Tag Archives: health care

Obamacare and ObamaMart Strike Again

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In the continuing story of ObamaMart’s still incomplete (!) backend, the part of the Web site that takes the citizen’s input and sorts it, collates it with other government information, and then passes it on to other relevant parties—the health plan providers, for instance, and the IRS—there’s this:

Because of complicated connections between the new health care law and income taxes, the Department of Health and Human Services must send out millions of new tax forms next year.

The forms are called 1095-As, and list who in each household has health coverage, and how much the government paid each month to subsidize those insurance premiums. Nearly 5 million people have gotten subsidies through HealthCare.gov.

If the forms are delayed past their Jan 31 deadline, some people may have to wait to file tax returns—and collect their refunds.

A delay of a week or two may not sound like much, but many people depend on their tax refunds to plug holes in family finances.

That folks should better plan their withholding (where possible) and not extend Uncle Sugar a year-long interest-free loan is a separate story. Such planning is typical, and the folks who do this the most are the poorest among us—the very folks President Barack Obama and his ilk claim to be trying to help.

And there’s the coming collapse of employer-provided health plans.

Analysts predict that as ObamaCare takes hold, it will mean the end of employer-provided insurance….

The Wall Street research firm S&P IQ went even further, predicting 90% of such plans will disappear.

Now, I don’t see such an eventuality as necessarily a bad thing. Employer-supplied health plans should be what employer-supplied insurance plans used to be, when the practice began: a matter of employment compensation negotiation between employer and (prospective) employee. What interests me here is the hypocrisy of the thing.

President Barack Obama promised, repeatedly, that

you can keep your plan and your doctor, no matter what[.]

If you lose your employer-supplied health plan, you lose with that “your plan and your doctor” bit. Which, of course, Obama knew at the time he was making those promises. He even bragged about it to then Majority Leader Eric Cantor at the infamous health summit.

Also, when Presidential Candidate Barack Obama was debating Presidential Candidate John McCain in 2008, he decried McCain’s health insurance industry reform proposal as being destructive of employer-supplied health insurance.

[T]his would lead to the unraveling of the employer-based health care system. That, I don’t think, is the kind of change that we need.

Hmm….

The Wrong Question

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Jim Angle, of Fox News, usually does better than this.

“Right now the savings that was projected to pay for all this spending [on Obamacare] is not being collected as originally projected,” said Charles Blahous, of the Mercatus Center. He estimated the law will eventually cost $200 billion a year by 2020.

And

“There was about $100 billion that was supposed to come in over the next 10 years from penalties on individuals, if they did not carry health insurance, penalties on employers, if they do not offer health insurance, and to date, those penalties have not been enforced,” Blahous said.

The law also counted on more than $700 billion in cuts to Medicare, including up to $150 billion in cuts to Medicare Advantage, but the president set those aside at the behest of Senate Democrats who feared angering seniors in an election year.

It’s gotten so bad that the CBO will no longer do estimates on Obamacare’s costs, Angle cites American Enterprise Institute’s Joe Antos as saying.

But then Angle goes astray:

The changes, and the overall uncertainty regarding the price tag, are raising concerns about whether the law even has enough revenue coming in to pay for the program.

This is the wrong question. The delays and alterations illustrated above show the essential capriciousness of any government effort—not just the present administration’s effort; this one is only the most active—at emulating a private business arrangement. This law shouldn’t have any revenue coming in to pay for it. This should be a private enterprise matter, with private enterprise raising the money for its private enterprise endeavor—or the endeavor fails, because the free market—American citizen participants—don’t want it. The law shouldn’t exist.

A…Misunderstanding…on the Supreme Court

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The liberal wing of the Supreme Court is at it again. The three women of the wing are furthering their demand that women generally are entitled to get their contraceptives via OPM, rather than with the women’s own money—apparently, it seems, because these three female Justices think women generally are too helpless to have their own money. These three also are continuing their demand that access to contraceptives must take priority over the religious tenets of the ones they would require to make the provision.

Writing for the dissent to a Supreme Court order advising that Wheaton College, a Christian school in Illinois, need not continue to provide birth control coverage absent filing a form with its insurer asserting its religious objections, Justice Sonia Sotomayor wrote the following:

Those who are bound by our decisions usually believe they can take us at our word. Not so today. After expressly relying on the availability of the religious-nonprofit accommodation [in Hobby Lobby to justify expanding exemptions from contraceptive coverage to closely held commercial businesses], the court now, as the dissent in Hobby Lobby feared it might, retreats from that position.

Of course, the Court’s opinion created no such reliance, as Justice Sotomayor knows full well. The “religious non-profit exemption” was one of a couple of possible alternatives proffered in the Court’s opinion that illustrated less restrictive means of facilitating women’s ability to obtain contraceptives. The Hobby Lobby ruling included this potential alternative in a part of its discussion of the requirement that a government-generated religious burden (or burden of any sort) be applied through the least restrictive means possible:

The least-restrictive-means standard is exceptionally demanding, see City of Boerne…and it is not satisfied here. HHS has not shown that it lacks other means of achieving its desired goal without imposing a substantial burden on the exercise of religion by the objecting parties in these cases. See §§2000bb–1(a), (b)(requiring the Government to “demonstrat[e] that application of [a substantial] burden to the person…is the least restrictive means of furthering [a] compelling governmental interest” (emphasis added)).

The most straightforward way of doing this would be for the Government to assume the cost of providing the four contraceptives at issue to any women who are unable to obtain them under their health-insurance policies due to their employers’ religious objections. This would certainly be less restrictive of the plaintiffs’ religious liberty, and HHS has not shown, see §2000bb–1(b)(2), that this is not a viable alternative.

That the opinion went on at greater length about the “religious non-profit exemption” in no way alters its status as one of at least two hypothetically offered alternatives for satisfying the (hypothetically accepted) government interest in providing contraception free to the user. There plainly is no basis to any claim that filing for a “religious non-profit exemption” is the sole means of being…excused…from providing religiously proscribed contraception.

Another aspect that makes the Wheaton matter interesting here, though, is the question of the form itself that Sotomayor insists that Wheaton should be bound to file in order to get that “religious non-profit exemption.”

As Wheaton correctly notes, it’s not who pays for the provision that’s at issue, it’s that Wheaton would be required to sanction the provision by still being required to have contraception coverage done in their name.

“Wheaton believes that authorizing its [insurance administrator] to provide these drugs in Wheaton’s place makes it complicit in grave moral evil,” the college said in its injunction application filed Sunday with the court. “Wheaton can neither provide the mandated coverage nor execute and deliver” forms that prompt others to do so.

This is clear enough to all but the Progressive who cannot distinguish the pecuniary from the moral.

Status of Obamacare Six Months In

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The preliminary results are not promising. And unsurprising.

Among those health-law marketplace enrollees who have seen a doctor or other health-care provider in the first quarter of this year, around 27% have significant health issues such as diabetes, psychiatric conditions, asthma, heart problems or cancer, the data show. That is sharply higher than the rate of 16% for last year’s individual-consumer market over the same time frame, according to the data[.]

It is also more than double the rate among people who held on to their existing individual policies; among those enrollees, the rate was 12%.

This was well understood and predicted from the jump by those (not only on the right) who viewed the matter objectively rather than through the lens of must-pass because it’s the Progressive thing to do.

Look for sharply higher premiums this summer and fall.

An Illustration

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…of why government is unsuited to run what are essentially business operations.

Not to keep picking on Obamacare, but this program really is a poster child for why government can’t do this sort of thing. All year long, the Federal government has been trying to revamp its failed ObamaMart, euphemistically known as Healthcare.gov. Here’s the status of that effort.

  • ObamaMart still is transitioning to new government contractors to manage basic functions. This transition has been going on since the first of the year. They’re not even stable yet on what companies have been hired to do the work.
  • Some back-end functions, including a system to automate payments to insurers, are running behind schedule—still. These functions were supposed to be fully operational last October 1, at the initial deployment of ObamaMart. The revamp can’t get this right, either.
  • [N]ew versions of some functions still will need to be tested with insurers before open enrollment begins 15 Nov. Actual testing is a new wrinkle. Welcome to be sure, but even though CDS has said that ObamaMart was never seriously tested the first time, apparently CDS still is only testing some parts—spot checking.
  • [The] exchange for small businesses, delayed by technical problems last year…will “launch” without some functions.
  • [T]he system to funnel subsidy payments to plan providers for the benefit of plan purchasers (remember that back end?), originally supposed to be ready for the launch in October, then later set for completion by mid-March, is now scheduled to be fully operational in 2015—well after the enrollment period for purchasing 2015 plans has closed.

These highlights demonstrate a terrible performance, by an entity that has no concept of the cost of money and that has none of the performance incentives that a competitive environment in a free market economy provides.