Bruce Bialosky

Deluged with catastrophes, court challenges and criticism, Obamacare (ACA) has had a controversial life to date. Yet it is ready to enter a completely new phase where the implementation gets shifted to the Internal Revenue Service – America’s favorite three words. If you liked the health care plan up to now, you ain’t seen nothing yet.

Services to taxpayers are likely to drop to their worst levels since 2001, when the Internal Revenue Service first started measuring its performance, the agency’s taxpayer advocate said in her annual report released on Wednesday.

Five years of budget-cutting have “brought about a devastating erosion of taxpayer service, harming taxpayers individually and collectively,” wrote Nina E. Olson, who leads the Taxpayer Advocate Service, an independent office within the I.R.S.

In the next few days, consumers who enrolled in qualified health plans through the marketplaces in 2014 will begin receiving IRS form 1095-As from the marketplaces, be they the federally facilitated marketplaces (FFMs) or state-operated marketplaces. The form 1095-A is the form that provides individuals who have enrolled in qualified health plans through the marketplaces the information they need to fill out form 8962, which in turn is the form enrollees will need to reconcile the advance premium tax credits (APTC) they received in 2014 with the premium tax credits they were actually entitled to. The marketplace also reports the information on the 1095-A to the IRS.

Mere days into a Republican Congress, Democrats are making charges of ideological bias when it comes to the majority’s handling of the Congressional Budget Office. A group of leading Senate Democrats wrote a letter to House Speaker John Boehner specifically noting that “a CBO director should not be required to revise the score of the Affordable Care Act in order to please partisan interests.” It’s an ironic charge, given that it’s far from partisan to question why the CBO failed to perform analyses that could have predicted the collapse of an $86 billion Obamacare program — exactly what happened under its current director, Doug Elmendorf.

New York Times correspondent Abby Goodnough asks if the latest legal challenges to ObamaCare are signaling a divide within the party or are Republicans still recovering from getting burned when the ACA went to the Supreme Court last time?”
About 5 million middle-income people in 36 states currently are receiving subsidies for health insurance through the federal exchanges. Since 87 percent of them are receiving subsidies to purchase coverage, many likely would no longer be able to afford coverage.
Ms. Goodenough reports that after the health overhaul law was passed in 2010, Republicans on both the state and federal level spoke with one voice flatly rejecting ObamaCare. However, in the years following ObamaCare’s passage while the majority of governor’s still remain critical of the law, nine governors have expanded their Medicaid programs and four more governors are considering Medicaid expansion this year at the urging of hospitals and business groups.
In the past months, a number of conservative groups and political leaders have filed Amicus briefs in the King vs. Burwell challenge that will be heard by the Supreme Court on March 4. As a result, Ms. Goodenough reports that new attention is being drawn to the divisions within the Republican Party over the law. . Almost two dozen briefs were filed on behalf of the plaintiffs in the King case, but she says “shockingly few state officials” signed on.
One of the few exceptions was the Amicus brief filed by the Galen Institute which had 19 Republican state legislators in Tennessee and two in Ohio join. Other notable briefs include one filed by six Republican state attorneys general- in Alabama, Georgia, Nebraska, Oklahoma, South Carolina and West Virginia. Divides in the party can be seen within states like Florida where Senator Marco Rubio who signed a brief with 14 members of Congress, but Florida’s Republican Attorney General, Pam Bondi, did not join in the States brief.

On Sunday evening, CBS’ 60 Minutes did a feature story on Steven Brill’s new book, America’s Bitter Pill, in which Brill complains that Obamacare didn’t do enough to tackle the exorbitantly high price of U.S. hospital care. “Obamacare does zero to change any of that,” says Brill. That’s not exactly right. What Brill—and CBS—don’t tell you—is that Obamacare is driving hospitals to charge you more than they already do.

The U.S. hospital industry is crony capitalism at its finest

The following is a script of “Obamacare” which aired on Jan. 11, 2015. Lesley Stahl is the correspondent. Rich Bonin, producer.

This month marks one year since health insurance coverage under the Affordable Care Act began, and from the president’s point of view: so far, so good. More than 10 million Americans who didn’t have health insurance before have signed up. But congressional Republicans are gunning for Obamacare. Even if they can’t outright repeal it, they want an overhaul.

By Kimberly Leonard
Grace Brewer says she never thought she would be without health insurance at this stage of her life. “I’m a casualty of Obamacare,” says Brewer, 60, a self-employed chiropractor in the Kansas City, Kansas, area.

She wanted to keep the catastrophic health insurance plan she once had, which she says fit her needs. But under the Affordable Care Act, the government’s health care reform law, the plan was discontinued because it did not comply with the law’s requirements, and her bills doubled to more than $400 a month. “I wanted a minimal plan and I’m not allowed to have it,” she says. “That seems like an encroachment on my freedom.”

The complicated process of signing up for Obamacare is now being matched by IRS instructions to help Americans figure out how much in healthcare taxes they owe Uncle Sam.

The agency has issued 21 pages of instructions, complete with links to at least three long forms and nine tip sheets.

It is geared to those who have Obamacare or who owe a fine, dubbed “shared responsibility payment,” for refusing to get health insurance. The IRS warned that everybody must have health insurance or pay the tax.

”Safer Cars Lead to Drop in Fatalities” trumpets a recent Wall Street Journal headline. Not to be a curmudgeon, but whether this is good news or bad news depends on what it cost to achieve this reduction in mortality. No one disputes that saving lives is a very good thing, but even the richest nation in the world lacks infinite resources. We will never lack opportunities to save lives. But since there are more and less cost-effective ways of achieving this objective, we are best served by policies that move us in the direction of saving lives at the least cost. Auto safety regulation and Obamacare are simply the latest illustrations of where we may have focused far too much on the benefits being achieved and much too little attention on the cost side of the ledger.

Is Auto Safety Regulation Cost-effective?