Tag: Affordable Care Act

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Media Misleads on Obamacare Repeal

Media coverage of the ongoing debate over how to repeal and replace Obamacare has been exceptionally inept.  It has ignored the deceptive manner in which the former President’s failed legislation was enacted, the depth of nationwide opposition to it, and the failures that require its elimination.

One of the key architects of the “affordable Care Act,” Jonathon Gruber, has boasted about the misstatements and coverups that were employed to gain passage. Notably, he has stated that “lack of transparency is a huge political advantage, and basically, call it the stupidity of the American voter.”

Obamacare was enacted in a Democrat-only, party line vote, in which even the elected officials voting on the measure has only a limited knowledge of what was in the bill. The American people knew even less, as demonstrated by then-speaker Pelosi’s infamous comment: “But we have to pass the…bill so that you can find out what’s in it….”

The Washington Post reports that “…there are now seven Gruber [Jonathon Gruber has been termed Obamacare’s “architect”] videos, in which he mocks the “stupidity” of American voters and boasts of the Obama administration’s ability to take advantage of it…”

The Americans for Prosperity (AFP)  organization has listed the most notable deceptions.

  • “If you like your healthcare plan, you will be able to keep your healthcare plan.”
  • “If you like your doctor, you will be able to keep your doctor.”
  • “We’re going to lower your premiums by up to $2500 per family per year.”
  • “No family making less than $250,000 a year will see their taxes increase.”
  • “I will not sign a plan that adds one dime to our deficits, now or in the future.”
  • “I will sign a universal healthcare bill into law…that covers every American.”

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Marketwatch notes that “Obamacare barely passed Congress in 2010. If people had known how it would develop, the health-care act would likely never have become law.”

Among the many failings of the measure noted by Marketwatch:

  1. Low enrollment. The Department of Health and Human Services estimates that between 9.4 million and 11.4 million signed up in 2016…In contrast, in March 2010, the Congressional Budget Office estimated that 21 million people would be enrolled on the exchanges.
  2. High numbers of uninsured. There are still 31 million uninsured, and the number is never projected to go below 29 million, according to CBO.
  3. Lost doctors. Varioussources note that a common (and popular) way to reduce premium costs has been to reduce the number of doctors in the insurer’s network.
  4. Lost plans.Sen. Ben Sasse released a reportabout Obamacare’s effects on competition among insurers, concluding that outcomes have worsened for most Americans, in terms of choice of insurers and plans. Over the past year, the number of insurers offering plans in exchanges has dropped by nearly 6%.Many states have lost more than 80% of their insurers: Alabama went from 23 to 3, Arkansas went from 24 to 4, and Wyoming from 21 to 1, just to name a few. Only New York did not lose over half of its insurers, going from 28 to 15 insurers, a 46% decline.
  5. Higher premiums.A reportby the Kaiser Family Foundation and the Health Research & Educational Trust found that, since 2008, average employer family premiums have climbed a total of $4,865. From 2015 to 2016 the most popular exchange family plan, Family Silver, saw a 10% average increase in its premiums. In some states, premiums rose by nearly 40%.In 2015 the average annual family premium was $17,545 per year, and the average premium for a single policy was $6,251. Young men were particularly hard-hit. Average premiums rose by 49% from 2013 to 2014, the year Obamacare was supposed to go into effect.
  6. Higher deductibles. The New York Times, long a cheerleader for Obamacare, reported that many people can’t afford to use the health insurancethat they have purchased because of the deductibles.New York Times reporter Robert Pear wrote that the median deductible in Miami was $5,000 in 2015. It was $5,500 in Jackson, Miss., and $4,000 in Phoenix. One Chicago family of four paid $1,200 monthly for coverage yet had an annual deductible of $12,700.
  7. High costs.The Office of the Actuary of the Center for Medicare and Medicaid Services has projected that Obamacarewill result in an additional $274 billion in administrative costs alone over the period of 2014 through 2022.

AFP  noted that “The promise to repeal Obamacare is what drove Americans to overwhelmingly cast their ballots for Obamacare’s opponents in three out of the last four elections.” The anger over the measure, in addition to its deceptions and failures, ran roughshod over individual rights. WND  worries that “The…Affordable Health Care Act…has forced nuns to pay for abortions, demanded that Christians violate their doctrines of faith…and much more.”

Much has been written about the fact that, just two months into his term, President Trump and Congress have not yet replaced the failed legislation.  However, a more open and vigorous debate about the replacement attempt is a good thing.  Rather than a secretive, deceptive, and ill-conceived measure such as Obama’s bill, a more fact-based and strenuous process centered on a vigorous exchange of ideas has a far better chance to produce an end product that actually improves, rather than harms, health care.  

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Health Care Challenges Rising

Health care in the U.S. is entering a challenging period. Both Medicare and Obamacare patients will experience serious obstacles

According to a study by The Kaiser Family Foundation (KFF) 21 percent of physicians are not accepting new Medicare patients. This compares to the 14 percent that have decided not to accept new privately insured patients. That is, the proportion not taking new Medicare patients is 1.5 times greater than the proportion not taking new privately insured patients. KFF notes that “Previous studies show that the vast majority of physicians accept Medicare, but the proportion taking new Medicare patients is smaller, particularly among primary care physicians compared with specialists…” This growing limitation of choice will limit choices for those who are aging into the system.

For those using Obamacare, premiums are set to rise. Bloomberg  reports that “Premiums for mid-level Obamacare health plans sold on the federal exchanges will see their biggest jump yet next year, another speed bump in the administration’s push for enrollment in the final months of the U.S. president’s term. Monthly premiums for benchmark silver-level plans are going up by an average of 25 percent in the 38 states using the federal HealthCare.gov website, the U.S. Department of Health and Human Services said in a report today. Last year, premiums for the second-lowest-cost silver plans went up by 7.5 percent on average across 37 states. Individuals signing up for plans this year are facing not only rising premiums, but also fewer options to choose from after several big insurers pulled out from some of the markets created under the Affordable Care Act, known as Obamacare.”

A Guardian review found that “ the ACA relies on competition between insurers to provide affordable coverage, and that is dwindling. Under the ACA, health insurance marketplaces, also called health exchanges, were set up to facilitate the purchase of health insurance in each state. Customers are free to choose from a set of standardized healthcare plans from participating insurers, and those policies are eligible for federal subsidies. But insurers have been fleeing the exchanges, arguing that they are loss makers and the types of people attracted to them make the risks too great for the insurers to provide affordable (and profitable) policies.”

A Breitbart analysis concludes that Obamacare’s (ACA) financial unsustainability is causing both insureds and insurers to abandon the system, “leaving President Obama’s takeover of the nation’s healthcare system on the verge of collapse.” Due to the high and rising costs, young, healthy people, whose payments and relatively light use of medical care were expected to prop up the system, are staying away in sufficient numbers to cause major problems.

Realclearpolitics fleshes out the details. “Economic reality is making it increasingly obvious that we are in the midst of Obamacare’s long anticipated death spiral. Most recently, Aetna  joined United Health care and Humana as the third of the ‘big five’ insurance firms to announce major cuts to its Obamacare exchange business. For insurers, it’s simple math: Premiums collected must exceed claims paid. If too few healthy, low risk individuals enroll to offset the costs of insuring unhealthy, high risk individuals, the math doesn’t work. This imbalance forces insurers to raise premiums on the low risk individuals who do enroll to cover the costs of insuring high risk individuals. The rising premiums cause even more healthy individuals to drop coverage – resulting in what has been called a death spiral…Aetna, for example, suffered a second-quarter pretax 2016 loss of $200 million and total pretax losses of more than $430 million since January 2014 when the exchanges opened for business. Aetna wasn’t alone…UnitedHealth lost $475 million in the exchanges in 2015 and expects to lose $650 million in 2016.”

The US. House of Representatives Committee on Energy and Commerce  recently concluded an investigation which found that lower-than-expected enrollment, higher-than-anticipated costs, and more complicated-than-anticipated technology challenges have caused state based exchanges (SBE) in Oregon, Hawaii, New Mexico and Nevada to fail, ( having wasted hundreds of millions of taxpayer dollars) and Kentucky will be added to that list next year. Only 12 will remain. Washington now appears to be encouraging state exchanges to close and join the federal exchange.

The major findings of the Congressional investigation noted that the state based exchanges will not be sustainable in the long term. As of September 2016, every SBE still relies upon federal establishment grant funds—20 months after SBEs were to be self-sustaining by law. Washington failed to enforce its own rules on Medicaid allocations, and did not recover  misspent dollars.

The looming financial collapse of Obamacare may finally clear the path for more viable options, such as:

  • Tort reform (which would significantly reduce the cost of practicing medicine,)
  •  Allowing nationwide competition between insurance companies (which would lower costs for purchasers of health insurance to be tried)
  • Tax credits to help make private policies affordable
  • Allowing the sale of more flexible policies with different types of coverage, a concept that will be far more attractive for healthier, younger people.

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Big Government Hurts Middle Class

How much interference in their daily lives will Americans tolerate from increasingly powerful government, especially when that interference results in a reduced quality of life?

The Foundation for Economic Education notes:

“Government in America was never supposed to engage in the multitude of activities that it does today. When the United States gained its independence more than 200 years ago, the founding fathers envisioned a national government with explicit and restricted responsibilities. These responsibilities pertained mainly to protecting the security of the nation and ensuring “domestic tranquility,” which meant preserving public safety. Especially in the realm of domestic affairs the founders foresaw very limited government interference in the daily lives of its citizens.”

The Institute for Policy Innovation outlines the challenge:

“We have to put Big Government back within its Constitutional restraints because Big Government has led to the establishment of a Government Class that lives at the expense and off the backs of the productive private sector. And when you allow a ruling class to live better than you but at your expense, you are on the way to losing your freedom. …And what happens when we dare suggest that they should rein in their spending by a couple of pennies out of a dollar? They punish us by releasing illegal immigrant felons from prison, by delaying our flights, by closing government buildings and by threatening us with restricted services. This is not the behavior of public servants. This is the behavior of a Ruling Class, punishing its subjects for questioning its authority. And these are but the first few skirmishes.”

As America’s governments, both on the national and state levels have grown increasingly large, powerful, and intrusive, the middle class has suffered accordingly. As the New York Analysis previously reported, A Pew Research Center review  notes that “Middle-income Americans are no longer the nation’s economic majority…The share of U.S. aggregate household income held by middle-income households has plunged, from 62% in 1970 to 43% in 2014.”  According to the U.S. Census Bureau   In 2014, real median household income was 6.5 percent lower than in 2007…The 2014 poverty rate increased for two groups: people aged 25 and older with at least a bachelor’s degree.
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This discloses another reason for the declining fortunate of the middle class:  “Liberals across the country supported the misnamed Affordable Care Act (aka Obamacare). The law’s mandates have made health coverage more expensive for both individuals and businesses…when benefit costs rise, employers cut wages. Empirical research confirms this prediction. “ Research from the Heritage Foundation  concurs.

How have “Progressive” ideas affected average Americans? “The curse of the U.S. economy today is the downward trend in “take-home pay, Heritage  notes.  “In the 50 years since that the war on poverty began, U.S. taxpayers have spent over $22 trillion on anti-poverty programs. Adjusted for inflation, this spending (which does not include Social Security or Medicare) is three times the cost of all U.S. military wars since the American Revolution. Yet progress against poverty, as measured by the U.S. Census Bureau, has been minimal, and in terms of President Johnson’s main goal of reducing the ‘causes’ rather than the mere ‘consequences’ of poverty, the War on Poverty has failed completely.”

Scholar Charles Murray believes that “Aspects of America’s legal system have become lawless, for reasons that are inextricably embedded in the use of law for social agendas.

The federal government has a debt of over $18 and a half trillion, Social Security is heading towards insolvency, the nation’s infrastructure remains in poor condition, and the military is significantly underfunded.

While Washington’s spending concentrates on failed poverty programs, (spending on poverty programs has reached its highest level under President Obama) real median income of working Americans has declined.

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Obamacare-Medicaid Connection: Back Door to a National Single Payer Plan?

President Obama is seeking to expand federal funding to states that expand medicaid eligibility.

One of the key results of the Affordable Care Act (ACA, better known as Obamacare) has been an explosion in Medicaid enrollment.  About 12 million people have signed up for Medicaid under the program. Some observers believe that the Medicaid-expansion provisions of the ACA were a stealth effort to lay the groundwork for a one-payer system.

A revealing study by the Henry J. Kaiser Foundation  notes that  “policy changes introduced by the Affordable Care Act (ACA) have been driving Medicaid enrollment and spending growth…Medicaid enrollment and spending increased substantially in FY 2015, the first full year of implementation of the major ACA coverage expansions. Across all 50 states and DC, Medicaid enrollment increased on average by 13.8 percent in FY 2015, largely due to the ACA coverage expansions.”

Those states that accepted Medicaid expansion under the ACA experienced Medicaid growth far in excess of non-expansion states. The Kaiser study found that “Expansion states reported Medicaid enrollment and total spending growth nearly three times the rate of non-expansion states. A total of 29 states were implementing the ACA Medicaid expansion in FY 2015, up from 26 states in the previous year (FY 2015 additions include: New Hampshire, Pennsylvania and Indiana.)

“Across the 29 expansion states in FY 2015, enrollment increased on average by 18.0 percent and total spending increased by 17.7 percent; both enrollment and spending growth were driven by increases in enrollment among adults qualifying under the new expansion group. Of the 29 states expanding Medicaid in FY 2015, more than half (17 states) noted that enrollment initially increased faster than expected.”

“ Over two-thirds of expansion states reported that per member per month costs for the expansion population were at or below projections.  Across the 22 states not implementing the Medicaid expansion in FY 2015, enrollment and total spending growth was 5.1 percent and 6.1 percent (respectively), much slower growth compared to the expansion states. Increased enrollment among previously eligible parents and children was the primary reason cited for enrollment growth in non-expansion states.”

Obamacarefacts.com otes that “ObamaCare’s Medicaid Expansion Could Insure 21.3 Million Americans in the Next Decade. ObamaCare Medicaid Expansion is one of the biggest milestones in health care reform. “
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A Heritage review  found that the increased Medicaid enrollment under Obamacare has been accompanied by declining enrollment  in employer plans.

A Washington Examiner  review emphasizes that “There are 393 appearances of the word ‘Medicaid’ in the legislative text of Obamacare. The expansion of Medicaid itself is authorized in Title II, Subtitle A of Obamacare — a section called, ‘Improved Access to Medicaid.’ The Medicaid expansion is one of the main two ways through which Obamacare expands insurance coverage. By 2025, the Congressional Budget Office projects that Obamacare will add 14 million people to Medicaid. The Medicaid expansion will account for $824 billion (or slightly more than half) of Obamacare spending over the next decade, according to the CBO.

“It’s also worth noting that Medicaid is the one aspect of Obamacare that both left and right agree is explicitly a single-payer system. The logical implication of Kasich’s position of boasting about rejecting setting up a state-based exchange while expanding Medicaid is that Obamacare would have been better if it simply expanded single-payer healthcare in the U.S. instead of monkeying around with regulated exchanges that featured private insurers.”

Jeff Reynolds, writing in Freedomworks states that  “the expansion of Medicaid under Obamacare has come with all sorts of surprises and unintended (or perhaps intended) consequences. Medicaid expansion creates a two-tier medical delivery system that forces all but the most well-off into a single-payer system. Indeed, Obamacare’s similarities to Great Britain’s NHS are becoming more apparent. Another way this is being accomplished: the removal of asset limits for Medicaid qualification.

“In addition to the huge cost to the taxpayers, there is much to worry about in expanding Medicaid, particularly in the quality of care, notes Reynolds. “There is also strong evidence Medicaid provides substandard care. The Manhattan Institute’s Avik Roy wrote in 2012, ‘Medicaid patients were almost twice as likely to die as those with private insurance; their hospital stays were 42 percent longer and cost 26 percent more.’

“Many doctors refuse to accept Medicaid patients because payments are low. John Goodman of the National Center for Policy Analysis told Fox News, ‘One woman in Boston who was in Medicaid said she had to go through a list of 20 doctors before she found one who would see her.’ He adds, ‘I asked if she was going through the Yellow Pages,’ and she said, ‘No, I’m going through the list of doctors Medicaid gave me.”

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Medicaid patients encounter difficulties getting appointments

Disturbing information continues to build concerning the growing difficulty of individuals covered under the affordable care act as well as those under Medicaid in finding physicians who will treat them.

According to Healthline News, “many of the newly insured will have trouble finding a doctor. Those who do may have difficulty getting quick appointments. Many have gained or will gain coverage under the expansion of Medicaid. …A big problem, even for those who do live in Medicaid expansion states, is that there are not enough primary care physicians to treat people on the government insurance plan. This was a problem even before the expansion.” Healthline News reports that those not able to obtain primary care frequently end up in emergency rooms.

Part of the reason is that, this year, primary care doctors are receiving lesser reimbursement.

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To address the problem, which can greatly increase costs to states and local governments, which in many cases are responsible for the emergency room expenses incurred at public hospitals, “Fifteen states indicated that they will continue the primary care fee increase in 2015, at least in part” according to a Kaiser Family Foundation study.

Adding to the difficulties faced by Obamacare enrollees, a CNN Money study  finds that “Deductibles, co-payments, and drug payments are higher under the average Obamacare silver-level plans — the most popular — than employer policies.”

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Will Obamacare Survive 2015?

Supporters of the Affordable Care Act, better known as Obamacare, may find 2015 troublesome.

The law may be increasingly criticized by those with rejected claims. Increasingly, reports from medical billers interviewed by the New York Analysis report that rejections of claims for coverage are being denied with great frequency. Further, many are finding that the rates are not as “affordable” as the title of the legislation suggests.

Much of the financial burden is being placed on Medicaid. According to the Heritage Foundation,  “Medicaid enrollment increased by almost 6.1 million—principally as a result of Obamacare expanding eligibility to able-bodied, working-age adults.” The Political Insider website has noted that “Across the nation, states from California to Rhode Island, are facing new concerns that their Medicaid costs will rise as a result of the federal health care law.”

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On March 4, the U.S. Supreme Court will hear the case of King v. Burwell.  In this case, the plaintiffs contend that the law only permits subsidies on state-run exchanges, making the federal versions essentially illegal. About 5 million people are covered under federal exchanges.

Ultimately, Obamacare’s political fate will hinge on how effectively and affordably it provides coverage. Indications are the critics, who have expressed concern about its cost to the nation, and the possibility that financial concerns will cause rationing of service, may be proved correct.

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Senator Feinstein’s Incoherent Hearing

This week, on the same day that doctors were informing the wife and daughter of yet another victim of the 9/11 attack on New York’s World Trade Center that, as a possible result of exposure to toxins at the site he was expected to succumb to an untimely death within several days, Senator Diane Feinstein (D-CA) was conducting hearings and releasing a report jeopardizing both the efforts and the safety of those who are diligently working to prevent another such assault.

The time has come to question the monumental incoherence of those who weaken the nation by reducing key defense programs, withdrawing American forces from hotspots, or handcuffing those who seek to gain the information needed to prevent another terrorist assault.  Many of the same individuals in government and the media who scream and protest about nonlethal interrogation practices such as waterboarding have said far less in reaction to the beheadings, rapes, and wholescale  murders committed by those who seek every opportunity to kill as many innocent Americans as they can.

Their so-called moral arguments are baseless.  There is general agreement that eliminating terrorist leaders, including traitorous U.S. citizens, by drone attacks are justified (and it is indeed appropriate.) But why then do they question nonlethal interrogation practices that do not cause any permanent harm? Are their sensibilities so delicate that they would prefer to chance another 9/11 rather than to authorize harsh questioning?

Any government official who would prefer to jeopardize innocent lives rather than permit harsh but non-injurious interrogation is unfit for office. The fact that Feinstein’s hearing is being accompanied by the release of the names of those involved further impairs the ability to keep Americans safe, and punishes those who are merely seeking to keep the U.S. secure. Intelligence officials and other absolutely refute Feinstein’s unsupported contention that these interrogations did not yield vital information.
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There is a foul stench coming from the timing of the Feinstein Senate hearings, suddenly scheduled as they were to coincide with the House questioning of Jonathon Gruber, an Obamacare architect who famously revealed that the passage of the Affordable Care Act legislation was linked to what he perceived to be the “stupidity” of the American people. The highly offensive history of Obamacare’s passage—with provisions hidden from the American citizenry and shielded from public discussion—is a continuing embarrassment both for the President and his party.  The House’s Gruber hearings add an exclamation point to that.  Feinstein’s sensationalist meeting concerning interrogation practices can easily be seen as a desperate means to divert attention.

And therein lays the ultimate problem: for far too long, too many elected officials, particularly those of the Obama regime, have put their party’s political aspirations, and their intense devotion to a hard left philosophy, far above the good of the nation.

The harm resulting from that is exacerbated by the absurd fantasy world of far too many in the media who fail to report or acknowledge the dire threats facing America, both from terrorism and from the increasing military power and aggressiveness of Russia, China, Iran and North Korea.