“Indiana’s Medicaid chief told lawmakers Thursday that the federal government has largely left states in the dark on implementing the federal health care overhaul because it hasn’t yet provided needed guidelines. Medicaid Director Pat Casanova told the Health Finance Commission that key parts of the overhaul take effect in 2014 — about 3 1/2 years away — but states will need several years to pass their own rules and implement the overhaul.”

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Medicare is an enormous, unfunded liability for the government.  Medicare reform was urgently needed before ObamaCare’s passage, and the law was supposed to have addressed those problems. But instead of improving the program, and the country’s fiscal outlook, ObamaCare used the same failed policy changes tried over the last 20 years.

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“The Congressional Budget Office estimates that the PPACA will add 16 million new individuals to Medicaid. And that almost certainly means many, many more emergency room visits. ObamaCare was sold as a way to ease America’s health care burdens. Instead, it looks more and more like its legacy will be to increase the strain on a broken system.”

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“This essay argues that the Patient Protection and Affordable Care Act exceeds Congress’s authority to regulate interstate commerce and its taxing power, and infringes on state prerogatives. The lawsuits that have been filed by states and individuals arguing these points raise serious legal issues, not the least of which is whether there are any constitutional limits remaining on government power. Because the new law is unprecedented—in both its regulatory scope and its expansion of federal authority—it is difficult to predict how courts will react. However, a holding that these measures were in fact constitutional would fundamentally alter the relationship of the federal government to the states and the people, as there would seem to be no constitutional limits on federal power.”

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Rules forcing insurers to cover certain procedures without any out-of-pocket costs doesn’t make them free as most reports claim, it just makes them pre-paid. “Each use of ‘free’ and ‘no cost’ in these excerpts is false, even within its original context. There’s no such thing as a free lunch. Everything has a cost. No government can change that. Mandating that insurers cover certain services does not magically make them free. Consumers still pay, just in the form of higher health insurance premiums and lower wages.”

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ObamaCare’s new preventive services guidelines creates huge incentives for medical lobbyists to get their prefered treatments designated as preventive care. “When government agencies are making non-scientific value judgments–e.g., are these studies reliable enough to merit an A or B recommendation? what should be the thresholds for an A or B recommendation? will the benefits of mandating this coverage outweigh the costs?–politics does even better. Witness Sen. Barbara Mikulski (D-Md) overruling a USPSTF recommendation when she ‘inserted an amendment in the [new] health-care law to explicitly cover regular mammograms for women between 40 and 50.'”

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ObamaCare lets the government define what is or isn’t “preventive care” and thus provided cost-free by insurers. While rulings were previously merely advisory, their increased role will subject them to substantial lobbying pressures, which could lead to politicized decision-making. “Under the new health care overhaul law, insurers will be required to pay fully for services that get an ‘A’ or ‘B’ recommendation from the U.S. Preventive Services Task Force, a volunteer group made up of primary care and public health experts. [I]t puts the group in the crosshairs of lobbyists and disease advocates eager to see their top priorities – including routine screening for Alzheimer’s disease, domestic violence, diabetes or HIV – become covered services. ‘It’s a wide-open door for lobbying,’ says Robert Laszewski, a health insurance industry consultant.”

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ObamaCare includes new mandates which require all insurance companies to provide “free” preventive care, with no co-pays or deductibles. Of course, patients will still be paying for it, but the costs will instead be built into increased insurance premiums to pay for the new requirements. A government board will be deciding what does or does not qualify as preventive. “The rules stipulate that no co-payments can be charged for tests and screenings recommended by the United States Preventive Services Task Force, an independent panel of scientific experts. The rules apply to new health plans that begin coverage after Sept. 23 and to existing health plans that make significant changes after that date. The administration said the requirements could increase premiums by 1.5 percent, on average.”

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“I think what is interesting is how poorly the law stacks up against its proponents’ own criteria. The new law fails to control rising health-care costs or increasing health-insurance premiums. In fact, the legislation will actually increase U.S. health-care spending by $311 billion over ten years. Insurance premiums will roughly double over the next six years, roughly what was expected before the law passed. It doesn’t restructure programs in a way to improve quality… By 2019, there will still be 21 million uninsured Americans, and nearly half of those who do get coverage under this law are merely thrown into Medicaid. Many other touted reforms come with surprisingly high price tags. For example, sure you can now keep your children on you insurance plan through age 26, but it will cost them an average of $3,380 per year per child in higher premiums. Even if you believed completely in President Obama’s goals, it’s hard to see what there is to like about this law.”

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“Is the IRS capable of handling all of its new responsibilities under ObamaCare? Not according to the National Taxpayer Advocate. A new report from the IRS watchdog says that your friendly neighborhood tax collectors are insufficiently prepared to carry out their duties under the new health care law, and will therefore require additional funding not included in the bill.”

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