“Sebelius began her remarks by stating that taxpayer funds will not be used to bail out CLASS in the event of insolvency. But a taxpayer bailout is a real possibility for several reasons. First, premiums may be set lower than the actuarially correct amount. This is because there isn’t a useful model for actuaries to determine premiums, especially given the uncertainties of enrollee make-up. Second, within the law’s provisions, if benefits paid out are larger than anticipated, then either premiums will have to increase or benefits will have to be cut. This is a move that would be vigorously opposed by interested parties. Beneficiaries with a vested interest in preserving their CLASS payment will likely lobby vigorously to spread the pain through broad-based tax increases.”

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“If waivers are necessary to keep 733 insurance plans in place now, think of what will be necessary in 2013, when the amount policies must cover in a year will be nearly three times that cost, or in 2014, when full-blown PPACA kicks in and insurers are prohibited from offering a policy without unlimited coverage. The waiver option will be gone: nothing in PPACA gives HHS the authority to waive the statutory ban on annual limits. At the same time, other parts of PPACA will require Americans to have more comprehensive insurance than what they have now. Ineluctably, the result will be to require Americans to purchase insurance packages far more comprehensive and far more costly than what HHS has already determined in 733 cases is too expensive to buy.”

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“First, ObamaCare’s restraints amount to nothing more than ratcheting down the price controls that traditional Medicare uses to pay health care providers. Structuring Medicare subsidies in this way — setting the prices that Medicare pays specific providers — makes it very difficult to lower those prices, because the system itself creates huge incentives for providers to organize and lobby to undo those restraints. As I explain more fully in this op-ed from September 2010, Medicare vouchers would change that lobbying game by reducing the incentives for provider groups to expend resources in the pursuit of higher Medicare spending. That gives the Ryan-Rivlin restraints a much better shot at surviving.”

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“For example, under reconciliation the Senate Budget Committee could instruct the Senate Finance Committee to reduce mandatory spending on insurance subsidies and Medicaid expansion. These two items make up more than 90% of spending in ObamaCare. All the changes from all the committees are then bundled into one measure and voted upon. Because reconciliation is protected by the rules of the budget process, it doesn’t take 60 votes to bring it up and it requires only a simple majority to pass.”

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“Bending the cost curve is not a matter of simply paying less for a service. What’s needed is real and continuous productivity improvement in the health sector. Doctors, hospitals, nursing homes, labs, clinics and others finding better ways to deliver higher quality care at less cost. Because if productivity in the health sector does not rise, then payment-rate reductions will simply drive willing suppliers of services out of the marketplace.”

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“Virginia Attorney General Ken Cuccinelli petitioned the Supreme Court to take the case immediately, calling resolution of the overhaul’s constitutionality ‘a matter of imperative public importance.’ Separately, 28 Republican governors wrote to President Barack Obama, asking the administration to back an expedited review. The governors said that would ‘help prevent the states and the private sector from undertaking potentially unnecessary measures and expenses’ should the act be struck down.”

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“I will discuss why the Affordable Care Act is much more likely to increase the deficit than
reduce it; explain how the mandates, taxes, and penalties that it imposes on insurers and employers will
increase health care costs and decrease employment; and conclude by exploring the negative effects of
regulatory uncertainty at a time when companies are ‘sitting’ on trillions of dollars in cash that could
be used for job creation.”

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“The Society for Human Resource Management conducted the poll in late December, before a federal judge struck the law down and the House voted for repeal. At the time, 48 percent of respondents said they were waiting for more regulatory guidance on specific provisions, while 13 percent said they were hoping for full repeal.”

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“So, even though states can’t afford their current Medicaid obligations, ObamaCare forced an extension of existing eligibility standards until 2014. Arizona is especially affected because it has some of the most generous Medicaid eligibility standards in the country. Rather than allow states like Arizona to cut back to the level of other states, ObamaCare freezes in existing disparities. Beginning in June 2011, Arizona’s share of its Medicaid program will increase by $700 million. The annual cost of this mandate is almost $1 billion.”

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“In response to public opposition to enactment of the Patient Protection and Affordable Care Act (PPACA), President Obama assured Americans that if they were happy with their current health insurance, nothing in the PPACA would force them to change their coverage. This promise has been broken. Not only does the PPACA itself require changes in existing coverage, but regulations issued by the Administration further undercut the ability of Americans to continue with their current insurance plans. The rules are arbitrary and confusing.”

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