ObamaCare's Shoes Keep Dropping

None of us can claim to be great soothsayers just by figuring there would be more shoes to drop re the problems with ObamaCare.  Here is another batch that has developed over the past week – many of which pertain to the insurance exchanges – the electronic marketplaces that sell healthcare insurance policies to people who can't get coverage through an employer or government program.  I couldn't help but notice that none of the problems – old or new - have anything to do with the healthcare outcome of patients but rather they are concerned with pricing, payments, websites, & preserving & extending the political careers of people who could not care less about us.  In this regard BO announced on Friday that the open enrollment period for 2015 will begin on November 15 – right after the 2014 midterm elections thereby camouflaging as much as possible the insurance premium rates for 2015.

 

1.  Although ObamaCare itself has no requirements for doctors payments to be lowered, insurers have started to notify doctors who are considering joining or have joined the insurance exchanges that their payments will be reduced in some cases to levels below Medicare rates & even below Medicaid rates.  It turns out that the insurance plans that are listed on exchanges are really HMO-like closed networks.  Nearly all of the healthcare insurance premiums competitively priced on the exchanges were determined by each insurance company using a closed HMO-like narrow network of doctors who agreed to lower their normal fees.  My family doctor calls these doctors "nuts."

 

You don't have to think long & hard to see problems with this arrangement.  First, it places doctors on the exchanges in an assembly line mindset – they can't afford to spend much time with their patients meaning there will no longer be time for personal relationships with your doctor.  Second, the fee structure will ensure that the best doctors do not join the exchanges meaning that people who sign up for a healthcare insurance policy through the ObamaCare exchanges will not be getting what they thought – good healthcare @ bargain basement prices.  Third, this arrangement will lead to a two tier healthcare system in which low-income people are insured either by policies bought on the exchanges or expanded Medicaid & the higher-income people will get their healthcare through private medical practices with higher payments to doctors.  This is one of the set-ups to get to universal single payer healthcare - when the best doctors in the private practices cannot get their licenses renewed unless they join the exchanges – from there doctors retire, those remaining raise their rates so that the insurers are no longer competitive with their low-income clientele & it all unravels into single payer universal healthcare formerly known as the public option.

 

2.  Reacting to BO's most visible attack yet on seniors - to cut $150 billion from the Medicare Advantage program over the next ten years to help pay for ObamaCare - UnitedHealth Group announced it has cut thousands of doctors from its HMO network including more than 200 doctors @ one cancer center in Florida & 2,200 doctors statewide  in Connecticut.  Humana, Aetna, & WellPoint are evaluating similar moves.  Fewer doctors means having longer waiting times for appointments, & a combination of longer travel times to see a doctor & overall less convenience for the elderly patients in the Medicare Advantage program – some 13.1 million people many of whom are very sick in constant need of care.  Add these people to the list of those who couldn't keep their plan if they liked it.  Cutting funding & reducing the number of doctors can only result in rationing of care.

 

3.  BO has indicated that the next waiver that may be granted is to about 16 million union members who do not want to pay the part of ObamaCare known as the transitional reinsurance tax - an annual $63 per person (in 2014) fee charged to 190 million people covered by private healthcare insurance policies.  The reinsurance tax is a very obscure part of ObamaCare - it's a tax on healthcare insurers that goes into a fund that will pay subsidies to insurance companies if needed because the insurers underestimated the premiums charged on the exchanges.  Sounds like double talk but that is what it is.

 

Currently the federal government & 35 states operate so-called high risk pools that cover people who cannot get commercial healthcare insurance – a total of 300,000 people or 0.095% of the population.  In order for the ObamaCare premiums to not be too high for these high risk people a $25 billion fund capitalized by this reinsurance tax is to be established. Proceeds from the fund are intended to compensate insurance companies whose costs turn out to be higher than expected.

 

To summarize – 190 million taxpayers will pay into a fund designed to subsidize insurance companies who make pricing mistakes.  16 million union workers are asking for a waiver from this tax & very well may get it.

 

I don't remember this feature of ObamaCare being spelled out during the campaign to enact the healthcare law – do you?

 

Senator Marco Rubio calls this a bailout of insurance companies @ the expense of taxpayers.  Add the union-waiver insult to the injury.  Rubio plans to introduce legislation to repeal the reinsurance tax.

 

4.  The details of the health insurance tax (HIT), an even more obscure tax than the reinsurance tax, have started to surface.  The HIT will impose a fee on insurance companies that insure the 84% of small businesses who do not self-insure, the 17% of large companies who do not self-insure, & consumers who buy their own policies.  It is expected that the HIT costs of insurers will be passed on to these policy holders through higher premiums meaning it is predominantly a hidden tax.  The HIT is estimated to increase insurance costs in 2014 by $150 per employee & $360 per family.  Large companies that self-insure (about 83%) will escape this tax because they are not commercial insurance companies.

 

5.  What would one of these posts be if it did not include an update concerning the problems with the federal ObamaCare website.  Testifying before the House Energy & Commerce subcommittee Henry Chao, Deputy Chief Information Officer @ CMS, said that @ least 30% of the federal website pertaining to back office functions transferring subsidies to insurers has yet to be built meaning that there currently is no mechanism to transfer money (subsidies) from the government to the insurance companies starting in January.

 

6.  At another House Energy & Commerce Committee hearing it was pointed out that applicants using the insurance exchanges never see the following statement that is "under the covers" in that it is part of the source code (a collection of computer instructions specifically designed to facilitate the work of computer programmers that is understood by a computer but not necessarily by a human):  "You have no reasonable expectation of privacy regarding any communication or data transiting or stored on this information system."  Democrats on the committee tried to defuse this revelation by saying the health status information on the application is limited - but the broad way this statement is worded leaves no doubt that it can be used for disadvantage & evil.  The statement can serve no good purpose & if that is not true than why is it included in such a hidden way?

"You have no reasonable expectation of privacy regarding any communication or data transiting or stored on this information system."
Read more at http://www.westernjournalism.com/hidden-source-code-obamacare/#8cacMhOFSjLVUHse.99

"You have no reasonable expectation of privacy regarding any communication or data transiting or stored on this information system."
Read more at http://www.westernjournalism.com/hidden-source-code-obamacare/#8cacMhOFSjLVUHse.99

"You have no reasonable expectation of privacy regarding any communication or data transiting or stored on this information system."
Read more at http://www.westernjournalism.com/hidden-source-code-obamacare/#8cacMhOFSjLVUHse.99

 

7.  The political furor caused by the healthcare insurance policy cancellation letters sent to current policy holders continued to devastate the minds of politicians who had supported ObamaCare.  Even after BO back pedaled with a "fix" saying that people could keep their policies that had previously been cancelled because they did not comply with ObamaCare 39 Democrats voted with all but four Republicans for the Keep Your Health Plan Act of 2013 (known as the Upton bill after sponsor Fred Upton of MI) the next day.  This bill not only allows people to permanently keep any plan they had but also allows insurance companies to sell any plan to new customers – not just those people with cancelled policies.  See vote below.

 

The four Republicans who voted against the act were Thomas Massie (KY), Jim Bridenstine (OK), Paul Broun (GA), & Ralph Hall (TX).  These four comprise the handful of House members who still won't accept anything short of a full repeal of ObamaCare.  The split is smaller than the one that produced the harmful shutdown last month that diverted attention away from the ObamaCare problems & most likely cost Republicans the Virginia governor's race.  One side says the Upton bill does not do enough to fix the long-term problems with ObamaCare & the other says it is a good first step toward protecting people who need healthcare insurance.

 

Congressman Broun was the most adamant saying "I voted against the Keep Your Health Plan Act because I am serious about putting a stop to ObamaCare, & this bill does nothing to address ObamaCare in the long-term.  We need to focus on real reform that will actually lower costs and deliver quality care, not waste time with another delay or 'fix.'"

 

Now nothing resembling either argument will ever make it to the floor of the Senate let alone get past BO's veto pen.  With all the problems ObamaCare is having doesn't it make sense to appear helpful, like voting for the Upton bill, & then just get out of the way & let ObamaCare continue to destroy itself?

FINAL VOTE RESULTS FOR ROLL CALL 587

(Republicans in roman; Democrats in italic; Independents underlined)

      H R 3350      RECORDED VOTE      15-Nov-2013      1:34 PM
      QUESTION:  On Passage
      BILL TITLE: Keep Your Health Plan Act of 2013

	Ayes	Noes	PRES	NV
Republican	222	4		4
Democratic	39	153		8
Independent
TOTALS	261	157		12

 

---- NOT VOTING    12 ---

 

Becerra Campbell Cárdenas Gosar

Granger Green, Gene Jones McCarthy (NY)

Miller, George Rush Sires Tsongas

The thirty-nine Democrats who voted for the Upton bill – all had previously supported ObamaCare:

 

• Ron Barber (Ariz.)  • John Barrow (Ga.)  • Ami Bera (Calif.)  • Tim Bishop (N.Y.)  • Bruce Braley (Iowa)  • Julia Brownley (Calif.)  • Cheri Bustos (Ill.)  • Jim Costa (Calif.)  • Peter DeFazio (Ore.)  • Suzan DelBene (Wash.)  • Tammy Duckworth (Ill.)  • Bill Enyart (Ill.)   Elizabeth Esty (Conn.)  • Bill Foster (Ill.)  • Pete Gallego (Texas)  • John Garamendi (Calif.),  • Joe Garcia (Fla.)  • Ron Kind (Wis.)  • Ann McLane Kuster (N.H.)  • Dave Loebsack (Iowa)  • Dan Maffei (N.Y.)  • Sean Patrick Maloney (N.Y.)  • Jim Matheson (Utah)  • Mike McIntyre (N.C.) Jerry McNerney (Calif.)  • Patrick Murphy (Fla.)  • Rick Nolan (Minn.)  • Bill Owens(N.Y.)  • Gary Peters (Mich.)  • Scott Peters(Calif.)  • Collin Peterson (Minn.)  • Nick Rahall (W. VA)  • Raul Ruiz (Calif.)  • Brad Schneider (Ill.)  • Kurt Schrader (Ore.)  • Carol Shea-Porter (N.H.)   Krysten Sinema (Ariz.)  • Filemon Vela (Texas)  • Tim Walz (Minn.)