Freedom Line Blog

If you didn’t have health insurance last year, could afford it (according to ObamaCare), and don’t have a waiver from the individual or employer mandate, you will be getting a notice from the IRS this year that you owe Uncle Sam some money.

Apparently, this will be a surprise to a lot of people.

“A Kaiser Family Foundation poll released Thursday found that while slightly more than half of respondents were aware the penalty kicks in this year, one in five think it goes into effect next year, roughly one in six say they don’t know when it goes into effect, and one in 10 believe it was rolled out last year,” reports the Washington Examiner.

Look for ObamaCare’s unpopularity to increase even more after Tax Day.

There are many ways to skin a cat, the saying goes, and there may be more than one way to frame the Supreme Court striking down the IRS’ lawless extension of ObamaCare subsidies to an estimated 5 to 6 million Americans.

If the Court invalidates the subsidies for people living in states without a state-run ObamaCare exchange – as a plain reading of the law requires – then the consequences will have a ripple effect.

“For instance,” columnist Philip Klein explains, “ObamaCare’s fines against employers that do not offer health insurance coverage are triggered when a worker claims government subsidies to purchase insurance on an exchange – but in states where workers can no longer legally receive those subsidies, then there are no fines. The employer mandate, thus, is effectively dead in those states.”

There’s more.

“Additionally,” says Klein, “the individual mandate exempts those who can’t find health insurance options for less than 8 percent of their income – thus, if the subsidies are eliminated, more people will be able to claim this exemption.”

In other words, if a lack of ObamaCare subsidies make individual health insurance unaffordable, then the individual and employer mandates are null and void.

An ObamaCare without mandates weakens the law substantially, and makes it far more likely for Republicans to change. If the Supreme Court delivers a decision that brings it about, the GOP should be in a good position to enact a more workable alternative.

Fresh from beating Democratic incumbent Mary Landrieu in a run-off last December, Republican Bill Cassidy is off to a fast start as a freshman in the U.S. Senate.

Making good on his campaign promise to get rid of ObamaCare, Cassidy, a physician, has introduced two bills within just weeks of taking office.

The “No ObamaCare Mandate Act” would repeal the medical device tax, the employer mandate and the individual mandate, according to a report in The Hill.

In addition, “The Employee Health Care Protection Act” would reduce benefit requirements in health insurance plans regulated by ObamaCare, giving providers more flexibility and consumers more options.

And apparently, Cassidy knows how to give a good speech. In defending the Keystone XL pipeline from ideologically motivated attacks by environmentalists, Cassidy said, “We are not to be guided by our prejudice. We’re not to be guided by what we want to be the case. We are to be guided by the facts.”

Usually, it’s liberals who claim the mantle of science and scold conservatives for being fearful of the truth. It’s good to see a conservative U.S. senator return the favor.

With its newest batch of regulations, the federal Department of Health and Human Services (HHS) essentially is telling non-profit religious employers that they can claim an exemption from ObamaCare’s contraception mandate, so long as they provide all the information necessary to violate the deeply held beliefs that justify the exemption.

As Lyle Denniston of SCOTUS Blog explains, the rules “also required the organization to tell the government what its health coverage plan for its employees was by name and type, and to provide contact information to the insurer operating the plan.

“The added information was designed to enable HHS to then take the initiative to arrange for the religious organization’s female employees to have contraceptive coverage at no cost, and with no cost to the organization itself.”

The controversial HHS rules came to light because of a legal challenge filed by a Catholic university in Florida. A federal judge blocked enforcement of the rules pending the outcome of the lawsuit.

A couple of observations immediately come to mind. First, there is no such thing as free contraception. If the insurance company must provide it “free” to some customers, it will then pass on the cost to others (e.g. higher premiums). Even the manpower at HHS spent on coordinating this run-around the First Amendment costs taxpayers money.

This brings up another point. How can it be that the federal agency charged with implementing ObamaCare has the resources and personnel available to investigate, negotiate and procure “free” contraception to the thousands (and more) employees working at exempt religious employers?

It’s not like there’s a public health crisis over lack of access to contraception. If HHS has so many extra people and dollars laying around, it should funnel them to real priorities like fighting Ebola, or perhaps, finishing ObamaCare’s main insurance portal before the second enrollment period begins in a matter of days.

Instead we get demands for information in order to make religious objectors participate in the very activity they cannot abide.

“Amy Lotven of the trade publication Inside Health Reform reports that before insurers agreed to sell coverage through the Patient Protection and Affordable Care Act’s health insurance Exchanges in 2015, they demanded that the federal Centers for Medicare and Medicaid Services explicitly agree to let them cancel policies if any of the Halbig cases succeed in blocking the subsidies that carriers had been receiving in the 36 states whose ObamaCare Exchanges were not, as [ObamaCare] requires before subsidies can flow, ‘established by the State’”, writes Michael Cannon.

You’ll recall that there is a big fight over whether the Obama administration is blatantly violating its own law by making subsidies available to people who don’t qualify under the statute. And, as Cannon points out, making illegal subsidies available also subjects up to 57 million individuals and employers to illegal penalties under ObamaCare’s individual and employer mandates.

That insurance companies demanded the right to cancel policies relying on subsidies shows how concerned the industry is at being blamed for high-cost coverage when and if the government’s policy is ruled illegal. That the Obama administration agreed indicates the strength of the argument that even the executive branch should follow the law.

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.

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.

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.

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

Gallup released a new poll this week showing that a sizeable portion of an important cohort for Obamacare’s success is planning to pay fine rather than foot the bill for most costly insurance.

The so-called young invincibles – defined by Gallup as Americans under 30 years old – is the group whose purchase of health insurance on Obamacare exchanges is most coveted because they are projected to pay for more services than they use. The money made off their premiums will cover the cost of care for older and sicker people in the risk pool.

But the financial coercion desired by Obamacare’s operators could likely hit a snag this year because the penalty for not buying insurance is only $95, or less than any monthly premium available on an exchange.

Unfortunately for Obamacare’s supporters, Gallup says that 26 percent of young invincibles are planning to pay the fine instead of buy insurance. If enough do so, Obamacare’s cost structure gets up-ended, putting the feds on the hook to cover the overruns. Private insurers will then spike premiums in future years to compensate.

The big question is, “What number is ‘enough’?” No one knows the answer.

That’s because the key number for making the Obamacare exchanges financially workable is a ratio. For Healthcare.gov – the federal exchange – the Congressional Budget Office estimates that 38 percent of the risk pool needs to be young invincibles in order for the system to operate.

That means that the critical number for Healthcare.gov isn’t whether it actually enrolls the 7 million people it originally projected; it’s whether 38 percent of whatever population enrolls is made up of young invincibles, says Ezra Klein.

Early returns aren’t boding well, reports Breitbart News. The Obama administration so far has refused to release a breakdown of federal enrollees by age bracket, but the State of Kentucky has. The Bluegrass State runs its own exchange and only 19 percent of its enrollees are between the ages of 18-34 – a span that includes more years than Gallup’s. If that trend holds throughout the enrollment period that runs through March, Kentucky – and any other exchange with less than 38 percent of young invincibles – could face the dreaded ‘death spiral’ where premium costs soar to cover a sicker population that anticipated.

For now, we’ll have to wait and see whether the Obamacare-affiliated exchanges hit the magic number by the enrollment deadline. My guess is that the lack of transparency is directly related to the failure to meet the goal.

Obamacare’s “original vision of seamless Medicaid enrollment for all consumers will remain elusive indefinitely because of varying levels of readiness among states and the continued inability of the feds to transfer accounts directly to individual Medicaid agencies,” reports Governing.

That’s more bad news for Healthcare.gov, the federal health insurance exchange serving 36 states.

The problem is simple but not easy to fix. Because there is such a wide disparity among states in their ability to connect their Medicaid databases to the federal server, many of those who qualify for Medicaid can’t sign up for the program online. To compensate, federal workers send digital copies of an applicant’s qualifying information to state counterparts who then must verify eligibility.

Bottom line: All this checking and rechecking loses the efficiency gains assumed by Obamacare’s drafters. Among others, these cost savings were counted toward the health law’s now dubious claim of deficit neutrality.

Now the bad news for states.

Since every state participates in Medicaid, problems with the program created by Obamacare will impact state budgets regardless of whether they run their own health insurance exchange or let the feds do it. That’s because the exchanges are designed to serve those who don’t qualify for Medicaid. If seamless Medicaid enrollment proves impossible, then the resulting expenditures to meet the uptick in demand will be yet another unfunded mandate passed on to state taxpayers.

Among other social-engineering priorities, Obamacare’s drafters decided that pricing insurance policies for men and women in relation to the services each group is likely to use is discrimination, since women, unlike men, need access to costly reproductive services.

The solution to this perceived problem is to mandate that all people purchasing insurance under Obamacare – including males covering only themselves – must pay for services like maternity care that they cannot use. The result is another HHS mandate that significantly raises the cost of health insurance on one group (men) for the sake of making it more affordable for another (women).

For a glimpse of where this comes from and where we’re heading, consider the Obama 2012 campaign’s much-maligned “Life of Julia” web video. It shows how a young girl in America progresses through adulthood without ever forming a family. Instead, her entire life requires a series of massive interventions from paternalistic government, including the likes of Head Start, public school, college loans, small business subsidies, child support services, as well as health and pension payments. The creators revel in the fact that all of these programs allow their heroine to live a life completely unimaginable absent such government-coerced public assistance.

My hunch is that many Republicans aren’t brave enough to denounce the Democrats’ “War on Men,” for fear of a feminist backlash. But if no protest is lodged, then the Party of Dependency will be encouraged to continue enacting policies that force traditionally conservative constituencies to pay for the lifestyle choices of consistently liberal voters.

Though Obamacare’s individual mandate barely survived the Supreme Court last year, there’s no guarantee that some of the law’s other elements will be so lucky.

Last week, Tim explained that litigation challenging the health law’s federal subsidy structure is proceeding toward the Court. If the Court’s four consistent conservatives and swinger Anthony Kennedy stay true to the text, citizens in 34 states won’t be eligible for subsidies that make Obamacare-approved insurance plans (somewhat) more affordable.

Another series of cases challenge the controversial ‘HHS mandate’ that requires all non-houses of worship to provide employees with access to contraceptives and abortion-related services; despite the objecting employer’s religious beliefs. Appellate level decisions are split between the government and private business, meaning the Court is very likely to decide the issue as a way to provide continuity throughout the nation.

If recent trends hold, the Supreme Court will hear oral arguments in both lines of litigation sometime next spring, releasing a high-profile opinion in mid-summer.

As long as Obamacare is the law of the land, there will be no end to the headaches it creates.

Even though it’s been delayed for a year, Obamacare’s employer mandate is still giving business owners cold sweats.

North Georgia Staffing, a family-owned boutique staffing agency, currently employs 18 full-time workers and 400 temporary workers. Next year it plans to add another 200 temps.

The problem facing Debbie and Larry Underkoffler, the owners, is whether to extend the same insurance coverage to all workers or pay a $2,000 per employee fine, they told Fox News.

The projected fine would be $400,000, while giving all workers an Obamacare-approved plan would top $2 million.

The Underkofflers’ case is particularly galling because prior to any government mandate they already provide their workers – both full-timers and temps – with access to health insurance.

Yet under Obamacare’s system of mandates and penalties, it makes better financial sense for the Underkofflers to dump their temporary workers on Georgia’s federally-run exchange and pare back benefits for the full-timers. In both cases, workers are projected to pay more for health insurance and get less.

All this makes perfect sense, however, if you agree with Obamacare’s primary goal of increasing the number of people with health insurance by regulatory fiat.

North Georgia Staffing, supporters would argue, is laudable but an outlier. Most temporary workers don’t have health insurance. The way to (somewhat) pay for the cost of covering them is to either (1) make employers eat the price increase, or (2) use the fines when they refuse to (partially) fund the federal subsidies temps will use to buy insurance on an exchange. If that means that some owners and workers will pay more for less, it’s a worthy sacrifice to increase access to health insurance for others.

That’s the baseline policy argument for Obamacare’s employer mandate. No doubt it doesn’t poll as well as “If you like your doctor and insurance you can keep it,” but at least it’s the truth.

Sarah Kliff, a liberal health policy blogger at Wonkblog, explains why the Obama administration won’t delay the individual mandate like it has other elements of ObamaCare.

“…all the delays so have one thing in common: They erased political headaches for the law while barely denting the number of people that the health overhaul will cover in 2014,” writes Kilff. “The delays Republicans are asking for now would cause major political and substantive headaches for the law while sharply reducing the number of people it covers.”

The political headaches Kliff alluded to include vociferous opposition by businesses to the employer mandate. That’s because, once implemented, the employer mandate – the requirement to provide government-approved health insurance on any firm employing 50 or more full-time workers or pay a fine – will very likely result in shedding jobs to avoid compliance costs.

“This predictable employer response is a very good reason to want to postpone the mandate until after the midterm,” wrote Walter Russell Mead said when the employer mandate delay was announced this summer. “Nobody wants to run as an ally of the job-killing President whose policies led your voters’ employers to dump their health insurance.”

It’s both refreshing and appalling to see an ObamaCare cheerleader like Kliff admit that the only kind of acceptable delays are the ones that politically advantage the Obama administration.

No wonder opponents see the only real solution to ObamaCare’s metastasizing problems as repealing and starting over.

Today, I’m up with a column that identifies what ObamaCare’s employer mandate really means for small businesses.

Note to Members of Congress and HR consultants – it’s not what you think.

Most of the attention on this particular mandate has focused on the idea that employers can avoid the twin threats of costly insurance or hefty fines if they pare back full-time employees to part-time status.

By not employing 50 full-time employees a small business can avoid triggering the mandate, or so the thinking goes.

But the reality is that ObamaCare adds up the total amount of part-time hours worked to create “full-time equivalent” (FTE) employees that count toward the 50 employee total. Meet or exceed the threshold, and say hello to huge compliance costs.

This is why a proposed legislative fix won’t actually solve the underlying problem, which is capping the amount of hours a small business can pay out to 50 FTEs – whether they are full-time, part-time or some combination of both.

It’s time for Congress to take a closer look at how ObamaCare’s employer mandate works and repeal it.

Add the Laborers International Union of North America to the list of organized labor groups criticizing ObamaCare’s disastrous effects on the status quo.

In a letter to Democratic leaders, President Terry O’Sullivan called for a halt to the health law’s “destructive consequences” on the costs and provision of health care.

Unlike the Teamsters and other unions, Laborers International did not support ObamaCare when it was passed into law. Unfortunately, they are just as oppressed by the law’s cost increases and coverage interruptions as those that did.

With the employer mandate delayed for at least a year, maybe there’s enough angst brewing among the Democrats’ liberal base to pressure delaying the entire law for at least as long.

House Speaker John Boehner (R-OH) is using a populist line of attack to show how delaying ObamaCare’s employer mandate will harm individuals and families that don’t get an exemption, according to Politico.

“If you’re a software company making billions in profits, you’re exempt from Obamacare next year,” he said. “But if you’re a 28-year-old struggling to pay off your student loans, you’re not.”

“If you’re a big bank or financial company, you don’t have to comply with Obamcare,” Boehner added. “But if you’re a single parent trying to make ends meet, there’s no exemption for you.”

To level the playing field, Boehner is scheduling back-to-back floor votes in the House next week to delay both the employer and the individual mandate. The move would pose a dilemma for Democrats looking to support President Barack Obama’s policy, but unable to justify exempting businesses but not families and individuals too.

This strikes me as a good strategy. It’s past time for Democrats to own ObamaCare and all its flaws.

In my column last week, I outlined how ObamaCare’s Medicaid expansion is a way to sneak in socialized medicine by making it cheaper to accept government health insurance instead of paying for it (directly) oneself.

But the Medicaid expansion is only half of ObamaCare’s formula for moving most of America onto a federally-run health system.

The other half is made up of the so-called state-based health insurance exchanges that are subsidized (and regulated) by the federal government.  With the individual mandate in place, people that fail to qualify for Medicaid will most likely be forced into the exchanges.  (ObamaCare purposefully makes it cheaper for employers to pay a fine rather than cover employees.)

Writing in the New York Times on Saturday, Tyler Cowen, an economics professor at George Mason University, explains how to make the best of the very bad possibility that President Barack Obama is reelected and ObamaCare continues to be implemented, albeit with the inevitable cost overruns.

There is one way this might work: by limiting the subsidies for insurance. Note that the law itself mandates cuts if those subsidies exceed a certain percentage of gross domestic product by 2018. Most likely, the reform could not stop there, because the insurance cost burden for many Americans would feel intolerably high without the subsidies.

The next step, therefore, would lower costs by limiting the mandate to covering catastrophic conditions. Yet a further step would remove the mandate for noncatastrophic coverage, thus giving people more control over how much they want to spend on health care versus other priorities.

We would then have government-subsidized and mandated catastrophic insurance, and a freer market for other health care expenditures. We might even return to a health savings account approach on the noncatastrophic side.

That’s far from a perfect outcome, but it’s probably the most positive path that can be achieved.

Let’s hope it doesn’t come to that.

Okay, it’s time for me to weigh in, now that everybody else has so thoughtfully risen to my challenge to put their predictive skills on the line. I see we run the gamut from total victory against the whole law to a doleful prediction that the mandate will stand.

Well, count me in the mushy middle. After going back and forth and around and around on this subject for months, I just can’t tell where my own analysis — and my own wish for a defeat of ObamaCare — ends and my assessment of each of the justices’ proclivities begins.

But here’s what I have come up with: I think this is going to be one of those horribly fractured decisions where observers have trouble making heads or tails of everything. I think there may even be concurrent pluralities rather than a simple majority on at least a couple of the questions presented to the court. In the end, though, I do — yes, I do — expect the mandate in this particular form, applied in this particular way, to be adjudged at least partially unconstitutional. In other words, the court will leave open the possibility that such a mandate in theory could be within the federal government’s powers, but just not THIS mandate in this form. But I think a majority may not agree on what the remedy for this abuse is, and will come up with some Rube Goldberg way of punting the ultimate decision back to lower courts or to Congress.

Meanwhile, the challenge to the Medicaid provision will fail, 6-3.

If I am right, perhaps we should be thankful for even tiny victories. But I say: “Ugh!”