The impact of ObamaCare on doctors and patients, companies inside and outside the health sector, and American workers and taxpayers
Approaching ObamaCare With Humility
Washington can’t get out of Its own way on health care. Give states a chance.
President Obama spoke frequently of humility during last week’s prayer breakfast. Congressional Republicans could use a healthy measure of that virtue should the Supreme Court rule that ObamaCare subsidies are not available in the 37 states with federally-facilitated exchanges.
ObamaCare is the product of a yawning humility deficit. Its core conceit is that a group of very smart and ideologically like-minded people could reorganize the financing of a $3 trillion industry that touches the lives of 320 million Americans.
Its architects boast that more people have “selected a plan” this time around than during the program’s disastrous initial open season. They are quick to overlook the law’s wreckage – canceled policies, loss of employer-sponsored coverage, erroneous subsidies that will require people of modest means to repay the government with interest, and assorted other disruptions and deformations.
A law that is minutely prescriptive too often got its prescriptions horribly wrong. Its flaws will reach the point of absurdity should the Supreme Court rule that its attempt to subsidize health insurance made most health insurance subsidies illegal.
The case of King v. Burwell would be a simple one, but for its social and political implications. The Court is examining a defect in the law, one of many in what is perhaps the most poorly drafted statute in U.S. history. The provision in question provides that subsidized health insurance coverage is available only through an exchange “established by the state.”
The IRS effectively rewrote the law to allow subsidies to be paid as well through the 37 exchanges that were not “established by the state,” but by the federal government. In defending the agency, the Justice Department in essence argues that the IRS can change laws so that they conform to what Congress must surely have meant to write, rather than what they actually wrote.
The Court should instead base its ruling on the bedrock principle that only Congress has constitutional warrant to correct its own legislative blunders. If it does, health insurance subsidies will no longer be available to millions of people who live in states with federal exchanges, presenting 37 Governors with a stark choice between two unpalatable options: submit to ObamaCare’s flawed framework by establishing state exchanges or let their constituents forfeit subsidized coverage.
Democrats will pressure Governors to establish such exchanges while also pushing Congressional legislation to authorize the provision of subsidies through federal exchanges. Republicans are floating alternative proposals that would subsidize coverage for low-income people and those with pre-existing conditions, while stripping ObamaCare of mandates and relaxing some of its other requirements.
These proposals will meet with criticism, some of it justified. Getting the right subsidy in the right amount to the right person (or the right insurance company) on a monthly basis is tricky business. The Administration had 3-1/2 years from the law’s enactment to the launch of the exchanges to get it right. They didn’t. Erecting an alternative federally administered system in a matter of months would risk a similar fate.
Perhaps what is needed is not an alternative national system at all. ObamaCare’s serial pratfalls have led millions to question the federal government’s capacity to administer the law. A judicial smackdown five years after the law’s enactment will reinforce the view that Washington can’t get out of its own way on health care.
Republicans should embrace this sentiment and argue that health care is too important to be entrusted to the people who brought us ObamaCare. They should advocate that Governors be empowered to advance alternative ways of expanding coverage, springing them from ObamaCare’s take-it-or-leave-it trap.
Congressional Republicans could accomplish this by advancing a bill to provide capitated allotments to states that would be based on the amount of refundable tax credits that its residents received during 2014. To qualify for an allotment, a state would be required to develop a plan for providing affordable coverage to low-income residents and those with pre-existing conditions. Each state would decide how best to achieve these objectives, with the results subject to rigorous evaluation.
States that already have set up exchanges could keep them and those that have not could still establish them. But they also could instead choose to be freed from ObamaCare’s one-size-fits-all rigidities by opting to receive allotments. These allotments would provide the resources to launch innovative and effective alternatives to ObamaCare tailored to their state’s unique characteristics. If some states institute defective regimes, the damage would at least be quarantined and not induce national contagion.
Resisting the temptation to develop comprehensive national legislation will prove no easier for Republicans than it has been for Democrats. But if ObamaCare has taught us anything, it is that the good intentions behind sweeping legislation are often overcome by unintended consequences. The humility that might engender perhaps will make them think twice about devising a national regime of health insurance subsidies and instead give each state the opportunity to fashion programs best suited to their circumstances.
A nonpartisan entity of the federal government has found that the Affordable Care Act will cost the government less than expected. However, the reduction in the law’s price tag comes among findings that millions of Americans could lose their employer-provided health insurance.
The Congressional Budget Office came out with a report yesterday revising the costs and budgetary effects of the Affordable Care Act, also known as Obamacare.
“I’m sorry sir,” the polite Healthcare.gov customer-service agent said. “There’s nothing I can do. You’re either going to have to enroll in Medicaid or you’re going to have to pay the full health-insurance rate.”
“The rate you quoted earlier?” I asked. “That’s nearly 30 percent higher than my current insurance bill, I just can’t afford it.”
“You’ll have to pay the full rate, yes,” the agent replied.
“I don’t understand,” I explained. “I have plenty of money to pay you a reasonable rate, but I can’t afford to pay the same rate a millionaire would be asked to pay. Why can’t I just receive a partial subsidy? I’m willing to pay more than what Medicaid offers.”
“Sir, that’s just not how the system works.”
Right. That’s not how ObamaCare works; it doesn’t work at all.
WASHINGTON, D.C. — Healthcare costs and lack of money or low wages rank as the most important financial problems facing American families, each mentioned by 14% of U.S. adults. Fewer Americans than a year ago cite the high cost of living or unemployment, and the percentage naming oil or gas prices is down from 2012.
Gallup has been asking Americans about the most important financial problem facing their family in an open-ended format for the past 10 years. Healthcare this year has returned to the top of the list for the first time since early 2010, when the Affordable Care Act, or “Obamacare,” was signed into law. Still, Americans viewed it as an even bigger financial problem in 2007, when a range of 16% to 19% said it was most important.
Posted By Richard Pollock
H&R Block, the nation’s largest retail tax preparation company warns that the newly released Obamacare tax code, officially called the Affordable Care Act, is likely to confuse millions of taxpayers who try to tackle their tax returns for 2014.
“Now that the Affordable Care Act has made health care a tax issue, no one can understand it,” H&R Block flatly tells taxpayers in a video that resides on its dedicated Obamacare web site.
By RICARDO ALONSO-ZALDIVAR and JACK GILLUM
WASHINGTON (AP) — A little-known side to the government’s health insurance website is prompting renewed concerns about privacy, just as the White House is calling for stronger cybersecurity protections for consumers.
It works like this: When you apply for coverage on HealthCare.gov, dozens of data companies may be able to tell that you are on the site. Some can even glean details such as your age, income, ZIP code, whether you smoke or if you are pregnant.
WASHINGTON (AP) — Filing a federal tax return is about to get more complicated for millions of families because of President Barack Obama’s health law. But they shouldn’t expect much help from the Internal Revenue Service.
Got a question for the IRS? Good luck reaching someone by phone. The tax agency says only half of the 100 million people expected to call this year will be able to reach a person.
By Ben Casselman
On Friday, I posted this chart, showing that nearly all the job growth since the recession ended has been in full-time jobs. Part-time employment is pretty much flat.
I wasn’t trying to make a political point, but many readers saw one anyway. Specifically, they saw it as a refutation of a frequent Republican talking point: that the Affordable Care Act, or “Obamacare,” is killing full-time jobs because it requires employers to offer health insurance to their full-time (but not their part-time) workers.
”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?
Over the past year, the ranks of people working part-time jobs by choice — as opposed to business-driven factors — has grown by more than one million, the fastest pace in at least two decades.
The timing with ObamaCare’s first year of subsidies to buy health insurance is likely more than coincidental. While analysts on the left and right have sparred over whether businesses have shifted to part-time jobs to limit liability under ObamaCare, no one disputes that the law will lead more people to choose to work part-time. Any disagreement is over whether the law should get credit for making less work possible or blame for making work less financially rewarding.