Wash Post: DC Faces Projected FY 2011 Shortfall of $175M

D.C. faces projected shortfall of $175 million next year

By Nikita Stewart and Tim Craig
Washington Post Staff Writers
Monday, September 27, 2010; 9:58 PM

The D.C. government, grappling with budget shortfalls since 2008, was hit with another projected gap of $175 million for fiscal 2011 – an estimate that presents an immediate challenge for D.C. Council Chairman Vincent C. Gray, the presumptive next mayor.

Sales and income tax collections have dropped dramatically, accounting for about $100 million. Chief Financial Officer Natwar M. Gandhi said that more than half of the city’s sales tax revenue is generated by tourism, an industry that has seen an estimated decline of $52 million. Income tax revenue has declined by $69 million, he said, partly as a result of a drop in capital gains tax collections. Some of the brunt has been offset by increases in property and property transfer taxes, attributed to several large commercial sales last year.

“The national economy has caught up with the District,” Gandhi said.

Gandhi briefed Gray (D) and council member Jack Evans (D-Ward 2) Monday morning after speaking to Mayor Adrian M. Fenty (D). By Monday afternoon, City Administrator Neil Albert and the mayor’s budget chief, Merav Bushlin, were meeting with Gandhi and his staff.

“The Administration is committed to producing a balanced budget just as we have over the past 3 years, and will present a gap closing plan to council in the coming days,” Mafara Hobson, a spokeswoman for the mayor, said in an e-mail.

Although Gray defeated Fenty for the Democratic nomination for mayor, he still faces a general election, and Fenty is not leaving office until January. It will be business as usual until then, with the Fenty administration probably proposing cuts and the council weighing in.

The shortfall “is not one that I haven’t tackled,” Gray said. “I’ve been dealing with this in the last two years.”

The difference with this year’s crisis, he said, is that “we clearly have fewer options.”

On the campaign trail, Gandhi and Gray criticized the Fenty administration for dipping into the city’s reserves to balance the budget and fill previous gaps. Fenty, who promised in 2006 to propose no new taxes, stuck to that pledge, instead using rainy-day funds and raising parking meter rates and other fees.

“We are at rock bottom at emergency contingency funds,” said Gandhi, adding that about $300 million remained in the rainy-day fund.

In addition to lower-than-expected tax revenue, the 2011 budget has a shortfall of $66 million to $75 million because of spending pressures.

D.C. public schools overspent the special education budget by about $25 million to $30 million, Gandhi said. The District also did not get about $35 million in stimulus money it had budgeted for Medicaid. Gandhi is forecasting that United Medical Center, which the city took over from a for-profit company over the summer, will cost taxpayers an additional $3 million in the coming fiscal year.

Evans has been saying that residents are tapped out when it comes to fees and taxes and that it’s time for the city to make tough decisions about reducing the size of government.

“It’s much worse than we expected,” said Evans, chairman of the Committee on Finance and Revenue. “You can’t even tax your way out of this thing. We are in a position to have to make substantial cuts, and you have to make them quickly to get the full year’s bang for the cut.”

If Fenty chooses across-the-board cuts, Evans said, each agency will have to take a hit of 3 to 5 percent to their 2011 spending plans.

He said the city should consider furloughs and layoffs. “Everything is on the table,” he said.

Gray, who had tremendous backing from labor unions in his campaign, said furloughs should not be one of the few options. “Furloughs only work if you think it’s a short-term problem,” he said.

The process could be a test for Gray as well as council member Kwame R. Brown (D-At Large), the next likely council chairman. During Brown’s successful campaign for the Democratic nomination, some of his critics questioned whether he had the intellectual heft to lead the often raucous body in challenging times.

In an interview Monday, Brown said it would be premature for him to speculate on a remedy until after Fenty submits his revised spending plan. “I’m pretty sure on the table will be cuts and looking at ways to run the government more efficiently, but I am also positive there will also be revenue-enhancement proposals from different members of the council, like there are every single year,” said Brown. He said he had not decided whether he would support a tax increase.

Council members are lining up to question Gandhi’s projections.

David A. Catania (I-At Large), chairman of the Health Committee, disputes that the hospital requires an additional $3 million infusion from the city. He also said that Gandhi failed to budget for the estimated savings the city will reap this year as part of the federal health-care reform law.

Gandhi said he doesn’t think there will be substantial savings, but his stance is worsening the feud between him and Catania.

In an interview, Catania faulted Gandhi for the overspending in the schools budget, which the city’s chief financial officer oversees.

Gandhi said that he takes “full responsibility for the budget” but that he has been warning the council and mayor for years about the potential for overspending.

“It’s easy in this town to blame the CFO for everything,” he said.

stewartn@washpost.com craigt@washpost.com

Kevin S. Wrege, Esq.

President

PULSE Issues & Advocacy LLC

4410 Massachusetts Ave., NW, #150

Washington, DC 20016

Office: 202-625-1787

Mobile: 202-253-4929

Exchange Vehicle for Single Payer?

EXCHANGES A PATH TO SINGLE-PAYER? A CRS report, sent to Sen. John Cornyn Friday, has raised a few Republican eyebrows as to whether states could use their authority to exclude private insurers from health exchanges, thereby forcing the market into a single payer system. While the general conclusion is “probably not” – too many mechanisms within the law make it unlikely – expect the GOP to focus on two key sentences hinting otherwise:

–”There is no specific language in PPACA that would prohibit an exchange from denying certification to every private plan that applies if the exchange were to determine that every plan is not in the ‘interest of plan participants.’ “

–”Presumably, unless regulations dictate otherwise, the exchange could have the ability to make a determination that any or all of the private health plans seeking certification are not in the interest of qualified individuals and employers.” Full doc http://politi.co/cHrkV3

Kevin S. Wrege, Esq.

President

PULSE Issues & Advocacy LLC

4410 Massachusetts Ave., NW, #150

Washington, DC 20016

Office: 202-625-1787

Mobile: 202-253-4929

Split Views on CareFirst Medical Home Program

Two views on CareFirst doc pay plan

Friday, September 24, 2010, 10:40am EDT | Modified: Friday, September 24, 2010, 3:35pm

On Tuesday, CareFirst BlueCross BlueShield Inc. received final approvals for its Primary Care Medical Home program — a voluntary program for primary care doctors that will change how the insurance company pays them. Doctors who join get extra money from the insurance company in exchange for spending more time with chronically ill patients, writing holistic care plans and following up. They get rewarded if those patients have fewer claims than expected. (The Business Journal wrote about it in July.)

For two very different perspectives, check out The Baltimore Sun from this week. The Sun’s editorial board loves it. They say it “makes a lot of sense.” They do a good job of explaining the potential downsides too, but overall the paper endorses it as a worthy experiment that could make health care cheaper and better in Maryland.

In a response, a doctor wrote back to the Sun, calling the effort “a gimmick, good on paper but in reality impractical.” The doctor says the system will be mired in CareFirst’s “bureaucratic nightmare,” predicting that even docs who fulfill the plan’s objectives will encounter frequent ministerial or clerical problems, and be forced to fight tooth and nail for the money they’ve earned. (The writer also believes the program is fundamentally unfair, punishing or rewarding docs for their patients’ behavior away from the office.)

If you ask me, the dualing essays capture the essence of the divide between policy and reality in health care reform efforts. On paper, it doesn’t take a Ph.D. or an M.B.A. to see what’s wrong in the incentive structures in health care — and CareFirst’s program takes aim squarely at those incentive structures and hopes to fix them. But for people who try to make a living in the bizarre world of health care business, like so many overworked, frustrated primary care doctors, fixing it on paper doesn’t mean anything if they can’t trust and work productively with insurance companies, Medicare or Medicaid. For them, they’ll believe it when they see it.

Kevin S. Wrege, Esq.

President

PULSE Issues & Advocacy LLC

4410 Massachusetts Ave., NW, #150

Washington, DC 20016

Office: 202-625-1787

Mobile: 202-253-4929

DC Media: Regional Hospital Consolidations

As They Consolidate, Hospitals Get Pricier

Topics: Hospitals, Insurance, Marketplace, Health Reform

By Julie Appleby

KHN Staff Writer

Sep 26, 2010

This story was produced in collaboration with http://www.washingtonpost.com/&&http://www.washingtonpost.com/

This is part of an occasional series: Costs and Clout: Hospitals in an Age of Expensive Care

From their base in Baltimore, leaders of Johns Hopkins Medicine can see the future — and it’s at the hospital down the road.

The world-class academic medical center is reaching deep into new territory, last year acquiring a hospital in suburban Maryland and now awaiting approval to add Sibley Memorial in the District to its roster of hospitals and clinics.

The acquisitions are part of a wave — particularly in the Mid-Atlantic region — of consolidations leading to fewer independent hospitals and doctors, a trend that many industry executives say will only grow because of the health reform law.

The action in the mid-Atlantic is being watched closely, as experts say consolidation in other parts of the country has led to higher health-care prices: Size is power, and commanding market share can give hospitals an edge in negotiations with insurers. That kind of leverage mirrors the advantage many big insurers have, which has prompted complaints from doctors and hospitals. Today, tensions between hospitals and insurers are running high as both face immense pressure to contain costs.

“All the evidence very clearly shows consolidation leads to higher prices,” says Martin Gaynor, an economist at Carnegie Mellon. “Guess who pays for those higher prices? One might think insurers would eat them. No, they don’t. It goes into higher premiums. When premiums go up, employers just pass them right on to their workers, either in the form of lower wages or reduced benefits.”

The Federal Trade Commission found rapidly rising prices in some markets after hospitals joined. For example, such steep increases followed the 2000 merger of two Chicago-area hospitals that in 2008 the FTC forced the two to negotiate with insurers separately.

That same year, the FTC filed a complaint over Fairfax-based Inova Health System’s plan to merge with Prince William Health System, which included a hospital in Manassas, saying the deal would give Inova control of nearly three-quarters of the Northern Virginia market and likely drive up costs for employers, consumers and insurers. The two dropped their plans to merge shortly after and the Prince William system eventually joined with North Carolina’s Novant Health.

Hospital leaders from Baltimore to Seattle say the health law approved by Congress in March gives them even more reason to merge with or buy rivals because of its emphasis on integrated systems where hospitals and doctors better coordinate care.

Also fueling the trend: More doctors want to be employed directly by hospitals, allowing them more job security without the hassles of running a business. But hiring groups of doctors can be an “expensive and daunting proposition” for a stand-alone facility, says Steven Thompson, senior vice president for Johns Hopkins Medicine.
Nationally and locally, he says, “it’s fair to say that (independent) hospitals are talking with everyone, feeling that they don’t want to be the last one standing.”

Power Over Price

Hospitals point to the benefits of consolidation. Larger systems have an easier time getting capital for new services or equipment, such as electronic medical records. The e-records, they say, should save money over time through more efficient care and fewer medical errors.

Proponents say that savings can be achieved by what the legislation calls “accountable care organizations” or ACOs.

Rules governing ACOs are still being developed, but it is envisioned that they would include doctors, hospitals and other providers, who would be paid by Medicare to cover all enrollees in a given service area. If the ACO meets quality and cost targets, its executives and doctors would share the expected savings and possibly receive bonuses.

The ACO concept expands on models that already exist through doctor groups or managed care health plans. One well-known example is the Geisinger Health System in Pennsylvania, which provides care and offers insurance, employs doctors and runs hospitals.

For patients, an ACO could mean swifter referrals from primary doctors to specialists when needed, with less time spent tracking down test results. Those with chronic illnesses, such as asthma or heart disease, would be closely tracked, and those who are hospitalized would suffer fewer readmissions for preventable problems.

Hopkins and others see expansions as a way to position themselves to qualify as an ACO.

There’s no question that the law is driving doctors and hospitals to talk about consolidating, says Brenda Bruns, with insurer Group Health of Puget Sound, in the Seattle market. With two dominant hospital systems and a number of independent hospitals, it is similar to ones around the nation’s capital where rival facilities are expanding into the suburbs and consolidating into systems.

“The biggest issue is who will be able to partner with whom,” Bruns says. “It’s been ongoing, but the speed has increased because of the whole ACO thing.”

Some fear that if regulators aren’t careful, ACOs could also further fuel consolidation among powerful groups of hospitals and doctors that could drive up costs. By studying such alliances in California, researchers writing in the journal Health Affairs concluded that if ACOs are able to exert more market power in negotiations, “private insurers could wind up paying more, even if care is delivered more efficiently.”

Hospitals And Insurers Slug It Out

Consolidation has added to already tense relations between insurers and hospitals, as both jockey for bargaining power. Insurers are under pressure to slow double-digit premium increases — or face increased scrutiny of their rates. For hospitals, the new law not only emphasizes ACOs, it also calls for smaller Medicare rate increases in the future, offsetting some of the financial benefits of having more insured patients.

Insurers are “playing hardball,” says Chrissy Yamada, the head of finance at independent Evergreen Hospital Medical Center outside Seattle. They want rate decreases, she says, and are backing their demands with threats.

“If you don’t accept their rates the first time, they issue a termination notice,” Yamada says. “This happened twice with us this year. That’s never happened before.”

Hospitals are pushing back, and looking for bigger payment increases. “None are in the single digits,” says Andrew Oliveira, senior medical director for Aetna in the Seattle market. “We’re seeing requests for 10 percent to 40 percent.”

In North Carolina, insurer Aetna and hospital system Novant Health settled a contract dispute in late July, but only after a fight in court. Aetna sent letters to patients and doctors saying Novant was demanding a 13.5 percent increase in payments July 1, on top of a 7.7 percent increase negotiated earlier in the year. Novant fired back with a lawsuit it filed against Aetna for defamation and false advertising, also claiming that the insurer was threatening doctors with being kicked out if its network if they continued to have sole privileges at Novant hospitals.

While disputes in the nation’s capital haven’t been as public, “conversations in the District are just as contentious as they are elsewhere,” Thompson says.

Talks in Maryland are different, he says, because the state takes a larger role in rate-setting between insurers and hospitals. Since the early 1970s, a state commission has approved how much hospitals can charge for services, an effort credited with keeping cost-per-admission rates below the national average.

A ‘Domino Effect’

Thompson thinks Hopkins’ move into Sibley and its Suburban Hospital purchase in Bethesda last year could help lower costs — even as Hopkins adds programs such as expanded cancer treatment.

If Hopkins takes over Sibley, the District will be left with two independent facilities — Howard University Hospital and Children’s National Medical Center. All the other hospitals are owned by either Columbia, Md.-based MedStar Health or other systems, according to a report by the consultancy KPMG. In Maryland, the University of Maryland Medical System controls 19 percent of the state’s hospitals, followed by MedStar with 14 percent and Hopkins with 9 percent, but independents still account for 31 percent of the hospitals, KPMG found. All three systems have bought independents in Maryland in the past three years.

Although the University of Maryland Medical System and Hopkins have long been seen as rivals, John Ashworth III, Maryland’s senior vice president of network development, says the two systems’ expansions so far have played out in a complementary fashion, rather than a competitive one.

He expects continued consolidation, but says that some facilities are likely to remain independent.

“There are clearly places where remaining independent is absolutely viable,” Ashworth says. “How fast that could change over time because of a better understanding of the health reform law is hard to say.”

Nationally, mergers and acquisitions have leveled off since their peak in 2006, KPMG found. But the mid-Atlantic is bucking the trend. Virginia, for example, had 23 independent hospitals in 2005 and now has 10, according to Mark Higdon, a partner at KPMG. Excluding Sibley, the District has gone from four independents in 2004 to two.

Higdon describes the trend as “a domino effect.”

He says the nation’s capital area is “on the way to becoming a very consolidated market.” And he agrees that such consolidation could slow rising costs. While boosting market share — and gaining leverage over insurers — was a main reason hospitals consolidated 10 or 15 years ago, that is not so much the case now, Higdon says.

Payments from the government and private insurers are going to be more restrictive in the future, he says, and hospitals “have to be more efficient ….. which is one of the major benefits of a larger system.”

Thompson, at Hopkins, says the system will be able to negotiate better deals than Sibley could on its own for supplies, for example. It will also find other efficiencies, although he says he does not anticipate job losses.
Would such savings result in reduced rates to insurers?

“It could, it certainly could,” Thompson said.

The head of Seattle’s Evergreen hospital doesn’t think mergers can save money or give hospitals more negotiating clout with insurers.

“For all the costs you jettison for economies of scale,” Bob Malte says, “you get new costs for being a system.”

And while some hospitals consolidate to better their hand when negotiating rates with insurers, Malte says, “that’s the least noble and least appropriate reason to come together if we’re all trying to lower the cost of care.”

Kaiser Health News reporter Christopher Weaver contributed to this report.

Kevin S. Wrege, Esq.

President

PULSE Issues & Advocacy LLC

4410 Massachusetts Ave., NW, #150

Washington, DC 20016

Office: 202-625-1787

Mobile: 202-253-4929

DC Health Insurance Exchange Subcommittee Meeting

This is a reminder that the Health Reform Implementation Committee’s (HRIC) Health Insurance Exchange Subcommittee is meeting Thursday, September 30th from 3:30 to 5:00 in the Department of Health Care Finance’s (DHCF) office (825 N. Capitol St NE). The meeting will be held on the 6th Floor in Conference Room 1.

Here is the list of people that have asked to be on the Subcommittee:

Name Organization
Atiba Madyun The Madyun Group
Janice Haynes Davis DC Association of Insurance Advisors
Howard Liebers DC Primary Care Association
Vincent A. Keane Unity Health Care, Inc.
Erling Hansen, Esq. Quadrus
Larry Berman NCQA
Kevin S. Wrege, Esq. PULSE Issues & Advocacy, LLC
Tom Seltz Marvin Address & Associates, Inc.
Barbara Raskin
Melissa Bishop Murphy Pfizer
Warner H. Session, Esq. Session Law Firm
Dione Dillard HMS, Inc.
Kristen Ballentine HMS, Inc.
Louis Davis AARP
Wayne McOwen D.C. Insurance Federation
Stefanie Jones DCHA
Clarence Brewton Washington Hospital Center
Below is a DRAFT of the agenda. We are assuming that we will spend a significant portion of the meeting discussing process and the charge of the subcommittee since this will be the first meeting.

I. Introductions

II. Subcommittee Charge

III. Subcommittee Process

IV. Exchange Implementation Planning Activities

V. Discussion on Topic 1: Background Research

VI. Next Steps

John McCarthy

Deputy Director

D.C. Department of Health Care Finance

825 North Capitol Street, NE Suite 6000

Washington, DC 20002-4210

202-442-5988 (voice)

202-380-6899 (cell)

202-442-4790 (fax)

John.McCarthy@dc.gov

Kevin S. Wrege, Esq.

President

PULSE Issues & Advocacy LLC

4410 Massachusetts Ave., NW, #150

Washington, DC 20016

Office: 202-625-1787

Mobile: 202-253-4929

20 September, 2010 23:19

Health insurance to cost more across region

By: Liz Farmer
September 17, 2010

Residents in the Washington area can expect to pay more for their health care as the federal health legislation takes effect in the coming months.

Many insurers have asked regulators in Maryland, Virginia and the District of Columbia to allow them to raise their rates, with D.C. carriers asking for the largest increases, between 7 and 13 percent.

Companies in Virginia are asking for rate increases from 1 to 10 percent, with most requests between 5 and 9 percent.

In Maryland, where health care already is heavily regulated, insurance officials said one request related to the federal overhaul has been filed — CareFirst’s health maintenance organization carrier, BlueChoice has asked for a 10 percent increase in individual plan rates because of the elimination of limits on prescription drug coverage.

Acting Maryland Insurance Administration Commissioner Elizabeth Sammis said the rate, which was approved, affects about 1 percent of the 172,000 Marylanders who buy individual coverage.

She said while other companies have filed requests for increases ranging from 0.3 to 3 percent, those are not related to the legislation.

Even though not all insurers plan to raise rates, many employers plan to pass on more of their monthly premiums to workers or to raise out-of-pocket deductibles.

Analysts said the two requirements expected to have the biggest effect on insurance rates will be insuring dependents up to age 26 and the removal of lifetime limits on coverage. The provisions kick in Thursday, but their cost won’t be included until renewal time, typically January.

The requests for rate increases, some of which are still pending, face a warning from Health and Human Services Secretary Kathleen Sebelius. In a letter to the insurance industry’s national association, Sebelius said there would be “zero tolerance” for companies “using scare tactics” to blame premium increases on the new federal regulations.

Not every company is requesting a rate increase, however.

Each company has different estimates — even from one jurisdiction to the next — on how many of their plans will be affected by the new requirements, said Jim Winkler, managing principal of Hewitt’s Health Management Consulting.

Some companies’ finances can handle the changes without a rate increase.

“Each health plan has to look at how the reform changes impact its specific book of business,” Winkler said.

CareFirst, the largest insurer in the District and Maryland, has requested increases in both jurisdictions. Its request in D.C. is waiting approval, while it has not applied for a rate bump in Virginia.

Gennet Purcell, commissioner of the D.C. Department of Insurance, Securities and Banking, said the agency has asked companies to justify increases in detail to ensure the costs are going toward more health coverage.

“Although there’s a slight increase, the consumer can rest assured they’re getting more bang for their buck,” Purcell said.
In Virginia, Anthem has been approved for a 10 percent increase in rates for individual plans as a result of the legislation, according to documents obtained from the Virginia Bureau of Insurance. Other requests, such as Aetna Inc.’s increases between 8 and 10 percent for small-group plans, are pending.

Maryland regulators said rate increases associated with the new requirements are “minimal” since the state already has extensive requirements for insurers, such as allowing dependents up to age 25.

Analysts expect the rate changes will have a greater effect on individual plans and small businesses than on plans through large employers, who can hold costs down by buying in bulk.

Twenty-nine states are challenging the constitutionality of the provision in the act that requires individuals who don’t purchase health insurance by 2014 to pay a penalty.

Virginia has filed a similar lawsuit, which a federal judge ruled can go forward.

Kevin S. Wrege, Esq.

President

PULSE Issues & Advocacy LLC

4410 Massachusetts Ave., NW, #150

Washington, DC 20016

Office: 202-625-1787

Mobile: 202-253-4929

DC Board of Elections Unofficial Primary Election Results

No surprises down ticket: Kwame Brown wins Council Chair and all Council incumbents re-elected…

SUMMARY REPORT MAYORAL PRIMARY ELECTION UNOFFICIAL RESULTS

RUN DATE:09/15/10 DISTRICT OF COLUMBIA

RUN TIME:01:30 AM TUESDAY, SEPTEMBER 14, 2010

STATISTICS

VOTES PERCENT

PRECINCTS COUNTED (OF 143). . . . . 128 89.51

REGISTERED VOTERS – TOTAL . . . . . 370,416

REGISTERED VOTERS – DEM. . . . . . 336,312 90.79

REGISTERED VOTERS – REP. . . . . . 29,772 8.04

REGISTERED VOTERS – STG. . . . . . 4,332 1.17

BALLOTS CAST – TOTAL. . . . . . . 114,595

BALLOTS CAST – DEM . . . . . . . 111,854 97.61

BALLOTS CAST – REP . . . . . . . 2,231 1.95

BALLOTS CAST – STG . . . . . . . 510 .45

VOTER TURNOUT – TOTAL . . . . . . 30.94

VOTER TURNOUT – DEM . . . . . . . 33.26

VOTER TURNOUT – REP . . . . . . . 7.49

VOTER TURNOUT – STG . . . . . . . 11.77

********** (DEMOCRATIC) **********

DELEGATE U.S. HOUSE OF REPRESENTATIVES

DISTRICT OF COLUMBIA

VOTE FOR NOT MORE THAN 1

(WITH 128 OF 143 PRECINCTS COUNTED 89.51%)

Douglass Sloan. . . . . . . . . 10,069 9.36

Eleanor Holmes Norton . . . . . . 96,808 90.01

WRITE-IN. . . . . . . . . . . 676 .63

MAYOR OF THE DISTRICT OF COLUMBIA

VOTE FOR NOT MORE THAN 1

(WITH 128 OF 143 PRECINCTS COUNTED 89.51%)

Vincent C. Gray . . . . . . . . 59,285 53.18

Ernest E. Johnson. . . . . . . . 248 .22

Leo Alexander . . . . . . . . . 721 .65

Sulaimon Brown. . . . . . . . . 167 .15

Adrian M. Fenty . . . . . . . . 50,850 45.62

WRITE-IN. . . . . . . . . . . 200 .18

CHAIRMAN OF THE COUNCIL DISTRICT OF COLUMBIA

VOTE FOR NOT MORE THAN 1

(WITH 128 OF 143 PRECINCTS COUNTED 89.51%)

Vincent Orange. . . . . . . . . 40,266 39.00

Kwame R. Brown. . . . . . . . . 56,641 54.86

Dorothy Douglas . . . . . . . . 5,649 5.47

WRITE-IN. . . . . . . . . . . 696 .67

AT – LARGE MEMBER OF THE COUNCIL

DISTRICT OF COLUMBIA

VOTE FOR NOT MORE THAN 1

(WITH 128 OF 143 PRECINCTS COUNTED 89.51%)

Michael Brown . . . . . . . . . 28,212 27.37

Phil Mendelson. . . . . . . . . 65,409 63.45

Clark Ray . . . . . . . . . . 8,921 8.65

WRITE-IN. . . . . . . . . . . 540 .52

MEMBER OF THE COUNCIL WARD 1

VOTE FOR NOT MORE THAN 1

(WITH 16 OF 16 PRECINCTS COUNTED)

Jeff Smith . . . . . . . . . . 2,903 21.40

Bryan Weaver . . . . . . . . . 2,849 21.00

Jim Graham . . . . . . . . . . 7,777 57.33

WRITE-IN. . . . . . . . . . . 37 .27

MEMBER OF THE COUNCIL WARD 3

VOTE FOR NOT MORE THAN 1

(WITH 16 OF 17 PRECINCTS COUNTED 94.12%)

Mary Cheh . . . . . . . . . . 12,443 93.68

WRITE-IN. . . . . . . . . . . 839 6.32

MEMBER OF THE COUNCIL WARD 5

VOTE FOR NOT MORE THAN 1

(WITH 16 OF 18 PRECINCTS COUNTED 88.89%)

Kenyan McDuffie . . . . . . . . 2,121 13.77

Delano Hunter . . . . . . . . . 3,091 20.07

Harry Tommy Thomas Jr. . . . . . . 9,556 62.05

Tracey D Turner . . . . . . . . 593 3.85

WRITE-IN. . . . . . . . . . . 39 .25

MEMBER OF THE COUNCIL WARD 6

VOTE FOR NOT MORE THAN 1

(WITH 16 OF 18 PRECINCTS COUNTED 88.89%)

Kelvin Robinson . . . . . . . . 3,447 24.66

Tommy Wells. . . . . . . . . . 10,467 74.88

WRITE-IN. . . . . . . . . . . 65 .46

UNITED STATES REPRESENTATIVE

DISTRICT OF COLUMBIA

VOTE FOR NOT MORE THAN 1

(WITH 128 OF 143 PRECINCTS COUNTED 89.51%)

Nate Bennett-Fleming. . . . . . . 35,400 41.09

Mike Panetta . . . . . . . . . 48,691 56.51

WRITE-IN. . . . . . . . . . . 2,069 2.40

********** (REPUBLICAN) **********

DELEGATE U.S. HOUSE OF REPRESENTATIVES

DISTRICT OF COLUMBIA

VOTE FOR NOT MORE THAN 1

(WITH 128 OF 143 PRECINCTS COUNTED 89.51%)

Missy Reilly Smith . . . . . . . 1,614 87.01

WRITE-IN. . . . . . . . . . . 241 12.99

MAYOR OF THE DISTRICT OF COLUMBIA

VOTE FOR NOT MORE THAN 1

(WITH 128 OF 143 PRECINCTS COUNTED 89.51%)

NO CANDIDATE FILED . . . . . . . 0

WRITE-IN. . . . . . . . . . . 1,275 100.00

CHAIRMAN OF THE COUNCIL DISTRICT OF COLUMBIA

VOTE FOR NOT MORE THAN 1

(WITH 128 OF 143 PRECINCTS COUNTED 89.51%)

NO CANDIDATE FILED . . . . . . . 0

WRITE-IN. . . . . . . . . . . 543 100.00

AT – LARGE MEMBER OF THE COUNCIL

DISTRICT OF COLUMBIA

VOTE FOR NOT MORE THAN 1

(WITH 128 OF 143 PRECINCTS COUNTED 89.51%)

NO CANDIDATE FILED . . . . . . . 0

WRITE-IN. . . . . . . . . . . 443 100.00

MEMBER OF THE COUNCIL WARD 1

VOTE FOR NOT MORE THAN 1

(WITH 16 OF 16 PRECINCTS COUNTED)

Marc Morgan. . . . . . . . . . 121 76.10

WRITE-IN. . . . . . . . . . . 38 23.90

MEMBER OF THE COUNCIL WARD 3

VOTE FOR NOT MORE THAN 1

(WITH 16 OF 17 PRECINCTS COUNTED 94.12%)

Dave Hedgepeth. . . . . . . . . 543 92.98

WRITE-IN. . . . . . . . . . . 41 7.02

MEMBER OF THE COUNCIL WARD 5

VOTE FOR NOT MORE THAN 1

(WITH 16 OF 18 PRECINCTS COUNTED 88.89%)

Tim Day . . . . . . . . . . . 90 75.00

WRITE-IN. . . . . . . . . . . 30 25.00

MEMBER OF THE COUNCIL WARD 6

VOTE FOR NOT MORE THAN 1

(WITH 16 OF 18 PRECINCTS COUNTED 88.89%)

Jim DeMartino . . . . . . . . . 379 91.11

WRITE-IN. . . . . . . . . . . 37 8.89

UNITED STATES REPRESENTATIVE

DISTRICT OF COLUMBIA

VOTE FOR NOT MORE THAN 1

(WITH 128 OF 143 PRECINCTS COUNTED 89.51%)

Nelson Rimensnyder . . . . . . . 1,652 92.97

WRITE-IN. . . . . . . . . . . 125 7.03

********** (STATEHOOD GREEN) **********

DELEGATE U.S. HOUSE OF REPRESENTATIVES

DISTRICT OF COLUMBIA

VOTE FOR NOT MORE THAN 1

(WITH 128 OF 143 PRECINCTS COUNTED 89.51%)

Natale (Lino) Nicola Stracuzzi . . . 166 37.64

Rick Tingling-Clemmons . . . . . . 196 44.44

WRITE-IN. . . . . . . . . . . 79 17.91

MAYOR OF THE DISTRICT OF COLUMBIA

VOTE FOR NOT MORE THAN 1

(WITH 128 OF 143 PRECINCTS COUNTED 89.51%)

Faith. . . . . . . . . . . . 173 39.86

WRITE-IN. . . . . . . . . . . 261 60.14

CHAIRMAN OF THE COUNCIL DISTRICT OF COLUMBIA

VOTE FOR NOT MORE THAN 1

(WITH 128 OF 143 PRECINCTS COUNTED 89.51%)

Ann C. Wilcox . . . . . . . . . 354 82.90

WRITE-IN. . . . . . . . . . . 73 17.10

AT – LARGE MEMBER OF THE COUNCIL

DISTRICT OF COLUMBIA

VOTE FOR NOT MORE THAN 1

(WITH 128 OF 143 PRECINCTS COUNTED 89.51%)

Darryl L. C. Moch. . . . . . . . 122 27.48

David Schwartzman. . . . . . . . 277 62.39

WRITE-IN. . . . . . . . . . . 45 10.14

MEMBER OF THE COUNCIL WARD 1

VOTE FOR NOT MORE THAN 1

(WITH 16 OF 16 PRECINCTS COUNTED)

NO CANDIDATE FILED . . . . . . . 0

WRITE-IN. . . . . . . . . . . 54 100.00

MEMBER OF THE COUNCIL WARD 3

VOTE FOR NOT MORE THAN 1

(WITH 16 OF 17 PRECINCTS COUNTED 94.12%)

NO CANDIDATE FILED . . . . . . . 0

WRITE-IN. . . . . . . . . . . 15 100.00

MEMBER OF THE COUNCIL WARD 5

VOTE FOR NOT MORE THAN 1

(WITH 16 OF 18 PRECINCTS COUNTED 88.89%)

NO CANDIDATE FILED . . . . . . . 0

WRITE-IN. . . . . . . . . . . 35 100.00

MEMBER OF THE COUNCIL WARD 6

VOTE FOR NOT MORE THAN 1

(WITH 16 OF 18 PRECINCTS COUNTED 88.89%)

NO CANDIDATE FILED . . . . . . . 0

WRITE-IN. . . . . . . . . . . 23 100.00

UNITED STATES REPRESENTATIVE

DISTRICT OF COLUMBIA

VOTE FOR NOT MORE THAN 1

(WITH 128 OF 143 PRECINCTS COUNTED 89.51%)

Joyce Robinson-Paul . . . . . . . 384 88.89

WRITE-IN. . . . . . . . . . . 48 11.11

Kevin S. Wrege, Esq.

President

PULSE Issues & Advocacy LLC

4410 Massachusetts Ave., NW, #150

Washington, DC 20016

Office: 202-625-1787

Mobile: 202-253-4929

Wash Post: Why Fenty Lost

How Adrian Fenty lost his reelection bid for D.C. mayor

By Nikita Stewart and Paul Schwartzman
Washington Post Staff Writers
Wednesday, September 15, 2010; 4:56 AM

One afternoon in late June, D.C. Mayor Adrian M. Fenty’s political advisers invited their boss to a downtown conference room to report an unsettling development: Focus groups commissioned by the campaign were saying that Fenty’s leadership style was offensive and that he was oblivious to constituents‘ concerns.

If the mayor had any chance of winning them over, the prospective voters told the campaign, he needed to apologize for his actions.

Tom Lindenfeld, the mayor’s chief political strategist, proposed a cure, a one-page letter to be delivered to thousands of voters across the District, a letter in which Fenty would acknowledge mistakes and express remorse. He would promise to change.

“What is this?” the mayor said, reading the letter and tossing it away.

“The things you don’t do now will be much harder for voters to ignore later,” Lindenfeld told him.

The mayor slammed his hand on the table.

“I’m proud of my record,” Fenty shot back, according to Lindenfeld and two others present at the meeting. The mayor stood and walked out.

Across the decade in which he shot to the top of the city’s political pyramid, Fenty relied on unrelenting energy and a well-honed internal compass – his gut – to navigate three elections and the often treacherous complexities of running a big city. His instinct told him he could win a D.C. Council seat in 2000, even against a veteran incumbent. He was right. In 2006, he ignored the doubters who said he was too young at 35 and unaccomplished to capture the mayoralty. He was right then, too.

As the 2010 Democratic primary campaign arrived, the mayor’s instinct told him that his accomplishments would far outweigh complaints that he seemed aloof and uncaring. Overhauling the school system meant something, he told loyalists. Building swimming pools and soccer fields affected people’s lives. His handpicked police chief was popular across the city. When it was time to vote, the mayor was confident, the substance of his administration’s work would trump all.

How Fenty came to squander that success and the goodwill that catapulted him to office is the story of a mayor who misread an electorate he was sure he knew better than anyone, who ignored advisers’ early warnings that key constituencies were abandoning him, who shut out confidantes who told him what he did not want to hear and who began to listen only when the race was all but lost. The account is based on interviews with more than a dozen of Fenty’s advisers and supporters, including some such as Lindenfeld and campaign chairman Bill Lightfoot, and others who talked only on the condition of anonymity because they did not want to appear critical of the mayor. The sources were interviewed Tuesday or earlier with the agreement that the information would not be published until after the election.

Fenty, an incumbent with a $5 million war chest who lost to council Chairman Vincent C. Gray on Tuesday, used many of the same tactics that had won him the mayoralty in 2006, frustrating advisers who thought he needed a more sophisticated campaign. He refused to pay for pollsters to measure the public mood, for example, or hire researchers to dig up dirt on Gray. Instead, the mayor appeared to run as an insurgent and relied on what had delivered him to the apex four years earlier: door-to-door campaigning and that internal compass that no longer seemed to work.

Fenty, in an interview, said he has lots of advisers but that he himself is a student of political history, citing books he has read about past elections and presidents such as John F. Kennedy and Barack Obama. He said he trusts himself to know the path to victory, when it’s time to attack an opponent or acknowledge a mistake.

“Ultimately,” Fenty said, “the candidate and person in charge has to make the final decision.”

But Lindenfeld, who found his advice to the mayor ignored, said Fenty’s belief in his own radar was misplaced.

“His campaign’s failing resulted from a combination of tenor, hubris, pride and political malpractice,” Lindenfeld said Tuesday. “Campaigns that win are ones that are nimble. He’s got only one play in his playbook: knocking on doors.”

Blind to a rising tide

As the year began and the mayor prepared for his reelection campaign, he knew that he could remind voters that crime was down and students’ math and reading scores were up. Despite a double-digit unemployment rate, the District’s economy had fared far better than nearly all other cities during a national recession. On top of that, the mayor’s campaign war chest had surpassed $4 million at that point, and months passed without a formidable challenger emerging.

Still, within his inner circle, concerns arose that a long string of decisions that threatened to alienate voters, such as the mayor’s unannounced vacation in Dubai that was paid for by a foreign government; his refusal to share Washington Nationals baseball tickets with the council; and Schools Chancellor Michelle A. Rhee‘s dismissal of hundreds of teachers and dozens of principals for what she said was poor performance. Allegations that the mayor’s fraternity brothers had gotten lucrative city contracts prompted the council to sponsor a special investigation and hold months of public hearings.

Advisers, including Lindenfeld and Lightfoot, warned Fenty in the spring that he needed to take notice. They questioned why Fenty was still traveling the campaign trail with Sinclair Skinner, a friend at the center of the contracts scandal. Independent polls showed the mayor’s popularity slipping, including a January survey sponsored by council member David A. Catania (I-At Large), a Fenty ally who took it upon himself to stop by the mayor’s office to share the results.

“I thought it was time to take the subject seriously and to start reversing those declining numbers if he was going to mount a serious reelection effort,” Catania said.

But the council member said Fenty seemed unfazed. “I didn’t see a sense of urgency on his part,” Catania said.

In mid-March, Fenty campaigned in Southeast, taking along his stepbrother, B. Seth Bryant, 40, who was surprised by the hostility they encountered.

Bryant wondered why there weren’t reporters around to record the moment. For months, the mayor refused to release a campaign schedule to the media or the public, a policy that confused some advisers.

“You need to have some cameras going with you door to door,” Bryant recalled telling the mayor, whom he described as unresponsive. “I think a lot of supporters, myself included, have been surprised at how insular his administration has been.”

On that afternoon in Southeast, Bryant said, the cameras would have caught the grateful woman who told the mayor that she had once been homeless and that his administration had helped find her an apartment.

On March 30, after weeks of speculation, Gray announced his candidacy, declaring that the city needed inclusive and transparent leadership, a direct appeal to those who thought that Fenty was too secretive, ruled by fiat, and had shut them out.

That night, four people were killed and five wounded in shootings on South Capitol Street, the deadliest spasm of violence in the city in years. The mayor didn’t show up to the crime scene until 24 hours later, his arrival prompting boos from the crowd and a renewed wave of complaints that he was disconnected.

Where had Fenty been? Initially, he and his aides were vague about his whereabouts, but then they confirmed that he had been on a family vacation in Jamaica. During an interview Saturday, the mayor amended the story to say that after Jamaica, he had taken his two sons to a tennis tournament in Florida, which is where he was when he learned of the shootings.

Asked where in Florida, Fenty said, “Can’t you just say Florida?”

A campaign in peril

Less than two weeks after the shootings, a couple hundred supporters, many of them Fenty appointees and paid staff members, listened to the mayor declare his candidacy for reelection at his Georgia Avenue NW headquarters.

The broad spectrum of former loyalists and donors missing from the crowd also suggested how the mayor’s fortunes had changed since 2006. Gone were people such as philanthropist Judith Terra, education advocate Marc Borbely and gay rights activist Peter Rosenstein, all of whom now support Gray. Fenty punctuated his speech with a mantra that seemed aimed at those who had questioned his hard-charging style: “We did it because it was the right thing to do!”

Despite Fenty’s defiance, his advisers were concerned about the anger toward the mayor that simmered in black neighborhoods. In May, Lightfoot asked Darryl Wiggins, a business owner who was vice chairman of the mayor’s 2006 transition committee, to host a meeting at which a half-dozen prospective black voters, a cross section of professionals and blue-collar workers ages 40 to 60, would be encouraged to speak candidly about Fenty.

For several hours, Wiggins recalled later, the group railed about Fenty’s failure to appoint African Americans to top administration posts, his approval of the mass firings of teachers, many of whom are black, and his apparent lack of concern for their struggles during an economic downturn. By the end of the meetings, Wiggins said, he was sure that, in a city that is majority black, the mayor’s campaign was deeply troubled.

“Black people are not going to go out quietly,” Wiggins said.

Based on the group’s attitudes, Lightfoot urged Fenty to pay for additional focus groups, since he would not agree to commission polls. Their campaign was in peril, and they needed to know the way forward. Fenty agreed, if grudgingly.

By May, some of Fenty’s advisers thought he needed to counter Gray’s unceasing focus on the allegations of cronyism that shadowed the mayor, a strategy that would represent a dramatic departure from his usual style. In three previous campaigns, including the 2006 mayoral race, Fenty’s draw as a candidate was at least partially rooted in his positive message and refusal to beat up opponents.

But advisers such as Ronald Moten, Fenty’s friend and a community activist, recall telling the mayor that “if the public doesn’t find out who Vince Gray is, there’s a good chance you could lose.”

Fenty’s response, Moten said, was cautious: His shots would come at the right time. Moten couldn’t wait. By mid-May, the activist launched his own Web site devoted to attacking Gray.

On June 3, Fenty jumped into the fray, using a Democratic candidates forum in Foxhall to criticize his opponent’s past record as director of the Department of Human Services, a gambit that surprised members of his campaign team who were in the audience and thought it made the mayor look petty to personally deride the council chairman.

Over the ensuing weeks, they thought that Fenty had no focus to his attack, meandering from DHS to a fence that Gray had improperly installed at his home to other matters. Some advisers thought the mayor’s delivery was unpolished, should have bored in solely on DHS and would have been more effective in campaign literature. At Fenty headquarters, the meetings to map strategy became less frequent, if they were held at all. The mayor, it seemed, was both candidate and campaign manager.

Fenty, in an interview Tuesday, said his reelection strategy was rooted in what had worked for him in the past. He hadn’t needed pollsters before, and he did not need them now. “I’ve never polled. It’s a decision I made 12 years ago. It’s always worked, so why change?” he said. “I ran this campaign like I ran all my campaigns.

“There’s no one thing that wins elections,” he said.

By early June, whatever the mayor was telling himself was not producing results he wanted.

On June 17, Gray beat Fenty in a straw poll in Ward 3, an area of Northwest that the mayor counted as his most enthusiastic base. The mayor’s allies were beginning to sense a changing landscape. Gray was raising money – nearly $100,000 more, in fact, than the mayor had in the three previous months.

One friend recalled driving along on 13th or 16th Street NW, near the mayor’s home, and being surprised by the number of Gray lawn signs. “It was like, ‘Wow, What’s going on?’ ” said the friend, who spoke on condition of anonymity because he didn’t want to appear to betray the mayor. “It was like 50-50, and it dawned on me, this thing is a lot closer than I thought.”

Contrition, too late

By early July, the mayor remained unwilling to follow his advisers’ recommendation that he apologize for offending Washingtonians. But he agreed to deal more head-on with voters’ criticism. He approved a commercial in which supporters voiced the common complaints about his apparent arrogance and indifference, and then provided their own answer for what mattered most: the results that his administration delivered.

Yet nothing seemed to turn the electorate toward him. On Aug. 4, Democrats in the mayor’s home district, Ward 4, held their straw vote, an event that drew so many people to the ballroom at St. George Antiochian Orthodox Christian Church that Lightfoot couldn’t get inside. Standing on the sidewalk, Lightfoot eyed the arriving masses of Gray supporters, many of them senior citizens, and knew the mayor was in for a difficult night.

The mayor’s performance during the forum – he lashed out at Gray on a range of topics – only further confirmed Lightfoot’s fears. “He’s supposed to be the king,” the campaign chairman said later. “The king doesn’t get dragged out to the gutter.”

Gray won the straw poll 581 to 401, leaving Fenty’s aides scrambling to play down the significance of the mayor losing in the ward that had launched his political career.

Almost immediately, friends began urging the mayor to shift gears: He needed to show contrition. He needed to prove to Washingtonians that he understood their disappointment with him. More than ever, he needed to apologize.

Neil O. Albert, the city administrator, and council member Muriel Bowser (D-Ward 4) helped assemble a list of more than 100 activists and former supporters for Fenty to call. On Aug. 11, during a debate with Gray, he inched closer to a mea culpa, saying, “I haven’t done a good job of communicating and including people.”

On Aug. 29, The Washington Post published the results of a poll that put into numbers what many in the Fenty campaign had feared. The mayor for months had refused to conduct a poll. Now he learned that he trailed Gray by 17 points among likely Democratic voters, a margin that seemed too much to make up with slightly more than two weeks to go. His wife, Michelle, later described herself and the mayor as “shocked” at the poll.

On that Sunday morning, Fenty summoned his staff members to campaign headquarters. He stood in the middle of the large room, pacing as he spoke, then grabbing a chair and sitting down, urging them not to lose hope.

Remember his race against council member Charlene Drew Jarvis in 2000? He had been the underdog and he had won. Or how about Obama after Hillary Rodham Clinton had surprised him in New Hampshire?

You get down, Fenty said, but you bounce back. This is when the work begins.

The staff erupted in cheers, some grabbing the mayor’s hands as they chanted, “One, two, three! Fenty!”

Three days later, at the last of the debates, Fenty asked for forgiveness and a second chance and said that “even mayors can make mistakes and that people can learn from their mistakes,” words not unlike those his advisers had proposed he tell voters more than two months before, when they urged him to apologize.

By September, though, an electorate once electrified by Adrian Fenty’s youth and energy no longer seemed to be listening.

Kevin S. Wrege, Esq.

President

PULSE Issues & Advocacy LLC

4410 Massachusetts Ave., NW, #150

Washington, DC 20016

Office: 202-625-1787

Mobile: 202-253-4929

Intriguing DC Watch Obit on Mayoral Election (Which is tomorrow:)

September 12, 2010

Why Fenty Lost

Dear Voters:

I know that I’ll have to eat a lot of crow if my prediction is wrong, but I need to try again to explain to Mayor Fenty’s adamant supporters how he alienated so many people. Fenty has run what was essentially a “bricks and mortar” race. His supporters, exemplified by the members of the Washington Post editorial board, accepted his campaign narrative that the rapid building spree of the last four years represented “progress” and mayoral accomplishments. But think of the way many of these building projects were done. Those that weren’t already started under Mayor Williams began in Fenty’s office with proposals that were kept secret until the last minute from the neighborhoods in which they were to be located, rather than with grassroots neighborhood demands. Since the plans were formulated without citizen input, they alienated the neighborhoods they were supposed to serve. Citizens who went to the so-called “planning meetings” for these projects found out that the plans had already been finalized, and that they were expected to rubber-stamp them. Any serious questions about projects and plans were dismissed by the Fenty administration as unwarranted; any objections from citizens ensured that those citizens were frozen out of future discussions; any opposition from citizens put those citizens on an enemies list, to be treated with scorn and contempt by the administration.

When the building project would be completed, the Fenty administration would brag about its accomplishment. The press would accept the completed project as evidence of progress in the city. And the affected neighborhoods, the citizens who had tried to work with the government, would be left angry and alienated. “Look at all the things I’ve done for you and given you,” said Fenty, and the people would say back, “That wasn’t what we wanted, and you never listened to us when we told you otherwise.” Fenty’s apologists routinely minimize the administration’s disregard and disrespect for its citizens as just a matter of “personality.” But democracy depends on regard and respect for citizens. Fenty’s failure has not been one of personality or of “style,” it has been a failure to govern democratically. Fenty and his apologists argue that democracy is an ineffective way to govern a city, and that unilateral decisions made by a strong man, an autocrat, is the only way to make progress. They are wrong, and dangerously wrong.

The next four years aren’t going to be easy for any mayor. Steve Chapman has written, in reference to the upcoming race to replace retiring Chicago Mayor Richard Daley: “The situation brings to mind what former New York Gov. Nelson Rockefeller said when Hugh Carey was elected to his old job in 1974: ‘He thinks it’s going to be fun being governor. It’s only fun being governor of New York if you have money to spend, and I spent it all,’” http://reason.com/archives/2010/09/09/what-mayor-daley-left-behind. The Fenty spending spree, which financed the building spree, is over no matter who wins the election; Fenty already spent it all, all we had in reserve. Fenty claims to have made “tough decisions,” but spending money freely when the government has plenty of money isn’t a tough decision. In the next four years, with a restricted budget and a depleted surplus, the mayor will have to make really tough decisions. That’s when the mayor will have to have respect for citizens and for democratic decision making, in order to earn the reciprocal respect of citizens.

#####

Two videos for your amusement: too brief a clip of Vincent Gray, dancing a “hand dance,” http://www.dcwatch.com/themail/2010/10-09-12a.flv and http://www.dcwatch.com/themail/2010/10-09-12a.avi (hat tip to Alan Suderman at City Paper for finding it); and a clip of Marion Barry, singing the blues (and rather well, too), http://www.dcwatch.com/themail/2010/2010/10-09-12b.mp4 and http://www.dcwatch.com/themail/2010/10-19-12b.avi.

Gary Imhoff
themail

Kevin S. Wrege, Esq.

President

PULSE Issues & Advocacy LLC

4410 Massachusetts Ave., NW, #150

Washington, DC 20016

Office: 202-625-1787

Mobile: 202-253-4929

HHS Sec Letter to AHIP re Rate Increases

<<…>>

Kevin S. Wrege, Esq.

President

PULSE Issues & Advocacy LLC

4410 Massachusetts Ave., NW, #150

Washington, DC 20016

Office: 202-625-1787

Mobile: 202-253-4929

Letter from HHS Sec to AHIP re rates 9.10.10.pdf

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