Archive

Posts Tagged ‘health’
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

April 17th, 2014 at 1:58 pm
Sebelius Back to Kansas as a U.S. Senate Candidate?

Say it ain’t so!

Soon-to-be-former HHS Secretary Kathleen Sebelius “is considering entreaties from Democrats who want her to run against her old friend, Senator Pat Roberts, Republican of Kansas,” reports the New York Times.

It’s hard to see how this news is anything other than an attempt to put a softer spin on Sebelius’s disastrous tenure as the face of ObamaCare.

Considering how much the Left loathes her mismanagement of Healthcare.gov – driving down public confidence in government to record lows – it’s no surprise that friends of Sebelius are trying to rehabilitate her image by saying the former two-term Kansas governor could be just the candidate to topple Roberts.

Making the GOP spend money and time on a race they would otherwise win easily could burnish Sebelius’s ‘good soldier’ credentials. Actually winning the seat would give Democrats their first U.S. Senator from Kansas since 1939.

Still, whatever goodwill Sebelius had as governor has been forgotten long ago. In the current reality, it’s difficult to see how she could step down from such a bad job at HHS into an underdog Senate campaign and emerge as anything other than a twice rejected public servant.

April 15th, 2014 at 6:31 pm
Suspicious Timing of Census Bureau’s New Health Insurance Questions Helps ObamaCare

After compiling three decades-worth of responses to health insurance questions, the U.S. Census Bureau is about to implement a new version that will make it impossible to compare insurance coverage data before and after ObamaCare.

Coincidence?

It gets better.

“An internal Census Bureau document said that the new questionnaire included a ‘total revision to health insurance questions,’ and, in a test last year, produced lower estimates of the uninsured,” reports the New York Times.

In practical terms this means “it will be difficult to say how much of any change is attributable to the Affordable Care Act and how much to the use of a new survey instrument.”

According to the Times, the new survey has been in the works for awhile. But there is no explanation given for why it is going into effect in the same year when millions of Americans are transitioning to the ObamaCare regime. The controversial health law was sold as a way to extend coverage to tens of millions of uninsured Americans. Why would the non-partisan Census Bureau make it impossible for observers to see whether ObamaCare actually achieved its goal?

Whatever the official line, it’s difficult to understand the timing of this development as anything other than a naked attempt to avoid accountability.

April 14th, 2014 at 4:57 pm
Will Sebelius’ Replacement Follow Her Lawless Lead?

Here’s a suggested question for GOP Senators to ask Sylvia Burwell – President Barack Obama’s nominee to succeed Kathleen Sebelius as Secretary of Health and Human Services – at her confirmation hearing next month.

Studies by the RAND Corporation and Goldman Sachs estimate as much as 20 percent of the claimed 7.5 million ObamaCare enrollments have not paid their first month’s premiums.

When enrollees start seeing how much their deductibles are – commonly $3,000 to $5,000 – many more may choose to stop paying ObamaCare’s higher out-of-pocket expenses.

If that happens, it’s really bad news for doctors and hospitals.

“Section 1412 of the health law gives consumers a 90-day ‘grace period’ before their subsidized plan is canceled for nonpayment. But insurers only have to keep paying doctors and hospitals for 30 days. The next 60 days of care on the care provider,” explains Betsy McCaughey.

“[I]t could pose a significant financial risk for medical practices,” the American Medical Association warns.

The HHS Secretary has no express power to bail out such care providers.

However, under the previous Secretary, the Department of Health and Human Services didn’t shy away from spending $8 billion without congressional authorization to hide Medicare Advantage cuts before the 2012 presidential election.

This and many other extra-legal actions by Secretary Sebelius have come to define HHS as the most powerful domestic federal agency.

Ms. Burwell, Do you think the absence of express authority to bail out care providers in the above situation limits you in any way from spending money for this purpose?

April 11th, 2014 at 2:44 pm
IRS’s ‘Big Brother’ ObamaCare Enforcement Coming into View

As Tax Day approaches, consider the bright side – at least there’s no ObamaCare form you have to fill out.

That changes next year.

“According to the agency, the IRS plans to include a specific line on the 1040 forms for taxpayers to ‘self-attest’ whether they purchased insurance,” reports Fox News. “It will most likely include a worksheet for taxpayers to calculate how much they owe – essentially either a flat penalty or a percentage of their income.”

Next year the penalty is either $95 or 1 percent of your income, whichever is greater.

The IRS plans to confirm whether taxpayers are telling the truth about purchasing insurance by getting enrollment records from insurance companies.

So along with increased paperwork, we can all look forward to a greater amount of government surveillance into our insurance (and eventually our health) records.

All in the name of helping us. Thank you, Big Brother.

April 5th, 2014 at 9:15 pm
Bipartisan Support for Repealing the Employer Mandate?

It sounds like there may be a growing bipartisan consensus to repeal ObamaCare’s onerous employer mandate.

“Republicans don’t like the mandate because they oppose the idea of government telling private sector entities what to do, but they also don’t support the lack of tax incentives for individuals who don’t pay for health care through an employer,” says The Street. For their part, “[s]ome Democrats don’t mind dumping the employer mandate because they would prefer to move away from businesses making health insurance decisions for individuals.”

The employer mandate is poised to hit small and growing businesses especially hard, since employing 50 full-time workers – defined as working 30 hours or more a week – triggers requirements to offer costly ObamaCare-compliant insurance plans.

This creates an obvious incentive to cut hours for people already at the margins, in effect robbing them of extra work and extra pay. Because of this liberal pundits like Ezra Klein have called for the full repeal of the employer mandate (and deplored the politically-motivated delays that have made ObamaCare’s implementation so arbitrary).

Of course, repealing the employer mandate isn’t a painless option. While it would no doubt free countless human resources directors from nimbly trying to anticipate the next extra-legal maneuverings of the Obama administration, it would also be a huge hit on ObamaCare’s financial scorecard.

“If you take [the employer mandate] out the congressional budget score looks a lot worse,” one academic supporter of ObamaCare tells The Street. That’s because the buck for subsidizing health insurance would move from private employers to the public treasury via a massive migration to ObamaCare exchanges. The individual mandate, remember, would be still be in effect. If that happens, expect ObamaCare’s price tag to soar.

So while it may be tempting for Republicans to ally with Democrats and vote to repeal the employer mandate, doing so could be used to charge the GOP with willfully spiking federal spending. Better, it seems, to just get rid of the whole law and start afresh.

April 4th, 2014 at 1:15 pm
Report: ObamaCare to Increase Large Employer Costs Up to $186 Billion

A new study by the American Health Policy Institute demonstrates that when it comes to ObamaCare’s disruption of the health insurance industry, the worst is yet to come.

The study looks at 100 large employers – defined as employing 10,000 workers or more – to estimate the direct and indirect costs of complying with ObamaCare’s costly mandates. (Due to extra-legal delays by the Obama administration, the employer mandate will go into effect starting in January 2015.)

When factoring in all of the direct mandates and fees – for example, covering children up to age 26 and accepting all enrollees regardless of preexisting conditions – as well as indirect costs – such as medical device companies and insurers passing on compliance costs to businesses in the form of higher prices – the total cost of complying with ObamaCare will be between $4,800 – $5,900 per employee. The net cost of ObamaCare for all large employers is projected to range from $151 billion to $186 billion.

Large employers employ about 52 million American workers, or about one-third of the nation’s workforce. You don’t have to be a Harvard-trained CFO to realize that companies “have a significant incentive to make fundamental changes to their health offerings” because of ObamaCare. The most obvious choice is to pay the $2,000 per employee penalty for not offering health insurance, and let employees try their luck on an ObamaCare exchange.

ObamaCare advocates insist that the law isn’t designed to separate workers from their health insurance, but the incentive structures buried within it tell a different story. Skeptics can be forgiven if the implementation phase looks like a coordinated effort first to get people into government-run exchanges, and eventually, under government-run health care.

H/T: Daily Caller

April 1st, 2014 at 6:48 pm
ObamaCare Promotion Driving Up Medicaid Applications

“According to a recent study by Avalere, the average application rate [for Medicaid] has increased 27 percent among non-expansion states and 41 percent for those expanding,” writes Angela Boothe of the American Action Forum.

For example, Tennessee – a state that chose not to expand its Medicaid program under ObamaCare – is still experiencing severe pressure on its budget due to high numbers of people trying to enroll. Though only the beginning of April, the Volunteer State has already enrolled the maximum number of people it projected to cover for the year. Adding to the pressure on state budget writers is the reality that by refusing to expand Medicaid under ObamaCare – which covers 100 percent of the increased costs until 2017 – part of the expense for covering the new enrollees falls on the state. If you work in a non-Medicaid state agency in Tennessee, beware bean counters wielding knives.

The Avalere report highlights the fact that ObamaCare creates a unique burden for non-expansion states like Tennessee. Because of the controversial health law’s media saturation, millions of people are aware that they are probably eligible for some sort of government assistance to purchase health coverage. Of these, many are discovering that they already qualify for Medicaid, even before ObamaCare was enacted. The awkward situation for states like Tennessee is that ObamaCare is still expanding Medicaid, just without any extra financial help.

If non-expansion states like Tennessee continue to see record Medicaid enrollment increases this year, don’t be surprised if anti-ObamaCare governors and legislatures start to rethink their opposition to expansion. Of course, as I’ve explained elsewhere, it would be a serious mistake to swap a three-year federal bailout for decades of increased costs by expanding Medicaid on ObamaCare’s terms. But for desperate lawmakers looking for a quick fix, ObamaCare’s “free money” may be too tempting to pass up.

March 31st, 2014 at 6:20 pm
IRS Compliance Nightmare Looms as ObamaCare Site Crashes Ahead of Deadline

This morning Healthcare.gov – the federal ObamaCare website serving citizens in 34 states – went down for four hours, stymieing customers from accessing or completing their applications for insurance.

NBC News reports that people unable to log onto the website were put in a “queue,” meaning they would be notified by email when they could resume the enrollment process.

But with the deadline to begin an application (supposedly) ending at midnight, what will happen to people unable to return to their computer screens after the lengthy delay? Last week’s extension to mid-April only covers people who start the process for enrolling by the end of March. If other commitments – say family or work responsibilities – don’t allow an applicant to return, what then? How will federal regulators distinguish between people who never tried to use Healthcare.gov and those that did, but for various reasons beyond their control couldn’t finish?

If history is any guide, don’t expect the feds to make a distinction. More likely, the response sometime soon will be a blanket extension for enrollment that allows anyone – without precondition – to complete the process.

Then it will be the IRS whose head will spin. When it comes to enrolling on an ObamaCare exchange, the carrots are the subsidies and the sticks are the fines. Any adult that goes without health insurance for three consecutive months is subject to a fine of $95 or 1 percent of her annual income, whichever is higher. And since that fee gets levied at next year’s tax filing, it will be the IRS’ job to sort out who is subject to the penalty.

That is, as soon as the political operatives in the Obama administration decide when enrollment really, really – no really we’re serious this time! – ends.

March 29th, 2014 at 7:52 pm
Latest ObamaCare Delay an Attempt to Hold Down Rate Spikes?

Megan McArdle posits three reasons why the Obama administration extended the enrollment deadline for purchasing insurance through Healthcare.gov, the federal ObamaCare exchange.

The most interesting, and to my mind most plausible, is that pushing the deadline into mid-April will make it more difficult for insurers to calculate next year’s premiums.

“Extending open enrollment, which is essentially what they’re doing, would then be a desperate play to get more young, healthy customers into the exchanges, and perhaps to make it a bit harder for insurers to raise rates,” writes McArdle. “In some states, insurers have to file preliminary rate increases in May. And thanks to this latest extension, they won’t have final data to back up any requests for a premium hike.”

Originally, the Obama administration estimated it needed 40 percent of enrollments to be from young and healthy people to avoid rate spikes the following year. With the current mix stuck at only 25 percent, insurers are signaling that prices will go up next year to cover the likely costs of insuring an older and sicker population than anticipated.

But with this extension the Obama administration is putting insurers in a bind. Do they assume the 25 percent number will hold and justify rate increases to state regulators using that assumption? Or do they wait and see if a last-ditch push to inflate the number of young and healthy enrollees reaches the magic 40 percent threshold?

The dilemma for the insurance companies is just the most recent example of how bending the law for one group punishes another. True, many people won’t mind that insurance carriers are the ones holding the bag this time, but that just underscores the growing lack of resistance to arbitrary regulation. Today, it’s unpopular insurance companies. Tomorrow, it’s you.