him with a $20,000 payment, sending it through a company Harris owned. Brown then reported it as a donation of his own money to his 2008 campaign.

Little has been publicly aired, however, about alleged illegal spending in support of other candidates Thompson favored in the years before the 2010 mayor’s race and in the 2011 at-large council contest.

The money, according to the people familiar with Thompson’s spending, allegedly went to support a variety of activities, from campaign literature and canvasser stipends to election-day food and transportation for voters and poll workers.

None of the candidates received support to the extent that Gray did, the individuals with knowledge of the expenditures said, and the candidates Thompson backed did not always win. But the alleged undisclosed assistance appears to have allowed the city businessman to skirt campaign finance limits and not reveal to incumbents that he was backing their long-shot challengers.

Federal investigators are aware of the alleged unreported spending on behalf of some of the other candidates and have reviewed receipts and other records that document some of the payments, according to two people close to the investigation. The three-year statute of limitations to file misdemeanor campaign finance charges has expired in most cases.

Cropp, the former council chairman who lost to former mayor Adrian M. Fenty (D) in the 2006 mayoral primary, said she had no knowledge of any illicit spending made by Thompson for her campaign. “We had a campaign that was above board,” she said Wednesday.

She called Thompson a “good fundraiser” for her campaign but said she was unaware of any other activities he had undertaken.

“In that campaign, I was busy,” she said. “I had never been busier. All I wanted to do was my job as chairman, and I campaigned very hard.”

Campaign finance records show that Cropp’s 2006 campaign made a series of publicly reported payments to one of Harris’s firms, Details International, totaling more than $68,000 for a wide range of services listed as advertising, campaign materials and rentals.

Off the books, the sources asserted, Thompson spent more than $100,000, covering additional costs for campaign materials and transportation for canvassers and voters.

Mara, who won the 2008 Republican primary but lost to Brown in the general election, said he was not aware of any payments Thompson made on behalf of his primary campaign.

Former council hopefuls Robinson and Long, who went on to serve as Gray’s driver during the 2010 mayoral race, did not return messages seeking comment. Smith could not be reached. Brian M. Heberlig, an attorney who represented Brown in his June guilty plea to a federal bribery charge, declined to comment because of his client’s ongoing cooperation with the government’s investigation.

Thompson, according to two people with knowledge of the arrangement, backed Orange during his 2010 run for council chairman. But the more serious effort came in 2011, the individuals said, when Orange won a special election to fill the at-large seat vacated by Kwame R. Brown (D), who had defeated Orange in the chairman’s race.

Some of the same figures known to have had roles in the Gray shadow campaign helped Orange that year, according to several individuals with direct knowledge of both campaigns.

According to interviews with several Orange campaign workers, Hawkins was a regular attendee at high-level campaign meetings, helping to organize field outreach and participating in strategy discussions. Harris, too, was seen on several occasions at the campaign’s Georgia Avenue office, several workers said. At least three other Orange 2011 staffers had also worked on the Gray shadow effort, those workers said.

Andi Pringle, a political consultant who worked for the 2011 Orange campaign, confirmed that Hawkins advised the Orange campaign and said that she saw Harris at the campaign office before the election.

Hawkins, who was employed at the time as an administrator for Union Temple Baptist Church in Anacostia, does not appear on campaign finance reports Orange filed for the 2011 campaign. Workers said Hawkins was reticent to be formally associated with the campaign, asking not to be included on mass e-mails and, in at least one instance, telling workers in a meeting they were to refer to him only as “Eugene.”

At least two Orange workers have been interviewed by federal authorities in recent months. One reported being shown invoices and receipts for political activities that were not listed in the campaign’s public financial disclosures.

Orange and his campaign aides have not been named in court documents. Orange did not respond to several phone messages and e-mails seeking comment. Joseph F. Johnson Jr., the campaign’s chairman, declined to comment.

In June, Orange acknowledged he had met with federal prosecutors about his past campaigns. “Certainly the U.S. attorney is doing their due diligence,” he said at the time.

Orange previously disclosed that, during the 2011 campaign, he accepted $26,000 in contributions, largely through money orders, that were later connected to Thompson or Harris. During his reelection campaign last year, Orange said he considered those donations — some of which featured similar handwriting and sequential serial numbers — “suspicious and questionable” upon closer examination, but he later claimed vindication after a city audit.

Federal City Council, Ralph Nader wade into ‘living wage’ debate

Federal City Council, Ralph Nader wade into ‘living wage’ debate

By Mike DeBonis, Washington Post, Updated: August 9, 2013

As the city political scene waits for the D.C. Council to send its controversial “living wage” act to Mayor Vincent C. Gray for a signature or veto, a powerful lobby has weighed in urging Hizzoner to send back the bill as soon as he gets a chance, while a legendary activist is telling him to sign away.

The Federal City Council on Friday shared a letter its chief executive, former mayor Anthony A. Williams, sent to Gray last week urging a veto. The letter was signed by Williams on behalf of 13 members of the secretive coalition of business leaders, including President Thomas M. Davis III, the former Northern Virginia congressman, and Chairman Robert J. Flanagan, an executive for the Clark construction, real-estate and investment empire.

“As business owners, operators and concerned citizens of the District of Columbia, we urge you to send a signal to the country and the world that we remain the destination for businesses, especially those that are providing opportunity and jobs in retail for those who need it most,” the letter reads.

It adds: “Arbitrary legislation like the [Large Retailer Accountability Act] that singles out one type of retailer for additional regulation creates an uncertain business climate. If the D.C. government is serious about bringing business to the city, then we need to roll out the welcome mat, not change the ground under their feet. … The LRAA will send the signal to the business community locally, nationally, and internationally that our city is ‘closed for business.’”

Williams had previously expressed personal opposition to the bill — which requires retailers with corporate sales of at least $1 billion who operate District stores of 75,000 square feet or more to pay their employees at least $12.50 hourly — in a Washington Post op-ed last month. While Williams’s opinion certainly carries influence with Gray — who has tapped the former mayor to make recommendations on revising the city tax code and to lead a search for the city’s next chief financial officer — a plea on Federal City Council letterhead lands with significant additional heft.

Washington Post Co. Chairman Donald E. Graham is a vice president of the council and a member of its executive committee, but he is not among the letter’s signatories.

On Thursday, meanwhile, legendary consumer advocate and social justice crusader Ralph Nader sent a letter to Gray urging him to sign the bill, noting that Wal-Mart is managing just fine in Canada, several provinces of which have minimum hourly wages well above the District’s $8.25.

“Walmart’s presence in jurisdictions with a minimum wage above $8.25, such as Canada,Washington, Oregon, Vermont and Santa Fe, NM, suggests that Walmart has the ability to pay its workers a minimum wage far greater than the current federal minimum wage and still make a profit.” Nader writes in the letter.

Mayoral spokesman Pedro Ribeiro said Friday that Gray has yet to receive the bill.

Gray has suggested that Council Chairman Phil Mendelson (D) is waiting to send the bill to ensure the full complement of 13 members will be available to vote on a veto override, should one be necessary. Mendelson has not denied that, with the council on summer recess, scheduling considerations are a factor.

Aetna pulls health plans from MD insurance exchange

Aetna pulls health plans from state insurance exchange

Insurer says Md.-approved rates weren’t feasible as it scrutinizes its offerings across the country

By Scott Dance, The Baltimore Sun

8:29 PM EDT, August 2, 2013

Aetna Inc. said Friday it canceled plans to sell insurance on Maryland’s new health insurance exchange, set to open Oct. 1 as part of the federal health care reform law, after regulators cut the rates it could charge consumers for its plans.

Aetna was one of several carriers poised to sell on the state’s exchange, along with Coventry Health Care, which Aetna acquired this spring. But Aetna told Maryland Insurance Commissioner Therese M. Goldsmith in a letter this week that cuts regulators made to the rates the companies had proposed "would not allow us to collect enough premiums to cover the cost of the plans."

The decision leaves the exchange with fewer choices for consumers who need to buy insurance, as required by the law, because they don’t have it now or can’t get it from their employer. But state officials said they don’t expect the loss of Aetna and Coventry to significantly reduce consumers’ options.

Officials hope the exchange will keep the cost of health insurance low for consumers with competition among the insurance carriers. And as more people enroll, costs are expected to decline.

"This is not a step that we take lightly," Aetna said in a statement. "We believe it is critical that our plans not only be competitive, but also financially viable, allowing Aetna and Coventry to meet the long-term needs of the Exchanges in which we choose to participate."

Aetna and Coventry combined insure 13,000 individual members in Maryland and 620,000 individuals nationwide. The decision does not affect coverage the insurers offer in the state through employers.

Aetna had filed a proposal with state insurance regulators to raise its rates 25.4 percent, the highest of any carrier. The rate the state approved July 26 was 29 percent lower than what Aetna sought, while other carriers saw their proposals cut back by as much as 33 percent.

State health officials estimate that 180,000 people will buy individual insurance policies from the exchange for 2014. They will largely come from the 146,078 Marylanders who currently buy in the individual market and from the estimated 740,000 uninsured people in the state.

Top state health insurance officials, including Goldsmith and Rebecca Pearce, executive director of the state exchange, Maryland Health Connection, said they were confident in the range of options that will be available on the exchange when it opens this fall. Coverage through the exchange becomes effective Jan. 1.

"Notwithstanding Aetna’s business decision not to offer products in Maryland’s individual insurance market, consumers will continue to have many choices among health insurance carriers and plan options when open enrollment begins in October," Goldsmith said in a statement.

Pearce added that the carriers’ departure does not affect an analysis showing rates on Maryland’s exchange to be competitive nationally.

"The rates are still the lowest in the country," Pearce said in an interview. "I believe the plans will be competitively priced and people will find something that’s right for them."

Insurance officials do not expect any other carriers whose rates were approved to follow Aetna.

Aetna’s decision came days after it pulled its and Coventry’s plans from Georgia’s exchange, and as its CEO expressed hesitation about participating in other exchanges around the country. The company pulled out of California’s individual insurance market earlier this year.

In a quarterly earnings conference call, Aetna CEO Mark Bertolini said the company was cautious about the rollout of the exchanges and was considering whether to cut back on its participation in them in 14 states. The company, meanwhile, plans to participate in private exchanges being run by benefits companies and is working on launching its own exchange for Aetna products.

"We are continuing to evaluate where Aetna and Coventry have submitted bids and are in the process of rationalizing our combined exchange participation," Bertolini said.

Also Friday, Coventry pulled a dental plan to be offered on Maryland’s exchange. That plan’s rates had been approved without modification.

One other insurer, a new cooperative model, said it remains committed to Maryland’s exchange.

"We are very much devoted to staying on the exchange. That’s the mission for our entire insurance company in the first place," said Dr. Peter Beilenson, president and CEO of Evergreen Health Cooperative Inc., which formed in November and plans to offer two types of plans on the exchange.

Other insurers, including CareFirst BlueCross BlueShield and Kaiser Foundation Health Plan of the Mid-Atlantic States Inc., could not be reached for comment late Friday. Nine carriers in all had proposed plans for sale on the exchange, though they were represented by five owners.

Beilenson, the former health commissioner for Baltimore and more recently for Howard County, said it was unfortunate that Aetna decided to drop out. The point of the health care law is to increase competition so consumers have more choices and more affordable care, he said.

On the other hand, he noted, Aetna’s action also means his new insurance company will have less competition.

Vincent DeMarco, president of the advocacy group Maryland Citizens Health Initiative, said Marylanders still will have plenty of choice within the exchange even without Aetna.

"There are seven carriers left providing a broad range of services, which we think are at reasonable rates, especially with the subsidy that the federal government is providing," he said. "Marylanders will be well-served."

DeMarco said he thought the commissioner did the right thing on setting rates.

"We wish as many as possible would have stayed," he said. "The point is the rates have to be fair for consumers. The commissioner came up with some fair rates."

Baltimore Sun reporter Eileen Ambrose and Reuters contributed to this article.


Washington Post: D.C. mayor poll: Vincent Gray has small lead, but many remain undecided

D.C. mayor poll: Vincent Gray has small lead, but many remain undecided

By Mike DeBonis, Updated: August 5, 2013

A recent poll commissioned by the mayoral campaign of D.C. Council member Tommy Wells shows the electorate is closely split among four top potential candidates in next year’s Democratic mayoral primary, with a third of likely voters still undecided.

In a mock primary of four likely candidates, incumbent Mayor Vincent C. Gray (D) held a small lead over the three council members who have launched mayoral campaigns — Wells (D-Ward 6), Muriel Bowser (D-Ward 4) and Jack Evans (D-Ward 2). Twenty-one percent said they would vote for Gray or would lean toward Gray if the election were held today, while 17 percent opted for Bowser, 16 percent supported Wells and 13 percent supported Evans. Thirty-one percent remain undecided.

The survey results were detailed in a July 18 memo from Wells’s pollster, Lake Research Partners, that has been shared with potential campaign funders in recent weeks. After The Washington Post obtained the pollster’s memo, the Wells campaign responded to subsequent questions from the Post about the poll’s methodology and questionnaire.

The poll of 503 likely voters in the 2014 Democratic mayoral primary was conducted between June 27 and July 1 — before three additional candidates, Reta Jo Lewis, Christian Carter and Nestor Djonkam, entered the race. The sample included both landline and mobile phones and was drawn by matching telephone numbers to lists of registered voters. Overall results carry a margin of error of plus or minus 4.4 percentage points.

Lake Research Partners is a well-respected Democratic polling firm, but the Wells poll remains a candidate-sponsored survey, meaning it should be read with the general caveat that candidate polls tend to produce more desirable results for that candidate than others.

After the initial heat, surveyors read respondents brief statements about each candidate, making note of each campaign’s likely key messages, then asked them again how they would vote. In the “informed” heat, Wells pulled even with Gray at 21 percent. Bowser gained two points, while Gray and Evans did not see any gain in support.

With a federal investigation into his 2010 campaign ongoing, Gray has not announced whether he intends to seek reelection, though he has hinted he is interested in running for a second term.

Wells’s pollster suggests in the memo that Wells is “very well positioned” in the race, with an “ability to attract additional votes in disproportionate numbers,” while Gray’s room to grow is limited, noting that only 31 percent of voters rate his job performance as excellent or good, vs. 67 percent fair or poor. In the informed heat, Wells pulled ahead in some subgroups, including those most likely to vote in the April 1 primary, adding, that a “well-resourced campaign is, of course, imperative in order to capitalize on these advantages.”

The poll stands to help Wells combat the perception that he will unable to compete with Bowser’s fundraising prowess and citywide political appeal, as well as the notion that Wells will be unable to win should Evans, another white male, remain in the race. In campaign finance reports released last week, Wells was outraised by both Bowser and Evans, but he touted his higher number of donations as indicating strong grass-roots support.

Wells said Monday that he found the poll results “very encouraging.”

“I think it shows there’s not a clear front-runner,” he said. “Undecided leads, but undecided never wins, so I feel very good about the poll.”

Capital Insight polling analyst Scott Clement contributed to this report.

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