Wednesday, March 26, 2014

Gusting Obamacare Schadenfreude

Our last blast of Fimbulwinter?  As a I reported on the Schadenfreude post yesterday, it was just starting to snow late yesterday morning.  The snow continued on and off all day, without showing any accumulation until the evening, when it started to thicken, and stick on the decks, trees and lawn.  This morning the clouds have mostly passed, the backside winds have arrived, and we have a light layer of snow remaining this morning.

Schadenfreude seems to be reaching a fever pitch as we approach the March 31 deadline for enrollments.  Oh, wait a minute... What deadline?

Obama administration will allow more time to enroll in health care on federal marketplace
The Obama administration has decided to give extra time to Americans who say that they are unable to enroll in health plans through the federal insurance marketplace by the March 31 deadline.

Federal officials confirmed Tuesday evening that all consumers who have begun to apply for coverage on, but who do not finish by Monday, will have until about mid-April to ask for an extension.

Under the new rules, people will be able to qualify for an extension by checking a blue box on to indicate that they tried to enroll before the deadline. This method will rely on an honor system; the government will not try to determine whether the person is telling the truth.

The rules, which will apply to the federal exchanges operating in three dozen states, will essentially create a large loophole even as White House officials have repeatedly said that the March 31 deadline was firm. The extra time will not technically alter the deadline but will create a broad new category of people eligible for what’s known as a special enrollment period.
As often happens the best quip comes from Instapundit:
WITH THIS LATEST OBAMACARE DELAY IT BECOMES CLEAR THAT THE “TERRORISTS AND ANARCHISTS” ARE IN FULL CONTROL:Obama administration will allow more time to enroll in health care on federal marketplace. Remember when they told us that any delay would kill sick people, you MURDERER!!!!???
Honey, I shrunk the mandate
Some exceptions are part of the law. Some were added to quell political fires.
If you had a plan that was canceled and think the alternative costs too much, you get a pass. And it’s not an out just for this first rough year. According to a decision this month by the administration, you may be able to escape the obligation of the mandate for the rest of the Obama presidency — if you can deal with the paperwork.

If you are one of the several million low-income people who would qualify for Medicaid expansion — but your state opted out of expansion — you won’t be required to buy coverage.

These and other changes to the mandate encapsulate many of the challenges the administration has faced during the four years of implementation since the Affordable Care Act law was passed.

The White House needs the mandate to make its policies work, as it creates new insurance markets operating under new rules.

It needs the exemptions to make the politics work — or at least to take the edge off some of the sharpest political backlash, like the outcry over the canceled plans that people had been told they could keep.
The other "big" story consuming electrons, as well as news print and ink this morning, is, of course, the arguments before the Supreme Court over the Hobby Lobby and Conestoga Wagon vs Sebelius case. I'm not a lawyer, although my Dad ran a law school for years, my youngest brother is a lawyer, and sometimes I think I married one, so I don't pretend to be able suss out any great insights.  Everything I have read seems to suggest that the liberals and the women on the court (but I repeat), favored taxing the for profit corporations to death to defend the law, while the men and conservatives asked pointed questions about the law, and Justice Kennedy, neither man nor reliably conservative, sat on the fence and will almost certainly be the person to actually decide the case.  And we don't get to find out until June. Sort of a cliff-hanger ending. Stay tuned.

It is interesting that, under Obamacare, employers providing a plan without birth control draw a higher penalty tax than not providing a plan at all:
If your employer offers you insurance that doesn’t provide free ella, or anything else on the list of “preventive services”—as defined by Health and Human Services Secretary Kathleen Sebelius and ultimately by Obama—then it’s subject to a fine of $36,500 a year. But if your employer doesn’t offer you insurance at all, it’s subject to a fine of $2,000 a year. Actually, for now your employer’s choice is between a fine of $36,500 or $0, as Obama has extralegally decreed that fines for not providing insurance (but not fines for providing insurance that doesn’t cover all “preventive services”) will be waived until after we get to the other side of the midterm elections.

As Rep. Diane Black (R., Tenn.) put it after the oral arguments, “Only Obamacare could create a system that carries 18 times the fine for providing insurance coverage to employees than for not providing any coverage at all.”
The record breaking stupidity award goes to, of course, California Senator Barbara Boxer, who likens abortifacients to Viagra:

First and foremost, Viagra (and other erectile-dysfunction drugs and treatments) aren’twidely covered by insurance. That’s one reason why a large online market for inexpensive purchases of the drugs exist. Second, as anyone who gives a moment’s thought about the subject would realize, such drugs would be appropriate to help empower natural procreation, which isn’t against anyone’s religion, last I checked. Lastly, and this is a more minor point, Boxer ignorantly invokes the Catholicism of the plaintiffs in this court hearing, when none of them are actually Catholic.
Apparently, California has an affirmative action plan that has a quota for morons in politics.

Rand Paul, whom I generally respect, wants the Preznit to explain to Pope Francis why he’s infringing on faith:

“He ought to explain to the Pope why he is telling businesses in America they can’t remain true to their faith and stay in business,” the Kentucky Republican said on Fox News’s “Fox and Friends.” …

“The ‘Hobby Lobby’ case is being discussed today, and I think it’s important that he tell the leader of the Catholic Church why he thinks that businesses owned by Catholics can’t make their own decisions with regard to health care,” Paul said.
These remarks weren't completely out of context, as they followed the Vatican's Chief Justice, Cardinal Raymond Burke, criticizing Obama over the lack of religious exemptions, and other things:
The policy of the President of the US towards the Christian civilisation becomes more and more aggressive. Does Your Eminence notice any symptoms of Catholic reactions against this policy? If yes, what are they, if not why?

It is true that the policies of the President of the United States of America have become progressively more hostile toward Christian civilization. He appears to be a totally secularized man who aggressively promotes anti-life and anti-family policies. Now he wants to restrict the exercise of the freedom of religion to freedom of worship, that is, he holds that one is free to act according to his conscience within the confines of his place of worship but that, once the person leaves the place of worship, the government can constrain him to act against his rightly-formed conscience, even in the most serious of moral questions. Such policies would have been unimaginable in the United States even 40 years ago. . .
Now, back to the general grumbling and complaints about the peculiarities of Obamacare:

Shockingly, US Chamber of Commerce not wild about Obamacare: A ‘Cascade of Failures’
Health policy experts Tyler Hartsfield and Grace-Marie Turner of the Galen Institute calculate that more than 37 significant changes have been made to Obamacare since the law went into effect. More than half the changes have been made unilaterally by the Obama administration, rather than through legislative action or the normal regulatory process.

“But even this large number of changes hasn’t stopped the cascade of failures we are seeing today in the implementation of the law,” Hartsfield and Turner write.
IRS: Obamacare Raised Taxes for Some Children
When the Affordable Care Act was passed in 2010, one provision was a new 3.8 percent Net Investment Tax effective in 2013. Although the tax will generally hit high-end taxpayers (threshold is $250,000 for married and $200,000 for single), because of the way many parents choose to report their children's investment income, the tax will likely hit many other children as well.. . .
Starting in 2013, a child whose tax is figured on Form 8615 may be subject to the Net Investment Income Tax. NIIT is a 3.8% tax on the lesser of either net investment income or the excess of the child's modified adjusted gross income that is over a threshold amount...
The new tax paid on children's income will be part of a so-called "kiddie tax" that stems from 1980s tax reform when Congress sought to recover taxes that were being lost on income from assets transferred from parents to children ("child" is defined as under age 19, or under age 24 if a full-time student.) Investment income over $2,000 is taxed at the parents' highest rate instead of the rate used for regular income for the child. And if the parents' income exceeds the NIIT threshold, the child's investment income is also subject to the additional 3.8 percent tax.
Might as well get them used to the idea of being over taxed.

Hispanics Being Left Behind In Health Care Overhaul
Experts cite overlapping factors behind disappointing Latino sign-ups:

— A shortage of in-person helpers to guide consumers. “In our community, trust and confidence is so important — you want to make sure it’s okay before you share all this personal information,” Delgado said. There’s been a lack of “culturally sensitive” outreach to Latinos, added Rep. Lloyd Doggett, D-Texas.

— Fear that applying for health care will bring unwelcome scrutiny from immigration authorities. The health insurance exchanges are only for citizens and legal U.S. residents, but many Hispanic families have mixed immigration status. Some members may be native born, while others might be here illegally. Obama has tried to dispel concerns, repeatedly saying that information on applications will not be shared with immigration authorities.

—The decision by many Republican-led states not to expand Medicaid, as they could under the law. With states like Texas and Florida refusing to expand Medicaid, many low-income Latinos will remain uninsured. However, Medicaid expansion is separate from coverage on the exchanges, which is available in every state. Latinos don’t seem motivated to sign up for that, either.

— Technical difficulties that delayed the federal government’s Spanish-language enrollment site. has also had to cope with clunky translations.
California and Texas hardest hit.

Obamacare as Election Turnout Machine">

A settlement between California and left-wing groups begins to reveal the political architecture of Obamacare.

From the ACLU press release:
In a victory for voting rights, the state of California has agreed to mail voter registration cards to nearly 4 million Californians who have signed up for health insurance through the state health exchange, Covered California, and to ensure that Californians who apply for health benefits through the exchange going forward are provided voter registration opportunities. The action is the result of a settlement agreement reached with the ACLU of California, the ACLU’s Voting Rights Project, Demos, and Project Vote, which threatened legal action over the state’s failure to comply with the National Voter Registration Act and state laws.
Here’s the simple version: Obamacare requires millions of people to interact with the government who never would have done so before. At the point of interaction, NVRA requires them to be pushed to register to vote. Presto. Millions of people are now touched by a political touch when they just wanted to see a doctor. The politicization of health care has a GOTV component for the Democrat party.

Whether the Republicans fully understand this architecture remains to be seen.
Top Dem pollster: 'Don't defend' Obamacare, call it 'flawed from the beginning'
Celinda Lake, whose firm Lake Research Partners provided the Democratic analysis of the new George Washington University Battleground Poll released Tuesday morning, summed up her advice to Democrats when it comes to Obamacare: “Don't defend it.”

In unveiling the poll, she said that the new Democratic strategy should be for candidates to promise to fix the troubled system while pledging to help keep Americans out of the claws of greedy insurance firms.

“In terms of Obamacare, don’t defend it, say it was flawed from the beginning, and we’re going to fix it,” said Lake at a poll briefing hosted by the Christian Science Monitor.
Except that they haven't made any moves to fix the law legislatively. But Republicans are pretty much stuck at the same point; they can't end it, so all they can do is try to mend it:

GOP finds unwinding Obamacare vexing now that it's taken root
Republicans are still determined to repeal Obamacare, even though they have famously failed to unite behind an alternative. Now, it is dawning on some in the GOP that even if they succeed in repealing the Affordable Care Act, and even if they pass an alternative, they will still have to come up with a plan to get from here to there. Right now, they don't have one.

What is different about Republican calls for repeal today -- as opposed to calls for repeal from 2010 to the end of 2013 -- is that Obamacare is now in place. It exists.Exchanges are running -- many of them badly, but running. Subsidies are being paid.

Insurance companies have changed the way they do business. Medicaid has been expanded. Special taxesare being collected.
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Even though the system is new, millions of Americans have gone to a lot of trouble to adjust to it, and it would be disruptive to them to just stop cold. Halt subsidies? Undo Medicaid expansion? Just as last fall, when millions of Americans received coverage cancellation notices, millions more would face new burdens under the repeal of Obamacare.
Sen. Ted Cruz was prescient it this; but would it be more disruptive than Obamacare itself has been?  I doubt it.  Not if they actually thought about and debated the law that replaced it. From a commenter at Althouse:
We shouldn't forget that ObamaCare was written in the dead of night by Harry Reid's office, voted on, unread, by the Senate hours later and sent to the House which passed it "as is" so it would not have to go back to the Senate where Scott Brown's vote would have killed it.

Therefore, there was no internal consistency check. There was no opportunity for clarifying amendments. There was no opportunity for anything Harry Reid did not think was appropriate. That is why we keep finding these unintended consequences that Obama tries to paper over with Executive Orders.

That is why the idea of "fixing" ObamaCare is a very bad idea. There are so many traps in the bill (as well as in the stacks of "rules") that no one could untangle the mess. This is just like a badly designed web site. Best to start all over than try to add undocumented patch upon undocumented patch in a vain attempt to fix it.
GOP again accuses Sebelius of misleading ObamaCare testimony
Administration officials have repeatedly said they’re not able to break down enrollees by who has made a payment because they only have access to information about those selecting plans on the website, as consumers are expected to pay the insurers directly after enrolling.

Sebelius reiterated that claim in her March 12 testimony to the House panel.
But Reps. Camp (R-Mich.) and Kevin Brady (R-Tex.) say they have uncovered “new evidence” that “strongly suggests that the administration knows who has enrolled and paid their first month’s premium.”

The congressmen pointed to an online regulations portal run by the Centers for Medicaid and Medicare Services (CMS) that says insurers are required to inform the agency of “the full enrollment and payment profile” for consumers on a monthly basis.
Of course, if the numbers were on her side, she'd be be shouting them from the top of the building.

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