“This Essay argues that federal health care reform may induce employers to redesign their health plans to encourage employees who are likely to consume a greater-than-average amount of medical services to opt out of employer-provided coverage and instead acquire coverage on the individual market. Although largely overlooked in public policy debates, this prospect of employer dumping of high-risk employees raises serious concerns about the sustainability of health care reform more generally.”

“In the midst of the legislative debate over
the Patient Protection and Affordable Care Act
(PPACA), Speaker Pelosi famously said, “We have to
pass the bill so that you can find out what’s in it.”
Indeed, the 112
th
Congress must find out what is in the
law before irrevocable damage is done to our care
delivery system, private health insurance, and the
federal budget deficit. Oversight hearings should begin
immediately as the Obama Administration has abused
the traditional rulemaking process to limit public
comments from key stakeholders and the American
people. We recommend the following five areas for
oversight hearings in the 112
th
Congress.”

“My conversations lead me to believe that many people are expecting that the plans offered in the exchanges will be Medicare-like in many ways. I feel like many people think they will have choice of doctor, choice of hospital, and the ability to dictate care. I’m not seeing how insurance companies will be able to offer such products at prices people can afford. As I talk to more and more people in the insurance industry, my thoughts seem confirmed. I may be wrong, but I think it’s worth addressing. Mistaken expectations have been, and continue to be, a real problem in health care reform.”

Since the subsidies for the uninsured don’t begin until 2014, ObamaCare creates high-risk pools to help the uninsured get coverage. This program is so poorly designed and ill-conceived that instead of insuring hundreds of thousands of people, as expected, only about 8,000 people have coverage in the program.

“A conservative group of healthcare analysts today welcomed the intention of the new House Republican majority to immediately pass a bill repealing President Obama’s health reform law. After that’s done, though, the analysts suggested the Republican leaders get to work on a more realistic strategy to destroy the president’s signature piece of legislature.”

“Until the next presidential election, the short-term tactical agenda for the new de facto majority in Congress remains mostly defund, delay, and debunk. Initiatives to reduce or cut off funding for implementation of the next round of ObamaCare need to be targeted narrowly to succeed… Trying to wind back the ObamaCare implementation clock so that it doesn’t get so dark so early is a more promising approach. Congressional appropriations riders could attach new conditions that must be met before proceeding further.”

“Right now we’re estimating the cost of the minimum benefit package that everyone will be required to have at $4,750 for individuals and $12,250 for families… That translates into a minimum health benefit of $2.28 an hour for full time workers (individual coverage) and $5.89 an hour (family coverage) for fulltime employees.”

“ObamaCare was not about fixing the insurance market. It was about seizing control of it. Thus it shouldn’t be surprising that a new analysis by the Congressional Research Service says that states can use ObamaCare to erect a de facto single-payer system by simply excluding from their exchanges every plan but a state-run ‘public’ plan. ‘There is no specific language in [the president’s health plan] that would prohibit an exchange from denying certification to every private plan that applies,’ the analysis finds.”

“Back when Secretary Sebelius was nominated for her current position, a colleague enthused that, ‘An insurance commissioner is a great choice for Secretary of HHS, because his or her direct contact with consumers provides unique insight into the challenges…..’ Unfortunately, Secretary Sebelius’ current direct contact with the Beltway political class and its ideological agenda obviously have far more significance than her previous direct contact with consumers, whose suffering under ObamaCare has only just begun.”

ObamaCare’s high-risk pools are a failure, with high costs leading to few enrollees. “It’s a centerpiece of President Barack Obama’s health care remake, a lifeline available right now to vulnerable people whose medical problems have made them uninsurable. But the Pre-Existing Condition Insurance Plan started this summer isn’t living up to expectations. Enrollment lags in many parts of the country. People who could benefit may not be able to afford the premiums. Some state officials who run their own ‘high-risk pools’ have pointed out potential problems.”