Wednesday, May 14, 2014

The Sky is Crying Obamacare Schadenfreude

A drippy, misty day here, and cooler than the last two, only about 60 F.  I can watch the grass grow.

A Billion Dollar Rat Hole?

What kind of business could possibly survive by simply hitting refresh buttons every 10 minutes while no business comes across their desks? If you guessed public sector, congratulations, and claim a bonus for specifying ObamaCare.
Instapundit quips: "To be fair, it's implicitly understood that they'll vote for Obama."

Ace takes a riff from Ed Morrissey at HotAir, and turns it into a magnificent solo:

NPR Puts Lipstick on the Obamacare Pig. NPR: Great News, Employers Might Start Paying You For Health Care!!!

Employers will pay you money!!! Only in Obama's America would employers pay you consideration for your work!!!

Now, as Ed Morrissey noted, this is of course just an enormously deceptive, put-on-a-happy-smile euphemism for the truth: As predicted, and long denied by Obama and the progressives, Obamacare is a glidepath to destroying private insurance.

What NPR means, of course, is that employers plan to dump you on to the Obamacare exchanges.

They're not "paying you for healthcare," at least not in any new way: They were already paying you for healthcare. That's what "employer-provided healthcare" means, after all. They're paying you, partly in the form of a healthcare policy. But that policy was a private one.

Now they'll be saving money (hint: this means paying you less) by paying you a contribution towards your health care, which you will then use to... buy Obamacare on the terrific website

Incredibly dishonest. Conservatives have been complaining that this is precisely what Obamacare was designed to do, and the progressives called us liars every inch along the way.

Now that employers are openly discussing this -- and increasingly doing this -- NPR casts it as some kind of Victory for Employees.
The association of health insurance as a benefit for employment in the United States is an historical side effect of FDRs WWII salary caps.  Employers could use employment benefits as a lure when they could not use additional wages.  It has good, as well as bad features; the primary negative one, IMHO is the apparent broken link between costs and health care. If you don't pay for something directly, you don't value it as much as if you pay for it out of pocket. So breaking the link, and making people more responsible for paying their own insurance policies could be a good step. But is it worth the damage?

The real Obamacare story.  More people insured, but getting less for their money:  More Insured, but the Choices Are Narrowing. And it's mandatory.
In the midst of all the turmoil in health care these days, one thing is becoming clear: No matter what kind of health plan consumers choose, they will find fewer doctors and hospitals in their network — or pay much more for the privilege of going to any provider they want.

These so-called narrow networks, featuring limited groups of providers, have made a big entrance on the newly created state insurance exchanges, where they are a common feature in many of the plans. While the sizes of the networks vary considerably, many plans now exclude at least some large hospitals or doctors’ groups. Smaller networks are also becoming more common in health care coverage offered by employers and in private Medicare Advantage plans.

Insurers, ranging from national behemoths like WellPoint, UnitedHealth and Aetna to much smaller local carriers, are fully embracing the idea, saying narrower networks are essential to controlling costs and managing care. Major players contend they can avoid the uproar that crippled a similar push in the 1990s.

“We have to break people away from the choice habit that everyone has,” said Marcus Merz, the chief executive of PreferredOne, an insurer in Golden Valley, Minn., that is owned by two health systems and a physician group. “We’re all trying to break away from this fixation on open access and broad networks.”
. . .
Dr. Monica Wehby, a pediatric neurosurgeon, is using the potential reaction to narrower networks as momentum for her campaign for Senate in Oregon. A Republican promising to repeal the Affordable Care Act, her slogan is “Keep your doctor. Change your senator.”
An update on the recent story of how state Obamacare websites had wasted $480 million (call it half a billion).  Actually, Obamacare State Exchanges Have Wasted $1.2 Billion
Kyle Cheney of Politico is a solid, straight news reporter. So I was a little surprised this morning to see his analysis of state Obamacare exchange spending features numbers much smaller than the ones I have been using, most notably a figure of $248 million for Oregon and just $57 million for Massachusetts. Total federal grant funding to Oregon’s failed exchange, according to CMS, is $305 million. Massachusetts, according to CMS, is at $179 million. These are huge disparities.

Kyle explained to me on Twitter than they chose to report the amount these statesadmit to having already spent, rather than the amount federal taxpayers have been forced to send to the states, which he believes to be to be the more significant number. I strongly disagree.

First, it is highly likely the states will keep the full amounts, because there is no obvious mechanism, unfortunately, to force them to return the funds. Consider Oregon, which has about $57 million remaining. Ace reporter Chelsea Kopta of KATU – which has owned the Cover Oregon scandal story – immediately asked Oregon’s state CIO Alex Pettit about the unspent funds when the state exchange voted to shut down. His answer? They’re keeping it all.

Second, the amounts “spent so far” are self-reported by the states and almost certainly – in the case of the states with scandalous failures – lowball estimates to minimize political embarrassment. The only absolutely accurate numbers we have are federal grant data.

Third, as federal taxpayers, we want to know how much we have spent, not how much the states have spent. So far, that bottom line, according to HHS? “As of January 2014, 37 states and the District of Columbia had received over $4.9 billion in grants to operate Marketplaces since 2011.” That number will continue to climb as more grants are announced, including potentially another $120 million requested by Massachusetts to build a new exchange to replace the defunct exchange they are shutting down.
A billion here, a billion there.

Sing it, Susan!

Wombat-socho has the "Rule 5 Sunday: Armed Forces Day Edition" megapost up at The Other McCain. Thanks, Kevin!

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