Tuesday, January 28, 2014

Obamacare Schadenfreude, Back In the Deep Freeze

The second "polar vortex" of the year arrived as forecast yesterday afternoon, after our brief flirtation with above freezing temperatures (most, but not all of our snow is gone), and this morning the temperature was back to 12 F.

Similarly, after a couple of days of light output Obamacare Schadenfreude has ramped back up to a fever pitch in anticipation of the SOTU.

America's Worst Congressman Says Obamacare unraveling because the young aren't as stupid as he expected:
Perhaps it takes retirement for Democrats to be honest about the status of ObamaCare, and about its unsustainable structure. Rep. Jim Moran (D-VA), who recently announced his retirement from the House, told American University Radio last week that the dearth of enrollments from young, healthy Americans in ObamaCare would “unravel” the whole system — and that furthermore, they’d be right to avoid it:

From the "Yeah, like that's gonna happen department", Ted Cruz thinks the Preznit should use the SOTU address to apologize for the lie of the year:
“For the State of the Union, one of the things President Obama really oughta do is look in the TV camera and say to the over 5 million Americans all across this country who've had their health insurance canceled because of ObamaCare, to look in the camera and say, ‘I’m sorry,’ ” Cruz said on CBS’s "Face the Nation."
. . .
Cruz said that, in addition to apologizing, Obama should offer fixes for the law.

“But then, Bob, here's the real kicker. If you're really sorry, you don't just say you're sorry. You actually do something to fix the problem,” he added.
Speaking of the lie of the year, the numbers suggest that only about 1/3 of Californians kicked off their health insurance by Obamacare have succeeded in getting new policies:
The latest version of such inflation is Covered California's jubilant announcement last week that "500,108 Californians enrolled for health insurance and selected plans through the end of 2013."
By the end of October, the executive director of California's Obamacare exchange confirmed that up to 900,000 people in the state would lose their current health insurance by the end of 2013--not including those who may lose it through their workplaces in 2014. Many of those are among the 500,000 or so who signed up for Obamacare through Covered California by the end of 2013--about 330,000, according to McCormack. That also means that only about 200,000 previously uninsured people signed up for Obamacare.

As for the other 600,000 or so, no one know what happened to them--they are just uninsured. The state refused to participate in President Barack Obama's proposed "fix" for those who had their policies canceled.
Success! If by success you mean standing triumphant on the smoking ruins of the healthcare system.

Another "unintended" consequence of Obamacare is that many people who are able to get health insurance through the exchanges are unable to similarly insure their children, who are forced into Medicaid, making them medical wards of the state.
Children who qualify for Medicaid, the safety-net program for the poor and disabled, can’t be included on subsidized family plans purchased through the federal marketplace, a fact that is taking many parents by surprise and leaving some kids stuck without coverage.

And in New Hampshire, some parents who’ve enrolled in private plans for themselves alone are finding out later that their children aren’t eligible for Medicaid after all, leaving their kids with no options.
. . .
“The children are getting stuck in this spot where we’ve enrolled the parent, but we can’t bring the children back on the family plan,” Maria Proulx, senior legal counsel for Anthem Blue Cross and Blue Shield of New Hampshire, told a state advisory board panel this month.
Walmart and Walgren's pharmacies report that they are unable to provide free prescriptions to people who have lost their primary care physicians as a consequence of Obamacare.
Walgreens' and Walmart's pharmacies announced this month that they will help with the botched Obamacare rollout by providing free prescriptions to customers whose insurance coverage is pending. The move, while well-intentioned, only helps those possessing a prescription, leaving anyone still seeking a doctor’s assistance stranded.

The policies of both corporations this month were simple: those who can prove they signed up for Obamacare through HealthCare.gov and have a prescription can file it for free, even as they are not yet covered because of the system's inefficiency. The problem is that to have a prescription, patients must go to a doctor, and their pending insurance applications mean they will have to either handle the full cost of a visit themselves. If they wait until their application is no longer pending, they are not eligible to receive the benefits from the pharmacies’ programs.
But this one, no doubt, will receive lots of attention in the MSM.  North Carolina Blue Cross cuts benefits for gay couples:
Blue Cross and Blue Shield of North Carolina recently cancelled insurance polices which were previously purchased by gay and lesbian couples who opted to purchase a family insurance policy from the company.

The health insurance company opted to cancel the policies after stating that the language in the respective policies was geared more towards married couples and not gay couples. Terms such as “spouse” and “opposite sex” were used in the health insurance contracts, making them invalid.

Gay couples who purchased family coverage from Blue Cross have the option to instead purchase individual health care coverage.
I anticipate a couple of pairs of cute lipstick lesbians and gay males on TV tearfully explaining how their feelings are being hurt by having to by separate Obamacare policies.

But gay couples can take consolation in the fact that Obamacare manages to fund abortions through the back door: Surprise! Secret Abortion Fees Buried in ObamaCare Premiums
Insurance companies working under the Obamacare umbrella have secretly added a surcharge to cover the cost of abortions, an apparent violation of federal law that forbids the practice, congressional leaders charge.

Consumers signing up for insurance in an Obamacare exchange won’t find a single sentence telling them that they will pay at least $1 a month to fund abortions.
“The president promised when the health care bill passed that it would not cover abortion. We knew that was an empty promise as the bill stipulated a $1 a month surcharge for plans that covered abortions,” said Rep. Joe Pitts, R-Pa., who chairs the House’s Energy and Commerce subcommittee on Health. “On top of that … it’s near impossible to decipher which plans include abortion and at what cost!”

To fix this, a House bill will be introduced this week to demand full disclosure and a separate itemized premium. It also will prohibit federal subsidies for Obamacare insurance plans that cover abortion. That bill, HR-7, or the “No Taxpayer Funding for Abortion Act,” will be introduced by House Majority Leader Eric Cantor.
What?  Product labeling?  No way the democrats will support that.

Michelle Obama would like you to send $10 for her next well earned vacation to save Obamacare from those awful Republicans:
Friend —

Earlier this month, because of what you did, it became illegal for insurance companies to discriminate against the up to 129 million Americans living with pre-existing conditions. Young Americans are able to stay on their parents' health care plans as they get on their feet, and we can now know that our insurance companies won't put lifetime caps on our coverage.

You should be so proud of that. That happened because you organized, you talked to your friends and neighbors, and you chipped in what you could, when you could, to elect Barack and a Congress who supported his agenda.

Today, I'm asking you to do it again.

So before Barack gives his State of the Union address tomorrow, chip in $10 or more and help protect Obamacare:
GOP rolls out it's healthcare plan
Sens. Tom Coburn, R-Okla., Richard Burr, R-N.C., and Orrin Hatch, R-Utah, would repeal Obamacare as part of the Patient Choice, Affordability, Responsibility and Empowerment Act. But in crafting a replacement, the lawmakers were cognizant of both the popular and unpopular aspects of Obamacare.
. . .
Under the replacement proposal, as is the case with Obamacare, insurers would be barred from imposing lifetime limits on medical claims and required to allow individuals to remain on their parents’ policies until the age of 26.

Under the rules of Obamacare, insurers can only charge three times as much to older Americans as they charge younger Americans, one of the factors that has driven up the price of insurance for the young. The Coburn-Burr-Hatch proposal would create a federal benchmark allowing insurers to charge older Americans five times as much. However, states would be permitted to set their own ratio below that amount, or opt out of the requirement altogether.
This is a pretty big one, as the age differential is one of the big factors in making O-care policies have either outrageous prices or deductibles for the young.  I would have gone further, but that would be unpopular with older people, a significant block for the the Republican.
To address those with pre-existing conditions, who have been among the major targeted beneficiaries of Obamacare, the GOP proposal would require insurers to offer coverage to anybody who has applied as long as they have maintained continuous coverage, regardless of whether they are switching health plans or shifting from employer-based health care to the individual market. The theory is that this would offer some protection to those with pre-existing conditions without having the same effect on premiums as Obamacare’s full ban on the practice. At the same time, the idea is that this would create an incentive for everybody to maintain their insurance coverage, thus negating the need for the individual mandate.
Pre-existing conditions is a tough one.  People are generally against the "pre-existing conditions" clauses on insurance, but most don't understand how they help keep costs down for the rest of us. People need to be made to understand that to cover "pre-existing conditions" rates have to go up on everyone, effectively making it a charity situation.
For years, most free market health care proposals began with the idea of ending the discrimination in the tax code that gives an unfair advantage to those who obtain health insurance through their employers. But in consideration of the backlash against the way that Obamacare has disrupted people’s insurance coverage, the new GOP proposal would maintain the employer health insurance bias. Instead of scrapping the employer health insurance tax exclusion, the proposal would merely cap it at 65 percent of the average plan’s costs.
Agreed.  Another, better way to do it, in my opinion, would be to give individuals the same tax break for buying insurance that companies get.  Too much tax cut?  Too bad.  Make it up by taxing NGOs.
The savings generated by capping the exclusion would be used to help finance tax credits to be offered to individuals earning up to 300 percent of the federal poverty level (or annual earnings of about $35,000 for an individual). A new division of the U.S. Department of Treasury known as the Office of Health Financing would administer the credits. Obamacare’s subsidies are more generous and go up to 400 percent of the federal poverty level.
I would prefer low taxes in general to an exclusion that gives tax breaks to the 3 X poverty level.  I want a leveler field, not one with a steep slope to get out out of "3 X poverty".
In cases where individuals qualify for a tax credit high enough to cover the cost of a plan but never sign up for insurance, states have the option of automatically enrolling them in a default policy, though the individuals would also have the ability to opt out.

The proposal would also expand the use of tax free health savings accounts, for instance, by allowing funds to be withdrawn to pay premiums for long-term care insurance and COBRA.
Tax free is better.  A good provision, but one which will not be popular with democrats, as they prefer to take the money in taxes, and dole it back out in favors that buy votes.
Instead of expanding Medicaid, as Obamacare does, the Coburn-Burr-Hatch proposal would reform it to give more flexibility to states and allow Medicaid beneficiaries the option of using their tax credit to purchase private coverage.
What, federalism?  Heaven forfend that New York and Mississippi both get to run Medicaid the way they want.
In addition, the proposal encourages states to adopt medical malpractice reforms and requires hospitals and insurers to improve price transparency.
Yeah, the doctors support would be nice, but the insurance companies and hospitals are where the big money is.  Count on insurance companies to oppose this.  I would also have preferred to see an explicit rejection of the "insurance company bailouts" in Obamacare, but the fact they are not mentioned gives me some hope.
 . . .Ultimately, the new Coburn-Burr-Hatch plan would not usher in a free market for health insurance in the United States, which would require fully ending the distortion of the tax code and removing far more regulations. What it does do is offer individuals more freedom than now exists under Obamacare.
As was noted yesterday, this approach has some political risks.  Instead of a solid opposition to Obamacare as a unifying factor, now the Republicans have a plan that can be snipped at and torn apart piecemeal.  But is that an improvement over the unfounded, but generally accepted as true charge that the Republicans have no plans for improving healthcare?

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