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Obamacare: bait and switch

Obamacare: bait and switch

The gist of the message is that, from the outset, the calculations used to sell Obamacare to the American public were slipshod and/or naive and/or mistaken and/or simplistic and/or outright lies (see more here).

And this is news to exactly whom?

Obamacare: One Blow After Another

The Obamacare that consumers will finally be able to sign up for next week is  a long way from the health plan President Barack Obama first pitched to the  nation.

Millions of low-income Americans won’t receive coverage. Many workers at  small businesses won’t get a choice of insurance plans right away. Large  employers won’t need to provide insurance for another year. Far more states than  expected won’t run their own insurance marketplaces. And a growing number of  workers won’t get to keep their employer-provided coverage.

That’s one of the reasons that many people are distrustful of large federal government programs in the first place.

Small pilot programs are a better way to experiment with things. Local and state programs are another way to experiment with things—and then keep, or expand, the ones that seem to work. Redesigning the health care insurance system of the entire US at one fell swoop is inherently risky, and the promises that this would constitute an improvement should always have been taken with a grain of salt—even by liberals (I know; dream on).

Actually, when Obama assured the American people that their health insurance premiums would be lowered by [emphasis mine] “up to $2,500 for a typical family per year” he was saying absolutely nothing on the face of it, although he was counting on his listeners to hear something and like what they heard.

But a statement such as his merely means that a “typical” family (whatever that is; a family of four? living in what state?) would face a ceiling of $2,500 for the amount its premiums might be lowered per year. He’d be technically correct if a single “typical” family had its premiums lowered $2,500, and all the other families of that type had theirs lowered by a dollar. Or even had them raised.

In other words, it was a meaningless statement.

What will actually happen is anyone’s guess, including the author of this Forbes piece critical of Obama. One reason is that there is no “typical” family, because (a) the present state-to-state variation among what families of the same size are paying is vast; and (b) since poorer families will be subsidized by less-poor ones, families of the same size will end up paying very different premiums depending on income. So even an average premium would tell us very little.

What’s more, Obamacare is supposed to be financed in part by the famous individual mandate. But the penalty for not enrolling is far less than the yearly premium would be for most people and families, and since a person or family can enroll in Obamacare without increased penalty as soon as he/she experiences a decline in health, many people will probably wait to enroll. How will that affect the premiums of the others? Let’s just say it’s unlikely to make them go down.

[Neo-neocon is a writer with degrees in law and family therapy, who blogs at neo-neocon.]

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Comments

Obama lies! Dog bites man! Wild bear sh*ts in the woods!

News at eleven!

It seems Unfair to hold Democrats accountable for a Law that they never even read. Who could have predicted a law written by Lobbyists and passed without review would lead to rising premiums and falling service levels?

/s

Millions of low-income Americans won’t receive coverage.

Many states, mostly red states, have decided not to extend benefits. That’s their choice.

    Bruce Hayden in reply to Zachriel. | September 25, 2013 at 11:39 am

    So, you were expecting these states to have committed to bankrupting themselves in order to protect Obama and the Dems in DC? Let me suggest instead that the legislators or governors in these states had not drunk sufficient Kool-Aid to bail out the Dems here.

    What you are apparently intentionally ignoring here with your attempt at diversion, is that the legislation was fundamentally flawed in multiple ways. It was essentially designed to operate with whips (penalties), instead of carrots (economic incentives), and those designing the legislation were not smart enough to out-think the rest of the country.

    At a decently high level, pre-existing conditions were banned in underwriting, which provided an incentive for everyone to wait until they needed major medical treatment to apply for coverage. This meant that the well wouldn’t be covering the sick by choice, and it would no longer really be insurance, but rather, pre-paid medical care. That of course meant that premiums were going to rise dramatically, unless the healthy, and, in particular, the young were enrolled. Thus, the mandates and penalties (ok, “taxes” according to the Supreme Court). The employer mandates and coverage requirements are, of course, forcing companies to shift from full time to part time workers. Which is one reason that we are still mired in a recession. Making things worse, age rating is greatly reduced, pushing much of the rate burden onto younger workers – at an age when their earnings are at the lowest point, as they enter the work force. Which, is, of course, an incentive to not work, or to work under the table. Enough of that already going on with young adults between their early twenties and mid thirties, and esp. the men, and this is going to make it worse. These are, btw, the demographic with the lowest health care utilization (and lowest insurance coverage rate), and were expected to pick up much of the cost of ObamaCare.

    Making things worse, the move towards HSAs and high deductible health insurance policies was slowed down, if not halted. One of the benefits of such plans is that it gave those enrolled in such an incentive to not use the formal health care system unless it was necessary. Instead, moving the other way, ignores the reality that the more things cost, the less they are demanded, and the less things cost, the more they are demanded, and if they are essentially free, then demand skyrockets. ObamaCare essentially pushes required high premiums for low deductible, low co-pay, high limits coverage, which is exactly the wrong way to be pushing coverage because it gives people either an incentive to not insure, or, if they are, to over-utilize. And, of course, the youngest and healthiest have the biggest incentive to not insure. The middle ground was essentially removed.

    So, the states were given the choice of either helping plug the financing gap by signing up to run their own exchanges, or let the federal government carry that burden, and fund it with their ability to print money. I would suggest that since the states cannot legally print money, the rational response was the latter, leaving the exchanges to the federal government to set up and run.

      Bruce Hayden: So, you were expecting these states to have committed to bankrupting themselves in order to protect Obama and the Dems in DC?

      The medicaid expansion is funded 100% for three years by the federal government, then slow decreases to 90% after that.

Given that we don’t have enough doctors to provide care for all those currently with coverage, does it really matter if we only add half or a quarter of those uncovered to the insurance rolls? They still won’t get seen.

We’d have done much better using the PPACA monies to fund medical education and increase residency slots. That way we’d have more doctors, and they’d be more willing to go into primary care since they wouldn’t have to figure out how to pay off quarter million dollar student loan bills.

    LibraryGryffon: We’d have done much better using the PPACA monies to fund medical education and increase residency slots.

    ObamaCare includes money to train new primary care doctors, and incentives for working in underserved communities. There will be a lag, though, while new doctors are trained.

      Henry Hawkins in reply to Zachriel. | September 25, 2013 at 2:01 pm

      Regarding Obamacare provisions, have any been altered, delayed, omitted, added, or otherwise changed since first passed? Any exemptions awarded and special cases identified? /rhetorical

      Only a fool looks to the ACA and believes it will be followed as passed. It is nonsense to say it will do this or that. you have no idea what will happen. Nobody does – that’s why people hate it. Advocates like you were assuring us on Obamacare last year – before the employer mandate was delayed, before congressional staff were exempted, etc., etc., none of which you had a clue about.

      Your predictions of how it will work were meaningless then and they are meaningless now.

        Henry Hawkins: Only a fool looks to the ACA and believes it will be followed as passed.

        As with any complex regulatory undertaking, there will be many changes made as the plan unfolds. That’s how it is supported to work.

          Henry Hawkins in reply to Zachriel. | September 25, 2013 at 3:24 pm

          “That’s how it is supported to work.”

          Obamacare implementation is unfolding normally, nothing but the usual problems, eh?

          We take measure of the evidence and find your assertion lacking, lol.

          Bruce Hayden in reply to Zachriel. | September 25, 2013 at 5:03 pm

          How about the simplest – repeal it?

          The general theory on the left seems to be that they were able to pass it in the middle of the night, with no Republican votes, using parliamentary tricks and subterfuges, and so we are stuck with the legislation, regardless of its merits. One of these constantly ratcheting up of government things.

          But, it is horrible legislation. It won’t work. It was based on wishful thinking economics, and cannot work. It runs counter to human nature. Plus, of course, it is filled with special interest legislation. Tweaking it around the edges is just putting lipstick on a pig.

          What the Dems seemingly consistently ignore is that they lost the House in 2010 precisely because the Dems in the House under Speaker Pelosi passed this legislation. The Reps’ mandate to repeal it is probably far more significant than any the Dems can cobble together (as the President tried to a couple days ago, asserting that his reelection, despite all the cheating that it took, was the Dems’ mandate to continue implementing ObamaCare).

          Bruce Hayden: How about the simplest – repeal it?

          Obama defeated the Republican who promised to repeal ObamaCare. There’s apparently insufficient political support for repeal.

          murkyv in reply to Zachriel. | September 25, 2013 at 9:37 pm

          there was a whole lot that the public didn’t know about with Obamacare during the last Election cycle.

          Just as planned.

          fer instance…

          Congress was not granted an exemption yet. Now they are

          The unions were still all for it. Not now.

          People were not having their hours cut. They are now.

          People were not yet getting letters from their insurance companies tripling their premium. They are getting those letters this year.

          To credit Obamas re-election with Obamacare is one of the Talking Points I see quite regularly the past few days.

          Do you think we are so stupid we don’t see a WH choreographed rebuttal going on?

          Oh yeah…..

          the public also didn’t know about all of the domestic NSA spying, the Benghazi lies about a video and the IRS targetting and disenfranchising TEA party and other conservative groups.

          And, don’t get me started on the tens of thopusands of fraudulent votes in Swing states where dozens of precincts counted more votes than voters and 100% of votes going to Barry

      Phillep Harding in reply to Zachriel. | September 25, 2013 at 4:21 pm

      On a personal front, if I lose my present insurance, I will be able to buy the drugs keeping my cancer at bay for one year, if I get a good price on all my possessions. I will not be employable without those drugs, and the fedgov has /never/ kept their word about /anything/ related to health care, so I will slowly, and in great pain, die of cancer, if I do not eat a gun muzzle.

      I will not express my opinion of Obamacare or Obama, the words would never make it through the filters.

        I’m very sorry for your health issues, Phillip, and I hope you won’t have any problems accessing the drugs you need to treat your condition.

        I’ve helped a few people find Patient Assistance Plans to help them to be able to afford their meds, and I can personally recommend the NeedyMeds.org website for helping you to find a PAP (patient assistance plan) if it does come to that. It is kind of a “one-stop shopping” site for various PAPs, not real slick-looking but it does the job. Two others recommended by a charity I’ve worked with are RxAssist.org and PatientAssistance.com. They’re prettier than NeedyMeds but I find NeedyMeds is better at finding a wider variety of programs for people to plug into. Some PAPs are government-funded, some run by pharmaceutical companies, some by other combinations of public and private funding.

        I hope you won’t end up needing them, but they’re good resources to keep in mind. I wish you the best.

Eastwood Ravine | September 25, 2013 at 1:05 pm

Let it burn.

If the Democrats thought Obamacare was going to be a good thing politically, they and their sycophantic allies in the press wouldn’t be describing defunding Obamacare under the headline of “Republicans want to shut down the government.” They own it, and they are going to pay the political price, eventually. They can’t escape it. It’s going into effect until a Republican Congress and President repeal/replace Obamacare, despite the best efforts of the House’s Republican caucus and a handful of conservative Senators.

That moment will not be coming for at least 3 years, so in the interim, let it burn.

Eastwood Ravine: wouldn’t be describing defunding Obamacare under the headline of “Republicans want to shut down the government.”

While most Republicans don’t want to shut down the government, many are willing to do so in order to defund ObamaCare.

Eastwood Ravine: {The Democrats} own it

Sure.

    nordic_prince in reply to Zachriel. | September 25, 2013 at 5:46 pm

    Uh, no – if the government shuts down, it’s because 0bama and the Democrat continue in their obdurate, petulant ways and refuse to act like grownups. “Not funding 0-care” is fundamentally distinct from “not funding the federal government,” but then again if you’re accustomed to getting all your propaganda from whitehouse.gov and the MSM, I guess I can see why you’d be confused.

      nordic_prince: if the government shuts down, it’s because 0bama and the Democrat continue in their obdurate, petulant ways and refuse to act like grownups.

      There are insufficient votes to repeal ObamaCare. It nonsense to pretend otherwise and pass budgets in a single chamber that have no chance of passage into law.

        Eastwood Ravine in reply to Zachriel. | September 25, 2013 at 8:08 pm

        What’s being discussed isn’t part of a budget, but a CR [Continuing Resolution]. The Republicans would be well in their right to pass a full budget in the House, funding what should and should not be funded, and go home. Let Harry Reid, his caucus, and Obama to stew over it, then come back and negotiate their half of the conference committee. At that point, funding Obamacare becomes a separate bill to get the budget passed.

        The House has every right to insist on a budget, not a CR, since they have produced, and passed, budgets because that’s where budgets are supposed to start. If the government shuts down, its on Harry Reid and the Democrats.

        Alas, the Republicans don’t have the balls to do this.

          Eastwood Ravine: The Republicans would be well in their right to pass a full budget in the House, funding what should and should not be funded, and go home.

          Simply passing the House doesn’t make law. They have to work with the Senate and the President to do that, and what they passed will never be enacted. It’s obvious grandstanding.

          Eastwood Ravine in reply to Eastwood Ravine. | September 25, 2013 at 9:01 pm

          I guess I’m going to fed the Troll again. It’s not grandstanding, that’s the House’s constitutional duty.

          You lose.

          They passed a bill that won’t be enacted. In order to keep the government running, they have to pass another bill, which they will. Hence, grandstanding.

        nordic_prince in reply to Zachriel. | September 25, 2013 at 8:37 pm

        Exercising the power of the purse is not “grandstanding.” The Founding Fathers intended that those who were tasked with representing the people should have ultimate control of the people’s money, hence all spending is to originate in the House.

        Zero and the Dems can go pound sand and pout as is their wont. They’ve created the cesspool that is Washington. If nothing gets accomplished, it’s because they don’t want anything accomplished.

It’s not going to be affordable. Like the TSA, it is an opportunity for the Feds to hire unskilled workers on the taxpayers’ dime. And, just like waiting to board airplanes, you’ll line you in long lines … to be “felt up” for the paperwork.

Also. There are people who are untreated now. Who have “pre-existing” conditions. And, when the bell goes off on October 1st, they’ll try to line up for care they’re unable to receive at this point in time.

Politicians are also getting nervous. Maybe, they smell their ways to re-election burning up? But, I expect postponements. Expecially for private individuals, who will be told they need to wait for October 1, 2015.

Obama is also doing everything possible to erase his name from the bill. So it goes by the acronym “ACA.” Or “affordable” care act.

Like the patriot act. Our government uses Orwellian language.

Also don’t forget the 13 terrorists were also using grenades.

“Look at me…Loooook at Meeeeeeeeeeeeee….Looky, y’all, at Meeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeee… Look, Look, Look, Looooooooook at MEEEEEEEEEEEEEEEEEEEEEEEE…!!”

Signed: Zachriel

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