Anda di halaman 1dari 33

March 26, 2012

#ObamaCare: No Cause For Celebration


See How The Massive, Deeply Unpopular ObamaCare Law Is Harming Every State In America
_____________________________________________________________________

ALABAMA
ObamaCare Could Cost Alabama An Additional $60 Million To $100 Million A Year. Gov. Bob Riley said the federal health care plan passed by Congress and signed by President Barack Obama could cost the state an additional $60 million to $100 million a year -- money taken from an already cashstrapped General Fund. (Sebastian Kitchen, Riley: Cost Of National Health Care Plan Too High For Alabama, The Montgomery Advertiser,
3/25/10)

ALASKA
ObamaCare To Cost The State Of Alaska $46 Million Before The End Of The Decade. (Alaska Department of
Health and Social Services, Summary Of Medicaid Requirements Included In PPACA, 8/3/10, p. 9)

Already, The [Medicaid] Cost Problem Is Huge For State Government. The cost problem is huge for state government. Of the $7.5 billion paid annually in Alaska for medical services $2 billion is paid by the state. Much of this is in the states roughly 50 percent share of Medicaid, the health program for lower-income Alaskans, but also medical benefits for public employees and retirees. Medicaid, at about $800 million a year, is the largest state budget item aside from state funding for school districts. (Tim
Bradner, Health Care Costs Are Biting Alaskans, Businesses Harder, Alaska Journal, 2/19/12)

ARIZONA
ObamaCare Rejected By A Majority At The Ballot Box Arizona Voters Supported A Ballot Initiative That Rejected ObamaCare. Proposition 106 in Arizona gained 55 percent of the vote (Sarah Kliff, Arizona And Oklahoma Vote To Reject Insurance Mandate, Politico, 11/3/10) State Employees Face Rising Premiums Arizona State Employees Told To Expect To See Their Health Insurance Costs Rise As Much As 37 Percent. State and university employees with families can expect to see their monthly health-insurance
Paid for by the Republican National Committee. 310 First Street SE - Washington, D.C. 20003 - (202) 863-8500 - www.gop.com Not authorized by any candidate or candidates committee.

RESEARCH BRIEFING

REPUBLICAN NATIONAL COMMITTEE

PAGE 2 OF 33

costs rise as much as 37 percent next year, depending on the type of plan they choose. Figures provided by the Arizona Department of Administration show that health plans for families and single adults with children will shoulder the most-expensive premium increases beginning Jan. 1, while individuals will pay modest increases. (Kent Alltucker, State Tells Employees Health Insurance Will Rocket, The Arizona Republic, 7/21/11) ObamaCare Is Responsible For Increases. Alan Ecker, Department of Administration spokesman, said health reform is responsible for all increases for employee premiums next year.
(Kent Alltucker, State Tells Employees Health Insurance Will Rocket, The Arizona Republic, 7/21/11)

Arizona Forced To Shift Costs To Employees. He noted that federal health reform passed after the Legislature approved funding for next years states health plan, so with no money left in the state coffers to cover the mandated changes to health insurance plans, the state opted to shift costs to employees. (Kent Alltucker, State Tells Employees Health Insurance Will Rocket, The Arizona Republic, 7/21/11) ObamaCare Squeezing Arizonas State Budget

The Heritage Foundation Estimates From 2014 To 2020 ObamaCare Will Cost Arizona An Additional $544.5 Million. (Edmund Haislmaier and Brian Blas, Obamacare: Impact On States, www.heritage.org, 7/1/10)

ARKANSAS
ObamaCare Squeezing Arkansas State Budget The Heritage Foundation Estimates From 2014 To 2020 ObamaCares Medicaid Expansion Will Cost Arkansas An Additional $211 Million. (Edmund Haislmaier And Brian Blas, ObamaCare: Impact On States, www.heritage.org,
7/1/10)

ObamaCare Tanning Tax Slamming Arkansas Businesses Tanning Bed Manufacturer JK North American-Sun Ergoline Announced Seven Layoffs And 36 Employees Hours Cut In Half In Response To The Tax. JK North American-Sun Ergoline, based in Jonesboro, laid off seven employees in March and put another 36 on half-time in anticipation of lower sales of tanning beds. The 150-employee company is the world's largest manufacturer of tanning beds and has weathered the run-up to the tax pretty well, said Jerry Deveney, executive director of sales.
(Charlie Frago, Jonesboro Tanning-Bed Maker Says Coming 10% Tax A Job Killer, Arkansas Democrat-Gazette, 3/27/10)

Arkansas Tanning Bed Operators Began Leaving The Business Or Reducing Orders For Beds In Anticipation Of The Tanning Tax. In January, several small tanning-bed operators in central Arkansas said they would reduce the number of beds they offered or get out of the business altogether. (Charlie Frago,
Jonesboro Tanning-Bed Maker Says Coming 10% Tax A Job Killer, Arkansas Democrat-Gazette, 3/27/10)

CALIFORNIA
Californians Facing Rising Premiums In The Last Two Years Alone, The Proportion Of State Employers Offering Coverage To Workers Fell To 63 Percent From 73 Percent, The Survey Said. (Marc Lifsher, Survey Shows California Health Care Costs Rising,
Benefits Shrinking, Los Angeles Times, 1/4/12)

36 Percent Of California Employers Are Very Or Somewhat Likely To Raise Employee Contributions For Health Insurance. Health insurance is expected to take even more money out of workers' pockets this year. The survey indicated that 36% of California firms said they were

Paid for by the Republican National Committee. 310 First Street SE - Washington, D.C. 20003 - (202) 863-8500 - www.gop.com Not authorized by any candidate or candidates committee.

RESEARCH BRIEFING

REPUBLICAN NATIONAL COMMITTEE

PAGE 3 OF 33

either very or somewhat likely to raise the amount that their staff paid in premiums in 2012.
(Marc Lifsher, Survey Shows California Health Care Costs Rising, Benefits Shrinking, Los Angeles Times, 1/4/12)

The Annual California Employer Health Benefits Survey Administered By The California Health Care Foundation Found That Cumulative Premiums Increased By Nearly 20 Percent In 2011 As Compared To Inflation. (California Employer Health Benefits Survey, California Health Care Foundation, 12/11; California Employer Health
Benefits Survey, California Health Care Foundation, 12/10)

From 2010 To 2011, Californians Saw Their Monthly Family Coverage Premiums On All Plans Increased From $1,200 to $1,310. (California Employer Health Benefits Survey, California Health Care Foundation,
12/11; California Employer Health Benefits Survey, California Health Care Foundation, 12/10)

Annual Employer Premium Contributions For Single Coverage Increased $476 From $4,737 To $5,213. (California Employer Health Benefits Survey, California Health Care Foundation, 12/11; California Employer Health Benefits
Survey, California Health Care Foundation, 12/10)

Annual Worker Premium Contributions For Family Coverage Increased $171 From $3,632 In 2010 To $3,803 In 2011. (California Employer Health Benefits Survey, California Health Care Foundation, 12/11; California
Employer Health Benefits Survey, California Health Care Foundation, 12/10)

Annual Employer Premium Contributions For Family Coverage Increased $1,156 From $10,765 In 2010 To $11,921 In 2011. (California Employer Health Benefits Survey, California Health Care Foundation,
12/11; California Employer Health Benefits Survey, California Health Care Foundation, 12/10)

ObamaCare Squeezing Californias State Budget The Heritage Foundation Estimates From 2014 To 2020 ObamaCares Medicaid Expansion Will Cost California An Additional $3.52 Billion. (Edmund Haislmaier And Brian Blas, ObamaCare: Impact On States,
www.heritage.org, 7/1/10)

High-Risk Insurance Pool Failing In California Obama Administration Report Finds That Health Care Costs For Pre-Existing Insurance Plan (PCIP) Participants Will More Than Double Initial Estimates. Medical costs for enrollees in the health-care laws high-risk insurance pools are expected to more than double initial predictions, the Obama administration said Thursday in a report on the new program. (Sarah Kliff, Per Person Cost Of Federal High-Risk
Medical Plan Doubles, The Washington Post, 2/24/12)

In California, The Program Has Cost Three Times As Much Per Enrollee Than Previously Estimated. But California's PCIP has turned out to cost three times as much per enrollee than previously estimated. The state's Managed Risk Medical Insurance Board, which administers the plan, initially figured it would have to pay $1,000 a month in claims per enrollee. New data show claims cost $3,100 per member each month, meaning that the government will have to cap California's enrollment at 6,800 unless more funds are made available. As of October, 5,290 people are signed up in the state. (Arthur Delaney, Health Care Reform Program Much Costlier Than Expected In California, Huffington
Post, 11/29/11)

HHS Was Forced To Give California An Additional $118 Million To Boost Its Pre-Existing Condition Insurance Plan. California will receive $118 million in federal funds to bolster its 2012 coverage of adults with pre-existing medical conditions. The state-run, federally funded PreExisting Condition Insurance Plan, or PCIP, was created last year to insure the uninsurable those who because of their medical conditions have been denied coverage by insurers or who have had to pay prohibitive insurance premiums to ensure they were covered. (Darrell Smith, Californias Pre-Existing
Health Condition Plan Getting New Funds, Sacramento Bee, 12/20/11)

Paid for by the Republican National Committee. 310 First Street SE - Washington, D.C. 20003 - (202) 863-8500 - www.gop.com Not authorized by any candidate or candidates committee.

RESEARCH BRIEFING

REPUBLICAN NATIONAL COMMITTEE

PAGE 4 OF 33

While Nancy Pelosis District Gets Waivers Of The 204 New Obamacare Waivers President Barack Obamas Administration Approved In April, 38 Are For Fancy Eateries, Hip Nightclubs And Decadent Hotels In House Minority Leader Nancy Pelosis Northern California District. (Matthew Boyle, Nearly 20 Percent Of New Obamacare Waivers Are Gourmet
Restaurants, Nightclubs, Fancy Hotels In Nancy Pelosis District, The Daily Caller, 5/17/11)

COLORADO
Coloradans Facing Rising Premiums In 2012, Colorado Will Receive An Average 9.4 Percent Health Insurance Premium Hike. The bad news of Colorado's average 9.4 percent hikes in health insurance premiums for next year... (Michael Booth,
Colorado's 9.4% Jump In Health Insurance Rates An Improvement Over Recent Years, The Denver Post, 10/28/11)

In 2011, Health Insurance Premiums In Colorado Increased By An Average Of 14.4 Percent. But it's a huge improvement from 14.4 percent hikes this year (Michael Booth, Colorado's 9.4% Jump In
Health Insurance Rates An Improvement Over Recent Years, The Denver Post, 10/28/11)

ObamaCare Squeezing Colorados State Budget The Heritage Foundation Estimates From 2014 To 2020 ObamaCare Will Cost Colorado An Additional $346.5 Million. (Edmund Haislmaier and Brian Blas, Obamacare: Impact On States, www.heritage.org, 7/1/10) ObamaCare Delivering A Stunning Blow To Colorado Ski Resorts ObamaCare Would Have Colorado Ski Resorts Facing A Stunning Blow Of Between $9 Million And $14 Million In Penalties Annually. The potential impact to Colorado Ski Country member areas is somewhere between $9 million and $14 million in penalties (per year), Steamboat Ski and Resort Corp. President Chris Diamond said Tuesday, citing a Colorado Ski Country USA estimate. Its a stunning blow to any large employer like ours that employs seasonal staff. (Mike Lawrence, Health Policy Raises Red Flags At
Steamboat Ski Area, Steamboat Today, 3/24/10)

Impacting An Industry That Generates Thousands Of Jobs And Over $1.7 Billion For Colorado Annually. According to a recent Colorado Travel Year Report by Longwoods International, travel spending by overnight visitors to Colorado in 2008 totaled $9.6 billion. Of that, $1.7 billion -- or 18% -- was related to skiing. Those dollars are not just generated on the slopes, but by the hotels, rental shops, restaurants and other businesses dependent on coldweather vacationers. (Bruce Kennedy, Colorado Ski Industry Generates Higher Revenues, DailyFinance.com, 3/20/10) Insurance Companies Fleeing The State

Six Insurance Companies In Colorado Have Stopped Carrying Individual Child Policies Due To Rising Costs. In the past two weeks, at least six major insurers announced they would no longer sell individual child policies in Colorado, including Aetna, Cigna, Humana and Anthem. The dispute is part of the fallout from new consumer protections that took effect Thursday as a result of federal health care reform passed in March. One key provision says that if carriers offer policies to individual children often in the case of unemployed parents seeking coverage just for their kids then they must accept previously sick children as well as healthy ones. Carriers said they couldn't afford parents' waiting until their children grew sick and then signing up for a policy. (Michael Booth, Colorado Issues Regulation Trying To Lure Back
Carriers Of Children's Health Insurance, The Denver Post, 9/24/10)

Aetna To Halt Sales Of New Insurance In Colorado. Aetna will stop selling new health insurance to
Paid for by the Republican National Committee. 310 First Street SE - Washington, D.C. 20003 - (202) 863-8500 - www.gop.com Not authorized by any candidate or candidates committee.

RESEARCH BRIEFING

REPUBLICAN NATIONAL COMMITTEE

PAGE 5 OF 33

small groups in Colorado and move companies that are existing clients off the plan in the next year, affecting 1,200 companies and 5,200 employees and their dependents. (Michael Booth, Aetna To Drop Small Groups In
Colorado, Denver Post, 9/29/10)

The Insurance Giants Decision Affects 1,200 Colorado Firms And 5,200 Insured People.
(Michael Booth, Aetna To Drop Small Groups In Colorado, Denver Post, 9/29/10)

In Colorado, World Insurance Company/American Republic Insurance Company Announced It Is Leaving The Individual Market, Citing The Companys Inability To Comply With Insurance Regulations. (Grace Marie Turned, Op-Ed, Private Health Insurers Are Being Driven Out Of The Markets, Affecting Millions, Forbes, 1/17/12)

CONNECTICUT
Premiums For Individuals Policies Rising Anthem Blue Cross And Blue Shield, Connecticuts Largest Health Insurer Said ObamaCare Raised Insurance Rates From Between 5.5 Percent To 36.4 Percent On Individual Plans Last Year. Anthem Blue Cross and Blue Shield, Connecticuts largest health insurer In September, Connecticut regulators approved Anthems request to raise rates for its non-grandfathered individual plans, effective Oct. 1, 2010. The Anthem filings show the new federal law raised rates from 5.5 percent to 36.4 percent, depending on the type of coverage. (The Truth About Health Insurance Premiums, FactCheck.org, 11/19/10) ObamaCare Squeezing Connecticuts State Budget The Heritage Foundation Estimates From 2014 To 2020 ObamaCares Medicaid Expansion Will Cost Connecticut An Additional $148.8 Million. (Edmund Haislmaier And Brian Blas, ObamaCare: Impact On States,
www.heritage.org, 7/1/10)

Hundreds Of Companies Faced With Tax Increases ObamaCare Hit 121 Connecticut Medical Device Companies And 173 Connecticut Pharmaceutical Companies With New Taxes And Fees. "The tax will affect 121 medical device manufacturers in Connecticut, according to state Department of Economic & Community Development (DECD) Managing Economist Stan McMillen, who is preparing a report on the impact of health care reform on Connecticut companies. Beginning in 2011, McMillen says, Connecticut's 173 pharmaceutical firms will be among those nationwide paying an escalating annual fee, depending on their share of the market for business they do with the government. An annual fee also will be imposed on most health-insurance companies beginning in 2014, based on national market share, for at least the next decade." (Karen Singer, "ObamaCare: This
Might Hurt," Connecticut Business News Journal, 5/10/10)

Connecticut Economist: "Everyone is going to feel some impact but these three industries have specific levies or fees." (Karen Singer, "ObamaCare: This Might Hurt," Connecticut Business News Journal, 5/10/10) Eric George, Connecticut Business & Industry Association: "[B]ut 2014 is really when we're going to see the nuts and bolts... on the short end, we are expecting higher premiums and higher taxes." (Karen Singer, "ObamaCare: This Might Hurt," Connecticut Business News Journal, 5/10/10)

DELAWARE
The Heritage Foundation Estimates From 2014 To 2020 ObamaCares Medicaid Expansion Will Cost Delaware An Additional $46.6 Million. (Edmund Haislmaier And Brian Blas, ObamaCare: Impact On States,
www.heritage.org, 7/1/10)

Paid for by the Republican National Committee. 310 First Street SE - Washington, D.C. 20003 - (202) 863-8500 - www.gop.com Not authorized by any candidate or candidates committee.

RESEARCH BRIEFING

REPUBLICAN NATIONAL COMMITTEE

PAGE 6 OF 33

FLORIDA
Floridians Facing Higher Health Care Costs In 2012, Florida Is Expected To See An 8 Percent Increase In Employer-Sponsored Health Insurance Costs. The cost for employer-sponsored health insurance in Florida is expected to increase 8 percent next year (Liz Freeman, Study: Florida Workers Face 8 Percent Health Insurance Cost Hike Or Higher Deductible, Naples News,
11/21/11)

University Of North Florida Area Director For The Small Business Development Center Says ObamaCare Insurance Reforms Will "Drive Up Premiums." "Reform contains the immediate ending of several practices health care insurance companies used to hold down costs. The law includes a requirement to cover children through age 26, ending of the rejection of people who have pre-existing medical conditions and the placement of caps on what policies pay out. 'One of the things all this will do is drive up premiums,' Hagan said." (Kevin Turner, "Health Care Reform May Not Offer Enough To Small Businesses," The Florida Times-Union,
4/25/10)

ObamaCare Squeezing Floridas State Budget In 2014, ObamaCare Will Cost Florida $142 Million. The costs of PPACA to Florida Medicaid will be significant. Florida is expected to have over 379,000 new enrollees from the expanded PPACA Medicaid population in 2014, at a cost of $1.5 billion (of which $142 million will be paid by the state), bringing the total cost of Medicaid that year to $25 billion. (SM 1854, Florida State Senate, 2/17/12) By The End Of The Decade, ObamaCare Will Cost Florida $1 Billion Annually. By 2019, Florida Medicaid will have 1.9 million additional enrollees, at an additional cost of over $7.7 billion (of which $1 billion will be paid by the state). In subsequent years, the state share may increase. (SM 1854, Florida State Senate,
2/17/12)

ObamaCare Impacting Florida Seniors Non-Partisan CBO Director Says ObamaCare Gives Less Generous Benefit Packages To Medicare Advantage Recipients Forcing Seniors To Dig Deeper Into Their Wallets. A Medicare official concedes that seniors may have to dig deeper into their wallets next year thanks to the health care law. The new analysis obtained by POLITICO finds the health care overhaul will result in increased out-ofpocket costs for seniors on Medicare Advantage plans. Richard Foster, the actuary for the Centers for Medicare and Medicaid, also tells Senate Republicans that the overhaul will result in less generous benefit packages for Medicare Advantage plans next year. Foster is independent from the administration and non-partisan. (Jennifer Haberkorn, Medicare: Reform May Cost Seniors, Politico, 10/13/10) Center For Nursing At The University Of Central Florida Survey Finds ObamaCare Contributing To An Expected Nursing Shortage Of 15,000 In Florida. A new survey shows Florida is expected to have 15,000 vacancies for registered nurses during 2012. The state's Florida Center for Nursing at the University of Central Florida issued a report on the survey Wednesday. An aging population and new requirements tied to the national health care overhaul are contributing to the shortage. (Fla. Expected To Have
15,000 Nursing Vacancies, The Associated Press, 2/23/12)

The Center Is Projecting The Shortage Will Grow To More Than 56,000 By 2025. While some recent nursing graduates have been unable to find work in isolated pockets, the statewide demand far exceeds the supply of nurses. The center was created to collect and analyze data on

Paid for by the Republican National Committee. 310 First Street SE - Washington, D.C. 20003 - (202) 863-8500 - www.gop.com Not authorized by any candidate or candidates committee.

RESEARCH BRIEFING

REPUBLICAN NATIONAL COMMITTEE

PAGE 7 OF 33

nurse supply, demand and education in Florida. It is projecting the shortage will grow to more than 56,000 by 2025. (Fla. Expected To Have 15,000 Nursing Vacancies, The Associated Press, 2/23/12) Florida Businesses Slammed By Taxes, State Waiver Denial Florida Software-Engineering Firm CEO Doesn't "See The Benefit" Of The Medical Device Tax And Says "It Will Really Hurt Device Development." "Lee Krause, chief executive officer of Melbournebased Audigence Inc., a software-engineering firm for hearing aid systems, said while the impact on the tax will not affect his company, as an entrepreneur in a medical field he sees where it might stifle innovation and research. 'In general I don't see the benefit in creating this device tax and agree it will really hurt device development,' Krause said." (Wayne T. Price, Tax A Concern In Medical Device Field, Florida Today, 4/7/10) Tanning Salon Owner In Jacksonville, FL Says Fighting The Tax Is Like "David Vs. Goliath" Because Tanning Is "Not An Extremely Lucrative Business." "Nermin Dedic, owner of Sol Us, which has seven salons in Jacksonville, describes the tanning industry's battle against the lobbying efforts of other groups as a David-versus-Goliath-type fight, in which tanning salon owners can't compete. 'It's not an extremely lucrative business,' he said. 'So we're not able to afford things like that where you have lobbyists in Congress so you can do things like plastic surgeons did in completely eliminating the Botox tax.'" (Justin Pugh,
"Tanning Salons Look At How New Taxes Will Affect Business," The Florida Times-Union, 4/25/10)

Another Florida Tanning Salon Owner Says Business Will Suffer. "Paul Abdullah, owner of Four Seasons Tan, which has two Southside locations and one in Atlantic Beach, said the tax will cause salons to suffer more than they already have in a down economy. But tanning salons are 'not Walmart,' he said. 'We can't reduce our prices and make more people come in and tan. He says the tax will hurt middle-class Americans - predominantly younger, white women - who make up the majority of his clientele, he said."
(Justin Pugh, "Tanning Salons Look At How New Taxes Will Affect Business," The Florida Times-Union, 4/25/10)

The Obama Administration Denied Floridas Request For A Waiver From ObamaCares Medical Loss Ratio Rule. The Obama administration on Thursday rejected Florida's request for a waiver from Democrats' healthcare law. Florida is the fifth state whose insurers have been denied an exemption from the medical loss ratio provision that requires them to spend at least 80 percent of premiums on medical care or give rebates to consumers. Florida had asked for an MLR adjustment allowing insurers to meet lower thresholds of 68 percent in 2011, 72 percent in 2012 and 76 percent in 2013. (Julian Pecquet, Obama
Administration Rejects Florida's Request For Health Law Waiver, The Hill, 12/15/11)

Waiver Denial Destroyed Businesses, Led To Layoffs Among Florida Insurance Agents. Naples insurance agent Mark Fiacable says a part of the federal health care act destroyed his business and caused him to lose his home. Joan Galletta, who works at a Jacksonville insurance agency, says the same provision of the law led to staff cutbacks and a co-worker who left the industry because revenue decreased. In Pompano Beach, insurance agent William Kohn says he can't afford to hire an assistant, which is affecting the quality of service at his business. They all blame their losses on a portion of the federal health care law that mandates insurance companies spend at least 80 percent of premium dollars from individual plans on medical costs. Companies that failed to meet the threshold in 2011 must issue rebates to customers this year. (Tia Mitchell,
Florida Insurance Agents Protest 'Medical Loss Ratio' Provision In Health Care Law, Tampa Bay Times, 1/7/12)

Insurance Companies Dropping Policies For Children Due To ObamaCare, UnitedHealthcare And Blue Cross Blue Shield Have Stopped Issuing New Policies That Cover Children Individually. Some major health insurance companies have stopped issuing certain types of policies for children, an unintended consequence of President Barack Obama's
Paid for by the Republican National Committee. 310 First Street SE - Washington, D.C. 20003 - (202) 863-8500 - www.gop.com Not authorized by any candidate or candidates committee.

RESEARCH BRIEFING

REPUBLICAN NATIONAL COMMITTEE

PAGE 8 OF 33

health care overhaul law, state officials said Friday. Florida Insurance Commissioner Kevin McCarty said in his state UnitedHealthcare and Blue Cross Blue Shield have stopped issuing new policies that cover children individually. (Ricardo Alonso-Zaldivar, Some Insurers Stop Writing New Coverage For Kids, The Associated Press, 7/23/10)

GEORGIA
ObamaCare Squeezing Georgias State Budget ObamaCare Will Cost Georgia $2.4 Billion In The Last Five Years Of The Decade. This expansion would go into effect in 2013, with full federal financing in 2013 and 2014. After that, the federal government would pay for 91 percent of the cost of the newly eligible population, leaving the state to pay for the remaining nine percent beginning in 2015. The Georgia Department of Community Health recently estimated that Georgias share of this expansion would cost around $2.4 billion over the fiveyear period between 2015 and 2019. (Georgians For A Healthy Future, Accessed 3/21/12) ObamaCare Harming Businesses, Costing Jobs ObamaCare Causes Piedmont Healthcare To Cut 464 Jobs. Faced with a rising number of patients and unknown impact of the new health care law, Piedmont Healthcare announced Thursday evening plans to cut 464 jobs as part of an effort to save an estimated $68 million. (Misty Williams, Piedmont Healthcare
Cutting 5 Percent Of Workforce, The Atlanta Journal-Constitution, 6/9/11)

Shannah Lane, Owner Of Tan-Tastic Tanning: At First I Thought It Was A Joke, Because I Thought Surely Theyre Not Going To Impose Such A Double Digit, Large Tax On Lower And Middle Class Women. (Tanning Salons Upset Over 10 Percent Tax On Services, WSAV NBC [Savannah, GA], 3/29/10) Insurance Companies Fleeing The State Insurance Companies Are Leaving The State. State insurance officials reported that two other companies -- American Republic and World -- have notified the state that they will leave the individual market. (Carrie Teegardin, Feds Give Georgia Insurers More Time To Comply With Health Care Law, The Atlanta Journal-Constitution, 11/8/11)

IDAHO
A Conservative Estimate Places The Cost Of ObamaCare On Idaho At $228 Million By The End Of The Decade. The requirement to maintain eligibility is costly for Idaho. In a fact sheet attached to the letter, it is revealed that keeping the requirements of the PPACA in place until 2020 will cost the Gem State an extra $228 million, though it is noted that the estimate might be on the conservative side. (Dustin
Hurst, Otter, 32 Other Governors Ask For Leniency In Upkeep Of Medicaid Program, Idaho Reporter, 1/14/11)

ILLINOIS
Caterpillar Inc. Employees Facing Higher Premiums Caterpillar Inc. Employees Will Face Increased Health Insurance Premiums As A Result Of Higher Costs Associated With The Health Care Reform Law Caterpillar Inc. employees will face increased health insurance premiums as a result of higher costs associated with the health care reform law adopted earlier this year. For some employees, premiums for family coverage will increase by $41 a month, beginning Jan. 1. Even employee-only coverage will increase $5 a month, said a memo to management and salaried personnel that went out Thursday. (Paul Gordon, Caterpillar Raising Health Care Premiums, Peoria State Journal,
10/28/10)

Paid for by the Republican National Committee. 310 First Street SE - Washington, D.C. 20003 - (202) 863-8500 - www.gop.com Not authorized by any candidate or candidates committee.

RESEARCH BRIEFING

REPUBLICAN NATIONAL COMMITTEE

PAGE 9 OF 33

ObamaCare Will Squeeze Illinois State Budget Medicaid Expansion Will Cost Illinois Billions. But the study by Rand, a nonprofit research institute based in California, indicates that Illinois will incur about $700 million in new Medicaid costs not covered by the federal government in 2016. The cost to Illinois taxpayers would ramp up to $1.3 billion annually by 2020 and total $6.2 billion between now and 2020. (Dean Olsen, Health Care Expansion To Cost Illinois, Nonpartisan Study
Finds, The Northwest Herald, 9/4/11)

Obamacare Harming Illinois Companies, Killing Jobs Abbot Laboratories Announced 1,900 Layoffs That Will Help The Abbott Park, Illinois-Based Company Cope With The U.S. Health-Care Law. Abbott Laboratories, maker of the rheumatoid arthritis drug Humira, said it will cut about 1,900 jobs as part of a restructuring of its pharmaceutical business. The cuts, amounting to 2 percent of the workforce, will help the Abbott Park, Illinois-based company cope with the U.S. health-care law passed last year, Abbott said in a statement today. The drugmaker said it would take charges of about $295 million in the coming years to transfer product manufacturing to new locations, including about $165 million this year. (Alex Nussbaum, Abbott Labs Cuts 1,900 Jobs
After Health Overhaul Prompts Restructuring, Bloomberg, 1/26/11)

Caterpillar Inc. Said Obamas Bill Would Increase Their Costs By $100 Million In First Year, Place [Them] At A Disadvantage Versus [Their] Global Competitors. Caterpillar Inc. said the health-care overhaul legislation being considered by the U.S. House would increase the companys health-care costs by more than $100 million in the first year alone. ... We can ill-afford cost increases that place us at a disadvantage versus our global competitors, said the letter signed by Gregory Folley, vice president and chief human resources officer of Caterpillar. We are disappointed that efforts at reform have not addressed the cost concerns weve raised throughout the year. (Caterpillar: Health Care Bill Would Cost It $100M, Dow
Jones Newswires, 3/19/10)

Boeing Expected To Have A $150 Million Charge In First Quarter As A Result of ObamaCare. Boeing today announced that it expects to recognize an income tax charge of approximately $150 million as a result of the recently enacted Patient Protection and Affordable Care Act, as modified by the Health Care and Education Reconciliation Act. ... The charge is expected to reduce net earnings by approximately $150 million, or $0.20 per share, in the first quarter of 2010 as an increase to income tax expense and a reduction to the deferred income tax asset. Cash impacts of this charge will be realized over many years beginning in 2013. (Boeing To Recognize Charge Associated With Health Care Law, CNBC, 3/31/10) Chicago-Based Exelon Corp. Expects $65 Million In Additional Costs Due To ObamaCare. Exelon Corp., the largest operator of nuclear plants in the United States, expects a non-cash charge of about $65 million in the first quarter of 2010 due to the recently passed healthcare reform law. The reduced income tax deductions are also estimated to increase Exelons total annual income tax expense by about $10 million to $15 million, the company said in a filing with the U.S. Securities and Exchange Commission.
(Exelon To Take $65M Hit From Healthcare Reform, Reuters, 4/1/10)

INDIANA
Indiana Facing Rising Premiums In 2011, Indiana Insurance Premiums Rose 8 Percent For Families, And 7 Percent For Individuals. An actuarial and employee benefits consultant says a survey shows Indiana health care benefits at work rose an average of 7 percent this year for single coverage and 8 percent for family coverage. The survey by the firm Nyhart found the typical Hoosier is paying $105 per month for single coverage and $417 per
Paid for by the Republican National Committee. 310 First Street SE - Washington, D.C. 20003 - (202) 863-8500 - www.gop.com Not authorized by any candidate or candidates committee.

RESEARCH BRIEFING

REPUBLICAN NATIONAL COMMITTEE

PAGE 10 OF 33

month for family coverage. Indiana employers provide an average subsidy of $364 monthly for singles and $915 for families. (Actuary: Indiana Health Care Benefit Costs Rising, The Associated Press, 9/15/11) In 2011, One In Five Indiana Employers Increased Employee Deductibles. It also found nearly one in five employers increased their deductibles. (Actuary: Indiana Health Care Benefit Costs Rising, The
Associated Press, 9/15/11)

In 2011, Mike Ripley, Vice President Of Health Care Policy At The Indiana Chamber Of Commerce, Said Anecdotally Small Businesses Expected To See Insurance Rate Hikes Of 7 To 15 Percent On Top Of Standard Increases, While Large Businesses Are Seeing 3 To 5 Percent Increases. As many businesses are rolling out their employee health insurance policies for the upcoming year, the numbers coming anecdotally to [Mike] Ripley [Vice President of health care policy at the Indiana Chamber of Commerce] are brutal. In general, large companies with more than 100 workers are reporting 3 to 5 percent hikes in health care costs on top of their normal increases. Small businesses with fewer than 100 employees are hit worse, with 7 to 15 percent jumps in addition to their traditional upticks. (Marilyn Odendahl,
Small Businesses Grapple With Rising Health Care Costs, Indiana Economic Digest, 12/12/10)

Health Insurance Plans Could Be Up To 10 Times More Expensive Next Year For Some Indiana University Employees. The School Says The Hikes Are Necessary Because Of Rising Premiums. (IU
Health Insurance Costs on The Rise, Inside Indiana Business, 10/17/11)

ObamaCare Squeezing Indianas State Budget ObamaCare Could Increase Indianas Health Spending By $3.6 Billion Dollars By 2020. Confronted by severe budget crunches because of the recession, many governors are complaining that they cannot afford to meet current obligations to fund Medicaid, the state/federal health scheme for the poornever mind the increased contributions that will come in under the law after 2014. [Mitch] Daniels, for example, claims that the new legislation will increase his states health spending by as much as $3.6 billion by 2020, a lot for a state whose entire budget is only $13 billion a year. Other Republican governors are making similar claims. (The Appeal Of Repeal, The Economist, 6/24/10) Exodus Of Insurance Companies Fleeing The State The Obama Administration Rejected Indianas Request For A Waiver From ObamaCare. The U.S. Department of Health and Human Services has rejected Indianas bid for an exemption from federal health care overhaul rules that require insurers selling policies to individuals to essentially dedicate 80 percent of the premiums they collect to medical care. In other words, business costs and profits cannot total more than 20 percent of the premiums the insurers collect, or else they must pay rebates to policyholders the following year. (Ken Kusmer, Feds Reject Indiana Request For Health Care Waiver, Insurance Journal, 11/30/11) The Indiana Department Of Insurance, Arguing The 80 Percent Rule Was Discouraging Insurers From Selling Individual Policies. The Indiana Department of Insurance, arguing the 80 percent rule was discouraging insurers from selling individual policies, requested permission to allow the companies to devote just 65 percent of premiums to medical care this year, about 69 percent next year, 72 percent in 2013 and 76 percent in 2014. (Ken Kusmer, Feds Reject Indiana Request For
Health Care Waiver, Insurance Journal, 11/30/11)

Exodus Of Insurance Companies Will Likely Result In Fewer Choices And Higher Costs For Consumers. However, consumer advocates say the exodus of Aetna and other companies likely will result in fewer choices and higher costs for consumers under health insurance exchanges to be established in 2013 under the federal health care overhaul. (Aetna Latest Out Of Ind.
Paid for by the Republican National Committee. 310 First Street SE - Washington, D.C. 20003 - (202) 863-8500 - www.gop.com Not authorized by any candidate or candidates committee.

RESEARCH BRIEFING

REPUBLICAN NATIONAL COMMITTEE

PAGE 11 OF 33

Individual Market, The Associated Press, 8/3/11)

Navistar International Corp. Has Decided To Relocate And Shut Down Its Fort Wayne Operations, Which Employs 1,400 People. Navistar International Corp. is relocating, but thats not a signal a slew of For Sale signs will sprout across Fort Wayne, housing officials say. The maker of commercial and military trucks confirmed Wednesday it will cut ties to northeast Indiana by announcing it will consolidate some operations in Lisle, Ill., and the suburban Chicago area. The companys Fort Wayne workforce includes 1,400, many of them engineers. (Paul Wyche,
Realtors Doubt Mass Exodus To Illinois, The Journal Gazette, 9/9/10)

Aetna And Cigna Corp. Have Recently Withdrawn From The Individual Health Insurance Market In Indiana. Hartford-based Aetna Inc. and Philadelphia-based Cigna Corp., which are the third- and fifth-largest health insurers respectively, have announced their departure from Indianas individual health insurance market. (J.K. Wall, Five Individual Insurers Leaving Indiana, Indianapolis Business
Journal, 8/8/11)

The Exit Of These Insurance Companies In Indiana Leaves Over 20,000 Hoosiers Without Health Care Coverage. In addition, Illinois-based Pekin Insurance, Michigan-based American Community Mutual Insurance Co. and New York-based Guardian Life Insurance Co. of America also have decided to leave the individual market. The five companies covered more than 20,000 Hoosiers, or about 10 percent of all those who have individual health insurance. (J.K. Wall, Five Individual
Insurers Leaving Indiana, Indianapolis Business Journal, 8/8/11)

IOWA
Iowans Facing Rising Premiums In 2012, Iowas Largest Health Insurer Will Impose A 9.35 Percent Increase On Individual Policyholders Premiums Who Are Under The Age Of 65. The state has approved Wellmark Blue Cross Blue Shields request for a 9.35 percent increase in individual health insurance premiums. The decision will mean rate increases of up to $45 per month beginning April 1 for 86,000 individual Wellmark policyholders ages 65 and under. (Dave DeWitte, State Approves Wellmarks 9.35% Health Insurance Premium Hike,
business380.com, 1/3/12)

ObamaCare Squeezing Iowas State Budget The Heritage Foundation Estimates From 2014 To 2020 ObamaCares Medicaid Expansion Will Cost Iowa An Additional $120 Million. (Edmund Haislmaier And Brian Blas, ObamaCare: Impact On States, www.heritage.org,
7/1/10)

ObamaCare Harming Iowa Businesses, Costing Jobs Des Moines-Based American Enterprise Groups Decision To Stop Providing Individual Insurance To Iowans Cost 40 Jobs. Des Moines-based American Enterprise Group announced Thursday that it will exit the individual major medical insurance market, making it the 13th company to pull out of some portion of Iowas health insurance business since June 2010. The move means 110 employees will lose their jobs over the next three years 40 in Des Moines and 70 in Omaha. It also underscores the widespread anxiety among insurance companies over the raft of regulation resulting from the health care overhaul bill. Its a fairly predictable consequence of the regulation, said Michael Abbott, the president and CEO of American Enterprise Group, the parent company of American Republic Insurance. The regulatory environments getting really complicated. (Iowa Insurer Exits Some Individual Health Policies, Des Moines Register,
10/20/11)

Paid for by the Republican National Committee. 310 First Street SE - Washington, D.C. 20003 - (202) 863-8500 - www.gop.com Not authorized by any candidate or candidates committee.

RESEARCH BRIEFING

REPUBLICAN NATIONAL COMMITTEE

PAGE 12 OF 33

Iowas Largest Manufacturing Employer, John Deere, Lost $150 Million In 2010 Because Of ObamaCare. Deere & Company, Iowas largest manufacturing employer, said in a statement this morning that the recently-passed health care legislation will cost the company $150 million after tax this year... Golden said Deere and other companies warned congress in a letter last December that the imposition of a tax on the prescription costs would force publicly-traded corporations like Deere to publicly account for the extra costs. Deere said the impact of the legislation had not been included in its forecast for a profit of $1.3 billion for this year... (Dan Piller, Deere Says Health Care Bill Will Cost It $150 Million, The Des Moines
Registers Green Fields Blog, 3/25/10)

ObamaCare Will Cause Vermeer Corp. To Pay 15 To 20 Percent More For Health Care Costs. Federal health care legislation will cost Vermeer Corp. in Pella an extra 15 percent to 20 percent for health care, said Mary Andringa, the companys CEO. (Jennifer Jacobs and Adam Belz, President touts jobs, knocks cynicism, Des
Moines Register, 6/28/11)

Craig Kinzer, President And General Manager Of Seaberg Industries: We Expect To See More Cost Increase Resulting From The New Health Care Requirements. We expect to see more cost increase resulting from the new health care requirements, he said. Kinzer would like to see the scope of mandated coverage reduced or see the federal government work with small business in bearing the burden. (Kurt
Allemeier, Quad-City Area Business Leaders Offer Their Advice To President Barack Obama, Quad-City Times, 6/28/11)

Bettendorf, IA Mayor And Small Business Owner: ObamaCare Has Kept His Company From Hiring. Freemire said he could have added another employee at Results Integrated Marketing and Freemire Enterprises if not for the health care law. (Jennifer Jacobs and Adam Belz, President Touts Jobs, Knocks Cynicism, Des Moines Register,
6/28/11)

Insurance Companies Flee The State At Least 13 Health Insurance Companies Have Stopped Providing Individual Insurance To Iowans. Des Moines-based American Enterprise Group announced Thursday that it will exit the individual major medical insurance market, making it the 13th company to pull out of some portion of Iowas health insurance business since June 2010. (Iowa Insurer Exits Some Individual Health Policies, Des Moines Register, 10/20/11)

KANSAS
Kansans Facing Rising Premiums This Year, Health Insurance Premiums For Kansans To Increase By Up To 9.9 Percent. Health insurance premiums for next year are still rising, but the rate of increase may be starting to slow, according to experts in the insurance field. Health insurance companies who have filed their 2012 rates with the state are reporting between 0 and 9.9 percent increases, said Linda Sheppard, director of accident and health for the Kansas Insurance Commissioner's Office. (Health Insurance Costs Rising More Slowly, The
Wichita Eagle, 11/6/11)

[The Kansas Insurance Commissioner] Recently Approved A 4% Increase By Mennonite Mutual Aid Association To Pay For The New Provisions In The Health Law. (Janet Adamy, Health Insurers Plan Hikes, The
Wall Street Journal, 9/7/10)

ObamaCare Squeezing Kansass State Budget The Heritage Foundation Estimates From 2014 To 2020 ObamaCares Medicaid Expansion Will Cost Kansas An Additional $158.0 Million. (Edmund Haislmaier And Brian Blas, ObamaCare: Impact On States, www.heritage.org,
7/1/10)

Paid for by the Republican National Committee. 310 First Street SE - Washington, D.C. 20003 - (202) 863-8500 - www.gop.com Not authorized by any candidate or candidates committee.

RESEARCH BRIEFING

REPUBLICAN NATIONAL COMMITTEE

PAGE 13 OF 33

KENTUCKY
Kentucky Facing Rising Premiums Last Year, Louisville And Lexington Faced Insurance Premiums An Average Insurance Premium Increase Of Nearly 9 Percent. According to Hewitt Associates, which combines the Louisville and Lexington markets in its local reports, annual health premiums in those markets will rise an average of 8.8 percent in 2011. (Steve Ivey, Health Reform, Aging Workers Keep Insurance Premiums Rising, Louisville Business First, 10/22/10) ObamaCare Squeezing Kentuckys State Budget Kentuckys Medicaid Crisis Will Only Worsen As Mandates In The Nations New Federal HealthCare Law Are Implemented. A new report by the Bluegrass Institute for Public Policy Solutions indicates that without thorough reform, Kentuckys Medicaid crisis will only worsen as mandates in the nations new federal health-care law are implemented. (Joe Arnold, New Report: Kentucky Medicaid Crisis Will Only Gets Worse,
WHAS 11, 6/27/11)

Kentuckys Medicaid Spending Will Increase By 70 Percent In The Next Eight Years. The report's author projects Kentucky spending 70 percent more on Medicaid out of the General Fund by 2020. (Joe Arnold, New Report: Kentucky Medicaid Crisis Will Only Gets Worse, WHAS 11, 6/27/11)

John Garen, Professor Of Economics At The University Of Kentucky: Medicaid spending has been a problem for quite some time, brought on mostly by its expansive growth over the past 25 years, and this problem will intensify under PPACA. (Joe Arnold, New Report: Kentucky Medicaid Crisis Will Only Gets Worse, WHAS 11, 6/27/11) ObamaCare Will Hurt Kentucky Hospitals, Costing Over $1 Billion Kentucky Hospitals Stand To Lose $1.2 Billion In Revenues In The Next Decade Due To ObamaCare. "The Kentucky Hospital Association said in a report on Monday that Kentucky hospitals will lose $1.2 billion in revenues in the next 10 years because of health care reform." ("Hospital Association Says State Will
Lose Under Health Care Reform," Lexington Herald-Leader, 7/19/10)

The 126 Hospitals In Kentucky Employ More Than 80,000 People And Paid $3.52 Billion In Wages And Salaries In 2008. "Kentucky hospitals play a critical role in the economy of the commonwealth. According to the report by the Kentucky Hospital Association, the 126 hospitals in the commonwealth employ more than 80,000 people and paid $3.52 billion in wages and salaries in 2008. In smaller communities, the local hospital may be one of the largest employers." (Sen. Jim
Bunning, "Kentucky Hospitals Will Be Hurt By Health Care Reform," Lexington Herald-Leader, 8/3/10)

LOUISIANA
The Heritage Foundation Estimates From 2014 To 2020 ObamaCares Medicaid Expansion Will Cost Louisiana An Additional $389.5 Million. (Edmund Haislmaier And Brian Blas, ObamaCare: Impact On States,
www.heritage.org, 7/1/10)

MAINE
Maine Small Business Owners Facing Rising Premiums Average Increases For Small Businesses In Maine, For Example, Rose 17 Percent This Year, According To State Data. (Julie Appleby, Costs Of Employer Insurance Plans Surge In 2011, Kaiser Health News, 9/27/11) ObamaCare Squeezing Maines State Budget
Paid for by the Republican National Committee. 310 First Street SE - Washington, D.C. 20003 - (202) 863-8500 - www.gop.com Not authorized by any candidate or candidates committee.

RESEARCH BRIEFING

REPUBLICAN NATIONAL COMMITTEE

PAGE 14 OF 33

The Heritage Foundation Estimates From 2014 To 2020 ObamaCare Will Cost Maine An Additional $43.4 Million. (Edmund Haislmaier and Brian Blas, Obamacare: Impact On States, www.heritage.org, 7/1/10) ObamaCare Killing Jobs Maine Concrete Business Cut Back 100 Employees, Might Not Rehire More Than 25 In Response To ObamaCare. "Such penalties make Doug Newman, owner of Newman Concrete Services in Richmond, Maine, nervous. In the past 18 months, as the economy battered the construction industry, Newman's work force shrunk from 125 employees to just 25. He is worried that once the economy turns and he begins to hire back workers, he'll face a critical decision when he nears the 50-worker mark and is no longer exempt from penalties. Newman now pays 60 percent of his employees' individual premiums and 40 percent of their family premiums. 'The 51st employee could mean $100,000 in costs. I've been calling it the concrete ceiling,' he said. 'No employer is going to hire No. 51 if it brings all these mandates down on you, because they're pretty onerous.'" (Steve LeBlanc, "Small Businesses Fret Over Details Of Health Law," The Associated Press,
3/31/10)

MARYLAND
ObamaCare Squeezes Marylands State Budget The Heritage Foundation Estimates From 2014 To 2020 ObamaCares Medicaid Expansion Will Cost Maine An Additional $43.4 Million. (Edmund Haislmaier And Brian Blas, ObamaCare: Impact On States, www.heritage.org,
7/1/10)

ObamaCare Harming Maryland Business Bethesda, MD-Based USEC Inc. Took A $6.5 Million Charge Because Of ObamaCare. "USEC Inc. today reported a net loss of $9.7 million or 9 cents per share for the quarter ended March 31, 2010, compared to a net loss of $2.1 million or 2 cents per share for the first quarter of 2009. ... The income tax provision in the three months ended March 31, 2010 was $5.4 million which included a one-time charge of $6.5 million related to the change in tax treatment of Medicare Part D reimbursements as a result of the Patient Protection and Affordable Care Act as modified by the Reconciliation Act of 2010 signed into law at the end of March 2010." ("USEC Reports First Quarter 2010 Results," Press Release, 5/4/10)

MASSACHUSETTS
Medical Device Makers Moving Jobs Offshore In Response To ObamaCare Medical Device Tax "The Medical Device Industry Is Huge In Massachusetts 225 Companies Employing About 50,000 People." (Byron York, "Scott Brown: 'It's Me Against The Machine,'" The Washington Examiner, 1/14/10) Days After Passage, A Massachusetts Medical Device Manufacturing Executive Warned The Tax Was "A Jobs Killer" That Would "Force" Jobs Overseas. "'This bill is a jobs killer,' said Ernie Whiton, chief financial officer of Chelmsford's Zoll Medical Corp., which employs about 650 people in Massachusetts. Many of those employees work in Zoll's local manufacturing facility making heart defibrillators. 'We could be forced to (move) manufacturing overseas if we can't pass along these costs to our customers,' said Whiton." (Jay Fitzgerald, "Beware The 'Jobs Killer,'" The Boston Herald, 3/25/10) Two Years Later, A Survey Of Massachusetts Medical Device Makers Show That Half Will Slash R&D And 25 Percent Will Outsource Manufacturing As A Result Of The Tax. A small survey of Massachusetts medical device makers finds that jobs and research funding are likely
Paid for by the Republican National Committee. 310 First Street SE - Washington, D.C. 20003 - (202) 863-8500 - www.gop.com Not authorized by any candidate or candidates committee.

RESEARCH BRIEFING

REPUBLICAN NATIONAL COMMITTEE

PAGE 15 OF 33

targets for cost-cutting in the face of the 2.3% medical device excise tax set to take effect in 2013 Half of the 42 senior executives surveyed in the Bay State said they would slash R&D budgets and 25% said they would cut jobs at home and outsource manufacturing to lower-cost areas. (Device Tax:
Jobs, R&D Likely Sacrifices In The Face Of Tax Burden, Survey Shows, MassDevice, 3/14/12)

Medical Device Makers In Massachusetts Are Trimming Budgets, Cutting Staff, And Raising Prices. A small survey of Massachusetts medical device makers finds that jobs and research funding are likely targets for cost-cutting in the face of the 2.3% medical device excise tax set to take effect in 2013 Half of the 42 senior executives surveyed in the Bay State said they would slash R&D budgets and 25% said they would cut jobs at home and outsource manufacturing to lower-cost areas. Nearly 45% of survey participants said they plan to pass on the cost of the tax to their customers by raising prices. (Device Tax: Jobs, R&D Likely Sacrifices In The Face Of Tax Burden, Survey Shows,
MassDevice, 3/14/12)

High-Risk Insurance Pool Failing To Enroll People In Massachusetts States Are Doing A Much Better Job Than The Federal Government At Getting Sick People Enrolled In The Healthcare Reform Law's High-Risk Pools, According To A New Report. (Julian Pecquet,
Report: States Better Than Feds In Getting Sick People Enrolled In High-Risk Pools, The Hills Health Watch, 8/26/11)

As Of Last Month, There Were Five Massachusetts Residents Enrolled. (Center For Medicaid Studies, Covering
People With Pre-Existing Conditions: Report On The Implementation And Operation Of The Pre-Existing Condition Insurance Plan Program, 2/13/12)

MICHIGAN
Michiganders Facing Higher Costs In 2011, Michigan Employees Paid A Larger Share Of Their Premiums Than In 2010. Among the changes employers continue to make as they have for many years is requiring employees to pay a higher share of the premium. The percentage of the employee contribution to the premium increased to 27 percent in 2011 from 24 percent in 2010 for both family two-person plans. (Mark Sanchez, Survey: Health
Insurance Premium Increases Moderate, Wellness Grows, Business Review West Michigan, 8/3/11)

Employers In Detroit To Face A 7.3 Percent Increase In Health Care Costs Per Employee in 2012. Detroit area employers can expect a 7.3 percent increase in health care plan costs per employee next year, a higher jump than last year and slightly outpacing the 7 percent average rise expected nationally, according to a report issued Monday by global human resource consultant Aon Hewitt. (Melissa Burden, Health
Plans To Go Up 7.3% In 2012 In Metro Detroit, The Detroit News, 9/3/11)

Detroit Employees Paying Higher Premiums In 2012. Employees in Metro Detroit, like others across the United States, also can contribute more for their health coverage in 2012. Detroit workers on average will pay a projected $2,279 in 2012 in health plan premiums, up from $2,053 in 2011. (Melissa Burden, Health Plans To Go Up 7.3% In 2012 In Metro Detroit, The Detroit News, 9/3/11) ObamaCare Squeezing Michigans State Budget

In 2014, ObamaCare Will Cost Michigan $200 Million Per Year. The 2014 Medicaid expansion would not have any initial State costs. By 2020, the State would be paying roughly $200.0 million General Fund/General Purpose (GF/GP) yearly to support the costs of the expansion. (Steve Angelotti and David Fosdick,
Fiscal Analysis Of The Federal Health Reform Legislation, Michigan Senate, 4/10)

Michigan Medical Device Manufacturer Laying Off Workers Because Of ObamaCare ObamaCares Medical Devices Tax Is Causing Michigan-Based Medical Device Manufacturer
Paid for by the Republican National Committee. 310 First Street SE - Washington, D.C. 20003 - (202) 863-8500 - www.gop.com Not authorized by any candidate or candidates committee.

RESEARCH BRIEFING

REPUBLICAN NATIONAL COMMITTEE

PAGE 16 OF 33

Stryker To Cut Five Percent Of Its Workforce Approximately 1,000 Employees. Stryker, the Kalamazoo-based maker of artificial hips and knees, will cut 5% of its global workforce by the end of next year to reduce costs in the face of new fees on device makers required by the U.S. health care law. The job cuts will reduce annual pretax operating costs by more than $100 million beginning in 2013, when the medical-device excise tax is scheduled to take effect, Stryker said Thursday in a statement. Stryker had more than 20,000 employees as of Dec. 31, according to Bloomberg News data. (Stryker To Cut 5% Of Workforce,
Detroit Free Press, 11/11/11)

MINNESOTA
ObamaCare Squeezing Minnesotas State Budget Medicaid Expansion Will Cost Minnesota's General Fund $384 Million In Its First Two Years.Gov. Mark Dayton is expected today to put an end to an eight-month discussion over whether the state should enroll thousands of low- and middle-income Minnesotans into an expanded federal health care program. Finance officials say extending benefits will cost Minnesota's general fund $384 million over the next two years -- a number they say is already factored into the state's projected $6.2 billion budget deficit.
(Tom Scheck, Dayton Set To Expand State's Medicaid Enrollment, Minnesota Public Radio, 1/5/11)

ObamaCare Hurting Minnesota Businesses 14 Percent Of Minnesotas Tanning Salons Have Gone Out Of Business, Which The Industry Says Is Due To The Additional Burden Of A 10 Percent Tax Placed On Salons Starting July 1, 2010, As Part Of The Health Care Reform Law. The recession and a still-sluggish economy have pulled many businesses under. Indoor tanning salons say they've been dealt an additional blow, courtesy of the federal government. The Indoor Tanning Association, an industry group, claims that 14 percent of tanning salons in Minnesota have gone out of business since 2009, a decline from 477 to 419. The group blames the additional burden of a 10 percent tax placed on salons starting July 1, 2010, as part of the health care reform law. (Jackie Crosby, Indoor Tanning Operators Say They're Getting Burned By Tax, Minneapolis Star Tribune, 12/16/11) Assurant Health Laid Off 130 People In Its Offices In Milwaukee And Plymouth, Minnesota As The Health Insurer Prepares For Changes Under Federal Health Care Reform. Assurant Health is eliminating 130 jobs at its offices in Milwaukee and Plymouth, Minn., by Oct. 1 as the health insurer prepares for changes under federal health care reform. The company, which sells health insurance for individuals and small employers as well as short-term policies, faces an onslaught of new federal health care reform regulations, including the requirement that it spend 80% of premiums on medical care. The new regulations under federal health care reform are expected to remake the industry, particularly for insurance sold to individuals and families and to small employers, such as those with 100 or fewer workers. (Guy Boulton, Assurant Health To Eliminate 130 Jobs, Milwaukee Journal Sentinel, 8/19/10) Prior To ObamaCares Passage, Medical Device Maker Medtronic Warned That New Taxes On Its Products Could Force It To Lay Off A Thousand Workers. Medical device maker Medtronic warned that new taxes on its products could force it to lay off a thousand workers. (Editorial, ObamaCare Day One, The Wall
Street Journal, 3/25/10)

Soon After ObamaCares Passage, Medtronic Announced 268 Layoffs In The Twin Cities. Medtronic, the world's largest medical device maker, is laying off 268 Twin Cites employees. The job cuts are part of a previously announced plan to reduce the company's overall workforce by 4 to 5 percent. (Martin Moylan, Medtronic Announces Layoffs In Twin Cities, Minnesota Public Radio, 4/27/11)

In 2011, 3M Took An $84 Million Charge As A Result Of Modifications To Medicare Part D By


Paid for by the Republican National Committee. 310 First Street SE - Washington, D.C. 20003 - (202) 863-8500 - www.gop.com Not authorized by any candidate or candidates committee.

RESEARCH BRIEFING

REPUBLICAN NATIONAL COMMITTEE

PAGE 17 OF 33

ObamaCare. The twelve-months ended December 31, 2010 includes a one-time, non-cash income tax charge of $84 million, or 12 cents per diluted share, resulting from the March 2010 enactment of the Patient Protection and Affordable Care Act, including modifications made in the Health Care and Education Reconciliation Act of 2010 (collectively, the Act). (Consolidated Statement Of Income, 3M, 1/26/12)

MISSISSIPPI
From FY 2014 To FY2020, This Dramatic Increase In Enrollment Will Cost Mississippis Taxpayers An Extra $220 Million To $250 Million A Year On Average For The Next Seven Years.
(Gov. Haley Barbour, Letter, 10/8/10)

MISSOURI
ObamaCare Overwhelmingly Rejected By Voters In 2010, Missouri Voters Overwhelmingly Approved A Measure Aimed At Nullifying The New Federal Health Care Law With 71 Percent Of The Vote. Missouri voters on Tuesday overwhelmingly approved a measure aimed at nullifying the new federal health care law, becoming the first state in the nation where ordinary people made known their dismay over the issue at the ballot box. Supporters of the measure said it would send a firm signal to Washington about how this state, often a bellwether in presidential elections, felt about such a law. The referendum drew support from 71 percent of nearly 939,000 voters. (Monica Davey, Missouri Voters Reject Health Law, The New York Times, 8/3/10) ObamaCare Squeezing Missouris State Budget The Missouri Department Of Services Projects Obamacare Will Cost Missouri $99.2 Million In 2017 And Rise 4.5 Percent Annually. Yet even the Senate appropriations figures are greater than those cited by the Missouri Department of Services. Department projections provided last week to The Associated Press show the U.S. Senate bill would expand coverage to 255,000 adults at a cost to Missouri of $99.2 million in 2017, then would increase by 4.5 percent annually. (David A. Lieb, ANALYSIS: State Republicans
oppose federal Medicaid expansion, citing high costs, The Associated Press, 1/18/10)

MONTANA
ObamaCare Squeezing Montanas State Budget The Heritage Foundation Estimates From 2014 To 2020 ObamaCares Medicaid Expansion Will Cost Montana An Additional $56.6 Million. (Edmund Haislmaier And Brian Blas, ObamaCare: Impact On States, www.heritage.org,
7/1/10)

High-Risk Insurance Pool Failing In Montana Obama Administration Report Finds That Health Care Costs For Pre-Existing Insurance Plan (PCIP) Participants Will More Than Double Initial Estimates. Medical costs for enrollees in the health-care laws high-risk insurance pools are expected to more than double initial predictions, the Obama administration said Thursday in a report on the new program. (Sarah Kliff, Per Person Cost Of Federal High-Risk
Medical Plan Doubles, The Washington Post, 2/24/12)

Montana Blew Through Its Funding And Will Need A Total $22 To $23 Million Just To Cover 2012 Costs. Montanas federally funded health insurance high risk pool for the hard-to-insure will blow through its initially allocated $16 million this year, and needs another $6 million to $7 million to cover its 2012 costs, officials said Tuesday. The $16 million, issued in mid-2010 as part
Paid for by the Republican National Committee. 310 First Street SE - Washington, D.C. 20003 - (202) 863-8500 - www.gop.com Not authorized by any candidate or candidates committee.

RESEARCH BRIEFING

REPUBLICAN NATIONAL COMMITTEE

PAGE 18 OF 33

of the federal health care-reform law, was supposed to cover costs of the subsidized health insurance program through 2013, for as many as 400 people covered by the pool. (Mike Dennison, HighRisk Insurance Pool Out Of Funds, Helena Independent Record, 1/11/12)

Montanas Program Covered Just 290 Enrollees. Montanas pool currently provides health insurance for about 290 people, who are eligible if theyve been without insurance for at least six months and have a pre-existing condition that made them uninsurable or made available insurance unaffordable. (Mike Dennison, High-Risk Insurance Pool Out Of Funds, Helena Independent Record, 1/11/12)

NEBRASKA
Nebraska Businesses Seeing Higher Health Care Costs In 2012, Nebraska Employers Expect Health Benefit Costs To Rise By More Than 7 Percent. Employers in a new survey expect health benefit costs to rise 7.1 percent in Nebraska and 4.6 percent in Iowa next year, even though at least half of them plan to trim benefits or switch coverage to control costs. That's on top of increases this year of 3.7 percent in Nebraska and 7.7 percent in Iowa, according to employers who responded to the survey. (Steve Jordon, Health Benefits To Cost More In 2012, Omaha World-Herald, 11/17/11) ObamaCare Squeezing Nebraskas State Budget A Study Showed ObamaCare Will Cost The State Of Nebraska Between $526 Million And $766 Million By The End Of The Decade. Gov. Dave Heineman today announced the results of a fiscal analysis of the new federal health care law that predicts the cost to the State of Nebraska will be between $526 million and $766 million over the next 10 years in new state funding for Medicaid programs. Conducted by an independent third party, the analysis includes fiscal year 2011 through 2020. It estimates Nebraskas new obligation for funding new and expanded Medicaid programs resulting from the federal health care law will range from $526.3 million to $765.9 million. (Gov. Dave Heineman Federal Health Care
Medicaid Expansion To Cost Nebraska $526 To $766 Million, Press Release, 8/18/10)

ObamaCare Harming Nebraska Businesses, Killing Jobs Since ObamaCare Passed, About A Hundred Tanning Businesses In Nebraska Have Had To Close And About 500 Jobs Were Lost. Bonn says that since the Federal Sales Tax was added back in 2010, about a hundred tanning businesses in Nebraska have had to close and about 500 jobs were lost. (Tanning
Salons Getting Burned On Sales Tax, KPTM, 2/1/12)

Insurance Companys Decision To Stop Providing Individual Insurance To Cost 70 Jobs In Omaha. Des Moines-based American Enterprise Group announced Thursday that it will exit the individual major medical insurance market, making it the 13th company to pull out of some portion of Iowas health insurance business since June 2010. The move means 110 employees will lose their jobs over the next three years 40 in Des Moines and 70 in Omaha. It also underscores the widespread anxiety among insurance companies over the raft of regulation resulting from the health care overhaul bill. Its a fairly predictable consequence of the regulation, said Michael Abbott, the president and CEO of American Enterprise Group, the parent company of American Republic Insurance. The regulatory environments getting really complicated. (Iowa Insurer Exits Some Individual Health Policies, Des Moines Register, 10/20/11)

NEVADA
ObamaCare Will Increase State Medicaid Costs From $5.4 Billion To $5.7 Billion Over The Period From 2014 To 2023. Under a variety of assumptions regarding the future of federal match rates for
Paid for by the Republican National Committee. 310 First Street SE - Washington, D.C. 20003 - (202) 863-8500 - www.gop.com Not authorized by any candidate or candidates committee.

RESEARCH BRIEFING

REPUBLICAN NATIONAL COMMITTEE

PAGE 19 OF 33

the newly eligible population, the legislation will increase state Medicaid costs from $5.4 billion to $5.7 billion over the period from 2014 to 2023. When added to the $11.99 billion that Nevada taxpayers are projected to spend on Medicaid over the same time period without PPACA, the total approaches $17.7 billion. (ObamaCare Will Squeeze Education, Other Needs, Nevada Business Journal, 8/11) 2010 Nevada Democratic Nominee Rory Reid (D-NV) Said ObamaCare Has The Potential To Put Significant Pressure On States Because Medicaid Rates Could Go Up Significantly. Gubernatorial candidate Rory Reid (D) said Thursday that the new health reform law could hurt Nevada. During a televised debate, Rory Reid, the son of Senate Majority Leader Harry Reid (D-Nev.), said he does not support the legal challenges against the health overhaul. Yet, he does believe that President Obamas signature achievement could negatively affect Nevada. I dont deny, however, Rory Reid said, that Nevada needs to be vigilant on this issue. The law that was passed gives time for the new system to go into effect, but there is potential for it to put significant pressure on states because Medicaid rates could go up significantly. (Bob Cusack, Rory Reid: Healthcare Reform Could End Up Hurting Nevada, The Hills HealthWatch, 10/7/10)

NEW HAMPSHIRE
New Hampshire Seeing Out Of Control Insurance Premiums In 2011, Clients Of New Hampshire-Based E&S Insurance Services Saw Health Insurance Premium Increases Between 15 And 17 Percent. Our clients are seeing increases of 1517 percent, says Eleanor Spinazzola, owner of E&S Insurance Services. She says more employers are passing on those higher costs to their employees. (Rachel Gotbaum, New Hampshires Small Employers Grapple With Higher Health Insurance Rates, NPR
State Impact, 9/30/11)

Its Out Of Control, Says Kevin Boyarsky Owner Of Print Solutions In Concord. Our Premiums Went Up 28 Percent This Year. (Rachel Gotbaum, New Hampshires Small Employers Grapple With Higher
Health Insurance Rates, NPR State Impact, 9/30/11)

In Some States Like New Hampshire, Groups Of More Than 20 Workers Have Experienced Premium Increases Of Around 20 Percent This Year, While Smaller Groups Have Seen Increases Of 40 Percent Or More. (Robert Pear, Insurers Told to Justify Rate Increases Over 10 Percent, The New York Times, 5/19/11) ObamaCare Squeezing New Hampshires State Budget ObamaCare Will Cost New Hampshire $177 Million By The End Of The Decade. Several of the health care reform proposals currently circulating in Congress would require all states to extend their Medicaid coverage to residents who earn less than 133 percent of the federal poverty level, or $29,300 for a family of four, the Concord Monitor reported. Currently, New Hampshire offers Medicaid coverage to pregnant women, low-income children and low-income parents if the family income is less than 63 percent of the poverty level, or $13,900 for a family of four. The new limit would make about 83,000 additional citizens eligible for coverage, costing the state of New Hampshire an estimated $177 million over the programs first six years, the Monitor reported. (Lauren Vespoli, Gov. Comes Out Against Expansion Of Medicaid, The Dartmouth, 10/16/09) Gov. John Lynch (D-NH) Raised Concerns About The Costs Of ObamaCare. Gov. John Lynch, D-N.H., has raised concerns about potentially costly Congressional health care reform proposals to expand Medicaid. Medicaid costs for the state have already risen due to the economic downturn, and Lynch believes they will increase further with the proposed reform measures, Collin Manning, Lynchs press secretary, said in an interview with The Dartmouth. Medicaid, the government-run insurance program for low-income individuals and families, has seen increased demand this year due to the economic
Paid for by the Republican National Committee. 310 First Street SE - Washington, D.C. 20003 - (202) 863-8500 - www.gop.com Not authorized by any candidate or candidates committee.

RESEARCH BRIEFING

REPUBLICAN NATIONAL COMMITTEE

PAGE 20 OF 33

downturn. Its a burden we simply cant absorb these costs in good times, let alone right now, Manning said. (Lauren Vespoli, Gov. Comes Out Against Expansion Of Medicaid, The Dartmouth, 10/16/09) Thousands Of New Hampshire Seniors Dropped From Medicare Advantage 7,600 New Hampshire Seniors Medicare Advantage Plans Were Discontinued Due To Pending Funding Cuts And Provisions Within The New Health Care Law. Many local Medicare Advantage users are being left in the lurch by their health plan providers. About 7,600 seniors in Rockingham, Carroll, and Hillsborough Counties received notice earlier this month that their Medicare Advantage coverage is being discontinued. New Hampshire has one of the highest percentages of Medicare Advantage enrollees in New England. Pending funding cuts and provisions within the new health care law will make it impossible for providers to continue providing Medicare Advantage plans and remain solvent, he said. (Julie Hanson, Medicare Questions Just Keep Coming, Union Leader, 11/30/11) ObamaCare Harming New Hampshire Ski Resorts ObamaCare Hits New Hampshire Ski Resorts, Which Will Face "As Much As $1 Million In Fines." "The assessment is $2,000 per employee, which, according to SkiNH lobbyist Bruce Berke and group president Alice Pearce, could mean as much as $1 million in fines to the big ski resorts, some of which hire as many as 500 seasonal workers. Also affected would be any business that hires on a seasonal basis, and, like most nationally, do not offer health insurance." (John DiStaso, "Granite Status: Ski Resorts Worry Health Care Reform Will
Have Chilling Effect," The Union Leader, 3/25/10)

Forcing New Hampshire Ski Resorts To Either Cut Jobs Or Raise Prices. Otherwise, Pearce said, it will be up to each ski resort (and presumably, seasonal attractions statewide) to figure out how to handle it. The choices are pretty clear, either increase prices or cut costs, which could mean hiring fewer workers next winter. (John DiStaso, "Granite Status: Ski Resorts Worry Health Care Reform Will Have
Chilling Effect," The Union Leader, 3/25/10)

NEW JERSEY
ObamaCare Squeezing New Jerseys State Budget The Heritage Foundation Estimates From 2014 To 2020 ObamaCares Medicaid Expansion Will Cost New Jersey An Additional $596.9 Million. (Edmund Haislmaier And Brian Blas, ObamaCare: Impact On States,
www.heritage.org, 7/1/10)

New Jersey Businesses Face New Taxes, Charges And Premium Increases Vice President Of Medical Device Firm In New Jersey Says ObamaCare's Taxes Will "Impact All Of Our Domestic Products That We Sell." "Scott Lowry, vice president and treasurer of C.R. Bard, agreed that, while the predicted benefits are in doubt, the cost of the tax is not. ... 'I think what is clear to us is that the tax is real, and it's likely to impact all of our domestic product that we sell.' Bard, a medical device maker based in Murray Hill, N.J., employed about 900 at its Queensbury facility at last report." (Scott
Donnelly, "Tax Looms For Medical Device Firms," Glens Falls Post-Star, 4/16/10)

Whitehouse Station, NJ-Based Merck & Co., Inc. Took A $146.5 Million Charge Because Of ObamaCare. "Merck & Co., Inc. today announced financial results for the first quarter of 2010. ... The effective tax rate for the first quarter of 2010 reflects the impact of a one-time charge of $146.5 million, or approximately 24 percentage points, associated with a change in tax law that requires taxation of the prescription drug subsidy of the company's retiree health benefit plans which was enacted in the first quarter of 2010 as part of U.S. health care reform legislation, as well as by the impacts of purchase
Paid for by the Republican National Committee. 310 First Street SE - Washington, D.C. 20003 - (202) 863-8500 - www.gop.com Not authorized by any candidate or candidates committee.

RESEARCH BRIEFING

REPUBLICAN NATIONAL COMMITTEE

PAGE 21 OF 33

accounting adjustments and restructuring charges." ("Merck Announces First-Quarter 2010 Financial Results," Press Release,
5/4/10)

New Jersey Small Business Owner Facing Over $70,000 In Premium Increases Has Two Choices: Dump The Benefits Or Go Broke. In recent years, the Trenton business owner has laid off one-third of his workforce, trimmed benefits and switched insurance carriers. At one point, he even wrote President Obama about his predicament but received only a polite thank you letter signed by a White House staffer. His next step may be to drop insurance altogether. With premiums for his 32 employees jumping by nearly 20 percent this year, to a total of $71,000, Balka says he faces a tough choice: Dump the benefits or go broke. (Leslie Kwoh, Small Business Owners Worry Obama Health Plan Will Do Little To Offset Rising Premiums, The Star-Ledger
[NJ], 8/2/10)

NEW MEXICO
ObamaCare Squeezing New Mexicos State Budget Estimates Place ObamaCares Costs For New Mexicos State Budget Between $194 And $278 Million By The End Of The Decade. Under this enhanced outreach scenario, Kaiser report estimates that roughly 163,000 New Mexicans would sign up for the newly expanded Medicaid vs. 111,000 under the CBO scenario. The scenario where 163,000 New Mexicans sign up would cost New Mexico the $278 million in additional spending over the six-year period, from fiscal 2014 through 2019. The scenario where 111,000 New Mexicans sign up would cost New Mexico $194 million over the same period. (Trip
Jennings, Debate Over Cost Of Medicaid Expansion To States, New Mexico Independent, 5/27/10)

New Mexico Employers Hit With Higher Premiums In 2012, New Mexico Large Employer Health Insurance Premiums Are Expected To Increase From 6 To 7 Percent. Stephen R. Byrd of the Manuel Lujan Agencies in Albuquerque said large employers in New Mexico can expect a 6 to 7 percent increase next year, absent any changes in their groups' medical history and demographics. (Winthrop Quigley, Premium Increases Slow in N.M., Albuquerque Journal, 9/28/11) In 2011, Premium Increases Have Topped Out At 8 Or 9 Percent For Some Larger [New Mexico]Companies. (Winthrop Quigley, Premium Increases Slow in N.M., Albuquerque Journal, 9/28/11) New Mexico Tanning Salon Owner Turned Into Activist Against ObamaCare New Tanning Tax Turned A New Mexico Salon Owner Into An Activist Who Says Government-Run Health Care Thwarting The American Dream. [Lisa] Rowen, who owns an indoor tanning salon in northeast Las Cruces, said she hands out fliers, posts notices at her business and is trying to spread the word on her Facebook page But she said its likely shell have to pass the cost along to customers, meaning a rate increase for customers is on the horizon. Id like to be able to absorb it, but 10 percent is a lot, said Rowen A lot of my clients feel theyre getting an unfair shake Tanning salon owners across the country have said the new tax measure will cost jobs and force some businesses to close because people may not tan as often Were just small businesses living the American Dream like everybody else, she said. (Diana Alba, Business Owners Decry Tanning Tax In Health-Care Bill, The Las Cruces Sun-News, 4/12/10) New Mexico Small Business Owner: Some Of The Taxes Ive Heard That Are Included In The Health-Care Bill Have Made It Seem Like Everything You Do Is Considered A Luxury. Honie Graham, 40, a client of Rowens, said having a suntan helps improve her appearance, and, as a small business owner, her clients perceptions are important Asked whether the new tax would curtail her visits, Graham replied: I probably wouldnt come unless it was a totally special
Paid for by the Republican National Committee. 310 First Street SE - Washington, D.C. 20003 - (202) 863-8500 - www.gop.com Not authorized by any candidate or candidates committee.

RESEARCH BRIEFING

REPUBLICAN NATIONAL COMMITTEE

PAGE 22 OF 33

occasion Graham said the impending new tax is an example of what she views as the government clamping down more on personal freedoms. Some of the taxes Ive heard that are included in the health-care bill have made it seem like everything you do is considered a luxury, she said. (Diana Alba, Business Owners Decry Tanning Tax In Health-Care Bill, The Las Cruces Sun-News, 4/12/10)

NEW YORK
New Yorkers Facing Rising Premiums This Year, New York Insurance Rates Increased On Average By 8 Percent. Its enough to make your blood pressure skyrocket. New York regulators approved hikes averaging 8 percent in health insurance premiums for next year following requests by the companies. (Carl Campanile, Health Plans Get 8% Hike, New York Post,
11/7/11)

ObamaCare Squeezing New Yorks State Budget In 2010, ObamaCare Increased New York State Spending By $300 Million. "The federal health care overhaul President Obama signed ... adds an extra $300 million to New York State's State Budget deficit. The problem involves Medicaid reimbursements that state and local governments can use to help balance their budgets..." (Adam Sichko, New Health Care Law Adds $300M To NY's Deficit," The [Albany] Business Review, 3/24/10) Former Democratic Gov. David Patterson: $1 Billion In New Annual Medicaid Costs Unacceptable. Under the Senate bill, New York will face close to $1 billion annually in new Medicaid costs. That is unacceptable. New York already sends significantly more money to Washington than it gets back. In 2008, it was $55.6 billion more, a greater deficit than any other state. The Senate bill further increases this deficit at a time when we can least afford it. (David A. Paterson, Op-Ed, Senate Bill Would Cost New York An
Extra $1 Billion, Buffalo News, 12/25/09)

ObamaCare Harming New York Businesses New York-Based Pfizer Inc. Took A $56 Million Charge Because Of ObamaCare. "Pfizer Inc. today reported financial results for first-quarter 2010. ... Revenues for first-quarter 2010 reflect a reduction of $56 million due to the recently enacted U.S. healthcare legislation." ("Pfizer Reports First-Quarter 2010 Results; Reaffirms
2010 Financial Guidance," Press Release, 5/4/10)

NORTH CAROLINA
North Carolinians Facing Rising Premiums In 2012, North Carolina Will Receive An Average 5.2 Percent Health Insurance Premium Hike. Mercer, a human-resource consulting company in Charlotte, annually tracks health-insurance charges nationwide. The survey of 86 North Carolina employers all with at least 10 employees found an average projected premium increase of 5.2 percent over 2011 costs. (Richard Craver, Employee Health Care Costs Going
Up In 2012, Winston-Salem Journal, 11/15/11)

60 Percent Of Survey Respondents Said They Are Shifting Cost To Their Employees By Raising Deductibles, Copays/Coinsurance Or Out-Of-Pocket Maximums, Increasing Employees' Share Of The Premium Contribution. Mercer said 60 percent of N.C. respondents up from 40 percent in 2011 said they are shifting cost to their employees by raising deductibles, copays/coinsurance or out-of-pocket maximums, increasing employees' share of the premium contribution, or in some other way. (Richard Craver, Employee Health Care Costs Going Up In 2012, WinstonSalem Journal, 11/15/11)

Paid for by the Republican National Committee. 310 First Street SE - Washington, D.C. 20003 - (202) 863-8500 - www.gop.com Not authorized by any candidate or candidates committee.

RESEARCH BRIEFING

REPUBLICAN NATIONAL COMMITTEE

PAGE 23 OF 33

ObamaCare Squeezing North Carolinas State Budget Obamacare Will Cost North Carolina Between $171 Million To $299 Million Each Year For The Rest Of The Decade. To help explain the benefits and costs of this expansion, the respected Kaiser Family Foundation released estimates this week about what states can expect to spend on Medicaid between 2014 and 2019 as a part of the expansion of health reform. Kaiser gives a range of figures based on expected participation in Medicaid. According to this analysis, additional costs to the state will range between $171 million to $299 million each year or between $1.02 billion and $1.8 billion between 2014 and 2019. (Adam Searing, Op-Ed, Health Reform Will Save North Carolina's Poorest, The Herald Sun, 5/10) North Carolina Businesses Hit Hard By ObamaCares Taxes North Carolina Tanning Salon Owner Calls Tanning Tax Unnerving. One industry made up of small businesses across the Carolinas is feeling burned at the news of a brand new tax. Hollywood tans in Mooresville opened two years ago. It was difficult opening during the recession, but theyve made it because of a strong customer base. Its just a little unnerving, because we are a small business and we feel like weve been targeted. Starting July first, owner Genevieve Miller and her husband, will have to pay an extra 10% tax, along with other tanning salons to help pay for the new health care bill. (Rebecca Clark,
Tan Tax Burden On Small Business, FoxCharlotte.com, 4/7/10)

Owner Of North Carolina Tanning Salon Calls Tax Pretty Devastating. Its going to be pretty devastating, in all honesty, said Paula Poole, owner of Mimis Tanning Shak in Knightdale, near Raleigh. At Mimis, a 10 percent tax would amount to $4 a month on a monthly package of $40 for unlimited sessions. Poole said she cant afford to absorb the tax herself by lowering her prices so that customers dont end up paying more. (David Ranii and Steve Lyttle, Tanning Salon Tax May Turn Some Browners Blue, The Charlotte Observer, 4/13/10)

NORTH DAKOTA
The Heritage Foundation Estimates From 2014 To 2020 ObamaCares Medicaid Expansion Will Cost North Dakota An Additional $26.5 Million. (Edmund Haislmaier And Brian Blas, ObamaCare: Impact On States,
www.heritage.org, 7/1/10)

OHIO
ObamaCare Rejected In All 88 Ohio Counties A Ballot Measure Aimed At Blocking Obamas Health Care Law Won In All 88 Ohio Counties With 66 Percent Of The Vote. A ballot measure that State Impact Ohio (a creation of local public media and NPR) describes as a referendum on a constitutional amendmentaimed at keeping the national health care reform law from taking [e]ffect won in all 88 counties in Ohio. In 81 of the counties, it won by a margin of at least 20 percentage points. Statewide, it won by 32 points (66 to 34 percent). (Jeffrey H. Anferson,
Anti-Obamacare Measure Sweeps All 88 Counties in Ohio, The Weekly Standard, 11/9/11)

Ohioans Face Rising Premiums Report Says Ohioans Who Purchase Individual Insurance Policies Could See Premiums Spike By 55 To 85 Percent When Key Provisions Of The New Federal Health-Care Law Kick In. Ohioans who buy individual insurance policies could see their premiums jump 55 to 85 percent in 2014 when key provisions of the new federal health-care law kick in, according to a new report. Rates also are expected to increase for those with employer-sponsored coverage but not nearly as much. (Catherine Candisky, Insurance
Premiums Expected To Increase, Report Says, The Columbus Dispatch, 9/20/11)

Paid for by the Republican National Committee. 310 First Street SE - Washington, D.C. 20003 - (202) 863-8500 - www.gop.com Not authorized by any candidate or candidates committee.

RESEARCH BRIEFING

REPUBLICAN NATIONAL COMMITTEE

PAGE 24 OF 33

The Analysis Found That Premiums Offered Through Small Businesses Could Increase 5 To 15 Percent. The analysis by Milliman Inc. projected that premiums on policies offered through small businesses could increase 5 to 15 percent while the cost of insurance through large employers may jump 3 to 5 percent. (Catherine Candisky, Insurance Premiums Expected To Increase, Report Says, The
Columbus Dispatch, 9/20/11)

Last Year, Health Care Costs In Southwest Ohio Continue[d] To Climb, And At A Faster Pace Than In Previous Years. Health care costs in Southwest Ohio continue to climb, and at a faster pace than in previous years, according to a new survey. On Wednesday, Employers Resource Association announced the results of its 2011 Health and Welfare Benefits Survey. (Joe Cogliano, Report: Employers Health Costs Rise At Faster Pace,
The Dayton Business Journal, 8/3/11)

3 Out Of 4 Employers Experienced An Increase In Health Care Costs, Along With 1 In 5 Who Saw An Increase Of More Than 12 Percent. More than 75 percent of the employers surveyed in this corner of the state experienced an increase in their healthcare costs, including 22 percent of respondents who saw an increase of more than 12 percent, a higher rate than in previous years.
(Joe Cogliano, Report: Employers Health Costs Rise At Faster Pace, The Dayton Business Journal, 8/3/11)

Also, Deductibles Rose, On Average, By 18 Percent From 2010 To 2011 Across All Health Plans. (Joe Cogliano, Report: Employers Health Costs Rise At Faster Pace, The Dayton Business Journal, 8/3/11) High Risk Pool Underperforming

High Risk Pools Are Costing Ohio Much More Than Initially Estimated, Covering Fewer Than Expected. The federal government allocated $5 billion to the states to create the pools. Ohio's pot of $152 million was expected to cover at least 5,000 people until 2014, when the federal reforms are expected to be fully implemented. Now we're paying actual claims and those claims have come in much higher - the loss ratio is much higher - than what had been projected, said Carrie Haughawout, assistant director for health policy for the Ohio Department of Insurance. Ohio regulators now say the program can help only 2,381 people, and with an average of 150 new enrollees each month, it could be full by next year. (Sarah Jane Tribble, Sign-Ups Capped, Rates Rising For High-Risk Insurance Pool, The Cleveland Plain Dealer, 9/11/11) ObamaCare Squeezing Ohios State Budget Ohio Taxpayers Will Spend $1.45 Billion In The Coming Years To Finance A Sharp Expansion Of The State Medicaid Program Required Under The New Federal Health-Care Law. (Catherine Candisky,
Medicaid Expansion To Cost Ohio $1.45 Billion, Columbus Dispatch, 6/23/10)

CEO Of University Hospitals In Cleveland, Ohio Warns ObamaCare Creates A Larger Burden On The States. UHs Zenty said, Even though it appears more coverage will be provided through Medicaid, that creates a larger burden on the states. And with the state of Ohios looming budget deficit, we need to be mindful of how that will be funded. (Evelyn Theiss, Health Care Bill Should Save Cleveland Hospitals Money On Treating Poor, But
Exact Amount Unclear, The Cleveland Plain Dealer, 4/7/10)

And Executive Director Of Center For Community Solutions In Cleveland, Ohio Says Ohio Will Have To Raise Taxes To Meet The Obligations Assumed In The Bill. John Begala, executive director of the nonprofit Center for Community Solutions, said preliminary analyses show that $20 billion (per year) in costs for health care reform will be divided among the 50 states, but added, The budget estimates on this bill are so convoluted its simply impossible to know more. Were already facing a $3 [billion] to $4 billion shortfall going in the next biennium. Its almost unimaginable that Ohio will be in a position three years from now to meet the
Paid for by the Republican National Committee. 310 First Street SE - Washington, D.C. 20003 - (202) 863-8500 - www.gop.com Not authorized by any candidate or candidates committee.

RESEARCH BRIEFING

REPUBLICAN NATIONAL COMMITTEE

PAGE 25 OF 33

obligations assumed in the bill without raising revenue for that purpose. (Evelyn Theiss, Health Care Bill
Should Save Cleveland Hospitals Money On Treating Poor, But Exact Amount Unclear, The Cleveland Plain Dealer, 4/7/10)

Ohio Businesses Hit Hard By ObamaCare Columbus-Based White Castle Says ObamaCare Will Consume More Than Half Of Its Profits. The White Castle hamburger chain fears that a health insurance reform law adopted earlier this year will put its profits on a downward slide. The Columbus-based family owned restaurant chain - known for serving small square hamburgers called sliders says a single provision in the bill will eat up roughly 55 percent of its yearly net income after 2014. (Sabrina Eaton, Ohio Hamburger Chain Says Insurance Reform Will Bite Into Profits, The [Cleveland]
Plain Dealer, 7/4/10)

ObamaCare Preventing White Castle From Expanding In Ohio. The financial hit will make it hard for the company to maintain its 421 restaurants, let alone create new jobs, says company spokesman Jamie Richardson. White Castle employs more than 10,000 people nationwide, and more than 1,200 in Ohio. (Sabrina Eaton, Ohio Hamburger Chain Says Insurance Reform Will Bite Into Profits, The [Cleveland] Plain
Dealer, 7/4/10)

West Chester, OH-Based AK Steel Holding Corp. Took A $31 Million Charge From ObamaCare. AK Steel Holding Corp., The third largest U.S. steelmaker by sales, said it will record a non-cash charge of about $31 million resulting from the health-care overhaul signed into law by President Barack Obama.
(AK Steel Sees $31 Million Charge From New Health Law, BusinessWeek, 3/23/10)

Ohio Industrial Manufacturer Eaton Will Take A $25 Million Charge Due To ObamaCare. Industrial company Eaton said Thursday it plans to take a $25 million charge during the first quarter due to the recently-passed health-care legislation. Eaton joined a growing list of companies detailing the financial impact of the health-care bill, which was signed into law by President Barack Obama last week. Eaton said it needs to take the non-cash charge because it wont be able to receive a subsidy for providing prescription-drug benefits to retirees. (Matt Egan, Eaton To Take $25 Million Health Care Hit, Fox Business, 4/1/10) Columbus, OH-Based American Electric Power Took A $21 Million Charge From ObamaCare. American Electric Power said Thursday its first-quarter profit dropped 4 percent as the lingering effects of the recession continue to hurt power demand. AEP recorded a $21 million charge because of the recently enacted federal health care overhaul. AEP and other companies currently receive a government subsidy to keep prescription drug benefits for retirees. They have been able to deduct their expenses, but that ends in 2013 under the recently passed legislation. (Mark Williams, AEP 1Q Earnings Drop 4 Percent, The Associated Press,
4/29/10)

In Lorain County, The Threat Alone Of ObamaCares Medical Device Tax Caused One Of Their Largest Businesses To Stop Hiring Before The Bill Was Even Passed. [I]n the short run, some of his policies could cost existing jobs, especially health-care reform, if it is enacted. One of the few large businesses that has prospered in Lorain County in recent years has been Invacare, a maker of home medical devices, such as walkers and wheelchairs The company has 1,300 employees in Lorain County but has stopped hiring in anticipation of a tax on medical devices that was proposed to help pay for the presidents health-care reform plan. (Michael A. Fletcher, Assessing Obamas Promises Of Jobs In A Hub Of Manufacturing, The
Washington Post, 1/22/10)

ObamaCare Medical Devices Tax Forced Dayton Company Into First Layoffs In Companys History. Officials with Mound Laser & Photonics Center claim the uncertainty surrounding the federal health care overhaul and its excise tax on medical devices already is hurting their business MLPC, a laser marking, engraving and etching business at the former Mound Laboratory campus, had grown rapidly in recent
Paid for by the Republican National Committee. 310 First Street SE - Washington, D.C. 20003 - (202) 863-8500 - www.gop.com Not authorized by any candidate or candidates committee.

RESEARCH BRIEFING

REPUBLICAN NATIONAL COMMITTEE

PAGE 26 OF 33

years. Last year, employment reached 42 people, while revenues soared to about $5 million, largely on the strength of health care, which accounts for about 70 percent of the companys business. But on Jan. 1, MLPC had the first layoff ever in its history, which dates back to October 1995. It cut five manufacturing jobs Dr. Larry Dosser, MLPCs president and CEO, admits he doesnt know for sure why the backlog developed. But he assigns part of the blame to the health care overhaul, including a 2.3 percent excise tax that he claims is making the United States a less hospitable place for manufacturing. (Ben Sutherly, Controversy
Rages Over Medical Device Tax, Dayton Daily News, 1/28/12)

Rob Quinn, Owner Of TANPRO Which Operates 41 Ohio Tanning Salons Said That Small Tanning Salons In Ohio Began Closing After The 2010 Federal Health Care Law Levied A 10% Tax On Tanning Services. Small tanning salons in Ohio began closing after the 2010 federal health care law levied a 10% tax on tanning services, said Rob Quinn, owner of TANPRO, a chain of 41 Ohio tanning salons. (States Eye Limits On Indoor Tans For Teens, USA Today, 3/13/12)

OKLAHOMA
Oklahomans Overwhelmingly Reject ObamaCare At The Ballot Oklahoma Overwhelmingly Supported A Ballot Initiative By A 2 To 1 Margin That Rejected ObamaCare. Oklahoma approved an opt-out ballot initiative by a 2-to-1 margin. Proposition 106 in Arizona gained 55 percent of the vote (Sarah Kliff, Arizona And Oklahoma Vote To Reject Insurance Mandate, Politico, 11/3/10) Democrat State Insurance Commissioner Says ObamaCare Could Lead To Increased Premiums Oklahoma Insurance Commissioner Kim Holland (D-OK) On Impact Of Obamacare On Insurance Rates: If Anything, Theyre Going To Go Up. Theres so much information yet to come as to how this will all take place, Insurance Commissioner Kim Holland said. Meanwhile, Holland said she doesnt see a reduction in insurance rates. If anything, theyre going to go up. (Paula Burkes, Health Cares Reform Gets Mixed
Reactions In Oklahoma, The Oklahoman, 4/18/10)

ObamaCare Squeezing Oklahomas State Budget From 2014 2023, ObamaCare Will Increase State Expenditures On Medicaid By $11.4 Billion. The report, Projecting Oklahomas Medicaid Expenditure Growth Under the Patient Protection and Affordable Care Act, estimates the required expansion will increase Oklahomas Medicaid enrollment to 36 percent of the population by 2023 and will add an additional $11.4 billion to state program expenditures between 2014 and 2023. (Medicaid Expansion Forces $11 Billion Increase In Spending, Tulsa Today, 5/18/11) Insurance Companies Dropping Policies For Children ObamaCare Is Causing Insurance Companies To Limit Childrens Health Care Coverage In Oklahoma. Some major health insurance companies have stopped issuing certain types of policies for children, an unintended consequence of President Barack Obama's health care overhaul law, state officials said Friday . . . Oklahoma Insurance Commissioner Kim Holland said a couple of local insurers in her state have done likewise. (Ricardo Alonso-Zaldivar, Some Insurers Stop Writing New Coverage For Kids, The Associated Press, 7/23/10) Holland (D): This is a Serious Enough Concern. State officials have also brought the problem to the attention of the Obama administration. "We are attempting to convince (federal officials) that this is a serious enough concern to work with (insurers) to give them some relief," Holland said. (Ricardo Alonso-Zaldivar, Some Insurers Stop Writing New Coverage For Kids, The Associated Press, 7/23/10)

Paid for by the Republican National Committee. 310 First Street SE - Washington, D.C. 20003 - (202) 863-8500 - www.gop.com Not authorized by any candidate or candidates committee.

RESEARCH BRIEFING

REPUBLICAN NATIONAL COMMITTEE

PAGE 27 OF 33

OREGON
The Heritage Foundation Estimates From 2014 To 2020 ObamaCares Medicaid Expansion Will Cost Oregon An Additional $26.5 Million. (Edmund Haislmaier And Brian Blas, ObamaCare: Impact On States, www.heritage.org,
7/1/10)

PENNSYLVANIA
ObamaCare Squeezing Pennsylvanias State Budget Bigger Increases In Medicaid Spending On The Horizon As ObamaCare Takes Effect. Medicaid enrollment in Pennsylvania is expected to grow by 2 percent over the coming budget year, according to the Department of Public Welfare, which manages Medicaid. But bigger increases are on the horizon, if and when the federal health care overhaul takes full effect, allowing more people to enroll in Medicaid come 2014. (Bill Toland, States' Medicaid Costs Still Climbing, The Pittsburgh Post-Gazette, 11/9/11) In FY2012, Medicaid Spending In Pennsylvania Will Increase 36%. Medicaid enrollment in Pennsylvania remains high, while federal spending on the low-income health program is down this fiscal year -- which means that the state share of Medicaid spending is going through the roof Meanwhile, Pennsylvania's spending on Medicaid is State Budgeted to grow from $4.5 billion in the 2010-11 fiscal year to $6.1 billion in the 2011-12 year, an increase of 36 percent. (Bill
Toland, States' Medicaid Costs Still Climbing, The Pittsburgh Post-Gazette, 11/9/11)

Businesses In Pennsylvania Hit With Increased Taxes, Costs Medical Device Manufacturer Cook Vascular Inc. Says Medical Devices Tax Will Do Far More Harm Than Good. Our company and its 170 loyal employees have weathered many economic ups and downs. Five of the original employees still work at the plant and throughout the years many households have had two generations of family members employed at our facility. Growth has come through hard work, loyalty and a companywide quest to put patients first. But that abiding mission will face one of the biggest challenges in our company's history when a new 2.3 percent federal tax on sales goes into effect in 2013. While we support efforts to increase access to medical care, reduce spending and enhance quality in American health care, this tax provision of the Patient Protection and Affordable Care Act will do far more harm than good. (Louis B. Goode, Bitter Pill For Business, Pittsburgh Post-Gazette, 8/10/11) Pennsylvania Tanning Salon Owner Says The Tax Will "Obviously... Affect Business And It's Not Going To Be For The Better." "Kim Glancy, owner of A Total Tan on East 38th Street, expects her business will survive, but she certainly doesn't expect it will improve. 'I am not happy about it,' she said. 'Obviously this is going to affect business and it's not going to be for the better.'" (Jim Martin, "Erie Tanning Salon
Owners Worry About Impact Of Tanning Tax," GoErie.com, 5/16/10)

Pennsylvania-Based Alcoa To Take $80 Million Charge Due To ObamaCare. "Alcoa said it expects to take an $80 million charge to cover costs associated with new health care legislation, according to a filing with the Securities and Exchange Commission." ("Alcoa Sees $80 Million Charge From ObamaCare," The Street.com, 4/5/10) U.S. Steel Expects To Take A $27 Million Charge Because Of ObamaCare. "United States Steel Corp. said Wednesday it expects to record a $27 million charge in the first quarter as a result of tax adjustments in the health care reform law. ... US Steel said that based on the Medicare Part D subsidies expected to be received this year, the related annual cash tax increase would be less than $10 million." ("US
Steel To Record $27M Charge For Health Care Law," The Associated Press, 4/7/10)

Pittsburgh, PA-Based Allegheny Technologies Took A $5.3 Million Charge Because Of ObamaCare.
Paid for by the Republican National Committee. 310 First Street SE - Washington, D.C. 20003 - (202) 863-8500 - www.gop.com Not authorized by any candidate or candidates committee.

RESEARCH BRIEFING

REPUBLICAN NATIONAL COMMITTEE

PAGE 28 OF 33

"Allegheny Technologies Incorporated reported net income for the first quarter 2010 of $18.2 million, or $0.18 per share. Results included a non-recurring tax charge of $5.3 million related to the recentlyenacted Patient Protection and Affordable Care Act. Excluding this non-recurring tax charge, net income was $23.5 million, or $0.24 per share, on sales of $899.4 million." (Allegheny Technologies Inc., "Allegheny Technologies
Announces First Quarter 2010 Results," Press Release, 4/28/10)

RHODE ISLAND
The Heritage Foundation Estimates From 2014 To 2020 ObamaCares Medicaid Expansion Will Cost Rhode Island An Additional $53.1 Million. (Edmund Haislmaier And Brian Blas, ObamaCare: Impact On States,
www.heritage.org, 7/1/10)

SOUTH CAROLINA
ObamaCare Will Cost South Carolina $914 By The End Of The Decade. New federal health care legislation will cost the state of South Carolina and its taxpayers $914 million. That cost - the total of spending from July 1 to 2019 The expansion represents a 4.4 percent increase in the $20.9 billion the state would have spent on Medicaid during that nine-year period, adding roughly $100 million a year to the state's costs. (John O'Connor, S.C. Medicaid Coverage To Expand; Cost To Soar By $914 Million, The State, 3/25/10)

SOUTH DAKOTA
ObamaCare To Cost South Dakota $62.6 Million By The End Of The Decade, And $36 Million Annually Thereafter. It is estimated that South Dakotas cost will increase $62.6 million from 2010 to 2019, and $36 million annually thereafter. It is further estimated that it will cost $37.1 million to cover these related administrative expenses for 2014 through 2019. (Attorney General Marty Jackley, 26 State Challenge To Federal
Healthcare Update And National Press Event Scheduled, Press Release, 3/2/12)

TENNESSEE
ObamaCare Squeezing Tennessees State Budget ObamaCare Will Cost Tennessee $1.2 Billion Over Five Years. After a lunchtime address to the Rotary Club of Nashville on education, Bredesen was asked about the health care legislation. He estimated a mandated expansion of Medicaid could cost the state as much as $1.2 billion over five years.
(Brandon Gee, Gov. Phil Bredesen Blasts Health Reform's Unbalanced Treatment Of States, Nashville Business Journal, 1/4/10)

Former Gov. Phil Bredesen (D-TN): It is a huge load on the states at a time that we are still climbing out of the recession. (Brandon Gee, Gov. Phil Bredesen Blasts Health Reform's Unbalanced Treatment Of States, Nashville Business Journal,
1/4/10)

ObamaCare Harming Tennessee Businesses, Killing Jobs Memphis-Based International Paper Took A $32 Million Charge Because Of ObamaCare. "International Paper today reported a preliminary first-quarter 2010 net loss attributable to common shareholders totaling $162 million ($0.38 per share) compared with a loss of $101 million ($0.24 per share) in the fourth quarter of 2009 and net earnings of $257 million ($0.61 per share) in the first quarter of 2009. Amounts in all periods include special items. ... Special items in the first quarter of 2010 included... post-retirement prescription drug coverage (Medicare Part D reimbursements) ($32 million)."
(International Paper, "International Paper Reports First-Quarter Earnings," Press Release, 4/29/10)

Chattanooga, TN-Based Unum Group Took A $10.2 Million Charge Because Of ObamaCare. "Employee benefits and disability insurance provider Unum Group said Tuesday its first-quarter net
Paid for by the Republican National Committee. 310 First Street SE - Washington, D.C. 20003 - (202) 863-8500 - www.gop.com Not authorized by any candidate or candidates committee.

RESEARCH BRIEFING

REPUBLICAN NATIONAL COMMITTEE

PAGE 29 OF 33

income rose 39 percent on higher revenue and an investment gain. ... They also included a $10.2 million charge linked to health care reform." ("Unum Group 1Q Profit Rises 39 Percent," The Associated Press, 5/4/10) Prior To ObamaCares Passage, Medical Device Maker Medtronic Warned That New Taxes On Its Products Could Force It To Lay Off A Thousand Workers. Medical device maker Medtronic warned that new taxes on its products could force it to lay off a thousand workers. (Editorial, ObamaCare Day One, The Wall
Street Journal, 3/25/10)

Soon After ObamaCares Passage, Medtronic Annoucned 82 Layoffs In Memphis. As part of its vast restructuring in which Medtronic Inc. (NYSE:MDT) is reducing 2,000 positions worldwide, the worlds largest medical device maker is cutting 82 jobs in Memphis, Tennessee. (Arundhati Parmar,
Medtronic Layoffs To Hit 82 In Memphis, Med City News, 6/6/11)

TEXAS
ObamaCare Squeezing Texass State Budget Texas Estimates Implementing ObamaCare Will Cost The State $27 Billion By 2024. [Texas Health And Human Services] Commissioner Tom Suehs estimates that health care reforms top-dollar items -Medicaid expansion to roughly 2.1 million Texans, plus heightened reimbursement rates for primary care physicians -- will cost the state more than $27 billion between 2014 and 2024, up $3 billion from his most recent estimate. (Emily Ramshaw, The $27 Billion Question, Texas Tribune, 4/1/10) ObamaCare Will Double the Number of People Enrolled in Texas Medicaid Program. The [Thomas M. Suehs, the commissioner of health and human services] projects that 2.3 million people will be added to the Medicaid rolls by 2023, nearly doubling the current enrollment of 3.1 million. Thanks largely to job losses during the economic downturn, enrollment has surged 12 percent in the past year. (Kevin Sack, Texas
Battles Health Law Even as It Follows It, The New York Times, 7/27/10)

State Officials Are Worried About A Doctor and Hospital Shortage. Mr. Suehs and other state officials worry about a severe shortage of doctors who are willing to accept low Medicaid payments, which the state is about to cut by 1 percent. They also are concerned about the continuing strain on hospitals from treating an estimated 800,000 uninsured illegal immigrants, who will not be eligible for subsidized coverage under the new law. (Kevin Sack, Texas Battles Health Law Even
As It Follows It, The New York Times, 7/27/10)

ObamaCare Costs Texas Companies Millions Christus Health Cut 700 Houston Jobs Given The Dramatic Changes Going On In Health Care Reform. Christus Health will cut 700 jobs from its Houston corporate offices as part of a plan announced Friday to consolidate its headquarters in Irving. McClung said consolidating will enable Christus to be more efficient and act more as one company, given the dramatic changes going on in health care reform. (Todd Ackerman, Christus To Cut 700 Jobs In Houston, The Houston Chronicle, 1/27/12) Houston, TX-Based El Paso Corporation Took An $18 Million Charge Because Of ObamaCare. El Paso Corporation is today reporting first quarter 2010 financial and operational results for the company. This increase was partially offset by $18 million of additional income tax expense due to healthcare legislation enacted in March 2010, which reduces the tax deduction for certain retiree prescription drug expenses. (El Paso Corporation Reports Strong First Quarter 2010 Results And Significant Progress Toward 2010 Objectives, Press Release, 5/6/10)

UTAH
Paid for by the Republican National Committee. 310 First Street SE - Washington, D.C. 20003 - (202) 863-8500 - www.gop.com Not authorized by any candidate or candidates committee.

RESEARCH BRIEFING

REPUBLICAN NATIONAL COMMITTEE

PAGE 30 OF 33

ObamaCare Will Cost Utah $1.2 Billion Over The Next Decade. In the GOP governors' letter to federal officials, Utah cited the overall cost to implement the Patient Protections and Affordable Care Act Medicaid provisions, totaling $1.2 billion in state general funds over ten years. The governors requested immediate action to insure states have the flexibility to control programs and make budget decisions.
(Gov. Gary Herbert, Governor Tells Feds Utah Knows Best On Healthcare Reform, Press Release, 1/18/11)

VERMONT
Vermonts State Budget Squeezed By ObamaCare The Heritage Foundation Estimates From 2014 To 2020 ObamaCares Medicaid Expansion Will Cost Vermont An Additional $20.4 Million. (Edmund Haislmaier And Brian Blas, ObamaCare: Impact On States, www.heritage.org,
7/1/10)

Federally Administered High-Risk Insurance Pool Failing In Vermont After Rejecting Vermonts Request To Run Its Own High-Risk Insurance Pool, The Department Of Health And Human Services Couldnt Enroll A Single Vermont Resident. States are doing a much better job than the federal government at getting sick people enrolled in the healthcare reform law's high-risk pools, according to a new report. The report found that enrollment figures ranged from 0 in Vermont and 1 in Massachusetts (both operated by the Department of Health and Human Services) The program has come under criticism for failing to meet expectations, with fewer than 22,000 people enrolled as of April 30, far short of the 200,000 to 350,000 that had been predicted. The program's early failure in Vermont is especially noteworthy because federal officials last year rejected two proposals by the Green Mountain State to run its own pool. Vermont had proposed expanding its existing health insurance programs or working with Blue Cross and Blue Shield to establish a new program, according to the Burlington Free Press, but HHS rejected the proposals in part because they would not have been effective soon enough to comply with the law. (Julian Pecquet, Report: States Better Than Feds In Getting Sick People Enrolled In
High-Risk Pools, The Hills Health Watch, 8/26/11)

As Of Last Month, There Were Zero Vermont Residents Enrolled. (Center For Medicaid Studies, Covering People With
Pre-Existing Conditions: Report On The Implementation And Operation Of The Pre-Existing Condition Insurance Plan Program, 2/13/12)

VIRGINIA
ObamaCare Squeezing Virginias State Budget ObamaCare Will Cost Virginia $1.47 Billion Throughout 2022. In Virginia, where officials say the overhaul will cost $1.47 billion over the next 12 years, McDonnell has called the law a historic and unfunded federal mandate on the states and Attorney General Ken Cuccinelli II has bemoaned its possible impact on the bottom line.(Rosalind S. Helderman and Aaron C. Davis, Health-Care Overhaul's Costs To Virginia And Maryland
Unclear, The Washington Posts Breaking News Blog, 6/25/10)

ObamaCare Costing Virginia Businesses Virginia's Norfolk Southern Took A $27 Million Charge For New Health Care Costs. "Norfolk Southern Corp. has announced it will pay about $27 million more in expenses for the first quarter of the year as a result of federal health care legislation signed last month. 'Under the new legislation, to the extent the corporation's future health-care drug expenses are reimbursed under the Medicare Part D retiree drug subsidy program, the reimbursed expenses will no longer be tax deductible after 2012,' the company stated in a filing Monday with the Securities and Exchange Commission." (Robert McCabe, "Norfolk
Southern To Pay $27M More After Health Care Bill," The Virginian-Pilot, 4/8/10)

Paid for by the Republican National Committee. 310 First Street SE - Washington, D.C. 20003 - (202) 863-8500 - www.gop.com Not authorized by any candidate or candidates committee.

RESEARCH BRIEFING

REPUBLICAN NATIONAL COMMITTEE

PAGE 31 OF 33

Richmond, VA-Based Brink's Took A $14 Million Charge From ObamaCare. "The Brink's Company, a global leader in security-related services, reported a first-quarter loss from continuing operations of $5 million ($.10 per share) versus income of $22 million last year ($.48 per share). Results include an income tax charge of $14 million ($.28 per share) related to recently enacted U.S. healthcare legislation."
(The Brink's Company, "Brink's Reports First-Quarter Results," Press Release, 4/29/10)

WASHINGTON
Boeing Employees Hit With Rising Premiums Boeing Notified Its 90,000 Employees That Their Health Premiums Would Increase Next Year As The Company Braces For The Impact Of President Obama's National Health Care Law. In what could be a game changer for the deadlocked Washington Senate race, Boeing notified 90,000 employees, concentrated in huge plants in Washington, that their health premiums would increase next year as the company braces for the impact of President Obama's national health care law. Citing the need to shift plans to avoid new taxes in the plan, the company will increase annual deductibles for employees' family plans by $300 to $900. (Chris Stirewalt, Today's Power Play: Boeing Health Care Notices Sting Murray, Fox News, 10/17/10) The Group Representing Boeing Along With Other Companies Estimates That Its Members Had A 9 Percent Increase In Health Plan Premiums In 2011. The National Business Group on Health, which represents large companies such as Nike, Intel, Boeing and Microsoft, estimates that its members had a 9 percent increase in health plan premiums in 2011. (Gene Mechanic, Op-Ed, Insurance Exchange Should Include Large Employers,
The Oregonian, 2/6/12)

ObamaCare Squeezing Washington States State Budget The Heritage Foundation Estimates From 2014 To 2020 ObamaCares Medicaid Expansion Will Cost Washington An Additional $330.5 Million. (Edmund Haislmaier And Brian Blas, ObamaCare: Impact On States,
www.heritage.org, 7/1/10)

ObamaCare Harming Washington State Businesses Boeing Was Forced To Recognize A $150 Million Charge Due To A Tax Hike In The Health Care Bill. Boeing (NYSE: BA) today announced that it expects to recognize an income tax charge of approximately $150 million as a result of the recently enacted Patient Protection and Affordable Care Act, as modified by the Health Care and Education Reconciliation Act. Beginning in 2013, Boeing will no longer be able to claim an income tax deduction related to prescription drug benefits provided to retirees and reimbursed under the Medicare Part D retiree drug subsidy. (Boeing Corp., Boeing To Recognize Charge Associated With Health Care Law,
Press Release, 3/31/10)

Weyerhaeuser Co. Recognized A $31 Million Charge Related To The Health Care Overhaul. Forest products maker and homebuilder Weyerhaeuser Co (WY.N) said on Thursday its first-quarter loss narrowed and it expects to make a profit in the second quarter, news that sent its shares up more than 2 percent. Excluding one-time items, such as a $31 million charge related to President Barack Obama's healthcare overhaul, the company posted a loss of 7 cents per share. (Weyerhaeuser Shares Jump After Q2 Profit
Forecast, Reuters, 4/29/10)

WEST VIRGINIA
ObamaCare Squeezing West Virginias State Budget The Heritage Foundation Estimates From 2014 To 2020 ObamaCares Medicaid Expansion Will
Paid for by the Republican National Committee. 310 First Street SE - Washington, D.C. 20003 - (202) 863-8500 - www.gop.com Not authorized by any candidate or candidates committee.

RESEARCH BRIEFING

REPUBLICAN NATIONAL COMMITTEE

PAGE 32 OF 33

Cost West Virginia An Additional $106.4 Million. (Edmund Haislmaier And Brian Blas, ObamaCare: Impact On States,
www.heritage.org, 7/1/10)

ObamaCare To Cost West Virginias Public Employees Insurance Agency Tens Of Millions Annually ObamaCare Will Cost West Virginias Public Employees Insurance Agency (PEIA) $30.1 Million In The 2011-12 Budget Year, And Will Continue To Increase Each Year, To An Estimated $38 Million In 2014-15. According to a report presented to the PEIA Finance Board on Thursday, additional benefits mandated under the federal health-care act will increase PEIAs expenses by $30.1 million in the 2011-12 budget year, and will continue to increase each year, to an estimated $38 million in 2014-15.
(Phil Kabler, Federal Health-Care Law To Cost PEIA $30 Million A Year, The Charleston Gazette, 5/20/10)

PEIA Director Ted Cheatham (D-WV): The New Health Reform Is Going To Impose $30 Million [Of Costs] On This Plan That You Havent Budgeted For... (Phil Kabler, Federal Health-Care Law To
Cost PEIA $30 Million A Year, The Charleston Gazette, 5/20/10)

WISCONSIN
ObamaCare Squeezing Wisconsins State Budget The Heritage Foundation Estimates From 2014 To 2020 ObamaCares Medicaid Expansion Will Cost Wisconsin An Additional $225.9 Million. (Edmund Haislmaier And Brian Blas, ObamaCare: Impact On States,
www.heritage.org, 7/1/10)

ObamaCare Harming Wisconsin Businesses, Costing Jobs Milwaukee Based Assurant Health Laid Off 130 People In Its Offices In Milwaukee And Plymouth, Minnesota As The Health Insurer Prepares For Changes Under Federal Health Care Reform. Assurant Health is eliminating 130 jobs at its offices in Milwaukee and Plymouth, Minn., by Oct. 1 as the health insurer prepares for changes under federal health care reform. The company, which sells health insurance for individuals and small employers as well as short-term policies, faces an onslaught of new federal health care reform regulations, including the requirement that it spend 80% of premiums on medical care. The new regulations under federal health care reform are expected to remake the industry, particularly for insurance sold to individuals and families and to small employers, such as those with 100 or fewer workers. (Guy Boulton, Assurant Health To Eliminate 130 Jobs, Milwaukee Journal Sentinel, 8/19/10) Shareholders Of Madison-Based Alliant Energy Corporation Will See Lower Profits Because Of ObamaCare. "Alliant Energy Corporation today announced first quarter consolidated earnings as follows... Non-recurring income tax impacts: In March 2010, U.S. federal healthcare legislation was enacted, which reduces Alliant Energy's, IPL's and WPL's tax deductions for retiree health care costs beginning in 2013, to the extent that prescription drug expenses are reimbursed under the Medicare Part D retiree drug subsidy program. Due to enactment of this legislation in the first quarter of 2010, Alliant Energy recorded deferred income tax expense of $0.06 per share, which consisted of deferred income tax expense of $0.03 per share for IPL and $0.03 per share for WPL." ("Alliant Energy Announces First Quarter 2010 Results,"
Press Release, 5/4/10)

WYOMING
University Of Wyoming Premiums Rising University Of Wyoming Premiums Have Risen, Forcing The University To Ask For More State Funding And Raise Fees On Employees. To cover rising health insurance premiums, the University of
Paid for by the Republican National Committee. 310 First Street SE - Washington, D.C. 20003 - (202) 863-8500 - www.gop.com Not authorized by any candidate or candidates committee.

RESEARCH BRIEFING

REPUBLICAN NATIONAL COMMITTEE

PAGE 33 OF 33

Wyoming Board of Trustees is seeking $6 million in additional state funding. The university's share of monthly premium increases will range from $104.55 to $237.30. The $6 million in additional funding will only cover part of the increase, Vinzant said. To cover the rest, certain fees will have to be raised on campus, Vinzant said. (Josh Mitchell, UW Requests $6M To Cover Increased Health Premiums, Wyoming Tribune-Eagle, 11/22/10) Wyomings State Budget Squeezed By ObamaCare ObamaCare Will Cost Wyoming $50 Million By The End Of The Decade. The study, called Medicaid Expansion in the New Health Law: Costs to the States, predicts the law will cost 118 billion dollars in the next 11 years. Wyoming's share of that is 50 million between 2014 and 2019. (Rylee DeGood, New Study Shows Big
Medicaid Cost To States, KGWN, 3/2/11)

Paid for by the Republican National Committee. 310 First Street SE - Washington, D.C. 20003 - (202) 863-8500 - www.gop.com Not authorized by any candidate or candidates committee.