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Posts Tagged ‘health’
September 12th, 2014 at 1:31 pm
Workers Paying More for Health Insurance under ObamaCare

As ObamaCare’s next open enrollment period draws near, some of the controversial law’s biggest backers are cheering a seven city survey claiming that health insurance premiums associated with it are dropping.

This leads liberal health policy expert Ezra Klein of Vox to say that “Obama’s signature accomplishment is succeeding beyond all reasonable expectation.”

But not if you get your health insurance from your employer, however.

“Employees are on the hook for more and more of their health care costs. Premiums are increasing so slowly in part because employers are continuing to shift toward higher deductibles, requiring employees to pay more out of their own pockets before their health care plans kick in,” explains Sam Baker in National Journal.

Comparing monthly premium rates year-to-year makes sense if that’s the best single indicator of how ObamaCare is impacting paychecks. But it isn’t. For employees working in the real economy the shift to high deductible plans means more out-of-pocket spending every time they visit the doctor.

Translation: ObamaCare makes health insurance for workers more expensive.

When it comes to measuring ObamaCare’s success, we need to make sure we’re looking at the most relevant data. Otherwise, we risk scoring political points at the expense of the truth.

September 9th, 2014 at 7:51 pm
ObamaCare’s Popularity Dropping Ahead of Midterms

“Just 35 percent of voters now support the Affordable Care Act, down 3 percentage points from May, according to a monthly poll by the Kaiser Health Foundation,” reports The Hill.

Moreover, the poll found that 47 percent of respondents feel negatively about the law, otherwise known as ObamaCare.

The RealClearPolitics average of six national polls is even worse: 53.8 percent say they oppose the law, with only 40.3 percent in favor.

Little wonder that the controversial health law is so unpopular. States are continuing to resist Medicaid expansion under ObamaCare’s terms for fear of a Trojan horse spending spree, and consumers are getting shut out of some of the country’s best hospitals.

All this and it is still almost two months until the midterm elections.

President Barack Obama may not be on the ballot this year, but his eponymous health law surely is.

August 21st, 2014 at 2:38 pm
Avik Roy Updates His ObamaCare Alternative

Credit Avik Roy for being open-minded.

A week after unveiling his ambitious – and controversial – reform of ObamaCare, Roy, a well-respected health policy expert, is incorporating some of the best criticisms as amendments to his plan.

Most of the changes are highly technical, and not worth delving into in a short blog post. For readers interested in specifics, here is the link to Roy’s updates page.

What’s refreshing about Roy’s response to his fellow conservatives is his willingness to defend his ideas, but not to the point of brushing aside legitimate improvements.

As to the biggest concern – that preserving ObamaCare’s insurance exchanges makes it possible that Democrat congressional majorities in the future might use them as a springboard to a single-payer system – Roy replies, “No health-reform plan can singlehandedly prevent Democrats from doing whatever they want if they ever again have 2009-size, filibuster-proof majorities. But if that’s the standard for constructive GOP reform plans, well, let’s just call it a day.”

Roy’s point is well taken, but it highlights a central tension among conservatives whenever federal policymaking is considered – Which is more important: Market efficiency or federalism?

Policy wonks like Roy tend to favor efficiency as a way to lower spending and improve citizen-customer experiences. Constitutionalists like myself tend to favor federalism and the policy diversity that it affords. Of course, different regulatory regimes produce market inefficiencies. However, that just may be the price of freedom.

Roy should be applauded for trying to make his ObamaCare alternative as strong as possible. Time will tell whether conservatives will come to favor an efficient, federally-regulated national market, or continue to favor a system that lets states and their citizens decide what works best for them.

August 21st, 2014 at 1:23 pm
Ninth Circuit: IPAB Challenge Must Wait

Uncharacteristically, a three judge panel on the Ninth Circuit Court of Appeals has given constitutional conservatives a reason to smile.

The Ninth Circuit, a bastion of liberalism that gets routinely reversed by the Supreme Court, ruled that a constitutional challenge to the Independent Payment Advisory Board (IPAB) is not yet “ripe” for judicial review. Ripeness is the term judges use to denote when a case has a live issue that a court of law can decide. In the IPAB case, the agency hasn’t yet been created, so any challenges to the harm it might do must wait until they actually occur.

And make no mistake, there is much to fear from a fully functioning IPAB. For example, “IPAB is not dependent upon annual appropriations from Congress, need not follow traditional administrative processes, and is not subject to judicial review. As if that were not enough,” writes Jonathan Adler, “[ObamaCare] provides that Congress may dissolve IPAB only if it follows a specified procedure during a seven-month period in 2017 – a statutory provision even the Obama administration has acknowledged could not hold up in court.”

Each of the characteristics of IPAB cited by Adler above are intentionally designed to separate the agency from legislative, judicial and ultimately public control. This is dangerous because “IPAB is authorized to develop self-executing recommendations for limits on Medicare reimbursement rates and other cost controls should the rate of Medicare spending growth exceed a specified target.” That is, IPAB is empowered to ration care for Medicare beneficiaries without any oversight. If allowed to go into effect, IPAB could very well be the biggest step toward a European-style, centrally controlled nationalized health system.

So, how is a loss today really a win for the future? By dismissing the current challenge to IPAB for lack of ripeness, the Ninth Circuit panel is allowing those opposed to the agency to fight another day. At the trial level where this case began, the district judge was not so kind. He ruled against the challengers on the merits, foreclosing future attacks when IPAB actually gets going.

By allowing the challengers to refile later, the Ninth Circuit – at least for the time being – is leaving the door open to another, perhaps more successful assertion of constitutional principle.

August 14th, 2014 at 8:35 pm
Indiana Jumps on the Halbig Bandwagon

Add Indiana to the list of states arguing that ObamaCare’s subsidies can’t be used on Healthcare.gov, the federal exchange.

The challenge is the same mounted by other states contesting the IRS’s unilateral decision to go against the clear language of ObamaCare which makes subsidies available only on state-based exchanges, a restriction intended to induce states to shoulder the implementation costs for fear of angering residents by exposing them to ObamaCare’s real costs.

U.S. District Judge William T. Lawrence will decide whether Indiana’s case has merit in October. Precedent from other circuits isn’t all that helpful, since the D.C. Circuit upheld the statutory scheme while the Fourth Circuit sided with the IRS.

The silver lining: Whatever Lawrence and the appellate circuit decide will further fragment ObamaCare’s implementation, increasing the likelihood that the Supreme Court will weigh in.

Whenever that happens, hopefully there will still be five votes to uphold the plain meaning of the law.

H/T: Indianapolis Star

August 12th, 2014 at 6:06 pm
Signs Emerge that ObamaCare Enrollment Is Dropping

It looks like the Obama administration’s much celebrated achievement of 8 million ObamaCare enrollments is actually dropping over time.

“The nation’s third-largest health insurer [Aetna] had 720,000 people sign up for exchange coverage as of May 20,” writes Jed Graham of Investor’s Business Daily. “At the end of June, it had fewer than 600,000 paying customers. Aetna expects that to fall to ‘just over 500,000’ by the end of the year.”

While no other insurance company has publicly reported declines as steep as Aetna, many others have not denied it is happening during recent conference calls discussing earnings.

Some attrition in ObamaCare signups is to be expected since a number of major life events could cause a change in status. Getting a new job with health benefits, for example. But the Obama administration’s refusal to publicize monthly enrollment numbers makes it impossible to get a clear picture of how well the law is working.

Which may be precisely the goal.

August 11th, 2014 at 2:24 pm
HHS to Fund Coming ObamaCare Bailout of Insurance Companies

What makes conservatives so sure that the Obama administration will bailout insurance companies losing money under ObamaCare?

“According to a recent investigation conducted by the House Oversight and Government Reform Committee chaired by Darrell Issa, insurers widely expect to receive funds from the bailout program,” writes U.S. Senator Marco Rubio (R-FL). “One large insurer recently filed financial statements claiming they expect part of their revenue to come from American taxpayers via the ObamaCare bailout ‘fund.’”

Thwarted by the GOP majority in the U.S. House of Representatives who refuse to appropriate money for this part of ObamaCare, the Department of Health and Human Services “figured out a way to use general funds available through the Centers for Medicare and Medicaid Services to pay off health insurers,” says Rubio. “The effect is to circumvent Congress’ power of the purse for the purpose of bailing out health insurers with taxpayer funds.”

Whether it’s the CIA lying about spying on congressional investigators or IRS officials conveniently losing potentially damaging emails, executive branch officials in the Obama administration are destroying the ability of anybody outside their clique from being able to trust anything they say.

August 7th, 2014 at 3:24 pm
The Coming ObamaCare Bailout

Because of ObamaCare’s mismatched incentive structure, some savvy commentators are warning of an impending, multi-billion dollar bailout of the insurance companies selling health care policies under the law.

“Pre-ObamaCare,” writes Dan McLaughlin, “insurers had to price their policies mainly by reference to market forces (albeit in an already heavily-regulated market)… Guess wrong and you lost money. But under ObamaCare, consumers no longer have the choice whether or not to buy policies, and insurance companies no longer face any risk of losing money, because they’ve been promised a bailout. Money will still be lost, but it will be taxpayer money, and you never run out of that, do you?”

McLaughlin is talking about ObamaCare’s “3 R’s” – reinsurance, risk corridors and the risk adjustment program. I’ve written about this multi-year, $20 billion bailout before. In different ways, each is designed to subsidize insurers for lost revenue traceable to the health law’s dysfunctional mandates. The threefold scheme was buried in the legislation to buy the support of large insurance companies who would have refused to participate without it.

Now the bill is coming due.

Based on interviews and documents containing discussions between Obama administration officials and insurance industry executives, a House Government Oversight report reveals that insurers are expecting the following payments:

1)      $640 million from the Risk Corridor program for the 2014 plan year

2)      $346 million from the Risk Adjustment program

The reinsurance program redistributes money among private insurance companies, as determined by the federal government.

The numbers quoted above are two to three times higher than originally anticipated because of the high level of adverse selection – i.e. too many older and sicker enrollees, not enough younger and healthier ones. The latter group is avoiding enrollment, preferring to pay ObamaCare’s relatively low penalty. But even that is a mirage. Reports are surfacing that as many as 25 million uninsured Americans are getting ObamaCare penalty waivers for next year; further increasing the federal budget deficit.

Bailouts can be nice, if they apply to you. But as a governing strategy, they eventually bankrupt the entire system.

August 6th, 2014 at 1:36 pm
Vermont Latest to Fire ObamaCare Website Maker

After nearly a year of failed attempts, Vermont is firing CGI Federal – the company that bungled both the federal healthcare.gov and Massachusetts’ online insurance exchange – as its web designer.

“With Vermont still lacking a fully functioning health website more than 10 months after its glitch-plagued debut last October, Vermont officials said late Monday that they were pulling the plug on CGI’s CGI Technologies and Solutions’ contract,” reports Newsweek.

The decision will cost CGI almost $20 million, but at least Vermont has agreed not to sue the company for damages.

Vermont’s announcement follows several other states that have abandoned their original – and very expensive – ObamaCare websites. Some, like Nevada, Hawaii, and Oregon, are planning to cut their losses and transition to the federal healthcare.gov website. Others, like Massachusetts, Maryland, and now Vermont, are switching to new contractors hoping to recoup at least some of their investments.

Of course, there are success stories. State exchanges in Kentucky and Connecticut are routinely cited as well-functioning websites – though even these have glitches. However, the prevalence of so many high-profile failures indicates that this massive experiment in public-private partnerships has resulted in a huge transfer of wealth with precious little to show for it.

July 31st, 2014 at 1:10 pm
House Passes Bill to Sue Obama

The House of Representatives made history today when it passed a bill allowing Congress to sue the President of the United States for failing to implement a federal law, reports the L.A. Times.

The legislation authorizes House Speaker John Boehner (R-OH) to file suit in federal court demanding that President Barack Obama enforce ObamaCare’s employer mandate, which requires companies with 50 or more full-time workers to purchase ObamaCare-compliant health insurance or pay a penalty.

House Republicans have been critical of President Obama’s unilateral delays in enforcing the mandate – now scheduled to go into effect in 2016 – because it spares Democrats and the Obama administration substantial political pain. If the law is so great, Republicans reason, then it should go into full effect.

As with other anti-ObamaCare measures to pass the House, this bill has virtually no chance of clearing the Senate where Democrats are in the majority. Still, it’s very presence helps Republicans draw a clearer contrast over where each party stands on the rule of law; in particular the president’s ability to pick-and-choose which parts of a statute he will – as he swore upon taking office – to faithfully execute.

June 30th, 2014 at 2:08 pm
Obama Goes Outside Military Brass, Medical Community for New VA Chief

Robert McDonald, former CEO of Procter & Gamble, is President Barack Obama’s nominee to run the scandal-ridden Department of Veterans Affairs.

McDonald’s nomination is catching some in the veterans’ community off-guard. Unlike previous VA Secretaries, he’s not a general – though he did graduate from West Point and serve for five years as an Army paratrooper before jumping to P&G.

He’s also neither a medical doctor, nor does he have experience administering a hospital; traits that some think would be useful for a person stepping into the nation’s largest health system with 1,700 facilities.

Indeed, the case being made for McDonald is that his background in brand management and customer service signals that Obama thinks the main problem at the VA is bad leadership.

Which brings us to an interesting question – Is McDonald’s job just to make the VA’s public face more attractive, or is it to get the sprawling department into tip-top, customer satisfaction shape?

The answer depends on how much latitude President Obama is giving McDonald to operate. For example, in places like Phoenix where staff and administrators falsified records to get performance bonuses, does McDonald have the authority to fire and hire political appointees as well as career civil servants? Does he have the flexibility to outsource patients to private medical providers in regions where the VA hospitals are overbooked?

Senate Republicans should ask McDonald these and other questions during his confirmation hearings. Veterans and their families deserve to know whether the VA’s new chief has the power to be a turnaround artist, or just a place warmer.

June 27th, 2014 at 6:17 pm
Cover Oregon Offers Bonuses to Staff Not to Leave

Oregon’s failed ObamaCare website is so fraught with failure the state is offering to pay employees bonuses just to keep them on the job.

After spending over $250 million – and retaining more than $50 million in federal grants – to build an ObamaCare health insurance exchange that failed to enroll a single person, Oregon decided to switch to Healthcare.gov, the federal equivalent.

Apparently, though, the crisis isn’t over. Since April, 27 staff members of Cover Oregon have left, taking with them valuable skills that can’t easily be replaced in time to transition to the federal website. To staunch the bleeding, Oregon is making a total of $650,000 in bonuses available to the remaining 163 employees, if they stay on till the end of the job.

As I explained in my column this week, state officials are primarily responsible for the costly disaster that is Cover Oregon. This news is just one more reminder that simple, avoidable mistakes by politicians and bureaucrats have huge and prolonged consequences.

H/T: NRO

June 10th, 2014 at 5:26 pm
Interim VA Chief Adopts Boehner’s Private Option Fix

Last week House Speaker John Boehner (R-OH) sent a letter to President Barack Obama demanding that “any veteran unable to obtain an appointment within 30 days [have] the option to receive non-VA care.”

This week it was revealed that 57,000 veterans have been waiting 90 days or longer for care from VA facilities.

But at a time when the White House is dithering, the acting VA chief is adopting Boehner’s approach.

“The interim VA secretary said he would spend $300 million to increase hours for VA medical staffers and contract with private clinics to see veterans who are unable to get care through VA medical centers,” reports the Washington Post.

Kudos to Sloan Gibson, the temporary VA secretary, for leveraging the private sector to care for those who’ve rendered the highest public service.

May 21st, 2014 at 1:55 pm
Nevada Closes Its ObamaCare Exchange, Hawaii Next?

Fed up with a dysfunctional health exchange operated by Xerox, Nevada officials voted to terminate the contract and transfer responsibility to the federal government.

Apparently, spending $75 million to enroll about one-fourth the number of people initially projected convinced Nevada to throw in the towel.

Nevada joins Oregon, Maryland and Massachusetts as states who have scrapped their original state-based exchanges because of exceedingly poor performance.

The next domino to fall may be Hawaii, whose ObamaCare exchange – the Hawaii Health Connector – has registered just 8,500 people but needs at least 150,000 enrollees to ensure the program is self-sustaining.

Not surprisingly, Hawaiian officials are already being pressured to shut it down.

May 19th, 2014 at 2:05 pm
ObamaCare’s Cost Increases Could Push 90% of Workers at Large Firms onto Exchanges

“According to a new report from S&P Capital IQ, 90 percent of American workers who receive health insurance from large companies will instead get coverage through ObamaCare’s exchanges by 2020,” writes Sally Pipes of the Pacific Research Institute.

Large companies are those that employ 10,000 workers or more. They cover 59 percent of the American workforce.

ObamaCare’s escalating barrage of mandates, fees and fines are estimated to extract “about $163 million to $200 million in additional cost per employer – or $4,800 to $5,900 per employee,” says Pipes. Compared to the $2,000 per employee fine for not offering health insurance, large employers will in effect be forced to dump workers on ObamaCare exchanges to stay profitable.

There are many aspects of ObamaCare that defy easy explanation, but this much is clear – Forcing large employers who want to provide health insurance to their employees to pay more than twice the price of compliance just doesn’t pencil.

The only financially sensible thing to do – from a company’s perspective – is to shove workers onto taxpayer-funded exchanges. That may keep the firm afloat, but it will only add to the federal government’s fiscal problems.

May 8th, 2014 at 6:48 pm
More States Eye Switching to Healthcare.gov

A CNBC report says that multiple states now operating an ObamaCare exchange could decide the costs are unsustainable and relinquish control to Healthcare.gov, the exchange run by the federal government.

The reasons are multiplying. Oregon decided to shutter its woebegone website after spending $248 million and failing to enroll a single person online. Massachusetts is abandoning its software program, but if its replacement isn’t ready to launch by the next enrollment period in November it plans to default to Healthcare.gov. Colorado and Rhode Island are trying to figure out how to make their exchanges financially viable once federal subsidies run out. And at least one expert thinks Nevada and Hawaii may also decide to let the feds be responsible for continuing IT updates and rules changes.

But it’s not like the once foundering Healthcare.gov is experiencing smooth sailing. Recent testimony before Congress confirmed the existence of duplicate enrollments that cast doubt on the Obama administration’s overall enrollment claims.

“Due to website glitches, some individuals may have enrolled multiple times,” explains the Illinois Policy Institute. “For example, if there are three people with one enrollment each and one person with two enrollments, the government will report this as five total enrollments. If the first three people paid for each of their policies and the fourth person paid for one policy, the insurer will report 100 percent payment. In this way, the government numbers may be further overstating enrollments.”

And with it, Healthcare.gov’s ability to handle the increased responsibility for processing many more people.

April 30th, 2014 at 5:33 pm
Oregon Scraps $248M ObamaCare Exchange

Oregon spent $248 million developing its own ObamaCare insurance exchange and never enrolled a single person online.

That kind of return on investment convinced state officials “to abandon the exchange entirely and switch to the federal website, the first state to do so,” writes Lou Cannon. “The Oregon board made its decision after being told it would cost $78 million to fix Cover Oregon compared to $4 million to $6 million to make the technical changes needed to join the federal exchange.”

Investigations are ongoing into why the state’s heavily bankrolled website was such a bust. Once thought to be a model for progressive high-tech governing, Cover Oregon is now a source of embarrassment for the state’s Democratic establishment.

Whatever the causes for the technology failure, Oregon’s switch to the federal alternative could hit enrollees hard. An estimated 70,000 Oregonians enrolled with paper applications through Cover Oregon, making many of them eligible for federal subsidies. However, the text of ObamaCare doesn’t make subsidies available if insurance is bought via the federal website. So far, the IRS isn’t making the distinction, but a three-judge panel at the D.C. Circuit seems ready to apply the law as written.

The intent of ObamaCare’s drafters was to reward state citizens with federal subsidies if they chose to shoulder the start-up costs associated with running a state-based exchange. Now that Oregon is pulling the plug on its failed website, its citizens may be losing the assistance they need to make ObamaCare affordable.

April 26th, 2014 at 5:57 pm
Bad News: Holder Says He’s Staying

Any hopes the GOP had that Kathleen Sebelius’ resignation as HHS Secretary might convince fellow Obama Cabinet member Eric Holder to do the same were quashed on Friday.

“The Attorney General does not plan to leave before the mid-terms,” said a Justice Department official. “That does not mean that he is definitely leaving after the mid-terms, just that he is at least staying through that time.”

Prior to Sebelius taking the fall for ObamaCare’s disastrous rollout, it was Holder who was the face of bureaucratic scandal. Though voted in Contempt of Congress by the House of Representatives, Holder continues to stonewall investigators on details surrounding the “Fast and Furious” program that led to the deaths of at least one American and dozens of Mexicans.

Credit Sebelius with this much – At least the department she ran wasn’t responsible for killing anyone on her watch.

April 24th, 2014 at 6:05 pm
ObamaCare and Income Inequality

If President Barack Obama wants to improve income inequality he could start by removing ObamaCare’s barriers to working more hours.

“The savings from restricting hours worked can be enormous,” explains the Wall Street Journal. “If a company with 50 employees hires a new worker for $12 an hour for 29 hours a week, there is no health insurance requirement. But suppose that worker moves to 30 hours a week. This triggers the $2,000 federal penalty. So to get 50 more hours of work a year from that employee, the extra cost to the employer rises to about $52 an hour – the $12 salary and the ObamaCare tax of what works out to be $40 an hour.”

Liberals thought themselves clever by dropping full-time status to 30 hours per week from the traditional 40. What they didn’t count on was that the actual result would be an 11 hour per week pay cut.

April 18th, 2014 at 4:10 pm
Issa to Investigate Pro-ObamaCare ‘Census-Gate’

Darrell Issa (R-CA), Chairman of the House Government Oversight & Reform Committee, wants the Census Bureau to explain why it failed to tell Congress that it would change the way it measures whether people have health insurance in the same year ObamaCare goes into effect.

The new survey produces a lower uninsured rate than previous versions asked by the Census Bureau. The concern is that the new lower numbers will make ObamaCare enrollment figures now and the in the future appear to be higher than they would have had the same questions been asked.

“A two-percent adjustment in the nationwide uninsured rate would represent a change in status for six million Americans and could be used in misleading arguments about the coverage impact of the Affordable Care Act,” Issa wrote in a letter to the Census Bureau.

Politically-motivated shenanigans are nothing new for ObamaCare, but this latest revelation indicates that even a highly respected agency like the Census Bureau – which researchers in several fields look to for objective data – is being used to push the narrative that the controversial health law is a historic success; data to the contrary notwithstanding.

H/T: Washington Examiner