March 16, 2014

The Shambles Called ObamaCare.

by Hal Gershowitz

Comments Below

 

Honestly, we’re tired of writing about the Affordable Care Act (aka ObamaCare). We would much prefer to focus on the many other issues that loom so heavily today.  We suspect many of our readers also are thinking enough about ObamaCare.

But the ever-metastasizing mess of ObamaCare requires attention, as new revelation after new revelation demonstrates just how badly this colossal mélange of legislative sausage is turning out.  Yes, of course, heretofore uninsured men and women now have access to health insurance, often at very low or no cost (to them) – although the number of hospitals and doctors that accept only a few (or none) of these insurance plans is another matter.

Of course, ObamaCare never was really about providing coverage for the uninsured.  Making sure that the 15% of Americans who were uninsured had access to healthcare would not have required nearly 3,000 pages of legislation or the 20,000+ pages of regulations with which we are now saddled. Providing insurance for the uninsured was the window dressing – the sizzle as they used to say on Madison Avenue.  ObamaCare was, and is, all about a new, transformative, government-mandated, regulated and controlled health care system for all Americans.  Like so much sizzle selling, it was misrepresented, vastly oversold, and, for many, much more expensive than that promised by the come-on sales pitch.

The Obama Administration directly caused millions of Americans to lose their preferred health insurance coverage and required them to purchase government approved insurance, often at much higher premiums or much higher deductibles (or pay a penalty, or tax depending on whose definition of the hit you prefer).   The Administration knew this was going to happen, but kept it quiet rather than admit (or contradict) the President’s knowingly false assurance that no one who liked his or her health insurance plan (or medical practice) would lose it.  This was a calculated risk by the Administration.  They believed it would be but a pinprick on the veneer of their grand scheme for transformative medical care in America.  Instead, it is turning out be a hemorrhage.

Here’s why.  For good reason, most doctors don’t like ObamaCare, nor do most hospitals, and, for good measure, nor do most Americans.  Doctors are selling their practices left and right; many of the leading hospitals are saying, “no thanks” to the plans being offered through the ObamaCare exchanges, and many Americans are appalled by the cancelations of their policies and the higher premiums and deductibles they now face, and of the shrinking number of hospitals and medical practices that will accept the plans of exchange-participating insurers…and these Americans vote.

So, with the first sulfuric whiffs of the 2014 election season wafting across the White House lawn, the Administration has, once again, essentially moved to quietly wave a key unpopular provision of ObamaCare. This time it is the all-important individual mandate.  They accomplished this bit of legerdemain through a series of rule changes that have the effect of pushing the mandate back until (surprise of surprises) after the next presidential election for, well, just about anyone who doesn’t want to participate in ObamaCare.  This was done by announcing a laundry list of nebulous two-year hardship exemptions that, realistically, can be used by almost anyone who has a pulse, lives on a budget and who doesn’t want to sign up.  Ironically, a few months ago the House Republicans had agreed to avoid a government shutdown if the Administration would delay implementation of the just delayed mandate.

By our count there have been about three-dozen Administration directed delays and modifications to ObamaCare.  All of the delays have been carefully timed to avoid election cycle land mines for members of Congress who are identified as ObamaCare supporters.  First, exemptions were handed out willy-nilly to major corporations, then medium sized corporations, then small businesses and, now, pretty much anyone who really wants an exemption.  Soon, it seems the Administration may have to employ navigators (like those who help people navigate the sign-up procedure) to help folks navigate who want to avoid the various mandates.

The White House isn’t hiding the political calculus behind the implementation delay.  Jonathan Easley of the very savvy Capitol Hill insider publication, The Hill, reports:

 “They (the Administration) took the rare step of naming more than a dozen Democrats it worked ‘in close consultation with’ ahead of a Wednesday announcement about (these) changes to the Affordable Care Act. All of the Democrats the administration cited are up for reelection in 2014, and most are either vulnerable, or find themselves early targets by the GOP for their past support of ObamaCare. Prolonging the ‘keep your plan’ fix to accommodate for President Obama’s broken promise about the law will avoid another wave of health policy cancellations otherwise expected in critical weeks before Election Day in 2014.”

 These ad hoc exemptions could create real chaos in the insurance market. Insurers agreed to take older and sicker patients as part of the Affordable Care Act, because the mandates were supposed to deliver millions of young and healthy Americans as new customers. The individual mandate was, after all, supposed to compel young and healthy people who might not otherwise buy insurance to enter the system.  Now it is doubtful whether enough of those new young and healthy customers will be there to keep premiums down for everyone else.

The real fly in the ointment is that very few of the previously uninsured (you know, the one’s for whom the law was supposedly intended) are signing up.  The Administration is grinding out talking points stressing that about 4 million have signed up so far (the Administration had originally said they would need 7 million enrollees at this point in time to call the roll out a success).  Now, HHS Secretary Kathleen Sebelius says she’d simply call millions of new previously uninsured enrollees a success.  But a recently released McKinsey study has found that that isn’t happening either – not by a long shot.

McKinsey & Company (among the very largest consultants in the consulting world) has found that less than 500,000 of the people who have signed up were previously uninsured. The other 4 to 5 million are simply people who had their policies canceled because of ObamaCare.

McKinsey, conducts monthly surveys of the prospective exchange participants under the auspices of its Center for U.S. Health System Reform. So what did last month’s survey find? Only 48 percent of those eligible had signed up and of that 48 percent, 60 percent were simply previously insured people.  Of the sign-ups so far, only 27 percent were uninsured last year. And of that 27 percent, nearly half had yet to pay a premium.  That means they may have selected a plan they like, but they haven’t paid for it and are, therefore, not yet insured.

Bottom line: The vast majority (over 70 percent) of the 4 to 5 million enrollees the government is touting were insured before their policies were canceled because of ObamaCare.  They are just a lot of our fellow citizens who have been hassled by their government.

The Administration says total sign-ups now exceed 4 million. But when Gary Cohen, who is the ObamaCare implementation point man, was asked how many of the people who have signed up for ObamaCare were previously insured anyway, he replied: “That’s not a data point that we are really collecting in any sort of systematic way.” Really?

Respondents who declined to enroll were asked why.  Fifty percent of the respondents answered, “I could not afford to pay the premium.”

Well, as President Obama said just before being elected, “we’re going to fundamentally transform the United States of America.”  He got that right.

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3 responses to “The Shambles Called ObamaCare.”

  1. Mark J Levick says:

    As you pointed out the ACA was not about insuring the uninsured– it was about implementing socialized medicine. The wave of extensions of time to comply demonstrates that Obamacare does not work as a piece of legislation. It does work as part of the Obama plan to make Government the dominiant factor in every day American life. He has done that while at the same shrinking America’s leadership role in the world. Change has come to America just as Obama hoped it would. The young, the entitlement crowd, the unions, the intellectual elite and those with no financial skin in the game seem to like this change. Will they continue to like it when American cannot pay its bills and the ever decling number of income tax payers cannot cover the cost of floating the good ship lollipop which our spielmeister in chief commands from behind hi teleipromter?

    P

  2. Joseph Noren says:

    THE SECOND PARAGRAPH OF TODAY’S COMMENTARY STATES
    THAT THERE IS A QUESTION OF DOCTORS AND HOSPITALS ACCEPTING ALL OR SOME OF THE PLANS OFFERED BY OBAMACARE. I DID NOT KNOW THAT THEY HAD A CHOICE.
    PLEASE EXPAIN…THANK YOU

    • Neither hospitals nor doctors have to accept any insurance plan they do not like, nor do any insurance plans have to include any hospitals or doctors they do not want to include in their networks. It invariably comes down to fees. Many hospitals and doctors are not willing to accept what insurance companies are willing to pay and many insurance companies are not willing pay what some hospitals charge, especially the leading hospitals, which often have to charge more to cover the cost of the research and advanced treatment they provide.

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