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Obamacare Tag

Some patients in California are finding out that once they’ve managed to sign up for a health insurance plan through the state exchange, it still may be difficult to determine whether or not a doctor actually accepts their insurance plan. From the LA Times:
After overcoming website glitches and long waits to get Obamacare, some patients are now running into frustrating new roadblocks at the doctor's office. A month into the most sweeping changes to healthcare in half a century, people are having trouble finding doctors at all, getting faulty information on which ones are covered and receiving little help from insurers swamped by new business. Experts have warned for months that the logjam was inevitable. But the extent of the problems is taking by surprise many patients — and even doctors — as frustrations mount. Aliso Viejo resident Danielle Nelson said Anthem Blue Cross promised half a dozen times that her oncologists would be covered under her new policy. She was diagnosed last year with non-Hodgkin's lymphoma and discovered a suspicious lump near her jaw in early January. But when she went to her oncologist's office, she promptly encountered a bright orange sign saying that Covered California plans are not accepted. "I'm a complete fan of the Affordable Care Act, but now I can't sleep at night," Nelson said. "I can't imagine this is how President Obama wanted it to happen."
Nelson received a temporary extension from her new insurer through March 31 after numerous complaints to the company and public officials, but says she will look into other policies before the close of open enrollment, according to the LA Times.

This all was predicted. Obamacare subsidies decrease the incentive to work harder because as one's income increases, the subsidies vanish. It's what we call the implicit marginal rate which takes into account not only tax marginal rates, but also loss of government benefits. In the key 30-50,000 range, the implicit marginal rate has exceeded 100% even before Obamacare (see Featured Image above) -- meaning that it is economically irrational to earn an extra dollar because you will lose more than one dollar through taxes and loss of benefits. Obamacare makes that problem even worse because of the high cost of Obamacare health insurance which depends on subsidies to render it even somewhat "affordable." Lose those subsidies and the cost of mandatory health insurance becomes onerous. The CBO is predicting a loss of 1-2% of employee hours because workers choose not to lose the subsidies, as reported by Reuters (h/t Bryan Preston)(full report embedded at bottom of post):
A historically high number of people will be locked out of the workforce by 2021, according to a report by the Congressional Budget Office released Tuesday. President Barack Obama's signature health-care law will contribute to this phenomenon, the CBO said, citing new estimates that the Affordable Care Act will cause a larger than-expected reduction in working hours—eliminating the equivalent of about 2.3 million workers in 2021 versus a previous estimate of an 800,000 decline. "CBO estimates that the ACA will reduce the total number of hours worked, on net, by about 1.5 to 2 percent during the period from 2017 to 2024, almost entirely because workers will choose to supply less labor—given the new taxes and other incentives they will face and the financial benefits some will receive," said the report.
The CBO Report states (in Appendix C):

Many have addressed the issue of uncertainty created by the implementation of Obamacare and noted the impact that may have on a variety of areas, including for the health insurance industry. On Thursday, Moody's Investors Service downgraded its outlook for health insurers, citing such uncertainty. From Moody’s: Moody's...

A handful of stories from across the web on Obama's NSA reform speech, Hollywood hypocrisy, Obamacare and more. Something the President's NSA speech today didn't address. From the Wall Street Journal: After Obama's NSA Speech, Tech Companies Wait and See After saying he plans to make a movie...

We've finally gotten some data on who has actually signed up for Obamacare on the exchanges. At first glance, it would look bad for the insurance companies. There are way fewer young people (only 24% are between the ages of 18 and 34) than the original stated goal. But it doesn't matter for the first year or two because the government has guaranteed to insurance companies that they'll be protected against loss. So the fact that enrollees may be older than expected---and therefore much more likely to make claims and reduce insurance companies' profit margins---is okay because government will take up the slack. And by "government" we mean, of course, the taxpayer. And by "taxpayer" we mean the wealthy taxpayer, although the middle class taxpayer also will pay more in many circumstances. Here's a list of the taxes that are supposed to fund Obamacare. Will they be adequate to cover the fact that nearly 80% of the exchanges' enrollees are getting subsidies so far? It depends on whether this was approximately the number anticipated, and also on whether the tax revenues actually collected will be as great as had been projected. The Byzantine nature of Obamacare is reflected in the fact that one of the largest items in the list of Obamacare funding tax sources is the following:
$60.1 Billion [projected amount of revenue]: Tax on Health Insurers: Annual tax on the industry imposed relative to health insurance premiums collected that year. Phases in gradually until 2018. Fully-imposed on firms with $50 million in profits.
So Obamacare giveth to the insurance companies and then it taketh away. And then it giveth back again, in a sort of shell game.

Who really cares about those much-maligned kulak individual health insurance market policy holders? Hell, depending upon how you count them, they could number 15 million, or maybe as low as 6 million. You know who else didn't care about ... oh, never mind. Just because you are not one of the much-maligned, don't think you can run from Obamacare, which stalks each of us like the Grim ... oh, never mind. Second wave of health-insurance disruption affects small businesses (h/t Charles Cooke):
When millions of health-insurance plans were canceled last fall, the Obama administration tried to be reassuring, saying the terminations affected only the small minority of Americans who bought individual policies. But according to industry analysts, insurers and state regulators, the disruption will be far greater, potentially affecting millions of people who receive insurance through small employers by the end of 2014. While some cancellation notices already have gone out, insurers say the bulk of the letters will be sent in October, shortly before the next open-enrollment period begins. The timing — right before the midterm elections — could be difficult for Democrats who are already fending off Republican attacks about the Affordable Care Act and its troubled rollout. Some of the small-business cancellations are occurring because the policies don’t meet the law’s basic coverage requirements. But many are related only indirectly to the law; insurers are trying to move customers to new plans designed to offset the financial and administrative risks associated with the health-care overhaul. As part of that, they are consolidating their plan offerings to maximize profits and streamline how they manage them....

Obamacare affective disorder...

An official from the Centers for Medicare and Medicaid Services who helped oversee the rollout of healthcare.gov is retiring, according to the NY Times.
The No. 2 official at the Centers for Medicare and Medicaid Services, who supervised the troubled rollout of President Obama’s health care law, is retiring, administration officials said Monday. The official, Michelle Snyder, is the agency’s chief operating officer, in charge of day-to-day activities and the allocation of resources, including budget and personnel. Technology experts who built the website for the federal insurance exchange, HealthCare.gov, reported to her. Ms. Snyder is the second administration official to depart since problems with the website frustrated millions of people trying to buy insurance and caused acute political embarrassment to Mr. Obama. The chief information officer at the Medicare agency, Tony Trenkle, stepped down in November to take a job in the private sector. Marilyn B. Tavenner, the administrator of the Medicare agency, said Ms. Snyder was retiring this week “after 41 years of outstanding public service.”
Snyder’s name came up in congressional hearings in October.

https://twitter.com/realmyiq2xu/status/417410251936104448 (Featured image source: YouTube)...

Obamacare is ending the year on a very low note. Two states, both deep blue in their politics, are unhappy with the quality of the websites designed for the healthcare insurance exchanges.  Shockingly, they have opted to take a very free market approach to the problem.
Massachusetts -- whose government was one of the staunchest supporters of ObamaCare, and whose health plan arguably was the model for the law -- is refusing to pay any more until a working website is delivered. A spokesman for the Massachusetts exchange told FoxNews.com that CGI's system is "far from where it needs to be" and the state will apply "nonstop pressure" to fix the problems. ...Vermont, too, is withholding $5.1 million to CGI over its failure to meet deadlines, according to a report in the Boston Globe. CGI, though, claims that neither state is fully cutting off its funding.

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.

This Christmas, Senate Minority Leader Mitch McConnell offers his own spin on the "Night Before Christmas" classic. Set to Nutcracker music, McConnell makes jabs in the reinvented tale at both President Obama and democrat opponent Alison Lundergan Grimes. Check it out for yourself: “Twas the night before Christmas, four years...

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.

That's the take away from today's press conference, which still is in progress as of this writing. So Democrats should run on it in 2014. https://twitter.com/ByronYork/status/414123765698945024 https://twitter.com/AceofSpadesHQ/status/414127598596149248 https://twitter.com/charliespiering/status/414127354651213824 https://twitter.com/RyanLizza/status/414127417658470401...