Category Archives: markets

The Government’s Health Care Site

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HHS Secretary Kathleen Sebelius is busily shilling HealthCare.gov as up and running smoothly—but please,

you may want to visit HealthCare.gov in off-peak hours when there is less traffic—mornings, evenings, or on weekends.

And,

Have your information ready when you log on, and comparison shop to get the best deal.

Because you still can’t get into ObamaMart—HealthCare.gov—to see actual plans and what they cover (over and above those contraceptives, prenatal and maternity care, pediatric and child’s dental care that every man or childless couple or empty nester need) without giving up “your information.”  And you still can’t get in to see actual premiums and deductibles that you’ll pay without giving up “your information.”  Never mind that amazon.com, Walmart, Barnes & Noble, or any other on-line or brick and mortar store do not require this as a condition to go in and poke their shelves.  This is your government speaking.

But wait—there’s more!

Critical parts of the back end still aren’t there.  The functions, for instance, needed to transfer to the insurer “your” subsidy aren’t built, so either you’ll still be paying full freight, or your insurer will be forced by the Obama administration to front you the money when you see the doctor the plan allows you to see or go to the hospital the plan allows you to visit.

There’s still no security, so “your information” is freely available to any hacker who wanders by and wants to poke around in your personal financial and health information.  Mike Rogers (R, MI) says

It still doesn’t function right…The security of this site…doesn’t meet the minimum standards of the private sector.

And “work was only just starting to address some of the identity-verification issues as well as enrollment data,” and “the administration hadn’t yet been able to guarantee accurate enrollment data was coming out of the site.”

And HHS delayed for a year the requirement that small businesses get Obamacare insurance policies through ObamaMart.  Even though the data the businesses enter on the paper forms they’re now “allowed” to use have to be entered manually, by ObamaMart workers through that same ObamaMart.

And the IRS—the same gang that’s busily trying to stifle political speech of those groups of whom Obama disapproves, the same gang that routinely reveals the confidential tax information of those disapproved groups, still is in charge of passing around all of the financial data included in “your information.”

And on.  And on.

A Cost of Obamacare

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Anecdotal, certainly, but anecdotes are data, and they can accumulate into trends.  This one comes from Fox News‘ “Kelly File.”

One late-middle-aged family with two college-age children were paying $500/mo for a health insurance plan that suited their needs.  President Barack Obama’s Obamacare, though, termed that plan inadequate and so illegal: the family got one of those ubiquitous cancelation letters.  The new health “insurance” plan they got runs them $1,250/mo.

With that explosion in their pocketbook, this family did what any American family does and what the Obama administration refuses to do seriously: they budgeted.

“That’s actually a little bit more than my monthly mortgage on my home, so you can imagine that you have to start thinking about, you know, where is the extra money coming to pay for the policy,” the mother said.

They made a list of things that had to go in order to afford the new plan: charitable donations, extra mortgage payments, “splurges” such as more frequent haircuts, and so on.

Courtesy of Obama and his Obamacare, charity is hurt—that should be a government welfare program, anyway, eh?—accelerated debt pay down is hurt (isn’t that how we got into this mess, excessive debt?), less money to spend on the private economy, ….

The mother added, with considerably more economics acumen than Obama,

…maybe not eating out as much, not going to the movies, that directly affects small business in our community[.]

There Are Worse Names to be Called

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Recall the Bowie State University Obamacare kerfuffle [emphasis in the original].

Bowie State University has suspended offering health insurance for domestic students for the 2013-2014 academic year.  Due to new requirements of the Affordable Care Act which will go into effect on January 1, 2014, the cost of insurance for domestic students will increase to approximately $1800 per year [from $54/semester].  If you were covered by the university health insurance last Spring 2013, your policy will expire on August 29, 2013.

Earlier this month, BSU student Eugene Craig objected via the BSU newspaper, The Bulldog Collegian; his article had this closer:

Dr [Rita, BSU Wellness Center Director] Wutoh made the announcement that the university would not be providing coverage for students this academic year, and that they could obtain insurance through the Maryland Health Insurance exchange.  I guess if you like your coverage you really can’t keep it as millions of Americans have been finding out over the last month.  As the plan the University has provided for many semester is considered to be out of compliance with the rules that HHS released for Colleges and Universities the University is forced to send everyone to the Maryland Exchange.  This is one sure way to make sure those “Invincible Millennials” are on the exchanges to make sure the cost of the ACA is balanced out.

Craig since has been roundly criticized, including by school administrators and via his Facebook page.  There, alumni (!) are calling him the “wanna be grandson of Clarence Thomas.”

Worse names, indeed.

Another Implication

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…of Obamacare.

Unlike drug addicts, alcoholics, or the obese—all of whom represent higher-than-average medical costs—smokers are the only such group with a pre-existing condition that ObamaCare penalizes. It allows insurance companies to charge smokers up to 50 percent more than non-smokers for an identical policy….

There are a couple of things about this.  One is singling out a particular group for special treatment.  This is what the Obama administration does routinely, though.  Equality under law simply is inconceivable to President Barack Obama and his cronies.

The other is that “[Obamacare] allows insurance companies to charge” bit.  Big Government knows best.  Heaven forfend that a market solution, with individual Americans making our own decisions in an environment where businesses compete for customers without government interference, should be allowed.  Likely at lower cost to us, to boot.

And this double whammy especially hurts the poor, whom Obama studiously ignores in his drive to…deal with…the middle class.  The same high premiums hammer these poor—their low incomes are a major part of why they’re in that “47 million” who don’t have insurance, in the first place—but the subsidies for which they’re eligible cannot be used on the smoker surcharge, which is the mechanism by which the insurer is permitted to plus up the basic premium.

For instance, 64-yr-old non-smoker can get a Silver health “insurance” plan for $9,000 (!) per year.  A 64-yr-old non-smoker will pay $13,600 for the same plan.  Both non-smoker and smoker of an income level can get a subsidy for the $9,000 basic premium, but the smoker is on his own for those additional $4,600.

How Does This Work?

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The CMS has a Request for Proposal out [emphasis added]:

Solicitation Number: RFP-CMS-RMADA-2014
Notice Type: Modification/Amendment
Synopsis: Added: Nov 20, 2013 1:17 pm

The purpose is to develop a Research, Measurement, Assessment, Design, and Analysis (RMADA) IDIQ [Indefinite Delivery, Indefinite Quantity contracting/procurement type] to respond to expanded needs of the Patient Protection and Affordable Care ACT (ACA) and Health Care reform ACT (HCERA).  The work awarded under the RMADA will involve the design, implementation and evaluation of a broad range of research and/or payment and service delivery models to test their potential for reducing expenditures for Medicare, Medicaid, CHIP, and uninsured beneficiaries while maintaining or improving quality of care.

Section C of this RFP has this expansion [emphasis added]:

…the [CMS] will award task orders (TOs) for a wide range of analytic support and technical assistance activities that support models and demonstration programs created or derived under the auspices of the Patient Protection & Affordable Care Act (ACA), and future health reform legislation where new delivery and payment reform models are enacted.  The demands of new reforms created under ACA have redefined the way CMS approaches and conducts research activities and demonstrations affecting Medicare, Medicaid, CHIP, and uninsured populations.  The role of state and private sector payers is also redefined as many of the new models include multiple payers working in collaboration with CMS to reform the care delivery system.  The RMADA will provide CMS with a robust tool to meet those challenges.  Some of the major activities this umbrella contract will address include the following: designing, maintaining and refining model/demonstration design and operations; monitoring model site implementations; designing and carrying out surveys and other data collection activities; obtaining and analyzing secondary data sources including Medicare, Medicaid and Children’s Health Insurance Program (CHIP), and private payer sources that support model design and evaluations.  Some other evaluation activities envisioned under the RMADA include reporting on formative and summative analyses, providing rapid cycle quarterly evaluation feedback to all model participants and CMS, and the creation of summative annual and final program findings.

Aside from only just figuring out that “The demands of new reforms created under ACA have redefined the way CMS approaches and conducts research activities and demonstrations affecting Medicare, Medicaid, CHIP, and uninsured populations” and “The role of state and private sector payers is also redefined…,” they’ve also just discovered HHS, or its CMS ObamaMart Project “Integrator,” hadn’t thought about doing these things from the jump.

As a result, now they want to spend an additional $7 billion of our money on their failure.  Probably, it’s too much to hope for any of these billions being committed to saving pennies will be committed to reducing the costs of all that added reporting and paperwork.  Or even that the entire $7 billion could be saved (and sent over to Treasury to reduce our national debt) with withdrawing this foolish RFP.