Saturday, May 2, 2015

Some Saturday Obamacare Schadenfreude

You thought I forgot about this, didn't you?  Nope, I've been collected a few here and there, but today I was triggered to action by this article in the Washington Post:

Almost half of Obamacare exchanges face financial struggles in the future
Nearly half of the 17 insurance marketplaces set up by the states and the District under President Obama’s health law are struggling financially, presenting state officials with an unexpected and serious challenge five years after the passage of the landmark Affordable Care Act.

Many of the online exchanges are wrestling with surging costs, especially for balky technology and expensive customer call centers — and tepid enrollment numbers. To ease the fiscal distress, officials are considering raising fees on insurers, sharing costs with other states and pressing state lawmakers for cash infusions. 
The original design, to the extent that the camel was designed at all, was to coerce/bribe the states into taking the lead. That didn't work so well, as only about half the states assumed the burden, and this illustrates why. Managed economies, (and that's what this is really) never work well because all the market signals of demand and price are ignored in favor of the manager's whims. The only surprise is that only half the state markets are struggling. But they can't say they weren't warned.

Red ink could kill Covered California
After two previous extensions, the open enrollment period for Covered California ends April 30. That deadline just might prove to be the tipping point for the state’s two-year-old health insurance exchange.

That’s because this is the year Covered California is supposed to become completely self-sustaining.

Indeed, there’s no more money coming from Washington after the state exhausts the $1.1 billion it received from the federal government to get the Obamacare exchange up and running. And state law prohibits Sacramento from spending any money to keep the exchange afloat.

That presents an existential crisis for Covered California, which is facing a nearly $80 million budget deficit for its 2015-16 fiscal year. Although the exchange is setting aside $200 million to cover its near-term deficit, Covered California Executive Director Peter Lee acknowledged in December that there are questions about the “long-term sustainability of the organization.”
It's always been a stalking horse for a one payer system. Cloward-Piven.

It's Official: Employee Wellness Is a "Scam"
No Affordable Care Act (ACA) provision enjoys more bipartisan support than the provision encouraging employers to pay or fine employees based on their health and health behaviors, a practice known as "workplace wellness." Both the House and the Senate are likely to pass the Preserving Employee Wellness Programs Act and the President is likely to sign it.

It appears that neither the President nor Congress seem to have access to the internet, because for all its support and corporate popularity (most large companies now require employees to participate or else forfeit hundreds of dollars), wellness is generally agreed to be the worst idea in the ACA. Wellness damages employee morale and increases the cost of insurance.

And that's not according to opponents. That's according to its promoters -- the two official trade associations, Health Enhancement Research Organization (HERO) and the Population Health Alliance (PHA). These two leading wellness advocacy groups convened a joint committee of 39 self-described "subject matter experts" from 27 wellness vendors and health plans, which produced a free, downloadable, 88-page tome ostensibly to justify wellness.
A lie sold with lies.

Vitter’s Obamacare Probe Continues With Subpoena Vote
The Louisiana Republican is the chairman of the Senate Small Business Committee, and he has used his perch to investigate congressional enrollment in the District of Columbia’s small-business exchange, which allowed for a government contribution to congressional health care plans. But his investigation has some members questioning whether this is an issue for his committee.
. . .
Vitter has long criticized what he calls the “Washington exemption,” or the government contribution to congressional health care plans. Enrolling in the D.C. small-business exchange, rather than the individual exchange, allowed lawmakers and staffers to keep the government contribution.

Critics say the contribution shields members of Congress and their staffs from the effects of the Affordable Care Act. Congress inserted provisions in the legislation before passage that scrambled congressional health care, forcing members and staffs onto the exchanges that were initially intended to provide health plans for those not receiving health care already from an employer, such as small businesses.

“Congress should absolutely not be exempt from living under Obamacare just like the millions of Americans who don’t get a special taxpayer funded subsidy,” Vitter said in a Tuesday statement. “Issuing this subpoena will allow us to find out who is responsible for allowing Congress to receive a special taxpayer-funded subsidy on Obamacare, so we can fix this — and ultimately, end the special exemption.”
Needless to say, democrats are not pleased at the idea of being forced to rub elbows with the proletariat.

The Individual Mandate Has Made Tax Day Even More Miserable for the Poor
Beginning this year, anyone without health insurance, regardless of their reasons, potentially faces a sizeable increase in their tax burden.

More specifically, households that did not have health insurance in 2014 are required to pay the maximum of either 1 percent of their household income or the sum of $95 per uninsured adult and $47.50 per child under 18. According to a recent analysis from H&R Block using data from this tax season, the average tax penalty for not having insurance has been $172, an indication that most taxpayers are paying more than the flat fee of $95 per uncovered adult.

Next year those tax penalties will soar even further, as households that do not have coverage will be required to pay the maximum of either 2 percent of household income or the sum of $325 per uninsured adult and $162.50 per child under 18.
Elections have consequences; enjoy!

How the IRS repeatedly rewrites Obamacare tax credit provisions
These administrative rewrites of plain statutory language should be troubling whether or not one supports the PPACA. As Professor Grewal concludes:
A complex regime cannot be fairly administered when the words of the law are routinely flouted, especially when the granting of benefits to one group potentially triggers penalties for others.
Fairly administering this law requires implementing it as written, and seeking legislative revision of those provisions now understood to be unworkable or unwise. Congress has already made over one dozen changes to the PPACA that have been signed into law, and there is no reason it could not make others. If more changes are necessary (and I suspect most think they are), it is a job for Congress, not the IRS.
It's not really a law if the administration can change it on a whim.

It's Tax-plicated: Complexity Rising with Obamacare Burden
This year’s new analysis of tax complexity from National Taxpayers Union Foundation (NTUF) found some startling lead figures: a $234 billion cost to the economy due to 6.1 billion lost hours of productivity and $32 billion spent out-of-pocket to comply with America’s insanely complicated tax system.

As always, there is much more to the story.

Since 2010, tax complexity costs have remained sky-high, at well over $200 billion each year. From fiscal year 2005 to 2013, the Treasury's paperwork burden rose from 6.4 billion hours to 7 billion hours never making up less than 74 percent of the burden imposed by all government agencies combined.
Complexity is a boon to the regulators, giving them increased power in the interpretation and enforcement of the law, and a boon to the special interests that rent seek off the law.

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