Thursday, March 20, 2014

Obamacare Schadenfreude for Spring

The first day of Official (not meteorologic) spring. A typical early spring day in Slower Maryland.  45 F, sunny (for now) with slight westerly breezes. The only snow left is the heaps left from plowing or shoveling.  I hope it continues into the afternoon, so I can use it after some errands.  First, though, the daily dose of Obamacare Schadenfreude.

O-Care premiums to skyrocket
Health industry officials say ObamaCare-related premiums will double in some parts of the country, countering claims recently made by the administration.
The expected rate hikes will be announced in the coming months amid an intense election year, when control of the Senate is up for grabs. The sticker shock would likely bolster the GOP’s prospects in November and hamper ObamaCare insurance enrollment efforts in 2015.

The industry complaints come less than a week after Health and Human Services (HHS) Secretary Kathleen Sebelius sought to downplay concerns about rising premiums in the healthcare sector. She told lawmakers rates would increase in 2015 but grow more slowly than in the past.

“The increases are far less significant than what they were prior to the Affordable Care Act,” the secretary said in testimony before the House Ways and Means Committee.

Her comment baffled insurance officials, who said it runs counter to the industry’s consensus about next year.
You can't say you weren't warned. They're all bald faced liars.  And speaking of having a tenuous grasp of the truth: Fact check: Obama mixing and matching insurance stats
President Obama jumbled his facts when asked about "skyrocketing" premiums for people who get insurance through work. He was correct to say that, generally, the Affordable Care Act isn't to blame for "skyrocketing" employer-sponsored premiums, but he made two dubious claims to back up his argument:
Not yet; that's for next year's Obamacare Schadenfreude...
• Obama said "people forget that the average premium was going up 15% a year before the Affordable Care Act," leaving the mistaken impression that he was talking about employer plans. That's true of premiums in the individual insurance market — for people who buy their own insurance — but not of rates in the large employer market, which was the context of the conversation.
• The president also went a bit too far in saying that the only impact on employer plans was a requirement to offer a minimum set of benefits. Employer plans do face other new requirements, some of which have had a small impact on premiums.
But it certainly didn't "fix them" as originally promised.

CBO chief didn’t get memo ObamaCare fixed health care costs, calls them “fundamental challenge”
“So we have a choice as a society to either scale back those programs relative to what is promised under current law; or to raise tax revenue above its historical average to pay for the expansion of those programs; or to cut back on all other spending even more sharply than we already are,” Elmendorf said.

“And we haven’t actually decided as a society…what we’re going to do. But some combination of those three choices will be needed.”

Elmendorf said there are various ways to proceed: “But they tend to be unpleasant in one way or another, and we have not, as a society, decided how much of that sort of unpleasantness to inflict on whom.” …

Elmendorf said the nation’s main fiscal challenge is not short-term deficits, but “the very high level of debt” over the long term:

“And a high level of debt will ultimately crowd out capital investment and slow accumulation of capital and slow the growth of wages and incomes. It also reduces the flexibility for policymakers to respond to future crises that arise.

“So it’s the high level of debt and the growing deficits in the long-term. The reason why action today would be beneficial is because if you — we want to make changes in programs for retirees or changes in the tax code, it’s better to make those with a warning. One wants to set — one wants to make changes. One wants to set them in motion early, even if their full effect won’t be felt for many years.”
The only thing more reliable about campaigns than politicians kissing babies, is Democrats trying to scare seniors by claiming that those unsympathetic Republicans are going to take away Medicare and push Grandma off the cliff (nobody cares about Grandpa). But the Obamacarists have not made a talking point of the cuts Obamacare has brought to Medicare:

BusinessWeek Notices ‘Obamacare’s Surprise Medicare Cut’
A few weeks ago, I wrote about HHS Secretary Kathleen Sebelius’s decision to cut the maximum amount she could from Medicare’s payments for home health-care services. The short version:
Sebelius cut the maximum permitted by law, 3.5 percent, and declared HHS would do the same for the next three years.
As Angle’s report: noted, “The cuts were deep enough that officials offered a damaging prediction of the impact saying, it was estimated that approximately 40 percent of providers would have negative margins.”

“Negative margins” is another term for losing money. And businesses that lose money either go kaput or lay off workers. Forty percent of the firms in the industry adds up to roughly a half-million jobs. That doesn’t mean that 500,000 home health-care workers will be fired tomorrow, but it does mean that they’re at serious risk for layoffs in the next three years.
So we’re talking about a massive job-killer in a field dedicated to treating the health problems of the elderly. Keep in mind the National Association for Home Care and Hospice forecasts much worse consequences for these cuts; projecting that the reductions will likely render three-quarters of all industry operators unable to run profitably by 2017.
Proving that you can't fool all the media all the time:

So maybe single payer is the answer?  Medicare has 375,000 case appeals backlog
Rep. Jim McDermott (D-Wash.) is sounding the alarm this morning about a massive backlog within the Office of Medicare Hearings and Appeals. The 357,000-appeal clog delays providers from having their cases heard for longer than two years, McDermott noted in a letter to HHS Secretary Kathleen Sebelius. ” “The agencies must review their administrative procedures and act now to protect seniors who are struggling to get Medicare payment appeals addressed,” he wrote. He argued that problems with recovery auditors have been identified as the leading cause of the backlog.
. . .
The fact is, both of these programs are bureaucratic nightmares. Reading McDermott’s letter (he is the ranking member on the Ways and Means Subcommittee on Health), it is clear that the system in place is both inadequate and ineffective. It is also clear that it is subject to micro-managing by Congress, especially Democrats who are more and more worried about the impact of health care problems on their re-election prospects this November.

The bigger picture, however, is this is what “single payer” would look like, most likely at its best. 2 year waits for an appeal process. As McDermott notes, that’s a long time for a system designed to care for the elderly. Some may not survive the process and many are on fixed incomes. That and the fact that providers shouldn’t have to wait that long for resolution either. If it were a private insurance entity taking this time, they’d likely not be in business long as customers would endeavor to find a provider which was much more efficient in processing appeals. That’s just a few of the benefits provided by incentive, competition and a profit motive. Government bureaucracies, of course, aren’t motivated by any of those factors. And this is the result.
And bureaucracies are not motivated by compassion, either.

The Wall Street Journal: Tax Experts: Brace For Insurance Tumult
Headaches over the health care overhaul are likely to grow in the coming year as tens of millions of Americans face the task of establishing that they have insurance coverage to avoid paying penalties, tax experts say. … Perhaps the biggest problem is a lack of public understanding of the complex and frequently-changing program, tax experts say. They expect that to be compounded by a misunderstanding of the penalties, as many don't realize they could pay more than the minimum $95 for not having insurance (McKinnon, 3/18).
At least it's making more jobs for tax lawyers and accounts.

More tales from the Death Spiral: Only 5% of Alaska’s uninsured signed up for ObamaCare?
Which is worse about this story? Is it that only 6,666 people in Alaska have signed up in ObamaCare, or that it’s only the fifth-lowest total among states? The state estimated that more than 139,000 Alaskans would have eligibility to enroll in ObamaCare, but with the deadline approaching for enforcement — kind of, anyway — only five percent of them have done so, reports the Alaska Daily News (via Salena Zito):
In less than two weeks, the health insurance marketplace will close, shutting out Alaskans until the next enrollment cycle and imposing fines on some of the uninsured.
Nearly 5 percent of the 139,422 Alaska residents determined eligible to enroll in health insurance through the Affordable Care Act have actually done so in the first five months since launched on Oct. 1. With 6,666 enrolled as of the end of February, Alaska has the fifth lowest number of enrollees in the country, according to data from the U.S. Department of Health and Human Services.
. . .
The HHS figures on age demographics for sign-ups look bad in that graphic, too. The majority (53%) of them are between 45 and 64 years of age. Only 32% are under 35, which means that the risk pools will be more distorted than insurers wanted for premium adjustments. This is one reason why those premiums will double in 2015 in some areas, and that will keep more younger consumers away from the marketplaces entirely.
Which only raises my opinion of Alaskans.

GOP calling for independent watchdog for ObamaCare

The concept is a very simple one – follow the money and give an independent oversight agent, that is a Special Inspector General, the capacity to go across all of these jurisdictional lines. Because here’s the limitations right now: the Health and Human Services Inspector General can only ask HHS questions; Treasury can only ask Treasury questions. And there’s dozens of agencies that are involved in Obamacare and no one single entity has the capacity to ask all of the questions. This will be a money saver. …
Lefty groups now offering young people cash prizes to enroll in Obamacare
With roughly two weeks left in the open enrollment period for health insurance, some groups are trying to sell Obamacare to young people in terms they might actually understand: music, comedy, and cash. Young Invincibles, a nonprofit organization based in Washington, D.C. that is focused on the economic issues affecting young adults, launched a sweepstakes last week where it is awarding a cash prize of $1,200 — enough to potentially cover a year’s worth of health insurance premiums for a young adult — to people who download their health care app or submit a card in the mail. The contest runs through the fall, but by launching it now, organizers hope young people who download the app can use it to learn more about whether they qualify for financial assistance and where they should go to sign up….Young people are particularly lagging behind in other groups in signing up. So far, 25% of those who have selected private plans are between the ages of 18 and 34. Administration officials have said repeatedly that they expect young and healthy people to put off signing up for insurance until the last minute. So groups are getting creative with their approach in the final push.
The administration’s original target for this demographic was close to 40 percent — an outcome experts projected would be necessary to sustain viable risk pools. That goal, like others that won’t be reached, has since been discarded. The appeal of a $1,200 prize may seem intriguing for cash-strapped young adults, but let’s put that number into proper perspective. Let’s say you’re a healthy 30-year-old who is lucky enough to win the sweepstakes and claim the prize. That money, as the Marketwatch story says, is “potentially” enough to cover your first year’s premiums under Obamacare. Potentially. The real number could be significantly higher. Remember, the president just got through admonishing Latino families to ditch their cable or cell phones in order to scrape together enough money to afford Obamacare coverage — which he estimated could cost as “little” as $300 per month, or $3,600 per year. But expenses in that ballpark are precisely what compelled a young, urbanite Obama supporter to confess that he’d decided against obtaining coverage. Avik Roy’s in-depth analysis reveals how young people are likely to suffer the worst under Obamacare “rate shock,” even after factoring in taxpayer subsidies. CNN’s research shows that in the country’s largest metropolitan areas, many low-income young people won’t be eligible for any subsidies at all.
 A warning for the democrats not to take the "millennials" for granted: Millennial doesn't mean liberal:
Bad news for Democrats: It seems Millennials are special little snowflakes after all.
A new report by the centrist Democratic think tank Third Way highlights the political complexity of a generation raised to believe they were utterly unique. When it comes to politics, they do it their way. Which could make the cohort that turned out en masse for President Obama unpredictable as voters.

Third Way focused on how Millennials' experience as the first generation raised in an information-on-demand culture has shaped them. They are not "adaptors." They have only known a world full of endless choices, not a life where you make do with what is available.
 Millennials are "less likely to be satisfied with two static choices, and more apt to be swayed to change their tune," says the report. They "are much more likely to switch the party they support from election to election — even amongst those who claim to 'lean' towards one party or another."

Consider this: In a 2013 Harvard survey, 52% of 18- to 24-year-olds said they'd recall and replace President Obama.

But aren't we always hearing about how liberal Millennials are? Third Way's Michelle Diggles told me that while it's true they are more liberal than previous generations, "a plurality of Millennials are moderates." She added, "They are more pro-gay marriage, but also slightly less likely to support legalized abortion." This mix-and-match approach on divisive social issues is unique, reflecting Millennials' non-ideological views.

Diggles pointed out that what drew Millennials to Obama was his post-racial, post-partisan message. They were not checking the Democratic box. The report found that"Millennials are pragmatic — they want to know what works and are willing to take ideas from each side. They eschew ideological purity tests."
Possibly related; Rand Paul's warm reception at UC Berkeley.

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