Sunday, February 21, 2016

Some Sunday Obamacare Schadenfreude

Obamacare Schadenfreude has taken a backseat to the Hillarity at Clinton.com recently, but enough has accumulated that I need to clean up.

80,000 Ineligible ACA Enrollees Cost Minnesota Millions
A report by Minnesota’s Office of the Legislative Auditor released last month, found that more than 80,000 Minnesotans were enrolled in Medicaid, and the state’s Obamacare exchange even though they were ineligible for the services. That incredible number of ineligible enrollees cost Minnesota taxpayers hundreds of millions of dollars.

The problems apparently stem from “miscommunication and poor training at the Department of Human Services.” However, the audit found that, “software issues” are were also blamed for the errors, which seems to be an all too standard bureaucratic excuse these days for any expensive failure within government health care programs.
To err is human. But to make the same mistake over and over as faster than humanly possible, it takes a computer.

NC BCBS Considers Dropping Out Of Obamacare
Well, color me shocked
(Winston Salem Journal) North Carolina’s largest health insurer is considering dropping coverage under the Affordable Care Act.
The News & Observer of Raleigh reported that Blue Cross and Blue Shield expects to report its second consecutive financial loss as it deals with cost overruns.
CEO Brad Wilson said Wednesday the company cannot continue to suffer losses indefinitely in North Carolina. Wilson said the company may have to decide later this year whether to stop offering coverage under the Affordable Care Act.
The company raised rates by nearly one third this year but says it was not enough to cover losses.
This is on top of United Healthcare announcing in November 2015 that they were considering the same, and would pretty much leave Aetna as the only ACA provider left.

I was listening to local talk radio this morning on this, and the doctor they had on said this was caused by a flaw in Ocare. I disagree: it’s a feature. We had this discussion as Ocare was being considered, and right after it was passed and we could see the whole thing, and driving insurance companies out of business, as well as out of the Exchanges, is purposeful, as the government could now say ” well, listen, we tried it the free market way, look what happens, we need government to directly provide the insurance.” This is all a step towards single payer.
Yep, designed to fail and set the stage for single payer.

Obamacare Bait and switch: Cancer Patients Snagged in Health Laws Tangled Paperwork
Hundreds of thousands of people lose subsidies under the health law, or even their policies, when they get tangled in a web of paperwork problems involving income, citizenship and taxes. Some are dealing with serious illnesses like cancer. Advocates fear the problems, if left unresolved, could undermine the nation's historic gains in health insurance.
. . .
The government says about 470,000 people had coverage terminated through Sept. 30 last year because of unresolved documentation issues involving citizenship and immigration. During the same time, more than 1 million households had their financial assistance "adjusted" because of income discrepancies. Advocates say "adjusted" usually means the subsidies get eliminated.
Obamacare’s Dirty Little Secret: Subsidies for Illegal Immigrants
Now, in the clearest sign of Obamacare’s illicit coverage of illegal immigrants to date, a bombshell report from the Senate Homeland Security Committee found that the healthcare law doled out an estimated $750 million in taxpayer-funded insurance subsidies to some 500,000 people of unverified immigration status.

Here’s the real problem: this money has already gone out the door. So now the Obama administration has set up a pay-and-chase cycle where they must attempt to recoup taxpayer dollars after they’ve been spent – and the government does a notoriously poor job of getting that money back.
OK: IRS chief: Blame rotten customer service and data hacks on Obamacare
Both cybersecurity and customer service at the Internal Revenue Service have suffered because of Obamacare, the agency's head said in remarks to Congress on Thursday.

"Congress, as I noted in my testimony, has underfunded … the Affordable Care Act," IRS Commissioner John Koskinen told a panel of the House Appropriations Committee. "That does not remove the statutory mandate we have that we have to implement the act."

Koskinen delivered his remarks in response to a question from Chairman Rep. Hal Rogers, R-Ky., who pointed out that Congress had "increased funding specifically for taxpayer services" in 2014 and 2016.

Koskinen said it didn't matter where Congress intended the money to go, explaining the agency had pulled funding for customer service and cybersecurity in order to ensure compliance with the ACA.
So the lousy customer service at the IRS is a deliberate choice by the Koskinen to punish citizens and by extension, their congressmen, by putting the money elsewhere.

The Politically-Motivated Assault On Medical Innovation
. . . the same core coalition that created and passed Obamacare has sprung into action to blast drug companies and shift the blame to them. To head the effort, they turned to John Rother, a former AARP top lobbyist who spearheaded AARP’s surprising support for Obamacare – despite the fact the group’s own members opposed the bill 14 to 1.

NCHC’s goal is not just to misdirect anger over Obamacare to help Democrats survive the 2016 elections. They intend to actually implement price controls that would pad the profits of their industry allies, but have a potentially devastating impact on the discovery of new cures.
. . .
That would be a disaster. As Milton Friedman and 100 of his distinguished peers explained: “Drug price controls are more difficult to remove than other price controls. Controls on oil and other products often tend to be limited or short-lived, as voters eventually object to the resulting shortages and distortions. The effects of drug price controls, however, are far more difficult to observe because they mainly affect medicines that haven’t been invented yet.”
After computer hack, L.A. hospital pays $17,000 in bitcoin ransom to get back medical records
“To improve the quality of our health care while lowering its cost, we will make the immediate investments necessary to ensure that, within five years, all of America’s medical records are computerized,” President Obama said in 2009. “This will cut waste, eliminate red tape and reduce the need to repeat expensive medical tests.”

While the shift that Obama and many others pushed may have improved care, electronic medical records led to quite the unique hostage situation in Los Angeles this week. There, a hospital fell prey to a cyberattack — and the hospital has escaped its plight by paying hackers a $17,000 ransom.
Government health insurance: the ultimate sickness - Long but worth it
. . . Fast-forward to today. We get our 1095 form. It shows that our kids have been covered under Medicaid, which qualifies as full coverage under the ACA, but my wife and I, who have PCN, do not. PCN is apparently only a “limited” plan and does not qualify as full coverage under the ACA. We are now on the hook for penalties going back four months for not having adequate care under the ACA. And the enrollment period ended on Jan 31st, so we will be on the hook for the next year as well. We are talking thousands of dollars here.

This, understandably, sent my wife into a panic and tears. It’s money we don’t have.

I want to re-iterate: we went to the government website, which funneled us to a state website, where we got coverage, and NO ONE informed us that this did not comply with the law or that the coverage for us was not enough under the standards of the law. My wife and I are not dumb bunnies. This wasn’t an oversight. There was simply no way we could have known.

The website was worthless – an endless maze – so we worked the phones. We sat on hold for over an hour, but finally got a hold of a person, who admittedly, was very nice and helpful. We told her our situation, told her we acted in good faith, and wound up here anyway. She told us that since we make so little, we may qualify for an exemption. She gave us the info on how to apply for this exemption through the IRS, what forms to use etc. Part of this application for an exemption requires that we go to Healthcare.gov and look up and submit what the lowest bronze plan would have cost us.

But now you are probably seeing the first paradox: our income is so low, that the website automatically sent us to the Medicaid site without ever taking us to the exchanges. How do we get there to know what we didn’t know? She doesn’t have an answer.

Now comes the second paradox. Even if we get this exemption, how will we make sure we get adequate coverage in the future? My employment situation is unlikely to change in that time. How can we even get to the exchanges to get a plan we are REQUIRED to have when the website immediately redirects us back to the Medicaid application? Where do we go to buy into a plan we can’t even see because the application process won’t let us see it?

Again, she was very nice, but she didn’t have an answer. She thinks there might be a “tool” to help us on healthcare.gov. She suggests that we go to Healthcare.gov and search for “exemptions.” A search for “exemptions” on Healthcare.gov produces 50 hits, by the way.

Finally she suggested we talk to the local Medicaid office in Utah. Perhaps they can help. Maybe Utah offers a Medicaid benefit plan that has full coverage and qualifies under the ACA. So we do. The person at the Utah Medicaid office is very nice, but told us that there is only one full coverage Medicaid plan and it is basically only offered to invalids. PCN, which is, frankly, very generous (thank you, Utah taxpayers!) is what they offer to most of their clients.

It seems crazy that PCN somehow does not qualify under ACA, but here’s where the story gets surreal.

The person tells us that they have never been told whether or not PCN qualifies under ACA! Let that sink in for a moment.

The ACA has been law since January, 2010 and been implemented since 2013. Six years in, and the state government Medicaid office STILL does not know if their main Medicaid program complies with the law. They still don’t understand the ACA. This is obviously the root of the confusion.

Is everyone on Medicaid in Utah in violation of the law? Are they all paying penalties or forced to go through the exemption process? Do they even know? The person, who again, is very nice, has no answers. Who does know? Again, no answers.

All of this happened this morning. We have been delivered into a system that is completely opaque, with a curtain of websites and applications processes that are nearly impenetrable, and been left at the mercy of bureaucrats who do not even know the full meaning of the law they expect us to live under.

This simply cannot stand. . . .
This is what happens when unaccountable bureaucrats are put in charge of healthcare. Paperwork is all important, and service is not.

Trump on ObamaCare: “I like the mandate”

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