Wednesday, October 28, 2015

Obamacare Schadenfreude Revived

Oh yes, it's still alive and kicking:

Watchdog: Obamacare Exchanges Fail to Detect Counterfeit Documents
Obamacare exchanges are failing to verify key enrollment information, according to a new report by the Government Accountability Office (GAO). This new report is the latest in a long line finding that controls on federal and state Obamacare exchanges are abysmal.

As part of its review, GAO tested application and enrollment controls on the federal exchange and two state exchanges (California and Kentucky). Ten fictitious applicants were created to test whether verification steps including validating an applicant’s Social Security number, verifying citizenship, and verifying household income were completed properly.
. . .
As a result, each applicant received the Obamacare premium tax credit and cost-sharing reduction subsidies, without being properly verified. The ten applicants received a total of $2,300 in tax credits per month.
So, in this respect, the program is working pretty much how democrats wanted it to.

Doctors Agree: Obama’s Electronic-Medical-Records Mandate Is the Worst!
. . . in the clumsy, power-grabbing hands of Washington bureaucrats, Obama’s one-size-fits-all EMR regulations have morphed into what one expert called “health-care information technology’s version of cash-for-clunkers.”

In 2013, health-care analysts at the RAND Corporation admitted that their cost-savings predictions of $81 billion a year were vastly inflated. In 2014, RAND researchers interviewed doctors who spotlighted “important negative effects” of the EMR mandate on “their professional lives and, in some troubling ways, on patient care. They described poor EHR usability that did not match clinical workflows, time-consuming data entry, interference with face-to-face patient care, and overwhelming numbers of electronic messages and alerts.”
. . .
The American Medical Association, which foolishly backed Obamacare, is now balking at top-down government intrusion into its profession. Better late than never. The group launched a campaign called “Break the Red Tape” this summer to pressure D.C. to pause the new medical-record rules as an estimated 250,000 physicians face fines totaling $200 million a year for failing to comply with “meaningful use” EMR requirements.
Well, if you lay down with dogs. . .

Obamacare Enters a Downward Spiral as Co-ops Fail and Enrollment Slows
As of this week, nine of the law’s 23 state co-ops — nonprofit health-insurance companies set up to help people enroll in Obamacare — have collapsed. Over 600,000 people who enrolled in co-op health plans will lose their insurance at the end of this year. Many of them were forced into the co-ops to begin with when Obamacare canceled their private insurance policies in 2013, meaning they will have lost their health insurance twice because of the law.

All this is despite, of course, Obama’s now-infamous promise that if you liked your health plan, you could keep it. The bad news shows no sign of abating. According to recent news reports, eleven more co-ops are on the verge of failure. Twenty-two of the 23 co-ops lost money in 2014 despite receiving $2.4 billion in taxpayer support. The nine that have already failed received over $1 billion combined. Not even that was enough to keep them alive.
. . .
But co-op customers and insurers are not the only ones facing problems. After Obamacare drove up the price of individual-market insurance by 49 percent in 2014, and then caused millions of people to see double-digit increases, again, this year and next, new-enrollee projections plummeted. Last week, the White House announced that it expects just 1.3 million new enrollees in 2016, far below the 8 million originally predicted for 2016.
. . .
Perhaps this is why Health and Human Services secretary Sylvia Burwell expects it to be “challenging” to enroll more than just one in four eligible people, despite the president’s repeated insistence that the law is working. Unfortunately for Mr. Obama and his allies, reality can’t be hidden behind lofty rhetoric or “the stupidity of the American voter.” These are the realities of his health-care law. And three years in, it’s only getting worse.
Billions in Obamacare exchange money remains unaccounted for
Sixteen states (plus the District of Columbia) collected more than $5B to set up Obamacare exchanges after the Affordable Care Act kicked into action. But years later, much of that money was never directed toward the IT development costs for the exchanges or – in some cases – for any specified cost. And yet almost none of it has been returned. So what happened to all that sweet federal cash? That’s the question Fox News is asking today.
About $4.6 billion was given to these 17 recipients, including California, New York, Washington state and Kentucky.
But the GAO report found that so far, just $1.4 billion of that has been spent on IT projects, and a total of $3 billion has been “spent or drawn down,” though not all the spending is detailed.
That, then, leaves at least $1.6 billion unaccounted for. Yet only three states returned any portion of the money – a total of just over $1 million was given back.
“[T]he specific amount spent on marketplace-related projects was uncertain, as only a selected number of states reported to GAO that they tracked or estimated this information,” the report said.
Even though states were supposed to set up their marketplaces by the end of last year, they are not yet legally required to return unused funds.. . .
There’s a real puzzler for you, eh? 85% of the money went to states with Democrat controlled governments and they either didn’t use it for the intended purpose or it just disappeared. Shocking, I know. But how often do you see federal dollars going anywhere with the recipients turning around and saying, oh, that’s okay. We didn’t need that much. Take the rest back. That’s not how the system works, and frankly I’m not sure if Uncle Sam would know what to do with the cash if anyone actually gave it back.
A billion here, a billion there, and eventually you're talking real money.

Under single-payer, Coloradans will have another failed health-care experiment
Like many other states, Colorado’s Obamacare exchange has been plagued with problems since the get-go. Unrealistic expectations of the costs of government run health care, improper planning, and the absence of oversight over executives in charge of implementing the program has meant that Connect for Health Colorado is facing tough financial times.

But undeterred, Colorado lawmakers, appear to be ready to double down on their government run health care experiment and by doing so, will likely make the state’s financial problems even worse. How could it get worse you ask? By implementing a single-payer plan.

Through what is dubbed, “Initiative 20,” the state would dissolve Connect for Health Colorado and replace it with a single-payer system. As the Denver Post asks, “Would you trust an elected state board to govern your medical needs more than private insurers and Obamacare?” This in a state where the Obamacare co-op just canceled 80,000 plans. Thanks for asking Denver Post, but no, I wouldn’t.

But lawmakers like state Senator Irene Aguilar, a Democrat from Denver, thinks that even with all its failures Obamacare hasn’t gone far enough. She said, “The Affordable Care Act has made insurance available to more people, but we haven’t made a dent in the under-insured people who struggle to afford the deductibles and other out-of-pocket expenses.”

How would Senator Aguilar and her supporters pay for such a plan? For starters, “Coloradans would pay another 10 percent in premium taxes to cover their medical care.” Colorado has already proved they’re incapable of estimating health care costs appropriately, and there’s no reason to expect that the 10 percent tax would be enough either. In fact, according to Tammy Niederman, a Highlands Ranch insurance agency owner, “Private insurers doubt the 10 percent premium tax is a reliable figure to cover the costs and that it could force locally elected ColoradoCare boards to raise premiums.”
The purpose of Obamacare was always to fail and set up the prospect of single payer. Colorado is just getting ahead of the curve.

The quick answer is no: Is Obamacare Sustainable?
. . . In principle, the burdens could become lighter over time as firms learn how to adjust to the government programs. But if the government continues to push hard, that won’t happen. It is therefore disheartening to know that Obama’s response to the high premiums is the following: “If commissioners do their job and actively review rates, my expectation is that they’ll come in significantly lower than what’s being requested.” Idle talk like that from a ratemaking amateur will only aggravate the problem. It is precisely the risk of insufficient rate hikes that undermines the stable healthcare environment needed for these markets to work. The only way in which to reverse these pressures is to go for partial deregulation.

The only difficulty with a proposal for market liberalization is that it cannot happen in an Obama administration. Given its inflexible commitment to high government involvement in the healthcare market, the likely response of the Obama administration to its own failure is to renew its call for a single-payer plan that the less radical Democrats of 2010 were not prepared to endorse. But the utter decimation of the centrist bloc of the Democrats in Congress means that the new claim will be that the exchanges and co-ops failed because they did not go far enough. Sadly, however, any single-payer plan will fall prey to all the pathologies of over-ambition, given that monopoly government agencies cannot manage complex businesses that have frustrated the implementation of the more modest Obamacare plan.

In the absence of any meaningful market role for private healthcare insurers, it will be no longer possible to benchmark public norms to sensible standards of private behavior. But on this issue, progressives believe in the one-way ratchet: When markets fail, turn to government regulation. When government regulation fails, turn to more government regulation. . . 

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