Wednesday, March 19, 2014

Obamacare Schadenfreude Aplenty

The snow from the last blast of winter weather is rapidly melting away here, under gray skies, and temperatures in the mid 30s.  We're hoping it really was winters last gasp, but given another cold wave expected next week, that seems to be unnecessarily optimistic.

I'm wading through another mass of Obamacare Schadenfreude for you, depressing stuff. I hope you appreciate it.

ObamaCare supporters just pretending lax hardship exemption doesn’t exist
Specifically, the idea that the hardship exemption has been expanded to a point that makes the individual mandate de facto delayed, or at least willfully unenforced, is a “fantasy” of “right-wing blogs…to sabotage Obamacare.” Juan maintains the exemption is only for people who “had a fire in your home or if you’re a victim of spousal abuse,” and other major, verifiable hardships.

Juan is right that is what the hardship exemption was meant to be. But it’s far more than that now, thanks to President Obama’s administration and panicking Democrats who are more than happy to sabotage their own law with a Whack-a-Mole approach to every potential political problem the law precipitates. Let’s go back to December:
Individuals whose health plans were canceled will now automatically qualify for a “hardship exemption” from the mandate. If they can’t or don’t sign up for a new plan, they don’t have to pay the tax. They can also get a special category of ObamaCare insurance designed for people under age 30.
. . . 
Go see the video and read the whole thing.

Megan McArdle says that Young Invincibles Are Killing Obamacare
. . . let’s start with some basic numbers. As of March 1, 4,242,325 people had selected a plan on one of the exchanges; 1,075,990 of them, or just a smidge over 25 percent, were young adults ages 18 to 35 -- that critical demographic that the exchanges need to enroll. Previous projections had been for 40 percent. . .However, at this point, with one month to go, the youth contingent would have to be truly massive to get near the 38.5 percent that was originally projected.
. . .
How much does this matter? Well, a team from the Kaiser Family Foundation calculated that if enrollment were only 33 percent young, costs would exceed premiums by about 1.1 percent; if it were 25 percent (i.e. if it doesn't change much), costs would exceed premiums by about 2.4 percent.
. . .
But what if what we’re witnessing is the broad operation of adverse selection -- older and sicker people buying while the young and healthy stay away? The first place that would show up in the data would be . . . a disproportionately low number of young people, particularly young men. Which is exactly what we do see. This explanation seems more likely to me than the alternative.

So are we definitely due for a death spiral?

No. For one thing, that 38.5 percent number doesn’t come from the insurers; it comes from the government. The government has been talking to insurers, but it isn't running their actuarial models. If the insurers assumed a worse demographic mix than the government analysts, then we may not need so many young people to keep the markets sound.

Insurers also want this to work, so they may be willing to take losses for a few years to keep premiums low -- especially if the government funnels money to them through the risk-corridor program.

What this does tell us, however, is that it is now probably impossible to achieve the demographic mix that the government has been forecasting. And keeping it from happening may well prove very expensive for the federal government.
So it sounds to me like we, the tax payers, will be forced to pay the insurance companies for Obamacare's mistakes.

And another demographic is heard from: Middle-Age Men Say No to Obamacare Plans
Anyone wondering why Obamacare is having a hard time meeting its enrollment projections, even after the problems with have mostly been fixed, will want to look at a survey released today by Bankrate.

The headline number from the telephone survey of more than 3,000 people is that 34 percent of respondents without insurance say they plan to stay that way, even after being told that the new law requires them to get covered or pay a penalty. What's more interesting is who's saying that:
  • It's not just the young. Of the 1,249 respondents without insurance, people age 18 to 29 were in fact the least likely to say they will remain uninsured, with just 28 percent making that claim. Among those 50 to 64, the figure was 33 percent; for those 30 to 49, 39 percent said they would stay uninsured.
  • Gender matters. When the pollsters asked the uninsured whether they planned to stay that way, despite the individual mandate, 37 percent of men said yes, compared with 29 percent of women. . . 
My guess, based on having been one, is that middle aged men have considerably less medical expenses than middle aged women, and that this too, will substantially contribute to the lack of profitability of Obamacare plans.  Just another spin of the death spiral.

One of the biggest lies in the selling of Obamacare was the promise that it would save people money ($2500 per family IRRC), and hold down future costs increases.  The truth, pretty much the exact opposite: Premiums rising faster than eight years before Obamacare COMBINED
Health insurance premiums have risen more after Obamacare than the average premium increases over the eight years before it became law, according to the private health exchange eHealthInsurance.

The individual market for health insurance has seen premiums rise by 39 percent since February 2013, eHealth reports. Without a subsidy, the average individual premium is now $274 a month. Families have been hit even harder with an average increase of 56 percent over the same period — average premiums are now $663 per family, over $426 last year.

Between 2005 and 2013, average premiums for individual plans increased 37 percent and average family premiums were upped 31 percent. So they have risen faster under Obamacare than in the previous eight years.
So how do we square that circle?  Subsidies!
An important caveat is that eHealth’s prices don’t include subsidies, so the prices for anyone earning between 100 and 400 percent of the federal poverty level will be lower. The Department of Health and Human Services (HHS) has repeatedly claimed patients will pay as little as $18 per month, without noting the taxpayer cost.
. . .
But premiums aren’t the only key to health care costs — deductibles and out-of-pocket costs like co-pays are also rising. When it comes to employer health plans alone, four out of five U.S. companies have increased deductibles or are considering doing so.
So where is the money going? Obama admin rule change lets insurance companies keep more profits, pay less for care
Republican Tennessee Rep. Diane Black says that the Obama administration’s most recent Obamacare rule change will result in insurance companies keeping more profits while paying less for customers’ health care needs.

“I am writing to express my concern with the proposed rule change released on Friday, March 14th that would allow insurance companies to keep an additional two percent of premiums for purposes other than medical care…your department is now proposing to increase the amount of money that insurance companies will be allowed to retain for profit,” Black wrote in a letter Tuesday to Health and Human Services (HHS) Secretary Kathleen Sebelius, which was obtained by The Daily Caller.

HHS’ Centers for Medicare and Medicaid Services quietly introduced the new rule Friday, which relieves insurance companies of some of the damage about to be levied on them by Obamacare-related administrative costs.
More bad news on the coverage front, Obamacare networks commonly exclude the major cancer centers.
Some of America's best cancer hospitals are off-limits to many of the people now signing up for coverage under the nation's new health care program.

Doctors and administrators say they're concerned. So are some state insurance regulators.

An Associated Press survey found examples coast to coast. Seattle Cancer Care Alliance is excluded by five out of eight insurers in Washington's insurance exchange. MD Anderson Cancer Center says it's in less than half of the plans in the Houston area. Memorial Sloan-Kettering is included by two of nine insurers in New York City and has out-of-network agreements with two more.

In all, only four of 19 nationally recognized comprehensive cancer centers that responded to AP's survey said patients have access through all the insurance companies in their states' exchanges.
Pastor Diagnosed With Cancer: 'No Compassion in the Affordable Care Act'
A pastor recently diagnosed with cancer, and who is covered under Obamacare, tells a local Iowa reporter that there's "no compassion in the Affordable Care Act."

"Back in January, Pastor Angran was diagnosed with stage three cancer of the esophagus. He had insurance, but because of a previous heart condition, it did not cover the treatments he needed for his cancer. He found that out just minutes before receiving life-saving chemo," says the local reporter.

The pastor says, "One of the workers came and said let me talk to you. And so I went to talk to her. She says that we found out that your insurance does not include chemo."
"Over the past two months, the Angrans have emptied their savings account and racked up $50,000 in debt. They signed up for the Affordable Care Act," says the local reporter, "but found it to be anything but affordable. It will cost the couple more than $800 per month, money they just don't have."

Of course, laws don't have compassion, governments don't have compassion. People have compassion, and Obamacare is just another step in taking control of healthcare away from people.

Another unlucky victim of Obamacare: Man leaves Las Vegas man owing $407,000 in doctor bills
The hospital bills are hitting Larry Basich’s mailbox. That would be OK if Basich had health insurance. But he doesn’t. Thing is, he should be covered. Basich, 62, bought a plan through the state’s Nevada Health Link insurance exchange in the fall. He’s been paying monthly premiums since November.

Yet the Las Vegan is stranded in a no-man’s-land where no carrier claims him, and his tab is mounting: Basich owes $407,000 for care received in January and February, when his policy was supposed to be in effect. Instead, he’s covered only for March and beyond.

Basich has begged for weeks for help from the exchange and its contractor, Xerox. But Basich’s insurance broker said Xerox seems more interested in lawyering up and covering its hide than in working out Basich’s problems. Nor is Basich the only client facing plan-selection errors through the exchange, she added. Xerox, meanwhile, said it’s working every day to fix Basich’s problem, and its legal counsel is routine.

In the rollout of the Affordable Care Act and its insurance exchanges, you can find a success story for every failure. But Basich’s case is extreme. Basich said he began trying to enroll on Oct. 1, the day the exchange website went live. Like many consumers, he fought technical flaws during multiple sign-up attempts. In mid-November he finally got through and chose his plan: UnitedHealthcare’s MyHPNSilver1.

“It was like reaching the third level of Doom,” Basich said of the torturous sign-up process. Basich paid his first premium on Nov. 21, and within days the exchange withdrew the $160.77 payment from his money-market savings account. Because Basich paid a month before the Dec. 23 deadline, his coverage was to begin Jan. 1.  Weeks ticked by, but Basich received nothing to confirm he had insurance. Nevada Health Link kept telling him he was enrolled, but UnitedHealthcare said he wasn’t in their system.

Basich’s predicament went critical on Dec. 31, when he had a heart attack. His treatment, which included a triple bypass on Jan. 3, resulted in $407,000 in medical bills in January and February that no insurer is covering.
Maybe he should have just taken the money he set aside for premiums and put it all on "red".

Obama to Hispanics: We won’t deport relatives because you enroll in ObamaCare
President Obama on Tuesday sought to assure legal immigrants that they can sign up for ObamaCare without worrying that “the immigration people” will come for family members who are in the country illegally.

In an interview with Univision Deportes, a Spanish-language sports radio show, Obama said immigration officials won’t have access to the personal information that consumers provide when signing up for healthcare on the new exchanges.

“Well, the main thing for people to know is that any information you get, you know, asked with respect to buying insurance, does not have anything to do with … the rules governing immigration,” Obama said. “And you know, you can qualify if you’re a legal resident, if you are … legally present in the United States.

“You know, if you have a family where some people are citizens or legally here, and others are not documented, the immigration people will never get that information.”
But then, he promised everyone that the IRS would not release information from their 501c(4) applications too, and somehow they were released, too. But to be fair, he probably really means it with Hispanics, unlike the conservatives who were legally trying to keep the donor of funds potentially used against the administration private.

America's major news networks (with the exception of, of course, Fox) have acquitted themselves well in revealing the problems with Obamacare, if by acquitted themselves well means having ignored them as much as much as possible:

ABC's 'Nightline' Skipped ObamaCare for 123 Days, Gossips Over 'Bootleg Butt Injections'
How do the journalists at Nightline define news? On Monday night, co-host Dan Harris and reporter Mariana van Zeller spent an astonishing nine minutes and 33 seconds on the salacious, gossipy phenomenon of "bootleg butt injections." Yet, it's been 123 days, 17 and a half weeks, since the show's hosts have focused on ObamaCare and the problems with the law's implementation.

Harris educated his audience: "In the iconic rap song, Baby Got Back, Sir-Mix-A-Lot professes his love for women with large rear ends." He continued, "Since that song came out in 1992, the world's obsession with plus-size backsides has only intensified..." Yes, the once-prestigious Nightline investigated why some women "are risking it all on bootleg butt injections."

In contrast, Nightline has demonstrated little interest for the myriad problems facing ObamaCare. It was way back on November 14, 2013 that Harris discussed the "epic failures" of the health care law. On that date, he could only manage two minutes on it.

After all, ObamaCare's impact on America doesn't rise to the level of "bootleg butts."
Which is one of the reasons I've kept this thread of Obamacare Schadenfreude posts going since I first started it in early November.

Finally, Michael Barone has an interesting article likening democrats facing reelection in 2014 with the French military in 1940 facing the German Army
It is reminiscent of the quandary faced by Gen. Maurice Gamelin on the evening of May 15, 1940. Suddenly he realized that German panzer troops had broken through the supposedly impassable Ardennes.

French troops to the north were cut off and rendered useless, troops to the south were falling back in disarray on all sides and no reserves were available between the front and Paris. "Yes," he told the prime minister, "it means the destruction of the French Army."

Now, analogies between military history and politics are never exact, and no one in American politics remotely resembles the Nazis. But there is some resemblance between the plight of Gen. Gamelin and the plight of Democratic strategists in key Senate and congressional races this year.

The general had run out of feasible alternatives. His one hope was that the other side would make a mistake. Alas, the Germans didn't, and a great nation was lost within a few days.

Today's Democrats face losing an election, not a nation, and the cause is Obamacare. They stand on ground of their own choosing, which they suddenly find themselves unable to defend, and they must hope that the opposition makes disabling mistakes.
Read the whole thing. I'm less than confident that the Republicans might find a way to blow this advantage.

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