#Obamacare: first time in a long time I’ve agreed with Bill Clinton

October 5, 2016
"Obamacare has arrived"

“Obamacare has arrived”

Boy, this must annoy just about everyone else in the (Social) Democratic camp, including his wife and the current president: former President Bill Clinton being honest (1) about one aspect of how painful Obamacare is for Americans. Jim Geraghty quotes him:

If you’re already on Medicare or if you get enough subsidies on a modest income then you can afford your healthcare. But the people who are getting killed in this deal are small business people and individuals who make just a little too much to get in these subsidies. Why? Because they’re not organized. They don’t have any bargaining power with insurance companies and they’re getting whacked. So you’ve got this crazy system where all of a sudden 25 million more people have healthcare and then the people are out there busting it sometimes 60 hours a week wind up with their premiums double and their coverage cut in half. It’s the craziest thing in the world.

Darn right, Mr. President. And a lot of us have been saying Obamacare is crazy for a long time.

Welcome to the party, pal.

Footnote:
(1) Must’ve been an accident.

 


King v Burwell: The SCOTUS saves #Obamacare, again.

June 25, 2015
x

These guys would probably do a better job.

Sigh.

The Supreme Court decision most everyone was waiting for, a ruling in King v. Burwell about the legality of Obamacare subsidies for insurance purchasers on federal exchanges, has just come out (PDF).

Spoiler: the administration won. The anti-constitutional monstrosity lives on.

I haven’t much to add to a legal analysis of this decision. For that, I recommend you read William Jacobson at Legal Insurrection, whose post on the decision will be updated as the day goes by.

I will say, however, that this is the second time a majority lead by Chief Justice Roberts has twisted and tortured the plain meaning of words and the processes of reason in order to achieve a desired result –preserving the Affordable Care Act. In the first,  he beat the square peg of the Obamacare penalties for not having insurance into the round hole of constitutional logic by declaring them simultaneously a tax and a fine. The goddess Reason wept.

Now, however, he and his colleagues on the majority have magically decided that the obvious meaning of the plain language of the law, that subsidies are only available through an exchange established by a state, is somehow ambiguous. To top it off, they ignored the unambiguous evidence offered by Jonathan Gruber, one of the key architects of the ACA, that the intent was to use the lack of federal subsidies to coerce states into establishing exchanges. Law and legal reasoning be damned, the Court’s role was to save Obamacare:

Given that the text is ambiguous, we must turn to the broader structure of the Act to determine the meaning of Section 36B. “A provision that may seem ambiguous in isolation is often clarified by the remainder of the statutory scheme . . . because only one of the permissible meanings produces a substantive effect that is compatible with the rest of the law.” United Sav. Assn. of Tex. v. Timbers
of Inwood Forest Associates, Ltd., 484 U. S. 365, 371 (1988). Here, the statutory scheme compels us to reject petitioners’ interpretation because it would destabilize the individual insurance market in any State with a Federal Exchange, and likely create the very “death spirals” that Congress designed the Act to avoid. [at 15]

In fact, we know this is not true. The text is not ambiguous, and the Democrats knew the “death spiral” was in there. Reasoning from Gruber’s own words, they designed things so it would be a Sword of Damocles hanging over the head of opponents of the ACA. “Nice insurance industry you have there. Be a shame if you didn’t agree to set up an exchange and the whole thing crashed for a lack of subsidies.” Trouble is, more states than expected refused to set up an exchange, so it was the Fed that had to illegally provide subsidies to prevent a death spiral. As Professor Jacobson said on Twitter:

This is disgusting and disheartening, but not wholly unexpected. After the last Obamacare decision, it wasn’t likely a Court majority would cut the legs out from under the ACA, no matter what. That is left for us to do in 2017, when a Republican Congress has a Republican president — and us ready to hold their feet to the fire to repeal this damned thing.

I’ll leave you with a quote from Justice Scalia’s flaming dissent, per Legal Insurrection:

“We should start calling this law SCOTUScare.”

Indeed.


Welcome to tax season, now prepare to give your #Obamacare subsidy back

February 2, 2015
"Obamacare has arrived"

“Obamacare has arrived”

This item has been sitting in my files for a while (1), but, since we’re deep into tax season, it’s still relevant — especially so for people relying on that federal subsidy to help pay for their “affordable” health care:

As many as 3.4 million people who received Obamacare subsidies may owe refunds to the federal government, according to an estimate by a tax preparation firm.

H&R Block is estimating that as many as half of the 6.8 million people who received insurance premium subsidies under the Affordable Care Act benefited from subsidies that were too large, the Wall Street Journal reported Thursday.

“The ACA is going to result in more confusion for existing clients, and many taxpayers may well be very disappointed by getting less money and possibly even owing money,” the president of a tax preparation and education school told the Journal.

While the Affordable Care Act fines those who don’t have health insurance, it also provides subsidies for people making up to four times the federal poverty line ($46,680).

But the subsidies are based on past tax returns, so many people may be receiving too much, according to Vanderbilt University assistant professor John Graves, who projects the average subsidy is $208 too high, the Journal reports.

If, like a lot of people, you’re used to getting some sort of a refund, you probably already have an idea of how much you expect and how you plan to spend it. Imagine then how happy these many millions of people will be when they’re told they’re either getting less of a refund, or that they in fact owe money. And, on top of that, their subsidy for the next year will almost certainly be lower, so even more of their money will go to the insurance companies by force of law for coverage that probably isn’t as good as they had before, or at least isn’t what was promised.

That, my friends, is a recipe for angry voters. And, oh, there’s a presidential election warming up, too. Fancy that.

If anything good comes of this fiasco, it will probably be the hard-learned lesson that government is poorly equipped to do more than a certain few tasks and running a huge, massively complicated healthcare system isn’t among them.

Call it another “teachable moment.”

Footnote:
(1) Ancient by Internet standards — a whole month!

(Crossposted at Sister Toldjah)


#Obamacare success! New Medicaid enrollee turned down by 96 doctors

April 9, 2014
"Train wreck"

“Train wreck”

One of the oft-stated goals of the Affordable Care Act was insuring the uninsured. For those who couldn’t afford insurance even with the new subsidies, states could expand their Medicaid offerings with (temporary) help from the federal government (i.e., taxation and borrowing). Great, right? Even if you don’t make enough to afford private insurance, you still get medical care, right?

Not if the doctor refuses to take Medicare:

“I’m sorry, we are no longer accepting that kind of insurance. I apologize for the confusion; Dr. [insert name] is only willing to see existing patients at this time.”

As a proud new beneficiary of the Affordable Health Care Act, I’d like to report that I am doctorless. Ninety-six. Ninety-six is the number of soul crushing rejections that greeted me as I attempted to find one. It’s the number of physicians whose secretaries feigned empathy while rehearsing the “I’m so sorry” line before curtly hanging up. You see, when the rush of the formerly uninsured came knocking, doctors in my New Jersey town began closing their doors and promptly telling insurance companies that they had no room for new patients.

My shiny, never used Horizon health card is as effective as a dollar bill during the Great Depression. In fact, an expert tells CNN, “I think of (Obamacare) as giving everyone an ATM card in a town where there are no ATM machines.” According to a study 33% of doctors are NOT accepting Medicaid. Here in Jersey, one has a dismal 40 percent chance of finding a doctor who accepts Medicaid – the lowest in the country.

That insurance or Medicaid card does one a whole lot of good when no one will accept it, doesn’t it?

This is one aspect of a broader access problem that’s going to get more and more attention as we get deeper into the Obamacare morass. In addition to a growing doctor shortage (something that Obamacare may make worse), and shrinking provider networks, the limited number of doctors who accept Medicaid will only get smaller, because the system underpays for their services, and yet under Obamacare is greatly increasing the number of patients. Noble sentiments aside, a medical practice is a business, and a physician or hospital can only afford to see so many money-losing patients before it’s no longer worth staying in business.

Call it another of Obamacare’s broken promises: the government promises you medical care, but what if the care-provider refuses to play?

Of course, one would-be Democratic lawmaker in Virginia has a solution for that: serfdom.

Via Jim Geraghty, who notes it’s even harder to find specialists who take Obamacare.

RELATED: Bobby Jindal has a better idea.

(Crossposted at Sister Toldjah)


#Obamacare navigators helping people sign up at Mexican consulates

March 27, 2014
"Train wreck"

“Train wreck”

Nah, there’s no potential for fraud, here:

The Obama administration has been helping to facilitate a series of events nationwide at Mexican Consulate offices to enroll people in Obamacare – and a key activist says the efforts are “our responsibility” regardless of citizenship.

“Whether they’re Mexican nationals or whether they’re United States citizens or whether they’re in transition– and if they’re there it is our responsibility within all of America to educate on the Affordable Care Act,” Enroll America Field Organizer Jose Medrano told Breitbart News on Wednesday.

Health Care insurance navigator groups hosted an Obamacare enrollment fair on Tuesday in the Mexican Consulate’s Brownsville office, The Rio Grande Guardian reported last Friday, where Mexican nationals among others were counseled about enrolling in the ACA.

“The Mexican consulate is a very reliable source of information to the Latino community. And therefore when they host their events, yesterday being the health fair, there are several hundred people that show up,” Medrano said.

Under the Affordable Care Act (ACA), undocumented immigrants aren’t supposed to be receiving government-run health benefits or subsidized coverage. However, President Barack Obama told Latinos in early March that the Healthcare.gov website would not be used to find out about an individual’s immigration status.

“None of the information that is provided in order for you to obtain health insurance is in any way transferred to immigration services,” he said.

As the article points out, this isn’t the first time the administration has made use of Mexican consulates to push entitlement programs to Latino communities: in 2012, USDA ran Spanish-language commercials encouraging people to sign up for food stamps.

Back to Obamacare, the extensive use of Mexican consulates, which are a trusted source of information for Mexican communities in the US, and the promise to not forward an applicant’s information to ICE all but guarantees that the American taxpayer will wind up subsidizing health insurance for Mexican nationals who are in the US illegally.

And if some sort of amnesty goes through, guess which party expects (1) to reap the benefits of our state-mandated generosity?

Why, it’s almost as if that’s the plan.

via Fausta

Footnote:
(1) Then again, with all the screw ups and problems experienced with O-care to date, maybe the Democrats’ shouldn’t expect much gratitude.

(Crossposted at Sister Toldjah)


#Obamacare: people who think they have coverage get hit with massive bills

March 23, 2014
"Obamacare has arrived"

“Obamacare has arrived”

Correct me if I’m wrong, but wasn’t our new, glorious, designed by unicorns healthcare system supposed to prevent things like this? If you signed up for coverage and made your payments, you weren’t supposed to get crushed by the ensuing medical bills, right? All those horror stories from the dark days before Obamacare the Affordable Affordable Affordable Affordable Affordable Care Act (1) of people with unbearable financial burdens? Gone. Banished forever. Not gonna happen ever again in our new progressive paradise.

Just ask Alex Szablya of Washington:

Alex Szablya just wants the best health care she can get for her children. So she got a gold plan, the highest level possible with the Washington Health Benefit Exchange. She picked a plan with Lifewise, an affiliate of Premera Blue Cross.

In early March, her 16-year old daughter had a medical emergency. Alex drove her to the nearest hospital, which was Seattle Children’s. Alex says doctors there felt her daughter’s situation was so dire she needed to be admitted to the hospital immediately. She was there for nine days.

Then came news that her stay, which involved specialized mental health care for adolescents, was going to cost $36,000 and her insurance would only pay for half because Seattle Children’s was considered on out-of-network facility.

She thought by going for the highest premium PPO gold level coverage offered the state exchange, a majority of the bill would have been covered.

“I’m paying a premium for that and I’m willing to pay that premium, but I expect to get services that are not so limited by the insurance companies,” she said.

Premera told her to take her daughter to facilities either in Yakima or Bremerton, the one a three hour drive and the other two hours away via ferry, while Seattle Children’s was just 15 minutes away. Now, where would you go with your child in an emergency? Remember that she bought a gold plan. Among the many problems we’ve heard about regarding the exchanges is that is can be hard to tell if a particular doctor or hospital is included. Ms. Szablya might well have looked at the online offerings and just assumed that, of course, nearby Seattle Children’s would be included. When you have an emergency, especially one involving your child, you’re not going to stop, call your insurance agent, and ask if a particular doctor or hospital is part of the network. (via Katnandu)

An even worse bill awaited Larry Basich of Las Vegas, who thought he had done everything right, but, after undergoing triple bypass surgery, found himself on the hook for over $400,000:

The hospital bills are hitting Larry Basich’s mailbox.

That would be OK if Basich had health insurance. But he doesn’t.

Thing is, he should be covered. Basich, 62, bought a plan through the state’s Nevada Health Link insurance exchange in the fall. He’s been paying monthly premiums since November.

Yet the Las Vegan is stranded in a no-man’s-land where no carrier claims him, and his tab is mounting: Basich owes $407,000 for care received in January and February, when his policy was supposed to be in effect. Instead, he’s covered only for March and beyond.

Basich has begged for weeks for help from the exchange and its contractor, Xerox. But Basich’s insurance broker said Xerox seems more interested in lawyering up and covering its hide than in working out Basich’s problems. Nor is Basich the only client facing plan-selection errors through the exchange, she added.

Xerox, meanwhile, said it’s working every day to fix Basich’s problem, and its legal counsel is routine.

In the rollout of the Affordable Care Act and its insurance exchanges, you can find a success story for every failure (2). But Basich’s case is extreme.

Be sure to read the whole thing. Basich worked for weeks to make sure he had coverage, both using the crappy online exchange and telephone help. He’s dealt with Xerox and even gotten Governor Sandoval’s office involved. His case is so bad that Harry Reid won’t even call him a liar; his office is instead trying to help.

The problem in this case is the web site, itself. It looks like Xerox did almost as good a job with it as Oracle did with Oregon’s exchange. While payments have been deducted from Basich’s bank account, UnitedHealthCare has no record of his coverage beginning when he was told it would begin, the exchange says he signed up with a different company (even though he has proof otherwise), and that company has no record of him and doesn’t want to be stuck with the bill.

Before this ever gets worked out, the stress may drive Mr. Basich to another heart attack.

In both cases, the the articles miss the mark when attributing blame. By limiting its networks, Premera is doing what any company would when faced with government mandates that impose highers costs: find ways to control them. In Larry Basich’s situation, Xerox deserves all the blame that can be heaped on it, but they’re not the root.

The source of the problem isn’t corporate greed or incompetence: it’s Obamacare, itself. All these problems people are experiencing are due to the top-down mandates that are the essence of the Affordable Care Act. A bunch of legislators and bureaucrats trying to control by law something as complex as the health care system of the United States was bound to fail. And that ongoing, rolling disaster is causing real-life misery for Americans all over the nation.

It has to go.

Footnote:
(1) There apparently are five “affordables” in the bills name. Just ask Nancy Pelosi.
(2) Why do I think that last sentence was meant to deflect the ire of Harry Reid? “Sure there are success stories, too! Just trust us!”

(Crossposted at Sister Toldjah)


Bit by bit, Obama repeals #Obamacare, so Republicans don’t have to. Updated: Sebelius denies delay?

March 12, 2014
"Train wreck"

“Train wreck”

It’s long been known that the individual mandate is the foundation of the Affordable Care Act. Without the requirement for healthy young people to buy more insurance than they need or pay a penalty tax protection money, there would never be enough revenue coming into the system to pay for the elderly and those with preexisting conditions. And amidst all the waivers (1) and delays for unions and businesses claiming hardship under the new law, the one thing they’ve refused to rescind was the individual mandate, itself.

Until last week, when it was done in secret:

ObamaCare’s implementers continue to roam the battlefield and shoot their own wounded, and the latest casualty is the core of the Affordable Care Act—the individual mandate. To wit, last week the Administration quietly excused millions of people from the requirement to purchase health insurance or else pay a tax penalty.

This latest political reconstruction has received zero media notice, and the Health and Human Services Department didn’t think the details were worth discussing in a conference call, press materials or fact sheet. Instead, the mandate suspension was buried in an unrelated rule that was meant to preserve some health plans that don’t comply with ObamaCare benefit and redistribution mandates. Our sources only noticed the change this week.

That seven-page technical bulletin includes a paragraph and footnote that casually mention that a rule in a separate December 2013 bulletin would be extended for two more years, until 2016. Lo and behold, it turns out this second rule, which was supposed to last for only a year, allows Americans whose coverage was cancelled to opt out of the mandate altogether.

The WSJ article then goes through the various classes of exempted individuals and what they have to do to claim that exemption, but the short version is that if you feel you’ve been burdened or harmed by Obamacare –including not being able to afford the new, more expensive even though subsidized policies mandated by Obamacare– you can have a two-year hardship exception based solely on your word.

Yes, you read that right: our new, wonderful, Heaven-on-Earth healthcare-for-all law is now recognized as such a problem that people have to be exempted from obeying it.

Why are they doing this, you ask, since it’s sure to throw the ACA’s finances even more out of whack? Why are they gutting the core of the bill that has been a progressive dream since at least Truman? Trust me, it’s not from empathy for the very people the law is harming.

Have a look at this article from the Conservative Intelligence Briefing and this other from National Journal. (And, for a laugh, this desperate spin from DNC Chairwoman Rep. Debbie Wasserman-Schultz. (2) ) Both deal with the possible fallout from the Republican win in the special election in Florida’s 13th congressional district, one the Democrats thought they had a good chance to win against a flawed Republican candidate.

Instead, they lost, and a good part of the reason was popular anger over Obamacare (3). And now they’re looking at possibly losing seats in the House, in addition to an increasingly-likely loss of their Senate majority.

None of this is guaranteed, of course, but it’s a scary-enough prospect to have them reaching for the whisky bottle while quietly throwing Obamacare’s key provision under the bus, a move that stinks of desperation.

This is significant not just for its electoral consequence, either. Once exceptions like these are granted, it will be danged hard for Obama or a future Democrat president to take them back  and start enforcing the rules (4). And with The One establishing the precedent that the president can ignore laws that are inconvenient to him, what’s to stop a future Republican president from ignoring the ACA altogether?

The Republican-dominated House has voted roughly 50 times to repeal Obamacare since taking control in 2011. I think they can take a breather.

Bit by bit, Obama is repealing it for them.

via Salena Zito and Ben Domenech

PS: I agree with Josh Blackman. Republicans should send opt-out forms to all their constituents — and the Democrats’, too.

PPS: For those who are having trouble affording insurance under the Affordable Care Act, the president suggests cutting back on cable TV and cell phone use. No, really.

Footnote:
(1) And that was just through 1Q 2011…
(2) That is, the race-baiting Debbie Wasserman-Schultz
(3) As Jim Geraghty points out, Republicans have, thank God, improved their ground-game, too.
(4) Do you really think he’s going to reimpose them in 2016, just as the presidential race heats up? No way…

UPDATE: Sebelius denying there’s been a delay to the individual mandate? Hmmm…

(Crossposted at Sister Toldjah)