8:34 AM EST
As bad as the roll-out of the law has been so far, the worst part is the law itself. Wait until someone tries to get medical attention and have the provider paid. The individual market is 16% of insurance policies and people covered. The chaos when employers shift people off company plans will be historic.
Joe Goldner wrote:
8:31 AM EST
As a consumer, the best thing you should do is NOT to get involved with fiasco. There is NO security built into the system yet and you will be putting yourself for a identity theft risk. This site is very dangerous and is not for anyone!
8:17 AM EST
Considering the outrageous price increases over existing policies and the number of doctors who are being eliminated in the transfer to new networks, computer generated medication schedules, that may or may not be good for the patient, but are required if the doctor wants to work for the new system I’m not surprised that Sebelius is not in a hurry. The sooner we see this system work people can complain about it. Let us not forget most if not this entire group has spoken out for “single payer health care” or socialized medicine. The longer it takes for this system to work the more committed we are to it because the more gone the old one is!
8:14 AM EST
Set the bar ridiculously low and then claim success. We don’t even know if the 90% is correct, but any private company with that low a success rate would be boycooted by consumers immediately. If a private insurance company had given consumers this poor service for a crucial product the president would be castigating them and calling for an investigation. And Sebelius still has her job despite her cluelessness. and the press goes along with the administration’s sleight of hand. What a disaster for individuals and families who need insurance.
Making up good news about Obamacare
By Marc A. Thiessen, Monday, March 31, 9:17 AM
The Obama administration is celebrating that it has achieved its (downwardly revised) goal of signing up more than 6 million Americans for Obamacare by 11:59 p.m. March 31. Mission accomplished!
Not quite. The administration has not revealed how many of those 6 million people have paid their premiums. If you have not paid, you have not actually “enrolled.” It’s like putting merchandise in your Amazon cart but never clicking “buy.”
Besides, the number that matters is not how many Americans signed up for Obamacare but rather how many previously uninsured Americans signed up for Obamacare. By that standard, Obamacare may be headed for an epic failure.
Recall that between 5 million and 6 million Americans lost their health plans because of Obamacare last fall. If the administration now succeeds in signing up 5 million to 6 million previously insured Americans, it will have achieved . . . nothing. Breaking even is no great accomplishment.
And let’s not forget: Many of those new Obamacare sign-ups are self-sufficient people who were previously paying their own way and now receive government subsidies for insurance. Creating government dependency is not progress — it’s a step backward.
The stated goal of Obamacare was not to move millions of privately insured Americans into taxpayer-subsidized health coverage. The goal was to cover the uninsured. That was the justification for all the chaos and disruption Americans have experienced — and that is the standard by which the administration should be judged.
So how is it doing? We don’t know yet, but the signs are not good. A March survey by McKinsey & Co. found that only 27 percent of consumers who had purchased new coverage in the individual insurance market in February were previously uninsured — up from 11 percent in January. But McKinsey also found that the payment rate for the previously uninsured was just 53 percent, compared with 86 percent for the previously insured. We don’t know how many of those policies were purchased through Obamacare, but remember: Those who sign up and do not pay are not actually enrolled.
Goldman Sachs is projecting that only 1 million Obamacare sign-ups will come from previously uninsured Americans. Indeed, it estimates that the number of total signups will be just 4 million — not 6 million, as the administration claims — because “HHS figures . . . count all persons who selected an ACA exchange plan regardless of whether or not they have actually completed the enrollment process by paying their premium.” Goldman Sachs also anticipates that fully 75 percent of all the Obamacare sign-ups will be from people who already had insurance.
The administration faces a similar problem with Medicaid enrollments. President Obama recently declared, “We’ve got close to 7 million Americans who have access to health care for the first time because of Medicaid expansion.” That statement is flat untrue.
The president assumes that every single one of those Medicaid enrollees is getting health insurance for the first time because of Obamacare. But according to his own Department of Health and Human Services, that number includes people previously enrolled in Medicaid who are deemed eligible for another year, as well as people who would have been eligible under the law before Obamacare. The fact is, HHS does not know how many of the Medicaid signups are “newly eligible” and how many would have signed up anyway. If HHS doesn’t know, how can the president know? The answer is: He can’t.
Over any given six-month period since 2008, between 1.5 million and 2.5 million people have joined the Medicaid rolls just by the natural expansion of the program. Much of that figure, then, is likely just regular Medicaid growth that has nothing to do with Obamacare. Moreover, the health consulting firm Avalere examined the state-by-state numbers and estimates that only 1.1 million to 1.8 million of the claimed enrollees could be attributed to Obamacare. That’s a lot fewer than 7 million.
The Obama administration is so anxious for some good news about this law that if it doesn’t have any, it just makes some up.
There are other problems with Obamacare — coming cancellations of employer-based plans, not having enough young healthy enrollees to play for the old and the sick, skyrocketing deductibles and massive premium hikes despite Obama’s pledge to “cut the cost of a typical family’s premium by up to $2,500 a year.”
But the whole point of Obamacare was supposed to be to cover the uninsured. The president himself set the standard — giving Americans “access to health care for the first time” — by which Obamacare should be judged. So hold him to that standard, and ignore the hyped-up numbers touting how many people “sign up” for Obamacare.
What matters is how many of those who actually enroll were previously uninsured.
Democrats worry leaders in denial on Obamacare
Debbie Wasserman Schultz has said Democrats will run on the Affordable Care Act. | AP Photo
Remember how for months Democrats denounced Republicans for daring to vote to defund or postpone Obamacare? Saboteurs! Terrorists! How dare you alter “the law of the land.”
This was nonsense from the beginning. Every law is subject to revision and abolition if the people think it turned out to be a bad idea. Even constitutional amendments can be repealed — and have been (see Prohibition).
After indignant denunciation of Republicans for trying to amend “the law of the land” constitutionally (i.e. in Congress assembled), Democrats turn utterly silent when the president lawlessly tries to do so by executive fiat.
Nor is this the first time. The president wakes up one day and decides to unilaterally suspend the employer mandate, a naked invasion of Congress’s exclusive legislative prerogative, enshrined in Article I. Not a word from the Democrats. Nor now regarding the blatant usurpation of trying to restore canceled policies that violate explicit Obamacare coverage requirements.
And worse. When Congress tried to make Obama’s “fix” legal — i.e., through legislation — he opposed it. He even said he would veto it. Imagine: vetoing the very bill that would legally enact his own illegal fix.
At rallies, Obama routinely says he has important things to do and he’s not going to wait for Congress. Well, amending a statute after it’s been duly enacted is something a president may not do without Congress. It’s a gross violation of his Article II duty to take care that the laws be faithfully executed.
Michael S Wappingers Falls, NY
Just more spin and hype. Without the back-end its like entering your data and order on Amazon.com but not getting your order because the website doesn’t connect with the warehouse.Fixing only bits and pieces of the software is not meeting any meaningful deadline. There are a lot of moving parts that have to mesh for the underlying economics of Obamacare to work. The more the signup is impeded the fewer people will enroll.An even bigger problem is the high premiums and the fact that many good doctors and hospitals are out of network. Convincing the middle class that they are getting “better coverage” is going to be a hard sell if the reactions I’m hearing from staunch Obama supporters are any indication.Another shock will be when small employers start dropping for insurance coverage for thei employees or downsize in favor of part time employees. Then there are the claims that Obamacare is deficit neutral – maybe but only if the government doesn’t have to pay out on its three year guarantee of the insurance companies against losses.I had assumed, like most federal programs, Obamacare would be virtually impossible to get rid of it because there will be too many vested interests. I’m not so certain now. Each day brings news of promises not kept and that can’t be good for a lame duck President who the American public has ticked off as dishonest. The congressional elections will begin to loom larger than the Obama legacy and it may not be pretty.
Dec. 3, 2013 at 1:15 a.m.
“It is unprecedented in our market to have major insurance plans exclude Seattle Children’s,” said Sandy Melzer, senior vice president.
The result, some argue, is a two-tier system of health care: Many of the people who buy health plans on the exchanges have fewer hospitals and doctors to choose from than those with coverage through their employers.
A number of the nation’s top hospitals — including the Mayo Clinic in Minnesota, Cedars-Sinai in Los Angeles and children’s hospitals in Seattle, Houston and St. Louis — are cut out of most plans sold on the exchange.
The mistakes include failure to notify insurers about new customers, duplicate enrollments or cancellation notices for the same person, incorrect information about family members, and mistakes involving federal subsidies. The errors have been accumulating since HealthCare.gov opened two months ago, even as the Obama administration has been working to make it easier for consumers to sign up for coverage, the government and industry officials said.
Insurers restricting choice of doctors and hospitals to keep costs down
11/20/2013 11:53 PM EST
As far back as 1989 and more so in 1993 the concept that people should be required to buy health coverage was embraced by scholars at conservative research groups, including the Heritage Foundation and the American Enterprise Institute. The individual mandate, as it is known, was seen then as a conservative alternative to creating a national health service or requiring all employers to be mandated provide health coverage. Conservatives were seeking a more market oriented path to universal health care coverage, and enthusiastically endorsed the individual mandate. The idea was this would address the “free rider” problem caused by the EMTALA. This conseervative idea was to require people to be responsible for their own insurance, an individual based system. The Heritage Foundation proposed the Affordable Health Care for All Americas plan. (sound familiar?) One of the conservative arguments back then was that states require passengers in automobiles to wear seat belts for their own protection and to have liability insurance. So the federal government should require all households to protect themselves from accident and illness. This health care protection should be the mandated responsibility of the individual. This was center piece of a politically conservative health care insurance plan, until it was supported by Barack Obama.
12:34 AM EST
How did a R plan become so toxic to Rs? It’s not a snarky question, but I don’t get it. Creating competitive marketplaces (exchanges) driven by a free market. How radical. Snark
Econ Guy wrote:
1:37 AM EST
Exchanges are not Free Market, or even close (snark). You wouldn’t know a Free Market solution if it hit you between the eyes. Here-try this simpleton: Interstate competition for insurance and radical tort reform. Do those two things and repeal the ACA. then you will see real cost reduction.
2:52 AM EST
“Creating competitive marketplaces (exchanges) driven by a free market”…that the public if forced to participate in. Only Orwell could include the word, “free,” in any description of the exchanges. As for why conservatives would oppose a notion originating in nominally “conservative” think tanks, please recall that Einstein dismissed since-demonstrated quantum theories with, “God does not roll dice”. Geniuses do make mistakes. Sometimes, big ones.
Obama’s Bay of Pigs
By JOE NOCERA
Published: November 22, 2013
Obamacare’s Secret Success
Obamacare — a question of morality
By Colbert I. King, Published: November 29
There was a lot of bloviating about the Affordable Care Act on the talk shows last weekend. The Obamacare critics’ chief focus was the open-enrollment fiasco, the un-kept presidential promise and the millions of cancellation notices. Overlaying the palaver was the unrestrained glee of health-reform opponents.
The same weekend, in a section of our nation’s capital where pompous politicians and self-important opinion-makers seldom venture, the Affordable Care Act was the subject of thanks and praise at the First Baptist Church at Randolph Street and New Hampshire Avenue NW.
The talk-show criticism and the pulpit defense crystallized the Obamacare debate. Drawn into sharp relief is the struggle taking place in this country between doing what is right and good and an unashamed indulgence in the immorality of indifference.
The issue couldn’t be put more simply.
Forty-nine million Americans do not have health insurance. For many of them, the ability to deal with their illnesses and injuries depends on their ability to pay. Lacking the money, some of them just go without the care they need. Better to put food on the table for the kids than to check out that awful pain in the gut. Can’t afford to do both.
Which helps explain why the Affordable Care Act is viewed more kindly by the congregation at First Baptist Church, located a few miles from the shadow of the Capitol, than by those within the governmental structure.
First Baptist celebrates its 150th anniversary this year, having been founded in Southwest Washington by freed slaves in 1863.
The church’s broad ministry includes parts of the city where good health care is an unaffordable luxury.
The Rev. Frank D. Tucker, who has been First Baptist’s pastor for nearly 38 years, used Sunday morning’s service to address Obamacare in terms its critics do not.
He announced that First Baptist, working with the city’s health-care exchange, DC Health Link, would host a health insurance enrollment fair on Saturday. He issued an emotional call to his congregation, young and old, to enroll in the program, resorting to language associated with the battle to win the right to vote.
Tucker noted the decades of unsuccessful efforts by several presidents to extend medical care to all Americans, including those living in dire circumstances beyond their control. Not sugar-coating the problems that President Obama has encountered in bringing about health-care reform, Tucker hammered at the obligation of the uninsured to enroll in the insurance program that Obama and other health-reform advocates have worked so hard to create. The Obama administration and its congressional supporters, Tucker observed, have been opposed every step of the way, taking a beating from people in Congress and around the country. Don’t let their sacrifices be in vain by sitting on your hands, he contended. Get enrolled, he declared.
And Tucker wasn’t even Sunday morning’s featured speaker. That honor fell to William P. DeVeaux, the presiding bishop of the African Methodist Episcopal Church’s second district, which covers the nation’s capital. DeVeaux’s presence, however, made Tucker’s appeal more compelling because DeVeaux’s message drew heavily on the scriptural command to serve others. It reinforced Tucker’s appeal to give all Americans the health security they deserve.
Tucker, DeVeaux and other members of the cloth are those whom the opponents of health-care reform are up against.
Gaining access to no-cost preventive services to stay healthy, which Obamacare provides, is not a sign of indifference. Neither is giving senior citizens discounts on their prescription drugs, or allowing young adults to get health insurance on their parents’ plan, or ending insurance company abuses. Those steps represent the caring actions of government.
In his apostolic exhortation this week, Pope Francis said he begged “the Lord to grant us more politicians who are genuinely disturbed by the state of society, the people, the lives of the poor!” Referring to the “excluded and marginalized,” the pontiff said that “it is vital that government leaders . . . take heed and broaden their horizons, working to ensure that all citizens have dignified work, education and healthcare.”
That, too, is where the health-reform resisters come up short. Their horizons are too narrow to notice or care about people who lead lives stunted by lack of opportunity. Stunted lives leave the critics unmoved.
And that’s why, when the bloviators take to the airways, preachers like the Rev. Tucker, Bishop DeVeaux and Pope Francis take to the pulpit.
They know that indifference to the needs of others is, indeed, immoral.
11/29/2013 9:57 PM EST
Reading through the comments here leads me to believe Mr. King has hit a nerve. Such right-wing reactions, so vehement, so unChristian, so uncaring. Truly much worse that indifference to the suffering of so many people. Even Romney and bush, jr., showed a little compassion, Romney with his explanation that if you are having a heart attack you can call an ambulance, and bush, jr., with his health care for the poor at the emergence room.
2:20 AM EST
Oh boy have I had it with this bleeding heart share the wealth crap. I work like a dog for not nearly enough money, I help people when I can, MY CHOICE, NOT THE GOVERNMENT’S,and I’m waiting with amusement to see if my Blue Shield coverage provided through my company is going to be cancelled next year because it doesn’t meet the fine high minded standards created by a bunch of pencil necked geeks who never did a hard day’s work in their miserable life. You see, I expect my insurance to get cancelled because it doesn’t cover a 62 year old working male for MATERNITY CARE, MENTAL HEALTH, DRUG REHAB, BIRTH CONTROL, and god only knows what else. YOU GOTTA BE KIDDING ME!!!I’ve been to a doctor just 3 times in my life, once for an inguinal hernia, twice for broken bones. All I want or need is catastrophic coverage, and now I’ve got bleeding hearts trying to tell me I’m being selfish and stingy, because I’m not interested in paying for coverage I don’t need, because other people need it. Let’s take a look at auto insurance. If it was modeled after Obamacare, I would being a lot more for my premiums because somebody else racked up a bunch of tickets. That’s not how the real world works, people. You make life decisions, if you screw up usually somebody will help out, that’s how people are when not badgered by government mandate, but to mandate it? LIKE HELL!
Healthcare industry vested in success of Obamacare
Many in the industry have reservations about the Affordable Care Act. Even so, they have invested billions of dollars to help make the healthcare law work.
President Obama meets with health insurance executives at the White House. They discussed a proposal that would allow insurers to extend health plans that are being canceled because they fail to meet the Affordable Care Act’s standards. (Shawn Thew, European Pressphoto Agency / November 15, 2013)
By Noam N. Levey
November 21, 2013, 4:51 p.m
WASHINGTON — President Obama’s healthcare law, struggling to survive its botched rollout, now depends more than ever on insurance companies, doctor groups and hospitals — major forces in the industry that are committed to the law’s success despite persistent tensions with the White House.
Many healthcare industry leaders are increasingly frustrated with the Obama administration’s clumsy implementation of the Affordable Care Act. Nearly all harbor reservations about parts of the sweeping law. Some played key roles in killing previous Democratic efforts to widen healthcare coverage.
But since 2010, they have invested billions of dollars to overhaul their businesses, design new insurance plans and physician practices and develop better ways to monitor quality and control costs.
Few industry leaders want to go back to a system that most had concluded was failing, as costs skyrocketed and the ranks of the uninsured swelled.
Nor do they see much that is promising from the law’s Republican critics. The GOP has focused on repealing Obamacare, but has devoted less energy to developing a replacement.
Healthcare industry officials generally view several GOP proposals, such as limiting coverage for the poor and scuttling new insurance marketplaces created by the law, as more damaging than helpful to the nation’s healthcare system.
“The principle of providing the opportunity for everyone to get health coverage and of joining everybody together in shared responsibility is the right one,” said James Roosevelt Jr., president of Tufts Health Plan, one of Massachusetts’ largest insurers. “No one has presented a credible alternative.”
The value of the alliance between the administration and major insurers, hospitals, clinics and others in the healthcare industry can readily be seen in steps they have taken to help the White House overcome the rocky start of the law’s new insurance marketplaces.
Insurers, for example, are working with the administration to enroll consumers directly in health plans for next year, bypassing the troubled HealthCare.gov website that residents of 36 states were supposed to be able to use to select a health plan.
Major retail pharmacies, such as CVS Caremark, have agreed to market the law’s benefits in their stores. And hospitals and health clinics in many states are helping patients sign up for coverage.
For many of these organizations, the prospect of new customers and a more rational system outweighs their sometimes intense irritation with the Obama administration.
Insurance executives, in particular, have gnashed their teeth at the president’s attacks on their industry, often delivered as the administration simultaneously sought insurers’ cooperation. In recent days, industry leaders were galled by the president’s proposal to shift responsibility for the cancellation of several million existing insurance policies onto insurers and away from the new law.
“Some feel like they did their part to make the law work. It’s very frustrating,” said Bruce Bodaken, former chief executive of Blue Shield of California and a leading industry advocate for expanding health coverage in the state.
Fifteen insurance executives, including Roosevelt, met with Obama for 90 minutes last week at the White House to discuss the president’s proposal, which would allow insurers to extend health plans that are being canceled because they fail to meet the new law’s standards.
The health law was explicitly designed to move consumers out of those policies. Consumers were supposed to be able to shop for new, more comprehensive, plans on marketplaces created by the Affordable Care Act. That has been difficult because of persistent problems with the federal enrollment website (although most state-operated sites have worked better).
Industry leaders, state regulators and even many consumer advocates see canceling the old plans as critical to sustaining the law’s marketplaces and improving coverage. The new system depends on moving all consumers into a market where both healthy and sick Americans can get health coverage. In the old system, only healthy consumers could usually get insurance in the so-called individual market.
Despite the frustrations, most insurers remain committed to moving to a new market that would achieve the central promise of the Affordable Care Act: that all consumers can buy health plans even if they have preexisting medical conditions.
Even the chief executive of WellPoint, the nation’s second-largest health insurer, which spent heavily in 2010 to help defeat Democrats in Congress who had voted for Obamacare, signaled optimism this week about the prospects for people signing up for coverage under the law in coming months.
“The potential is there for a significant uptake,” Joseph Swedish said in an interview this week at a conference for corporate executives sponsored by the Wall Street Journal.
Four years ago, WellPoint’s double-digit rate hikes in California helped energize the final push to pass the health law. Today, WellPoint and other insurers, particularly state Blue Cross and Blue Shield plans, have staked their future on the law’s success, which many hope can reverse the slow decline in the number of Americans with commercial health coverage.
“Insurers may complain,” said former Rhode Island insurance commissioner Christopher Koller. “But they have nowhere to go.”
Others in the health system have become similarly invested in the law’s success.
Hospitals, which provided crucial backing for the law in hopes it would reduce the number of uninsured patients, have been redesigning the way they deliver care to keep patients out of the hospital, another goal of the law.
Although that transition has been difficult for many institutions that relied on filling hospital beds, few hospital executives talk about repealing the law.
“We are still not entirely sure where we are going,” said Judy Rich, chief executive of Tucson Medical Center in Arizona, which has been partnering with local doctors to help patients stay healthy so they don’t need to be hospitalized.
“But every time we reevaluate the options, we come back to one conclusion: This is fundamentally the right thing to do.”
Doctors, too, are being asked to deliver medicine differently, by using technology to better track patients and ensure they are getting recommended care.
Although some grumble about new requirements, the nation’s leading physician groups are forging ahead with new systems for measuring what they do and improving gaps in care.
“We’ve gone down this path with vigor,” said Dr. Brian H. Ewert, president of Marshfield Clinic, one of Wisconsin’s largest medical groups. “And we plan to continue.”
Marshfield, which has more than 700 physicians, is a national leader in developing ways to improve quality while lowering costs, another key aim of the Affordable Care Act.
In Los Angeles, Thomas Priselac, chief executive of Cedars-Sinai Medical Center, said there had been no buyer’s remorse.
“The fact is that doctors and hospitals around the country are committed to achieving the goals of the health law: expanding coverage and, more importantly, raising quality … and making healthcare more cost-effective,” he said.
“There is no going back.”
Why Obama can’t wave away this scandal
By John Podhoretz
November 23, 2013 | 9:30am
The media shielded the president from every criticism — until he betrayed a liberal cause
People are puzzled: Why would Barack Obama have lied about how wonderfully everything was going to go with ObamaCare when officials in his administration knew perfectly well that disaster was going to strike?
In one sense, the answer is simple: At the time, just before Oct. 1, Republicans were insisting ObamaCare be delayed or defunded. The president and his team weren’t going to give the enemy the satisfaction of agreeing — or the potent ammunition that would have come from a rueful admission the system wasn’t ready.
Today, a bipartisan agreement to delay ObamaCare seems like it would have been a pretty good deal. It didn’t look that way at all in the last two weeks of September.
But there’s a deeper reason he and his people lied: They did it because they could. They did it because nearly five years in the White House had given Obama and his team confidence they would not face the music and they could finesse the problems until they got fixed.
Consider the events that would have been unprecedented scandals in a Republican administration — with teams of reporters digging and scratching daily at every nook and cranny in every bureaucratic corridor — that have instead been covered dutifully but with relatively little passion and almost no follow-up. Why? Because it would have hurt Obama, that’s why.
First, the Obama Justice Department.
Attorney General Eric Holder has survived three scandals that would have felled a Republican. His department attempted to soft-pedal its responsibility for the so-called “gunwalking” policy called Fast and Furious — which led to the murders of US border agents by Mexican drug-cartel members with guns effectively provided to the killers by the Justice Department.
He approved the secret surveillance of Fox News Channel reporter James Rosen in a leak investigation on the outrageous grounds that Rosen was a possible “co-conspirator” in an act of espionage. And he approved similar tactics against reporters at the Associated Press in another leak investigation.
Holder’s still there. Obama defends him. When was the last time you heard Rosen’s name mentioned, or the AP story referenced, or Fast and Furious come up?
Second, the Internal Revenue Service.
The IRS’s own acknowledgement that it had targeted conservative groups with anti-liberal agendas has led to shamed retirements, hasty changes at the top of the agency and officials pleading the Fifth Amendment. These efforts were clearly undertaken to find means by which to aid Democratic efforts in the 2010 and 2012 election. One can only wonder at what would have been done to George W. Bush by the media had similar outrages been perpetated on leftist groups in 2003 and 2004. Obama suffered . . . a little. A very little.
Third, the State Department.
The unconscionable behavior of State Department and White House officials during and after the killing of four Americans in Benghazi at the height of the 2012 race — during which the American people were deliberately and consciously misled — has had no lasting consequences whatsoever. Obama felt free to select the chief liar, Susan Rice, as his national-security adviser without experiencing a moment’s fear about how her appointment might become a scandal.
Fourth, making law from the White House.
In 2011, the president said that owing to Republican recalcitrance in the House of Representatives, he would use his executive authority to get things done. And he has. As Tara Helfman writes in the December issue of Commentary, the magazine I edit, “Notwithstanding President Obama’s constitutional duty to enforce the law of the Untied States, where federal laws conflict with his policy preferences on gay marriage, illegal immigration and drug policy, the president has simply opted not to enforce or defend them.”
Moreover, to strengthen his hand with Hispanic voters in 2012, he ordered the Justice Department to follow certain provisions of a law governing illegal immigrants that has yet to be approved by the Congress. That is unprecedented.
So, if you want to understand the blindness and arrogance of the Obama White House in failing to appreciate the wave of rage and disappointment and disgusted wonderment that would hit them in the wake of the ObamaCare rollout, you need only consider these factors.
He has always had the protection of his liberal base.
He has always had the protection of Senate Democrats, who have not acted in any way to trouble him regarding these scandals and who have impeded aggressive investigations into them.
And he has always had the protection of the mainstream media.
As a result, Barack Obama and his administration have said what they felt they needed to say and done what they felt they needed to do for immediate political gain. They did so this time. But this time was different, because this time he was mishandling and discrediting the great liberal desideratum of our time — a national health-care system.
This time he hasn’t gotten away with it.
How the GOP Should Fix ObamaCare
Along the way Republicans can create real choice, real competition and real savings while protecting those who need help.
Nov. 19, 2013 7:27 p.m. ET
Republicans are the only ones who can fix President Obama’s broken promise now.
The problem is simply stated. Millions will be losing their individual insurance policies that they were promised they could keep. They will be expected to buy more expensive ObamaCare-approved policies than they want or need, and to do so from ObamaCare exchanges that aren’t working.
Mr. Obama’s fix, which he proposed on Thursday and which was quickly debunked by the insurance industry and its state regulators, can’t work because Mr. Obama can’t let it work. He has to fight to preserve the central purpose of ObamaCare—to use the individual mandate and ObamaCare’s compulsory benefit list to capture money from unwilling buyers of ObamaCare’s gold-plated insurance policies to subsidize others.
Let’s understand: The stumbling block to fixing Mr. Obama’s broken promise is Democrats clinging to the central redistributive scheme embedded in ObamaCare. There is no reconciling the two.
Americans are beginning to understand that the essence of the Affordable Care Act is that millions of people are being conscripted to buy overpriced insurance they would never choose for themselves in order to afford Mr. Obama monies to spend on the poor and those who are medically uninsurable due to pre-existing conditions. Both Mr. Obama and Republicans are blowing smoke in claiming that the damage done to the individual market by the forced cancellation of “substandard” plans (i.e., those that don’t meet the purposes of ObamaCare) can somehow be reversed at this point. It can’t be.
What can be done is Congress creating a new option in the form of a national health insurance charter under which insurers could design new low-cost policies free of mandated benefits imposed by ObamaCare and the 50 states that many of those losing their individual policies today surely would find attractive.
What’s the first thing the new nationally chartered insurers would do? Rush out cheap, high-deductible policies, allaying some of the resentment that the ObamaCare mandate provokes among the young, healthy and footloose affluent.
These folks could buy the minimalist coverage that (for various reasons) makes sense for them. They wouldn’t be forced to buy excessive coverage they don’t need to subsidize the old and sick.
If this idea sounds familiar, it was proposed right here three years ago, after the 2010 elections in which Democrats lost the House due to public disquiet over ObamaCare.
Because such a move could be sold as expanding the options under ObamaCare and lessening the burden of an unpopular mandate, it always had potential to draw Democratic support. That’s doubly true now that Democrats are saddled with President Obama’s promise that anybody who liked their existing insurance can keep it. Mr. Obama’s promise is not literally keepable but the national charter would be the next best thing, letting millions find policies that are a good deal for them in their particular circumstances.
And, yes, this would also blow up the disingenuous financial engine of ObamaCare. This is a feature not a bug.
The ObamaCare exchanges would devolve into refuges for those who are medically uninsurable. But this seems increasingly likely to happen anyway. The federal government, having assumed the job of subsidizing these people, should do so honestly and openly.
ObamaCare is dead on the vine. It becomes clearer by the day the only way insurers can make the Obama benefits package work at a monthly premium affordable by healthy people who don’t qualify for subsidies is with massive deductibles and copays and narrower provider networks. ObamaCare’s individual mandate, as philosophically odious as some find it, would survive. An admirable principle buried in ObamaCare—that subsidies should be reserved for the needy—would also survive.
What wouldn’t survive is the Democratic scheme to force everyone, regardless of age and actuarial risk, to buy a gold-plated package of benefits that will stimulate a wasteful race to spend more resources on health care. And, down the road, by reforming ObamaCare, much else could be reformed, including Medicare and the ill-begotten and destructive link between employment and health care.
This outcome will shock liberals who have single-payer sugar plums dancing in their head right now. Let’s leave them with one thought.
The government-run systems you so admire in other countries mostly came about long ago. They came about to expand access to medical care at a time when medical care couldn’t do all that much for people. We live in a different age. America, let’s face it, would be embarking on a single-payer system not to expand access—though that slogan would be used—but to deny and limit care in order to control runaway spending.
Liberals, you think you want to go there but you don’t.
Nicole Hopkins: ObamaCare Forced Mom Into Medicaid
My mother preferred to pay for her care rather than be on the government dole. Now she has no choice.
By NICOLE L. HOPKINS
Nov. 20, 2013 7:13 p.m. ET
My mother is not one to seek attention by complaining, so her recent woeful Facebook post caught my eye: “The poor get poorer.” It diverged from the more customary stream of inspirational quotes, recipes and snapshots from her tiny cottage in Pierce County, Wash.
The post continued: “I just received a notice: ‘In order to comply with the new healthcare law, your current health plan will be discontinued on December 31, 2013.’ Currently my premium is $276 and it is a stretch for me to cover. The new plan . . . are you ready . . . projected new rate $415.20. Now I can’t afford health insurance.”
The unaffordable ObamaCare-compliant plan that her insurer offered in a Sept. 26 letter is not what makes my mother’s story noteworthy. Countless individually insured Americans have received such letters; many are seeing more radical increases in premiums and deductibles.
But most of these people are still being offered the chance to choose what health-care insurance they will receive, or to opt out before they are automatically enrolled in a state program. Not so my mother, Charlene Hopkins, as I soon discovered when I called after seeing her Facebook post.
Since she couldn’t afford the new plan offered by her insurer, she told me she was eager to explore her new choices under the Affordable Care Act. Washington Healthplanfinder is one of the better health-exchange sites, and she was actually able to log on. She entered her personal and financial data. With efficiency uncommon to the ObamaCare process, the site quickly presented her with a health-care option.
That is not a typo: There was just one option—at the very affordable monthly rate of zero. The exchange had determined that my mother was not eligible to choose to pay for a plan, and so she was slated immediately for Medicaid. She couldn’t believe it was true and held off completing the application.
“How has it come to this?” she asked in one of our several talks over the past few weeks about what was happening. When she was a working mother and I was young, she easily carried health insurance for our whole family. “How have I fallen this far?”
In 2011, she had to give up her real-estate license; as a newer agent, she did not stand to earn enough in the tough market to justify the fees to renew. She has since managed to eke out a living as a substitute para-educator in the Central Kitsap School District. “I’m not on the couch, watching TV,” she said. “I’m out trying to find more work every day.”
Unable to secure employer-sponsored health care, she had, until this fall, chosen to pay $276 a month for bare-bones catastrophic coverage. “I think that we should be able to take care of ourselves and to earn enough money to pay for basics, and health insurance is one of them,” she told me. For two years she had paid out of pocket for that plan, but now she is being told that the plan isn’t good enough for her.
The Sept. 26 letter from my mother’s insurer promised that the more expensive plan “conforms with the new health care law”—by covering maternity needs, newborn wellness and pediatric dental care. My mother asked: “Do I need maternity care at 52?” In addition to requiring her to pay an extra $1,677 annually, the plan would have increased her deductible by $1,500.
But she had at least been presented with an option that she could turn down, unlike on the state exchange.
The situation sounded absurd, so I asked her to walk me through her application on Washington Healthplanfinder to make sure she wasn’t missing anything. Sitting in New York with my computer, I logged onto the site under her name and entered the information my mother provided over the phone. I fully expected her to realize that she had forgotten some crucial piece of information, like a decimal point in her annual income. We checked and double-checked the information, but the only option still appeared to be Medicaid. She suggested clicking on “Apply for Coverage,” thinking that other options might appear.
Instead, almost mockingly, her “Eligibility Results” came back: “Congratulations, we received and reviewed your application and determined [you] will receive the health care coverage listed below: Washington Apple Health. You will receive a letter telling you which managed care plan you are enrolled with.” Washington Apple Health is the mawkish rebranding of Medicaid in Washington state.
The page lacked a cancel button or any way to opt out of Medicaid. It was done; she was enrolled, and there was nothing to do but click “Next” and then to sign out.
Of course, Medicaid is not a new option for my mother; she knew that she was poor enough to qualify for cost-free health care. It was a deliberate choice on her part to pay that monthly $276 out of her own pocket. Clearly she had judged that she received a personal benefit from not being on Medicaid.
“I just don’t expect anything positive out of getting free health care,” she said. “I don’t see why other people should have to pay for my care, whether it be through taxes or otherwise.” In paying for health insurance herself—she won’t accept help from her family, either—she was safeguarding her dignity and independence and her sense of being a fully functioning member of society.
Before ObamaCare , Medicaid was one option. Not the option. Before this, she had never been, in effect, ordered to take a handout. Now she has been forced to join the government-reliant poor, though she would prefer to contribute her two mites. The authorities behind “affordable care” had erased her right to calculate what she was willing to spend to preserve her dignity—to determine what she thinks is affordable.
That little contribution can mean the difference between dignity and despair.
For the truly poor, being institutionally forced to take welfare is demoralizing. The Affordable Care Act is at risk of systematizing learned helplessness by telling individuals like my mother that they cannot afford to care for themselves in the way they could before the law was enacted. “This makes me feel poorer than ever,” she said.
My mother grew up, one of six children, in a dairy-farming family in Wisconsin. “The way I was raised, taking government handouts is shameful,” she said. Her siblings stayed in Wisconsin, but she set out on her own. Finding herself forced onto Medicaid is not a fate that she ever would have imagined. “I guarantee I’m the only person in my family in this situation.”
I’m proud to see the spiritedness and resolve that bears my mother up even now. Such character does not draw attention to itself: Its spark only catches the eye when oppression seeks to snuff it out.
Ms. Hopkins is a writer in Brooklyn, N.Y.