Freedom Line Blog

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.

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

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.

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.

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.

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

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.

Amid all the legitimate privacy concerns with ObamaCare’s regulatory apparatus – in particular the proposed data hub that allows agencies like the IRS, Social Security Administration and HHS to share reams of information about individual citizens with each other, states and insurance companies – it’s been taken for granted that the liberals in charge of this grand social experiment at least had the technical competency to build the necessary infrastructure.

But the facts say otherwise.

“Of the roughly 8 million Americans now signed up for coverage this year under the health care law, about 5.5 million are in the federal insurance exchange,” reports the Washington Post. “And according to internal documents, more than half of them – about 3 million – have an application containing at least one kind of inconsistency.”

The Post says the most frequent inconsistency is a discrepancy in the income reported on an ObamaCare application and the income reported to the IRS. This type of inconsistency is present on between 1.1 million and 1.5 million applications. To their credit, citizens have sent in “about 650,000 pieces of ‘proof’” to justify their asserted income.

Because of the level of detail required when filling out the 20-plus page ObamaCare application, it’s no surprise many people mistakenly enter something wrong; especially when considering that most people get help on their taxes from either a certified professional or software that easily finds all the right deductions. Neither option was readily available to the vast majority of ObamaCare applicants.

What is astonishing, however, is the federal government’s complete inability to process and verify corrections digitally. “Because the computer capability does not yet exist, the work will start by hand, according to two people familiar with the plans,” says the Post. (Emphasis added)

ObamaCare subsidies are the essential ingredient for claiming that ObamaCare insurance is “affordable” since they at least partially offset the increased cost of coverage. Failing to launch a website capable of verifying income claims that determine whether a person qualifies for subsidies is inexcusable.

If there is any silver lining to this latest blunder it’s that Serco – the federal contractor accused last week of billing HHS $1 billion while hiring employees literally to do nothing – is now on the hook for correcting the inconsistencies. Small comfort though, since apparently Serco gets paid based on the number of employees it hires rather than the efficiency of its work product. Requiring the company to sort paper applications by hand seems almost too awful to be true.

“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.

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.

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.

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

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.

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.

Viewed in the most favorable light, the Obama administration’s decision this week to extend ObamaCare’s enrollment deadline into the middle of April is a measure of justice to people forced to buy health insurance but unable to complete the transaction because of lousy government websites. Simply put, it’s just wrong to penalize people for failing at a task the government makes it impossible to do.

However, for every person receiving his due there are others getting the shaft. For example, consider all the people who diligently signed up for coverage last fall, spending hours surfing through glitch-prone websites and incoherent call centers, all because the Obama administration swore up-and-down that insurance had to be purchased by mid-December if coverage was wanted on January 1st. And then the deadline was extended.

Recall that millions of people lost their individual and family plans because they didn’t comply with ObamaCare’s heightened benefits mandates. Responsible customers swallowed hard and leapt into an ObamaCare exchange because the government said so. And then the Obama administration decided not to enforce its own law.

And let’s not forget the insurance companies, business owners and tax experts who spent thousands of hours trying to comply with ObamaCare’s deadlines and mandates only to watch those who did little or nothing to prepare get rewarded with delay after delay, or as we used to say during the last Bush administration, bailout after bailout.

So while it is true that it’s unjust that people should be penalized for government’s failures, it is equally unjust to punish those who are trying valiantly to play by the rules but then get hosed by last minute changes. The takeaway here is that the implementation of ObamaCare is destroying the incentive to take the government at its word. If this becomes its legacy, the law will be far more destructive than anyone thought possible.

There is a lot of misreporting with ObamaCare numbers as the open enrollment period draws to a close March 31.

Consider these two examples from California.

First, Covered California – the state’s ObamaCare exchange – announced recently that more than 1 million people had applied for coverage and chosen an insurance plan. Liberal bloggers at the Daily Kos are cheering this news as a triumph. Before the enrollment period began last October, the state set as a goal 696,000 enrollments by the end of March. At 1,018,315 as of the end of last Saturday, ObamaCare supporters think they are 300,000 over their goal.

Except Covered California isn’t anywhere close. Look again at the goal and the announcement. California wants at least 696,000 people to be enrolled by the end of March. To date, they have over 1 million people who have applied to be enrolled. That’s not the same thing. In fact, in speaking recently to a source at Medi-Cal – the state’s Medicaid program – I was told that thousands of applications are in limbo across the state because computer systems at the state and county levels don’t talk to one another. This impacts Covered California’s numbers because many of the uninsured applying for insurance through the exchange qualify for the state’s expanded Medicaid program. To compensate for the technology failure, caseworkers are processing emergency requests by hand. So to recap, don’t be fooled by news about applications posing as enrollments.

The other example of misreporting is on the type of coverage most enrollees are choosing. The most popular plans also cost the least. That’s not surprising since ObamaCare requires people to purchase health insurance or pay a fine. On one hand, the increased number of policyholders does allow ObamaCare supporters to say the law is covering more people. But at what price? “[E]xperts worry plans with lower premiums could come with a different cost: Fewer doctors and hospitals could mean fewer choices and longer waits for care,” reports the San Jose Mercury-News.

Lower premiums also mean higher out-of-pocket costs. I’ve written previously about how reporting on lower-than-expected premiums ignores across-the-board spikes in deductibles. The IRS says that annual deductibles larger than $1,250 should be considered high. On California’s exchange, it’s common for the lowest priced plans to have deductibles in excess of $2,000 annually (and some as high as $4,500 or more).

When all the dust settles after March 31, it’s very likely that California won’t have hit its enrollment goal, and that of the enrollees it does have many will come to loathe the longer wait times and higher costs. Maybe then we’ll get more help from journalists in how ObamaCare insurance actually works. But probably not.

And it just so happens to be the most crucial.

With only 4.2 million of the original 7 million Obamacare exchange enrollees confirmed, officials at the Department of Health and Human Services were asked yesterday whether they would extend the March 31 deadline.

“We have no plans to extend the open enrollment period,” responded an HHS official, according to the Weekly Standard. “In fact, we don’t actually have the statutory authority to extend the open enrollment period in 2014.” (Emphasis added)

Of course, none of the controversial Obamacare delays are rooted in the law’s statutory text. When pressed for an explanation of how the enrollment deadline is different from the extra-legal delays of the individual mandate, employer mandate, small business exchange, Cadillac tax and thirty other extensions, the HHS spokespeople had no credible response.

The question remains, though, Why not extend the enrollment period in order to get more sign-ups? My guess is that broadening the enrollment timeline would quickly destroy the Obama administration’s ability ever to impose another deadline. As we saw last week with the second yearlong delay allowing non-compliant individual plans to continue, once an exception is made the firmness needed to impose a new drop-dead-date disintegrates. Rules become subject to whim not reason.

And make no mistake, if the Obama administration folds on this deadline the whole logic of Obamacare crashes and burns. If there is no penalty for non-enrollment then there is an incentive for each person to wait until he or she gets sick before buying health insurance. To participate on an Obamacare exchange an insurance company must accept whoever wants to buy a plan. Insuring sick people at the point of sale is no longer insurance since every purchaser needs the service immediately. For Obamacare to work as designed, however, the law and its insurance company partners need a majority of people paying for benefits only a minority will access.

That’s the real reason the Obama administration won’t delay the March 31 enrollment deadline. It can’t afford to.

Up to 38% of people who qualify for Obamacare exchange subsidies may have to pay some or all of the money back to the IRS. That’s because the amount of subsidy dispensed is based on a sliding scale. As income rises, the amount of subsidy decreases. In practice, many people who currently qualify for a subsidy could wind up paying back the amount if they earn just a little bit more in income.

“At biggest risk are people who annual household income put them near the thresholds where the Obamacare subsidies make steep declines,” explains AEI expert Scott Gottlieb. “These cliffs are steepest for those people who earn 150% of the federal poverty level (family of four earning $35,000 in annual household income); 250% (a family of four earning about $55,000 annually); and 400% (a family of four earning about $95,000 annually).”

The upshot of this is that people may become much more sensitive to family budgeting since their financial stability depends on which side of the subsidy wall they fall. The downside of course is that we’re likely to start seeing people decline job promotions and salary hikes to avoid becoming a net loser at tax time.

As I’ve noted before, Obamacare’s War on Work is just beginning.

A new report by the non-partisan Congressional Budget Office predicts the Affordable Care Act (i.e. Obamacare) will cause up to 2 million lower-income workers to leave the labor force over the next decade because they will make more in government benefits than as a private employee.

“CBO estimates that the ACA will reduce the total number of hours worked, on net, by about 1.5 percent to 2.0 percent during the period from 2017 to 2024, almost entirely because workers will choose to supply less labor – given the new taxes and other incentives they will face and the financial benefits some will receive,” the agency says in Appendix C, Labor Market Effects of the Affordable Care Act: Updated Estimates (pdf).

The incentive to drop out of the workforce is one’s eligibility for a government subsidy to help pay for an insurance plan bought through an Obamacare exchange. Since eligibility for a subsidy phases out as a person’s income rises, people who will receive subsidies will have to factor in whether to take a job that makes more money, but will likely reduce or eliminate eligibility. In this scenario, taking the job may actually result in a net loss of income as the person must now pay for the full cost of health insurance.

The disincentive to work also applies to those hanging between Medicaid and Obamacare subsidies. Eligibility for Medicaid means the cost to the beneficiary is nothing (at least not directly). In this scenario, qualifying for a subsidy increases one’s out-of-pocket expenses, making it financially smart (for the individual) to work less and stay on Medicaid.

It’s important to emphasize that deciding to work less to receive more in government benefits is a financially rational decision for individuals to make, and one that any economist would readily predict. My hunch is that at least some of Obamacare’s architects knew this and designed their programs accordingly.

The problem, of course, is that convincing millions of people not to work is not financially sustainable for the country as a whole.