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Posts Tagged ‘Obamacare’
September 16th, 2014 at 7:03 pm
Top Minnesota ObamaCare Insurer Leaving Exchange

The largest player on Minnesota’s ObamaCare exchange is dropping out, and not even the promise of federal subsidies can get it back.

Earlier today PreferredOne – an insurance company that covered 59 percent of Minnesota’s ObamaCare population – announced that it will not offer health care plans next year paid for with ObamaCare subsidies.

Apparently, the decision is being driven by high administrative costs associated with doing business with MNsure. Even after hiring an additional 50 workers to handle the exchange’s post-launch fixes and tweaks, PreferredOne says continuing to participate is financially unsustainable.

The move makes it likely that MNsure’s ObamaCare rates will jump since PreferredOne sold the lowest cost option. Those rates will be released sometime in October – just weeks before the midterm elections.

September 15th, 2014 at 7:02 pm
Harkin Lashes Hillary to ObamaCare

In what some observers presume is an early sign of a presidential run, over the weekend Hillary Clinton spoke at a high-profile political event for Iowa’s retiring Democratic U.S. Senator Tom Harkin.

Though Clinton had her own gaffe, the biggest surprise was how much credit Harkin heaped on her for passing ObamaCare – even though she wasn’t even in Congress!

“One of the things she always worked on was advancing this concept, this idea that health care should be a right and not a privilege in this country,” said Harkin. “So, Hillary was not there when the Affordable Care Act was signed into law, she was of course secretary of state, but I want you all to know that her fingerprints are all over that legislation. It would not have happened without her strenuous advocacy in that committee all those years.”

Any hopes Clinton had of distancing herself from a law that only gets more unpopular is gone. All opponents have to do is show her smiling behind a gushing Harkin to make the connection.

Don’t like ObamaCare? Blame HRC.

No conservative could have said it better.

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.

September 3rd, 2014 at 8:08 pm
Wyoming Latest to Consider Medicaid Expansion

In my column this week, I explain how not every Medicaid expansion through ObamaCare is necessarily a bad thing. The crux of my argument is that states that use the extra money to move the program in a more market-friendly direction – and as a consequence, make it more cost-conscious and consumer-driven – should be given a chance to test their ideas.

This means that Republican governors in Indiana, Iowa, Pennsylvania – and now perhaps Wyoming – should be given some space before conservatives conflate them with other GOP leaders who simply expanded Medicaid without bothering to wring any reforms from the Obama administration.

Every state is already in the business of participating in Medicaid. If conservatives are willing to consider Paul Ryan’s Medicare reform a step in the right direction, then we should extend the same courtesy to Republican governors who are trying to do something similar with Medicaid.

At least for now.

September 2nd, 2014 at 7:28 pm
Tennessee Opts Into ObamaCare Medicaid Expansion

Another news cycle, another Republican governor decides to expand Medicaid with ObamaCare dollars.

Last Friday, Tennessee Republican Governor Bill Haslam joined Pennsylvania’s Tom Corbett, Indiana’s Mike Pence and others in trying to carve out a middle ground between a straight yes or no on expansion.

Haslam hasn’t committed himself to specifics, saying only that “sometime this fall” his administration will submit an alternative plan to federal regulators.

States like Wisconsin, Indiana, Pennsylvania, Arkansas and Iowa have won various levels of approval to use ObamaCare’s increased Medicaid funding to provide subsidized health insurance plans to some of the poorest members of their populations.

Expanding Medicaid is a tempting offer because the federal government pays for about half of every dollar spent on the state’s program. ObamaCare makes taking the plunge almost irresistible since it pays for every dollar of expansion until 2017, and 90 percent of all new spending until 2020.  For sitting governors with term limits, that translates into an opportunity to get lots of credit for helping poor people before most of the bill comes due.

The politics of ObamaCare are constantly evolving, and the lesson for conservatives about the law’s Medicaid expansion is this: Unless there is a credible alternative to growing government, many politicians will opt for good press and worry about the policy implications later.

Heading into the 2016 presidential cycle, there needs to be a way to determine which ideas adhere to constitutional principles, preserve the free market and bolster human flourishing – which includes access to health care.

The sooner, the better.

August 29th, 2014 at 6:09 pm
Pennsylvania Governor Says Yes to ObamaCare Medicaid Expansion

After years of rebuffing calls to participate in ObamaCare’s Medicaid expansion, Pennsylvania Republican Governor Tom Corbett is changing his mind.

Sort of.

While the announcement comes as a bit of a surprise, it doesn’t appear to be a total loss for fiscal conservatives. (Others may disagree, of course.)

According to the terms of the agreement between Gov. Corbett’s office and the Centers for Medicare and Medicaid, Pennsylvania won’t simply be expanding its Medicaid program. Instead, it will use the extra dollars made available under ObamaCare to pay for (i.e. subsidize) private health insurance plans for newly eligible state Medicaid beneficiaries.

The agreement stipulates that Corbett’s alternative is being allowed as a five-year “demonstration project,” meaning that its future is not assured. Much will depend on how the project’s measurements are defined, if the reforms Corbett supports are to survive.

For now, Pennsylvania joins the ranks of Indiana, Arkansas and Iowa as states that are attempting to use ObamaCare’s Medicaid expansion to decrease their uninsured population – without, of course, breaking the bank.

It’s hard to see how that will happen, but we now have at least four states offering themselves as very costly social science experiments. It should be interesting to see what the results will show.

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 7th, 2014 at 9:42 am
The Fate of ObamaCare and the Courts
Posted by CFIF Staff Print

Timothy Lee, Senior Vice President of Legal and Public Affairs at CFIF, discusses the recent contradictory federal appeals court rulings on ObamaCare subsidies and what they mean for consumers and the ultimate fate of ObamaCare.

Listen to the interview here.

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.

July 30th, 2014 at 3:06 pm
Aetna CEO: ObamaCare “really not an affordable product”

In an interview on CNBC’s “Squawk Box” this morning, Mark Bertolini, the Chairman and CEO of Aetna, explained that ObamaCare is “really not an affordable product for a lot of people.” He goes on to say that we “have to have a more affordable system.”

July 24th, 2014 at 2:20 pm
ObamaCare’s Eligibility Verification System Open to Abuse

The Government Accountability Office set up a sting operation to test whether ObamaCare’s eligibility verification system is open to abuse.

GAO discovered a resounding Yes.

“Fake applicants were able to get subsidized insurance coverage in 11 of 18 attempts,” reports National Journal.

Investigators had the most success when using ObamaCare’s online and telephone enrollment systems. These improper enrollments resulted in subsidies totaling $30,000 annually.

The findings of the sting operation bode ill for the controversial health reform law. The failure to correctly match applicants to subsidies indicates that ObamaCare’s expensive digital architecture is failing in one of its most basic tasks.

And the failure could be costly.

Assuming most ObamaCare applicants are not attempting to defraud taxpayers – but rather are just trying to comply with the law’s individual mandate – incorrectly receiving financial help this year could result in a heavier tax bill next year. That’s because the IRS is tasked with settling accounts on ObamaCare subsidies, with taxpayers required to pay back any subsidies they weren’t eligible for when calculating their income tax liability.

So far, the IRS hasn’t rewritten ObamaCare to cushion the blow from bad drafting – like it did when it made subsidies available to citizens in states without a state-based exchange.

Apparently, that kind of face-saving deference is only extended to government-growing ideologues; not every day Americans just trying to play by the rules.

July 15th, 2014 at 11:36 am
Judiciary Could Force Obama to Work with Congress

John Fund documents the Supreme Court’s growing impatience with the Obama administration’s refusal to adhere to the letter of the law in a piece out today with National Review.

Citing Jonathan Adler, a conservative legal expert, Fund highlights several recent Supreme Court decisions that slap down the executive branch’s significant regulatory overreach. Justices on both sides of the ideological spectrum – from the liberal Kagan to the conservative Scalia – refuse to grant President Barack Obama and his bureaucratic lieutenants the authority to change statutory requirements on a whim to suit policy goals the underlying law does not allow.

This backdrop is important as the D.C. Circuit Court of Appeals prepares to hand down its decision in Halbig v. Burwell, a case that challenges an IRS interpretation of ObamaCare that, if overturned, could prohibit the subsidies most Americans need to pay for the law’s expensive insurance plans.

Weighing in the challengers’ favor are the 13 unanimous Supreme Court decisions that have invalidated moves by Obama executive agencies since he took office. In its reasoning the Court has consistently said that the president must adhere to the constitutional framework for making laws, which limits the executive to faithfully executing (i.e. carrying out) what Congress has actually passed as legislation.

In the ObamaCare context, that means striking down the IRS rule that explicitly ignores the prohibition on giving federal subsidies to users of the federal health insurance portal.

Making them available only on state exchanges was an enticement to get states to foot the bill for implementation. It has since backfired with 34 states declining the deal.

Does that complicate the Obama administration’s ability to call federal ObamaCare plans affordable? You betcha. But it also preserves the constitutional check on a president prone to act beyond his designated powers.

Though it might be unpleasant for the White House and its allies, the world will not end if Barack Obama is forced to negotiate with Congress. Another judicial reminder to respect the structure of the Constitution would be a public service by the D.C. Circuit – and the Supreme Court.

July 8th, 2014 at 5:33 pm
Keep an Eye on Mike Lee

If you want to see what the future of the Republican Party might look like consider Mike Lee’s social network.

The Utah Republican has an enviable number of connections to fellow U.S. Senators Rand Paul of Kentucky, Marco Rubio of Florida and Ted Cruz of Texas. Each is strategic. With Paul it’s teaming up on civil liberties issues like reining in the National Security Agency and prison reform. Few remember that it was Cruz and Lee who helped force the government shutdown to halt ObamaCare. And now Rubio is coming around to Lee’s push to make the tax code more family friendly.

As James Antle puts it in a terrific post, “You don’t have to agree with all of the aforementioned proposals to see how different the Republican Party would look if Lee’s policy entrepreneurship with Paul and Rubio gained traction: Less identified with war, wiretapping, and mandatory sentences; more identified with reforming government programs and cutting taxes for the non-rich.”

By influencing the policy platforms of three likely GOP presidential contenders in 2016, Mike Lee is also forging friendships that could make him one of the most powerful officeholders on Capitol Hill.

Keep an eye on Mike Lee. He just may be the most important Tea Party Senator not running for president.