The Insiders: Obamacare – The incompetence and denials keep coming
Two stories converge today to illuminate how the White House and the Democratic establishment are attempting to hide the next wave of Obamacare failures. Both Post stories reveal how the president and Democratic leaders at the state level are hiding problems with Obamacare instead of confronting and fixing problems.
….It is painfully obvious that many Democrats think the best political tactics for dealing with the numerous Obamacare problems are to ignore them, hide them or otherwise deny they exist. Democrats just keep insisting that folks are signing up and “glitches” are being fixed.
These two stories suggest that the Democrats hope Obamacare fatigue will set in and voters will begin to simply shrug as the problems become part of American life, that Obamacare will become another government-supplied annoyance for which no one is responsible and no one is to blame. The problem is that voters can’t just learn to ignore the calamity that is Obamacare because health care and health insurance are vital to the life of every American.
You can bet President Obama has completely checked out from any Obamacare management, and there is zero chance his staff and Cabinet want to bring problems to his attention or ask for his instructions.
Democrats may think they can stiff-arm all the inquiries into the problems with Obamacare, but they can’t. The Obamacare blight is here to stay and Democrats own it. The best politics for them would be to do everything they can to make sure the system works. But they can’t make sure Obamacare works if they continue to deny problems exist or hide these problems from the public. It is insulting to voters for the Democrats to shamelessly shift blame, plead ignorance and pretend things are fine. The sooner they realize this, the better off they will be in November. Engaging in denial and deceit isn’t a plan, and they won’t be able to maintain multiple cover-ups for the next nine months. The Democrats can run, but they can’t hide.
If courts, perhaps ultimately including the Supreme Court, disallow the IRS’s “interpretation” of the law, the ACA will not function as intended in 34 states with 65 percent of the nation’s population. If courts allow the IRS’s demarche, they will validate this:
By dispensing subsidies through federal exchanges, the IRS will spend tax revenues without congressional authorization. And by enforcing the employer mandate in states that have only federal exchanges, it will collect taxes — remember, Chief Justice John Roberts saved the ACA by declaring that the penalty enforcing the mandate is really just a tax on the act of not purchasing insurance — without congressional authorization.
12/15/2013 6:54 PM EST
I really hope that the Kentucky version of Obamacare, which is doing quite well, opens up the eyes of the people who have been up until now conned by the Cons to vote against their best interests. All the Obama Hate that the GOP has encouraged could melt away once people discover the truth. President Obama wants Americans to be healthy. The Republican Party does not care. The GOP only wants to cut taxes for the rich, and the rest of us can go lie down and die for all they care.
12/15/2013 8:07 PM EST
16,000 Kentuckian’s have enrolled in health insurance through Obamacare. White at the same time, 56,000 Kentuckians have entered into Medicaid expansion – that program that other tax payers pay for 100%.
The premiums on healthcare.gov seem really low, right? Well, actually, according to most people that have gone to the site, the most common response has been that the premiums are much higher than they expected!
But in reality, the premiums are quite low! They are low because as part of OBAMACARE the insurance companies are guaranteed a profit! That’s right, if they sell through healthcare.gov, they cannot lose money by not charging enough in premiums to cover the care costs – because the LAW guarantees and protects them against losses – plus guaranteed profits!
Now this is only lasting a few years! Then the guarantees disappear and the true cost of the insurance will become known! Because the premiums will double or triple. But by then, the whole concept will become so ingrained, that it can’t be fixed.
OBAMACARE will in the first 10 years become the MOST expensive social welfare system in our country!
FYI, I am not a Republican! I have studied politics and understand how these things work. In the end, just like the 1% tax on a person’s first $1,400 of annual income (that is what the proponents said Social Security would cost – forever). Of course, all these decades later and the amount in taxes a person can pay into social security per year is 500 times higher than what the Liberals promised it could survive with. And that doesn’t even count the tens of trillions of SS unfunded liabilities. I guess that max capped $14 per year tax as promised didn’t really go so far, did it?
With new year, Medicaid takes on a broader health-care role
Medicare may be best known for paying the medical bills for millions of people 65 and older, but recent studies show it plays another gargantuan role in American health care: It helps determine prices for everyone.
For virtually every procedure and service — from routine colonoscopies to brain surgery and hospice care — Medicare comes up with a dollar figure that the government considers a fair price. But economists are finding that, largely because of the program’s vast scale, Medicare prices substantially shape what all Americans pay for health care.
“Our results suggest that Medicare’s decisions are far more influential than you may imagine,” said Joshua Gottlieb, an economist at the University of British Columbia. His research shows that a $1 change in the price that Medicare pays yields a $1.30 change in what private insurers pay.
What happens if the government gets those prices wrong? In the past year, a Washington Post investigation has shown that Medicare prices are sometimes based on faulty premises , offer perverse incentives for unnecessary care and provide widely varying amounts for equivalent drugs .
Expanded Medicaid’s fine print holds surprise: ‘payback’ from estate after death
As thousands of state residents enroll in Washington’s expanded Medicaid program, many will be surprised at fine print: After you’re dead, your estate can be billed for ordinary health-care expenses. State officials are scrambling to change the rule.
ObamaCare’s Troubles Are Only Beginning
Be prepared for eligibility, payment and information protection debacles—and longer waits for care.
By MICHAEL J. BOSKIN
Dec. 15, 2013 6:24 p.m. ET
The White House is claiming that the Healthcare.gov website is mostly fixed, that the millions of Americans whose health plans were canceled thanks to government rules may be able to keep them for another year, and that in any event these people will get better plans through ObamaCare exchanges. Whatever the truth of these assertions, those who expect better days ahead for the Affordable Care Act are in for a rude awakening. The shocks—economic and political—will get much worse next year and beyond. Here’s why:
The “sticker shock” that many buyers of new, ACA-compliant health plans have experienced—with premiums 30% higher, or more, than their previous coverage—has only begun. The costs borne by individuals will be even more obvious next year as more people start having to pay higher deductibles and copays.
If, as many predict, too few healthy young people sign up for insurance that is overpriced in order to subsidize older, sicker people, the insurance market will unravel in a “death spiral” of ever-higher premiums and fewer signups. The government, through taxpayer-funded “risk corridors,” is on the hook for billions of dollars of potential insurance-company losses. This will be about as politically popular as bank bailouts
The “I can’t keep my doctor” shock will also hit more and more people in coming months. To keep prices to consumers as low as possible—given cost pressures generated by the government’s rules, controls and coverage mandates—insurance companies in many cases are offering plans that have very restrictive networks, with lower-cost providers that exclude some of the best physicians and hospitals.
Next year, millions must choose among unfamiliar physicians and hospitals, or paying more for preferred providers who are not part of their insurance network. Some health outcomes will deteriorate from a less familiar doctor-patient relationship.
More IT failures are likely. People looking for health plans on ObamaCare exchanges may be able to fill out their applications with more ease. But the far more complex back-office side of the website—where the information in their application is checked against government databases to determine the premium subsidies and prices they will be charged, and where the applications are forwarded to insurance companies—is still under construction. Be prepared for eligibility, coverage gap, billing, claims, insurer payment and patient information-protection debacles.
The next shock will come when the scores of millions outside the individual market—people who are covered by employers, in union plans, or on Medicare and Medicaid—experience the downsides of ObamaCare. There will be longer waits for hospital visits, doctors’ appointments and specialist treatment, as more people crowd fewer providers.
Those with means can respond to the government-driven waiting lines by making side payments to providers or seeking care through doctors who do not participate in insurance plans. But this will be difficult for most people.
Next, the Congressional Budget Office’s estimated 25% expansion of Medicaid under ObamaCare will exert pressure on state Medicaid spending (although the pressure will be delayed for a few years by federal subsidies). This pressure on state budgets means less money on education and transportation, and higher state taxes.
The “Cadillac tax” on health plans to help pay for ObamaCare starts four years from this Jan. 1. It will fall heavily on unions whose plans are expensive due to generous health benefits.
In the nearer term, a political iceberg looms next year. Insurance companies usually submit proposed pricing to regulators in the summer, and the open enrollment period begins in the fall for plans starting Jan. 1. Businesses of all sizes that currently provide health care will have to offer ObamaCare’s expensive, mandated benefits, or drop their plans and—except the smallest firms—pay a fine. Tens of millions of Americans with employer-provided health plans risk paying more for less, and losing their policies and doctors to more restrictive networks. The administration is desperately trying to delay employer-plan problems beyond the 2014 election to avoid this shock.
Meanwhile, ObamaCare will lead to more part-time workers in some industries, as hours are cut back to conform to arbitrary definitions in the law of what constitutes full-time employment. Many small businesses will be cautious about hiring more than 50 full-time employees, which would subject them to the law’s employer insurance mandate.
On the supply side, medicine will become a far less attractive career for talented young people. More doctors will restrict practice or retire early rather than accept lower incomes and work conditions they did not anticipate. Already, many practices are closed to Medicaid recipients, some also to Medicare. The pace of innovation in drugs, medical devices and delivery is expected to slow significantly, as higher taxes and even rationing set in.
The repeated assertions by the law’s supporters that nobody but the rich would be worse off was based on a beyond-implausible claim that one could expand by millions the number of people with health insurance, lower health-care costs without rationing, and improve quality. The reality is that any squeezing of insurance-company profits, or reduction in uncompensated emergency-room care amounts to a tiny fraction of the trillions of dollars extracted from those people overpaying for insurance, or redistributed from taxpayers.
The Affordable Care Act’s disastrous debut sent the president’s approval ratings into a tailspin and congressional Democrats in competitive districts fleeing for cover. If the law’s continuing unpopularity enables Republicans to regain the Senate in 2014, the president will be forced to veto repeated attempts to repeal the law or to negotiate major changes.
The risk of a complete repeal if a Republican takes the White House in 2016 will put enormous pressure on Democratic candidates—and on Republicans—to articulate a compelling alternative to the cost and coverage problems that beset health care. A good start would be sliding-scale subsidies to help people buy a low-cost catastrophic plan, purchasable across state lines, equalized tax treatment of those buying insurance on their own with those on employer plans, and expanded high-risk pools.
— Mr. Boskin, an economics professor at Stanford University and senior fellow at the Hoover Institution, was chairman of the Council of Economic Advisers under President George H.W. Bush.
When liberal defenders say conservatives are betting on Obamacare’s failure, they are correct. Conservatives see millions more have lost than gained insurance, the back-end problems in transmitting critical information on coverage to insurers, the refusal of young people to dutifully sign up for insurance they don’t want, the sticker shock problem and the loss of people’s doctors’ and hospitals of choice and conclude this is a disaster. Whacky, I know. (The case for betting on Obamacare hasn’t been made in any convincing form.)
Last updated: December 27, 2013 4:46 p.m.
That health care law, by the numbers
CALVIN WOODWARD | Associated Press
WASHINGTON (AP) — The government churns out tons of numbers, but here’s one you won’t see: 0.0002. That’s the percentage of estimated online visitors to HealthCare.gov who actually signed up for coverage on the first day. That’s six people out of more than 3 million.
Not all the figures associated with the rollout of President Barack Obama’s health-care law are so ridiculously dreary. Three million tells a happier tale. That’s how many young adults have been able to get coverage under their parents’ plan thanks to the law’s rule that people up to age 26 can do so.
A look at the heath-care law’s early going, by the numbers:
Problem solved? Not entirely
55 million: Estimated number of uninsured in America
31 million: Remaining number of uninsured in America in 2016, when most of the law’s provisions have taken hold, according to federal projections
89: Percentage of all residents expected to have health insurance in 2016
91: Percentage of all residents, excluding people living in the country illegally, expected to have health insurance in 2016
14: States that set up their own health-insurance exchanges. The District of Columbia also has its own exchange
36: States that refused, leaving the federal government to do it
Who’s in? Part 2
25: States that are expanding Medicaid to more people under the health-care law, along with the District of Columbia
19: States that refused
6: States that haven’t decided
100: Percentage of the cost of the state Medicaid expansion being paid by Washington for three years, before dropping to 90 percent
Who’s in? Part 3
1 million: People who had signed up for private coverage under the federal health law by Dec. 20, up from 364,682 three weeks earlier
227,478: People who had signed up through the 14 state-run exchanges as of Nov. 30
137,204: People who had signed up through the federally run exchanges operating in 36 states by that date
This is progress?
65: Percentage of people who reported in early October that they had failed when they tried to buy insurance through the health exchanges, according to an AP-GfK poll
51: Percentage of people who reported in early December that they had failed when trying to buy from the exchanges, according to another AP-GfK poll
A new fiscal cliff?
$95: Fine for an adult who goes without health insurance in 2014, or 1 percent of taxable income, if greater. Maximum $285 penalty per family
$695: Fine for an adult going without health insurance in 2016, or 2.5 percent of taxable income. Up to $2,085 per family
6 million: The number of people who could be fined in 2016 for going without insurance, according to federal researchers
$46,000: Individuals earning up to this amount should qualify for some level of subsidy to buy private insurance; same for a family of four earning up to $94,200
$328: Average estimated monthly premium, before any subsidies, for a mid-range silver plan that covers 70percent of medical costs
$516: Estimated cost of that plan in Wyoming. Prices vary widely depending on where you live and other factors
$6,350: The most anyone with an individual plan (whether bronze, silver, gold or platinum) will have to pay for medical care in a year, on top of premiums. Family out-of-pocket expenses are capped at $12,70
3 million: Number of young adults up to age 26 who have stayed on their parents’ health plans under the law
4 million-plus: People whose individual plans were canceled because the plans didn’t measure up under the law
7 million: People expected to sign up by the end of open-enrollment season March 31, according to the administration’s original projections