The federal government is relying on an army of contractors to turn the 900-plus-page health care reform law into reality. Maximus, headquartered in Reston, Va., is one of them.
Maximus is hiring nearly 4,000 customer service representatives to staff eight call centers around the country. The workers will answer questions about the new online exchanges, which will sell health insurance. But Maximus is getting other business from the health care overhaul, according the head of the company's health services division, Bruce Caswell.
"When the Affordable Care Act first passed, we took the opportunity to look at what new opportunites were created for the company," Caswell says.
Maximus is training workers to help with the Medicaid expansion under health care reform, and it’s also doing some information technology work. Altogether, Caswell says, government health care reform contracts will contribute more than $200 million to his company’s bottom line over the next fiscal year -- 13 percent of its total revenues.
But the government isn’t the only one spending money to implement the Affordable Care Act.
“Spending by private industry and by hospitals will ultimately dwarf what the federal government is spending on administrative costs," says Dan Mendelson of Avalere Health, which tracks health care expenditures. Mendelson says health care reform requires hospitals to computerize patient records and hire extra staff to comply with mandates for improved care.
The total amount being spent on the private side to implement health care reform is hard to calculate, because so much money is being spent so quickly, according to Len Nichols, a health economist at George Mason University.
“I don’t know that anybody’s got a price tag on it, but I can assure you it’s a large number," he says. "I’m sure it’s billions.”
Nichols says that includes advertising by insurance companies marketing the policies they’ll be offering on the exchanges. We’ll start seeing those ads after Labor Day.
Reports about the use of chemical weapons near Damascus are "very troublesome," the president tells CNN. For the U.S., "core national interests" are now at stake: Syria's weapons of mass destruction must not be allowed to spread. But military action also requires international support, Obama says.
As President Obama puts pressure on colleges to keep tuition down, schools may have to get creative about finding ways to offset price increases. So while they’re looking under all the couch cushions, why not spend more of their endowments to defray tuition costs?
There are two big questions here. There’s how much of your endowment you spend every year -- usually 4 or 5 percent for colleges. And there’s what you spend it on. Hal Hartley of the Council of Independent Colleges says schools don’t have a lot of discretion there. Money is usually donated for a specific purpose.
“And the college or university is obligated by law to spend it only for that purpose,” he says. And, Hartley says, a lot of endowment money is already earmarked for scholarships.
But within many endowments, there’s a hidden world of frozen funds, designated for outdated causes, says John Thelin, the author of “The Rising Costs of Higher Education.”
“For example, say the children of veterans of a long distant war," he says. "Or if they have a scholarship that was devoted to polio research, but polio has been eradicated."
Thelin thinks a flagship state university could free up a few hundred thousand dollars by identifying unreasonable restrictions and having a court dissolve them -- but only if the school has the time and interest to prioritize the effort.
Obama and Biden will be making yet another visit to Scranton on Friday. The northeastern Pennsylvania city has become a must-stop for politicians trying to connect with working-class voters.
When Mohamed Morsi was elected to the Egyptian presidency in June, 2012, the country was in economic shambles. The political instability and occasional outbreaks of violence that followed the toppling of his predecessor, Hosni Mubarak, had eviscerated the country's tourism industry. Foreign currency reserves were dwindling, and foreign investors who fled during the popular uprising had yet to return.
In the months after his election, Morsi and his cabinet struggled to present a coherent economic program and lacked the broad popular support needed to implement even the few ideas they did have in their arsenal.
"They had no list of refoms; they had no clear social allies," says Amr Adly, a postdoctoral fellow at Stanford University's Center on Democracy, Development and the Rule of Law.
"It was a disaster," says Steve Henke, a professor of applied economics at Johns Hopkins University, of Morsi's economic record. "The Morsi government never had a credible economic plan for the economy. In fact, I don't think they knew what the word 'plan' meant."
As the deficiencies of Morsi's government became clearer, the country's foreign reserves plunged, and unemployment, inflation and black market activity rose higher. The government took a few stabs at specific economic initiatives, including an attempt to reform subsidies that cost the Egyptian government about $17 billion each year. To many they smacked of inefficacy, if not desperation.
"There is no doubt that Egypt desperately needs to reform the subsidy structure it has," says Moises Naim, a scholar at the Carnegie Endowment for International Peace. "But [Morsi] achieved nothing in terms of changing subsidies."
Naim is similarly dismissive of the Morsi administration's efforts to narrow Egypt's deficit by issuing Sukuk, or Islamic bonds, and to negotiate a $4.8 billion loan with the International Monetary Fund.
"Egypt was not giving the IMF the priority it needed," Naim says. "And negotations were just a sideshow."