Posts Tagged ‘Patient Protection and Affordable Care Act’

Last Friday, I wrote about the fragility of complex systems and how they can collapse. Currently, the most complex and fragile of our American systems is Obamacare. And it’s collapsing before it can even be implemented.

Official photographic portrait of US President...

Official photographic portrait of US President Barack Obama (born 4 August 1961; assumed office 20 January 2009) (Photo credit: Wikipedia)

I’m frequently asked if Obamacare can be repealed. I like to respond by saying, Obamacare is destroying itself. It’s so complex and byzantine that the government is struggling to implement the law.

The next big challenge on the calendar is the deadline to have health insurance exchanges operational by October 1, 2013. The full implementation of Obamacare is supposed to happen January 1, 2014. But how are the 45 million uninsured Americans supposed to sign up if there isn’t a place to sign up?

This week we heard from the nonpartisan Government Accountability Office (GAO). Their report on the exchanges was ugly. The health insurance exchanges being created by the federal government for more than 30 states will likely miss the October 1 deadline.

Houston, We Have a Problem

These health insurance exchanges are projected to provide health coverage for seven million people in 2014 and 22 million by 2016. But it’s becoming obvious Obama’s crown jewel policy achievement is shattered and in ruins.

According to the GAO, vital parts of the computer systems running the exchanges remain unfinished. This means the government has no way to know who’s even eligible for the federal subsidies. They have no system to monitor insurance plans for compliance with the mountains of new regulations.

Health insurance rates are doubling, tripling and even quadrupling. Any affordability in the Affordable Care Act was a mirage. In some cases, insurance companies are even suspending the sale of individual policies. Aetna has announced that it’s pulling the plug on California.

Worse yet, the existing healthcare system is also unraveling. The question is: Will Obamacare opponents be able to use this vulnerability to finally kill the beast?

A Lack of Courage

This much is obvious: Opponents of Obamacare don’t have much courage. If they did, Obamacare would already be gone. In order to push Obama hard enough to induce full repeal, they’ll have to go to the mat and shut down the government, much like Newt Gingrich did to Bill Clinton. Unfortunately, John Boehner is no Newt Gingrich. So I foresee a series of half-measures taking shape instead.

The House of Representatives may vote to repeal the individual mandate. The mandate is what makes the law unpopular with voters. But the House should also pass a bill proposed by Georgia Rep. Tom Price to cut off funding to enlarge the Internal Revenue Service. No IRS expansion, no enforcement of Obamacare. Americans never have liked the IRS. They like it even less under Obama’s aggressive tax collection policies.

Obama will never agree to a full repeal, but as the problems continue to mount, he could choose to come to the table and repeal the most onerous provisions of the law. Total repeal will have to wait until he’s out of office. He would veto any plan to fully repeal it.

The best plan of action is to not aid Obama and try to fix it piecemeal. Allow it to fail in full view so voters become committed to total repeal.  The current Obamacare system is unfixable and the sooner the problems come to light, the sooner all will see that the entire system is broken beyond repair.

Your eyes on the Hill,

Floyd Brown

Original story at Capitol Hill Daily

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Photo - A new rule requires state, federal and local agencies as well as health insurers to swap the protected personal health information of anybody seeking to join the new health care program that will be enforced by the Internal Revenue Service. (Photo: Thinkstock)

A new 253-page Obamacare rule issued late Friday requires state, federal and local agencies as well as health insurers to swap the protected personal health information of anybody seeking to join the new health care program that will be enforced by the Internal Revenue Service.

Protected health information, or PHI, is highly protected under federal law, but the latest ruling from the Department of Health and Human Services allows agencies to trade the information to verify that Obamacare applicants are getting the minimum amount of health insurance coverage they need from the health “exchanges.”

The ruling, explained on pages 72-73 of the book-thick guidance, does not mention any requirement that applicants first OK the release of their PHI. HHS already allows some exchange of PHI without an individual’s pre-approval, especially when for a “government program providing public benefits.” Officials said the swapping of information is simply meant to help figure the best insurance coverge of Obamacare users.

The new ruling surprised some congressional critics. “This sounds as if HHS will have access to protected health info to me,” said one top Hill aide worried about how well the administration will protect that information.

Conservative groups including Americans for Tax Reform have raised questions about the release of PHI in the aftermath of the IRS scandal.

PHI includes an individual’s medical history, test and laboratory results, insurance information and other data.

The new rule said that appropriate privacy laws will be followed.

“The exchange would submit specific identifying information to HHS and HHS would verify applicant information with information from the federal and state agencies or programs that provide eligibility and enrollment information regarding minimum essential coverage. Such agencies or programs may include but are not limited to Veterans Health Administration, TRICARE, and Medicare,” said the new rule, which HHS is seeking public comment on.

“HHS will work with the appropriate federal and state agencies to complete the appropriate computer matching agreements, data use agreements, and information exchange agreements which will comply with all appropriate federal privacy and security laws and regulations. The information obtained from federal and state agencies will be used and re-disclosed by HHS as part of the eligibility determination and information verification process,” added the rule.

Explaining the PHI release ruling, HHS said Obamacare “is a government program providing public benefits, is expressly authorized to disclose PHI … that relates to eligibility for or enrollment in the health plan to HHS for verification of applicant eligibility for minimum essential coverage as part of the eligibility determination process for advance payments of the premium tax credit or cost-sharing reductions.”

Original story at http://washingtonexaminer.com/article/2531990

First came the good news from the West Coast about how Obamacare will be lowering premiums for individuals shopping in the new state exchanges. Never mind that in California the official folks at the exchange, who are supporters of health reform, mixed apples and oranges to reach their conclusion that rate shock had not materialized. Now come the official folks in Ohio, who, by the way, are not big Obamacare supporters, warning Buckeye State consumers that “insurers expect the cost to cover healthcare expenses for consumers will significantly increase.” Never mind that their predictions are based on what insurers have told them their “costs” will be—not on the actual premiums they plan to charge.

The Ohio Department of Insurance explained its thinking in a press release:

“While those costs do not specifically track with the premiums insurers charge individual customers, it is expected that these increases in costs will also translate to significant premium increases for many Ohioans.”

Question: If the state isn’t exactly sure what these “increases in costs” mean in terms of dollars and cents in premiums, why did it issue a press release and hold a news call with reporters? The answer, according to the press release, was to “help health insurance consumers continue to prepare for the expected price increases.” But the Department’s real message seemed to be that insurers have no choice but to simply pass on some unidentified and unspecified costs.

A question the press might have explored: What costs? As I’ve explained recently, insurers consider lots of factors in determining premiums. These include the cost of medical services, how much more they can charge older people than younger ones, where policyholders live, how tough a state regulates them, what the competition looks like, their expenses in selling the policies—and the profits they’d like to earn. When actuaries mix these elements together, they arrive at a price, or a premium, that they hope will be low enough to entice shoppers to buy their products.

The Associated Press and The Columbus Dispatch picked up on the “analysis,” and the AP’s piece effort got a lot of pickup. Neither story was a model of clarity. It’s fair to ask what Ohioans got from this reporting. Probably not much, except maybe another helping of confusion.

The AP story started with the department’s thesis—that insurers’ costs of covering Ohioans in the insurance shopping exchange (which will be run by the feds in Ohio, since the state opted out of running its own exchange) would be “significantly higher.” The second graph continued:

“That means individuals should also brace for potentially higher costs when purchasing coverage through the new insurance marketplace created by President Barack Obama’s healthcare law, state officials said.”

The third graph told readers that the state did not look at actual premiums, however. The fourth reported that Lt. Gov. Mary Taylor, a Republican who is also the director of the insurance department, noted that specific premiums will vary and could change when the state reviews them, but that “premiums will track very closely with the cost.”

Taylor also said that benefits required by the law are “much richer” than the benefits previously available to Ohio consumers. What the heck did that mean to readers? And was that the reason for these higher costs? The AP didn’t really explain, but did throw out some numbers, telling readers that “projected costs to the companies for providing the required health benefits under the law ranged from roughly $283 to $577 for individual plans.” But for which plans—the bronze, the cheapest type offered in the exchanges; the silver plan; the gold plan; or the most expensive platinum plan, where coverage is top-notch. And who do these “costs” apply to—20 year olds? Or, 30, 40, or 60-year-olds? Numbers tossed out like confetti mean nothing without specifics.

At the end of the piece, the AP repeated what has become almost a standard graph in these kinds of stories:  Young, healthy people will get rate increases, but older people will see rates decrease, leaving readers to think 60-year-olds will pay lower premiums than 25-year-olds. They won’t. Older consumers will pay more—sometimes much more in absolute dollars.

Original article at cjr.org

MichaelRamirez

The predictable hits just keep on coming as the Obamacare clock ticks down toward full implementation.  Liberals have shifted gears from arguing the law will lower costs and reduce premiums for everyone — which is how the unpopular overhaul was dishonestly marketed — to shrugging that hey, at least many uninsured and lower-income citizens will get affordable coverage.  But even that’s not universally true, as many American workers are about to painfully discover.  Behold, the “Affordable” Care Act in action (via the Associated Press):

It’s called the Affordable Care Act, but President Barack Obama’s health care law may turn out to be unaffordable for many low-wage workers, including employees at big chain restaurants, retail stores and hotels. That might seem strange since the law requires medium-sized and large employers to offer “affordable” coverage or face fines. But what’s reasonable? Because of a wrinkle in the law, companies can meet their legal obligations by offering policies that would be too expensive for many low-wage workers. For the employee, it’s like a mirage — attractive but out of reach. The company can get off the hook, say corporate consultants and policy experts, but the employee could still face a federal requirement to get health insurance.  Many are expected to remain uninsured, possibly risking fines. That’s due to another provision: the law says workers with an offer of “affordable” workplace coverage aren’t entitled to new tax credits for private insurance, which could be a better deal for those on the lower rungs of the middle class.  Some supporters of the law are disappointed. It smacks of today’s Catch-22 insurance rules.

They’re “disappointed,” and are already mobilizing to pin their own mess on insurance companies.  Their solution, of course, will be to forge ahead to a fully government-run single payer system — which has been the objective from word one.  They’ll ask Americans to forgive them for producing a disastrous, unworkable federal power-grab, insisting that it can only be fixed by even bigger government.  No thanks.  The AP story above shines the spotlight on a gaping loophole in Obamacare.  Basically, major employers of low-wage workers can technically satisfy the law’s requirement that they offer “affordable” coverage to full-time employees, even if the new rates aren’t actually affordable in reality.  Unable to pay the premiums being offered by their employers, and ineligible for taxpayer subsidies to obtain coverage on their own (because they’re “choosing” not to accept their “affordable” employer options), many of these workers will determine they have no choice but to remain uninsured — and will pay the anti-middle classObamacare mandate tax for the privilege of doing so.  What a deal.  Guess who’s heading for the exits as this monstrosity looms?  Ta-da:

Dozens of lawmakers and aides are so afraid that their health insurance premiums will skyrocket next year thanks to Obamacare that they are thinking about retiring early or just quitting. The fear: Government-subsidized premiums will disappear at the end of the year under a provision in the health care law that nudges aides and lawmakers onto the government health care exchanges, which could make their benefits exorbitantly expensive…If the issue isn’t resolved, and massive numbers of lawmakers and aides bolt, many on Capitol Hill fear it could lead to a brain drain just as Congress tackles a slew of weighty issues — like fights over the Tax Code and immigration reform. The problem is far more acute in the House, where lawmakers and aides are generally younger and less wealthy. Sources said several aides have already given lawmakers notice that they’ll be leaving over concerns about Obamacare. Republican and Democratic lawmakers said the chatter about retiring now, to remain on the current health care plan, is constant.

Read more at TownHall.com