The Affordable Care Act is Coming Home to Roost

[B-Man]

 

Obamacare goes unprotected – No enrollment Plan B

 

It’s been reported often that enrolling enough young healthy people in Obamacare will be a critical part of the program in order to offset the costs of insuring the rest of enrolled Americans. And we’ve seen in recent weeks that the administration (and advocacy groups) are certainly targeting the “young invincibles” crowd.

 

Overall numbers of signups have been improving, but the numbers still have fallen far short of original targets. And that’s had some asking what the backup plan might be if enough young healthy people don’t enroll.

Byron York at the Washington Examiner reports:

Now, it’s becoming apparent why Obamacare advocates are putting on such a confident face: They have no backup plan if their national

health care

scheme fails.

 

 

Last Wednesday Jason Furman, chairman of the Council of Economic Advisers, joined the Washington think tank Third Way for a wide-ranging discussion. Near the end of the session, Third Way scholar Bill Schneider brought up Obamacare. “Does the administration have any kind of backup plan — if not enough young healthy people sign up for the Affordable Care Act, what’s going to happen?” Schneider asked. Noting that he teaches college classes, and his students don’t seem particularly well-informed about Obamacare, Schneider continued, “What are you going to do if they don’t sign up in large numbers? The numbers don’t look that good for young healthy people.”

 

Thurman’s[sic] response was not particularly encouraging for the administration. “We actually don’t have a great demographic breakdown,” he said, “but what we do know is that there was a big increase in enrollment in November relative to October, and we’ve seen increasing demand in December, although we don’t have the final numbers and we don’t have the demographic breakdown.”

 

Furman went on to explain that social media marketing will be an important part of the administration’s push to encourage young healthy people to enroll in the program. He also mentioned the importance of the advertising that insurance companies are doing.

 

But when pressed further about whether or not there was any sort of backup plan, Furman didn’t quite offer any Plan B in response, according to the Washington Examiner.

Schneider was still curious. “But you have no particular backup plan?”

 

“There’s a Plan A,” Furman answered. “Which is to enroll as many young healthy people as you possibly can.”

 

I could have put the same article under the "what if Obama can't lead" thread.

 

Because they cannot.

 

.

[keepthefaith]

Maybe Santa Claus can save Obamacare! He can give everyone a present of health care on Christmas, and best of all - it'll be FREE!

After all, B. O. won reelection by impersonating Saint Nick. Or was that Kris Kringle, or maybe Father Christmas. Okay, it was Peter Pan.

 

I believe it was Robin Hood.

[IDBillzFan]

 

 

 

I could have put the same article under the "what if Obama can't lead" thread.

 

Because they cannot.

 

.

 

Watching this law schitt the bed would be like watching porn if it weren't for all the damage that will take place when it fails. A lot of people are going to suffer, and it's going to take years upon years to clean up the mess.

[Nanker]

Hooray! Today's the big day! December 23, 2013 a date that will live in infamy.

Sign up today if you haven't already to get some swell coverage from some really, really great good sorta okay Doctors of your Obama's choosing.

Remember, if you like your plan, you can can't keep your plan unless it meets with Obama's approval.

And, if you like your doctor, well marry him/her and maybe, just maybe you'll be able to see them professionally speaking that is.

 

Meanwhile, B.O. is commiserating with his wife in Hawaii over the deeply sad events of the last 24 hours.

Michelle's brother's Oregon State Beavers lost to Akron. By their countenance this was a more profound loss than that of Nelson Mandela.

[B-Man]

CNN Poll: Health care law support drops to all-time low.

 

 

 

 

THE HILL: Manchin: Dems feeling ‘weight’ of O-Care.

 

 

 

 

 

 

 

 

[Nanker]

BREAKING NEWS!!!!!!!

 

Administration Extends Deadline for Obamacare Sign-Up THROUGH Christmas Eve

 

Over the weekend, government officials and outside IT contractors working on the online marketplace’s computer system made a software change that automatically gives people a Jan. 1 start date for their new coverage as long as they enroll by 11:59 p.m. on Christmas Eve.

 

Oh, how blessed are we to live in a country headed by such magnanimous leaders who are kindly allowing EVERY SINGLE AMERICAN an additional 24 hours to sign up for "health care coverage"

[DC Tom]

BREAKING NEWS!!!!!!!

 

Administration Extends Deadline for Obamacare Sign-Up THROUGH Christmas Eve

 

Over the weekend, government officials and outside IT contractors working on the online marketplace’s computer system made a software change that automatically gives people a Jan. 1 start date for their new coverage as long as they enroll by 11:59 p.m. on Christmas Eve.

 

Oh, how blessed are we to live in a country headed by such magnanimous leaders who are kindly allowing EVERY SINGLE AMERICAN an additional 24 hours to sign up for "health care coverage"

 

Thank you, Santa Claus!

[Azalin]

 

 

Thank you, Santa Claus!

sure, give a fat old white man the credit....

[Koko78]

Thank you, Santa Claus!

 

[Azalin]

 

 

okay, that's better.

[Keukasmallies]

Twas the night before the night before Christmas;

And all through the house, 'rents were scrambling to get hold of the mouse.

Mama in her kerchief, and I in my hat were clicking on links as fast as could be;

In hopes of insurance for the family and me.

 

On Aetna, on Blue Cross, on Magna and Pru fly swiftly to the website true;

We'll sign up and pay up and relax with a sigh, we'll never believe POTUS would lie.

 

 

….I'm outta' gas.

[OCinBuffalo]

Twas the night before the night before Christmas;

And all through the house, 'rents were scrambling to get hold of the mouse.

Mama in her kerchief, and I in my hat were clicking on links as fast as could be;

In hopes of insurance for the family and me.

 

On Aetna, on Blue Cross, on Magna and Pru fly swiftly to the website true;

We'll sign up and pay up and relax with a sigh, we'll never believe POTUS would lie.

 

 

….I'm outta' gas.

Bah! I was gonna do this!

 

I was sure that somebody was on task with the "24 hour Christmas Eve reprieve" part of this story.

 

Thus, I was thinking about my Christmas Eve carol. I will try to help out....

 

The young adults were nestled all snug in their beds,

Thinking "I'll just pay the fine, that'll F with their heads".

 

When out of DC there arose such a clatter,

I jumped on PPP to see some new chatter.

Away to this nut gallery, I flew like a flash,

clicked open this thread, to see the new bash.

 

The moon on the breast of the new-fallen snow? Wait...why the F don't I remember this part...it has breasts in it! Ok, I'll start again.

 

The moon is almost full and it's hanging quite low,

Tomorrow brings new ways for Obamacare to blow.

When what to our laughing eyes should appear?

But, DC_Tom(buck naked with a flashlight), yelling "Wait, what is happening here?!"

 

Tom's level of annoyance is now very thick,

"Which one of these agencies is?....ah, to hell with it, they can all suck a d_ck!"

Nanker has posted another change that is lame,

Funny how this "law of the land" is never the same.

 

"Now B-Man, now LABillz, now Keepthefaith and Koko?"

"Crush birdog, crush TPS, crush B-large and Gator!"

"Nail all Obamcare nonsense to the top of this "wall",

Now dash away, dash away, dash away all!"

 

 

This is fun, but I gotta get to bed....so I gotta dash away too.

Edited December 25, 2013 by OCinBuffalo

[Keukasmallies]

OC, I bow to your finish.

[3rdnlng]

OC, I bow to your finish.

 

Yes, and without one single emoticon.

[B-Man]

WHAT IF WE OFFERED SOCIALISM AND NOBODY SIGNED UP?

Despite well-functioning state exchange, New Mexico has enrolled . . . just 291 people.

 

“The NM HIX did everything right to sell Obamacare. The people are not buying.”

 

 

 

 

 

 

Destroying healthcare, one form at a time

 

The Washington Post article below documents one doctor’s experience with federally mandated electronic health care records.

The story is familiar, as I’ve heard it myself from doctors. Doctors always had to spend time filling out insurance forms, but now it is so much worse. To comply with federal Medicaid and Medicare regulations (plus new Obamacare regs) not only means having the staff to comply (hence, doctors moving to larger practice groups or hospital-affiliated groups), but also more and more time spent trying to comply with electronic medical records requirements.

 

Read the full tale below. It’s how we are destroying medicine one form at a time. Here’s the punch line:

When I get back to the office, I turn on the computer to write a progress note in Mr. Edgars’s electronic health record, or EHR. In addition to recording the details of our visit, I must try to meet the new federal criteria for “meaningful use,” [

explanation here

] criteria that have been adopted by my office with threats that I won’t get paid for my work if I don’t….

I spent more time checking boxes than talking to patients and their families.

I could see twice as many patients if I could write their notes at the bedside while visiting with them. I would happily do this on paper or using an EHR that created a logical note within the same amount of time. But that is not an option.

 

(more…)

[Nanker]

It'll be so great once the IRS hands over their financial data to the NSA to be combined with the HSS medical data and the NSA's own phone/Internet/email/TV viewing data so they'll be able to compile a realistic picture of America and Americans. I'm certain someone, somewhere will benefit greatly from that massive compilation. Meanwhile, millions and millions of Americans are being reduced to plantation slaves by an ever increasingly despotic federal government that requires its people to do its bidding or suffer the consequences. Of course, they suffer the consequences regardless, irrespective of their protestations, or their toeing of the master's line.

[B-Man]

Obama has begun repealing Obamacare

 

Obamacare as written is already gone, dismantled by its namesake. Obamacare itself has not, strictly speaking, collapsed of its own weight. Rather, it has been changed from its original, unworkable form first by Chief Justice John Roberts and then by the president into some new, unworkable mishmash. Obamacare per se is already gone. The question remains whether the law in some form will remain or whether the 2016 contest will be about what sort of plan replaces Obamacare. The latter is the odds-on favorite.

 

David Brooks on “Meet the Press” yesterday predicted (correctly, in my view) further undoing of the law in 2014: “The American people don’t like mandates anymore. We’re a much more individualistic culture. And every moment when the administration has been faced with either mandating something or surrendering on this bill, they’ve surrendered each time. They’ve weakened each individual mandate all the way along. So you have to expect they’ll weaken and surrender on the mandate down the line.” That is in effect leaving only the shell of Obamacare still in place, a kind of face-saver for the lame-duck president.

 

 

 

http://www.washingtonpost.com/blogs/right-turn/wp/2013/12/23/obama-has-begun-repealing-obamacare/

 

 

 

 

 

 

What to Do When ObamaCare Unravels

 

Health insurance should be individual, portable across jobs, states and providers, and lifelong and renewable.

 

 

The unraveling of the Affordable Care Act presents a historic opportunity for change. Its proponents call it "settled law," but as Prohibition taught us, not even a constitutional amendment is settled law—if it is dysfunctional enough, and if Americans can see a clear alternative.

 

This fall's website fiasco and policy cancellations are only the beginning. Next spring the individual mandate is likely to unravel when we see how sick the people are who signed up on exchanges, and if our government really is going to penalize voters for not buying health insurance. The employer mandate and "accountable care organizations" will take their turns in the news. There will be scandals. There will be fraud. This will go on for years.

 

 

 

http://online.wsj.com/news/articles/SB10001424052702304866904579265932490593594

[IDBillzFan]

New Obamacare taxes for 2014. Pay up, bitches.

 

WASHINGTON — Here comes the ObamaCare tax bill.

 

The cost of President Obama’s massive health-care law will hit Americans in 2014 as new taxes pile up on their insurance premiums and on their income-tax bills.

 

Most insurers aren’t advertising the ObamaCare taxes that are added on to premiums, opting instead to discretely pass them on to customers while quietly lobbying lawmakers for a break.

 

But one insurance company, Blue Cross Blue Shield of Alabama, laid bare the taxes on its bills with a separate line item for “Affordable Care Act Fees and Taxes.”

 

The new taxes on one customer’s bill added up to $23.14 a month, or $277.68 annually, according to Kaiser Health News. It boosted the monthly premium from $322.26 to $345.40 for that individual.

[B-Large]

http://www.washingtonpost.com/blogs/right-turn/wp/2013/12/23/obama-has-begun-repealing-obamacare/

 

 

 

 

 

 

What to Do When ObamaCare Unravels

 

Health insurance should be individual, portable across jobs, states and providers, and lifelong and renewable.

 

 

The unraveling of the Affordable Care Act presents a historic opportunity for change. Its proponents call it "settled law," but as Prohibition taught us, not even a constitutional amendment is settled law—if it is dysfunctional enough, and if Americans can see a clear alternative.

 

This fall's website fiasco and policy cancellations are only the beginning. Next spring the individual mandate is likely to unravel when we see how sick the people are who signed up on exchanges, and if our government really is going to penalize voters for not buying health insurance. The employer mandate and "accountable care organizations" will take their turns in the news. There will be scandals. There will be fraud. This will go on for years.

 

 

 

http://online.wsj.com/news/articles/SB10001424052702304866904579265932490593594

 

 

So many strange things inthat article, its hard to decided where to begin.

 

First, should be like Walmart, Southwest Airlines and Apple? When will be get our head around the concept that these comparisons, while offered as parralell and relevant are anyting but. If I don't want a $500 I-pad, I just don't buy it. I don't want to fly to see family, I don't book a ticket. I don't want to buy insurance to cover my health risk, and I get thyroid cancer and need sugery and radioactive iodine therapy, guess what, I still get it and everybody lese gets to pay for it. We're not a Nation that lets people just die int he streets now mater how popular that hyperbole is during policy discussion.. Also, I don't remember Walmart, Apple or SWAL offering life saving services that cost hundreds and thousands of dollars... it this basic premise that while we want to have competition in Healthcare, from facilties to providers, it will never behave alike a free market unless we go stricktly to a cash, pay as you go system- but sadly, 95% of Americans can do that, and we don't want to let people die. Healthcare is different, to pretend it is not in the basis for continuing expensive, inefficeint and conculved payment and delievry systems.

 

Degulate and take away State based insurance oversight and regulation? So now we want to give the Federal Government more power over healthcare, and replace the oversight enumerated to State Health/ Insurance depts? I like the idea of portability alot, but when you have naiton health plans, what difference does Aetna, UCH and Humana really do, what service to the provide, what Value do the create that a single payor would not? Its a payment mechanism, what reason is there to have a middle man that costs more? One payment source, a National Med Record system that all provider can access so we don't have to print out reams full of documents when a pateint gets referred to a specialist?

 

"People want to buy this insurance, and companies want to sell it"- really, I thought yougn healthy people won't buy what they don't need? How did that change? Under another GOP health reform law, do we really think all of the sudden young people will be jazzed up to do their duty, but that policy they don't need, and what us think it will be that much less expensive anyway? Premium will still be there, deductible will still be there... and what is considered "affordable and attractive" to young people?

[OCinBuffalo]

So many strange things inthat article, its hard to decided where to begin.

 

First, should be like Walmart, Southwest Airlines and Apple? When will be get our head around the concept that these comparisons, while offered as parralell and relevant are anyting but. If I don't want a $500 I-pad, I just don't buy it. I don't want to fly to see family, I don't book a ticket. I don't want to buy insurance to cover my health risk, and I get thyroid cancer and need sugery and radioactive iodine therapy, guess what, I still get it and everybody lese gets to pay for it. We're not a Nation that lets people just die int he streets now mater how popular that hyperbole is during policy discussion.. Also, I don't remember Walmart, Apple or SWAL offering life saving services that cost hundreds and thousands of dollars... it this basic premise that while we want to have competition in Healthcare, from facilties to providers, it will never behave alike a free market unless we go stricktly to a cash, pay as you go system- but sadly, 95% of Americans can do that, and we don't want to let people die. Healthcare is different, to pretend it is not in the basis for continuing expensive, inefficeint and conculved payment and delievry systems.

I want Walmart to be a TPA for catastrophic insurance, and offer to administer(manage the money) for risk pools that number in the 100ks. So, yeah, I want Walmart involved, and they sure as hell are relevant.

 

On the day-to-day stuff(doctor's visits, emergency room, scripts, etc.), I want pre-tax HSAs, run pretty much the same way 401ks are. I want cards issued that only work on machines that proviers are issued(see? I don't even make you pay for that). With....perhaps more regulation on what you can put your HSA money into. But, due to the smaller size of the average HSA account, this may not be necessary. So, we leave it unregulated for now, and see if we need to add some later.

 

You know what I've said above, and you know why it would work. Or, you don't understand health insurance very much.

 

Enough of these solutions from 1964. We have 0 need to run this as one big system. We can easily decentralize it(like we always do in my job) and have the states manage or regulate, their choice, the HSAs, while the Feds deal with the catastrophic. Big, one-size-fits-all, is precisely what the Feds do well, and that's exactly what we want for catastrophic. We also want to leverage Wal-mart's inherent economies of scale ability.

 

Meanwhile, as far as the truly needy/disabled the State/Feds can pay into the HSAs directly, but, since it's state money, the state can determine which doctors are allowed to be consulted, hospitals, etc. Everybody else is free to do as they please. This is as it should be: you don't want to pay your own way, you lose the freedom of choice. The people who are paying, should be the ones who are saying.

 

Employers can still attract employees by making payments to the HSA, AND, the HSA $ can be transferred to family members...no different than beneficiaries in any other form of insurance. If you don't use your $, you don't lose it, and you don't get taxed on it when you die.

 

This has the added benefit of killing the death tax permanently, because people will just load up their HSAs before they kick it....and that means...their family has a nice bit of security for their lives...and not money that can be blown on idiocy.

 

You want to deal with wealth inequality? Here's how you do it: putting cash into an HSA instantly creates wealth, and every single dollar counts.

 

Btw, every year of government service = the government double matches your HSA contribution. No exceptions.

 

This plan works, drives down cost, and holds every provider accountable by whom the are supposed to be held accountable: patients.

 

"The Big Insurance" companies are left to fight it out in the catastrophic market, and they can offer all sorts of plans, while being held to account by the Treasury Department(not the IRS). Finally, a small amount (variable %) of everyone's HSA is taken each quarter and put into a county, not state, WTF fund, which is used to cover overages when somebody gets their HSA drained by being unlucky. It's also used as a "get back on your feet" default(move 10k in there to start them out, but, if they leave the county, they lose that 10k = keeps the "poor" from coming to NY and welfare shopping) for people trying to rejoin the labor force(or human race, in terms of addicts). That quarterly % is decided by the county.

 

Thus, all bases are covered, and there's a built-in incentive for competition, and for those who are clue-deficient, to get one.

 

It's not difficult to construct similar/better/different parts of this that deal with the details or special circumstances, and ALL of those should be left to the county, not state, not Feds.

 

We can build systems for 100% of the people, without any "losers", provided that we realize that doing that means: decentralize, decentralize, decentralize....and throw the things that make sense being centralized(catastrophic) over the fence.

 

We can build all kinds of stuff....provided we remember one thing: it's not 1964, and, all of those programs represent "the worst way to do it".

Edited December 26, 2013 by OCinBuffalo