Tag Archives: health care

Costs of Obamacare

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The Washington Health Benefit Exchange…has enrolled 160,000 paying customers in ObamaCare exchange health plans but that’s more than 50,000 short of goal, which has led to an extension of the enrollment deadline and a request that the Washington State Legislature fork over $125 million to fund the exchange.

There’s a hint there.

Republicans are angry because they were told the exchange would be self-sufficient by the end of this year.

Leading Democrats were also skeptical. They were expecting a much lower subsidy as the exchange bridges from federal seed money to being able to fund itself through premium taxes and fees paid by insurance companies and customers.

There’s a hint there, too.

And

New York’s governor wants a $69 million tax on non-exchange health insurance policies while Vermont has projected a $20 million shortfall by the end of 2015. There also is a bill in Rhode Island to scrap the state exchange and go with the federal exchange to avoid a $24 million hit to taxpayers.

Wait—is there a pattern emerging?

Off Ramps

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That’s the cool, new buzz phrase. Congressmen John Kline (R, MN), Paul Ryan (R, WI), and Fred Upton (R, MI), Chairmen of the House Education and Workforce Committee, Ways and Means Committee, and Energy and Commerce Committee, respectively, used it Monday in The Wall Street Journal to propose alternatives to Obamacare should the Supreme Court strike down Federal subsidies related to health care coverage plans bought through ObamaMart rather than through the State exchanges that the Obamacare law requires for Federal subsidy eligibility.

In the main, their alternatives are good ones, but there are a couple points with which I wholeheartedly disagree, and it’s disappointing that three men who know better would propose them.

We would allow parents to keep children on their plan until age 26.

That’s fine, but 26-year-olds aren’t children; they’re grown adults. They stopped being children at 18, or 20, or 21 depending on the jurisdiction. They stopped being children when they became eligible to make their own binding decisions on legal documents. Retaining sons and daughters on parents’ plans should be a matter of negotiation between the plan seller and buyer; government shouldn’t be involved in magnanimously granting permission—which carries with it the authority to rescind that permission later.

We would prohibit insurers from imposing lifetime limits on benefits.

This is especially disappointing. This, too, should be a matter of negotiation between the involved parties. Mandating an expense to the company, which this plainly does, forces a cost on the customer. There is a greater cost for paying out over an indefinite lifetime than there is for paying out over a known and fixed interval. Denying the company the option to offer either forces the company to pass on the greater cost to the customer, whether the customer wants that much coverage or not. It’s also an unacceptable denial of market choice to the customer.

[W]e would offer those in the affected states a tax credit to buy insurance.

This comes from the false premise that government should be the default source of welfare, and not the last resort. From that, it jumps the gun: the magnitude of the need is not at all established, especially given the initial fluid market environment that would be created were the competition across state lines part discussed in their op-ed actually passed. Only after private sources of aid have been exhausted, in that stabilized environment of lower basic cost for health plans, should government aid become available. (It’ll also be interesting to see how these guys propose to pay for these tax credits, but perhaps that’s for a later op-ed.)

One More Nail

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…in what should be Obamacare’s coffin. Even if repeal will take some years and a Republican President.

More than half of tax filers who received subsidies for health insurance premiums may owe hundreds of dollars because they got tax credits that were too large, complicating an already messy tax season that has seen about 800,000 incorrect tax statements sent to consumers who obtained coverage via the federal HealthCare.gov exchange.

Almost six weeks into tax filing season, 52% of people who enrolled in insurance through state or federal exchanges are finding they must pay back a portion of their tax credits, according to a report Tuesday by tax preparation firm H&R Block Inc. and based on their clients. The average amount paid back is $530….

This isn’t even a sort-of funny parody, anymore.

The Judicial Branch and the Law

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In a couple of weeks, the Supreme Court will hear a case involving Federal subsidies to health coverage purchasers who bought their plans on ObamaMart instead of State exchanges. The Obamacare law limits those subsidies to purchasers via State exchanges argue the plaintiffs; the government demurs.

Some ACA critics fear the Supreme Court may hesitate to block the current subsidies because of a lack of confidence in the legislative branch in general.

Against that backdrop, Supreme Court Justice Ruth Bader Ginsburg has said

The current Congress is not equipped really to do anything[.]

That claim is the pseudo-logic President Barack Obama uses to justify his Executive Orders and “executive actions” that deliberately bypass Congress, and unconstitutionally so.

Justice Ginsburg, and others of like mind on the Supreme Court, may be entirely right on Congress’ ability—or willingness—to act. However, she, and they, would do well to remember that the Constitution they’re sworn to uphold does not authorize the Court to legislate in place of, or in addition to, Congress.

Justice Ginsburg and her fellows would do well to remember that the judiciary’s task is first to determine whether a law comports with the Constitution as the Constitution is written, and if it’s legitimate, to apply that law as that law is written.

Full stop.

Democrats and Those Pesky Laws

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Three senior House members told The Associated Press that they plan to strongly urge the administration to grant a special sign-up opportunity for uninsured taxpayers who will be facing fines under the law for the first time this year.

The three are Michigan’s Sander Levin, the ranking Democrat on the Ways and Means Committee, and Democratic Reps. Jim McDermott of Washington, and Lloyd Doggett of Texas. All worked to help steer Obama’s law through rancorous congressional debates from 2009-2010.

Because, voters. Because, law? That’s too inconvenient; just ignore it.

The Obamacare law—which Democrats have been trying to stifle debate about by insisting “It’s the law of the land”—specified the signup period. If these worthies want to change the signup period, they need to change the law—which they helped write this way—not ignore it.

The lawmakers say they are concerned that many of their constituents will find out about the penalties after it’s already too late for them to sign up for coverage, since open enrollment ended Sunday.

Wait, what? These Democrats haven’t been talking to their constituents about their responsibilities under these Democrats’ law? Not since 2010? At all!?

Oh, yeah. Voters.