Archive for the ‘Obamacare’ Tag

Death Spiral   Leave a comment

Has anyone noticed that Obamacare appears to be failing?

I know! Absolutely no one could have seen that coming and so nobody predicted it. Right?

Image result for image of obamacare failureInsurance companies are dropping out of the ACA’s exchanges. Pretty much weekly, Insurers are announcing that they are trimming or eliminating their Obamacare coverage in more and more states. Alaska is one of those. The companies explain that healthy individuals are not buying insurance under Obamacare as expected, thus triggering a corporate death spiral.

If you have a memory, and I do, you remember that John Robert’s opinion for the Supreme Court last year was supposedly meant to save the ACA from a death spiral by ruling that the individual mandate applies in every state, regardless of whether it is for a state exchange or the federal exchange. So what happened?

In the sausage factory that created the ACA, there were a modest number of exemptions allowed, one of which is a huge backdoor.

 

Fast-forward to today, just a little over one year later.  Insurers are announcing on practically a weekly basis that they are trimming or even eliminating their Obamacare coverage in more and more states.  They give as the reason that healthy individuals are not buying insurance under Obamacare as expected, thus triggering a death spiral.  Wait!  What?  Didn’t the Supreme Court protect Obamacare against a death spiral by deciding, as the president argued, that the individual mandate applies in every state, regardless of whether it has a state exchange or the federal exchange?  What is happening?

Image result for image of obamacare failureIn the sausage factory that produced the ACA several categories were exempted from the individual mandate and one category is a huge escape hatch: “any applicable individual who for any month is determined by the Secretary of Health and Human Services … to have suffered a hardship with respect to capability to obtain coverage under a qualified health plan.”  It’s a “hardship” exemption.

The Obama administration then took it upon themselves to define “hardship” in such expansive language that huge swathes of the population are exempt from the individual mandate.  Yup! You can’t make this crap up. After pleading before the Supreme Court to make sure that the individual mandate applies nationwide, arguing that it would prevent a death spiral, the administration has triggered a death spiral by issuing regulations exempting 10s of millions from the individual mandate.

For 2015, the list of exemptions invented by the bureaucrats and said to represent “hardship” relieving the individual from the individual mandate includes:

– homelessness,
– eviction within the past six months,
– facing eviction or foreclosure (even if not evicted yet),
– received a shutoff notice from a utility company,
– experienced domestic violence,
– death of a close family member,
– fire or flood or other disaster that caused substantial damage to your property whether natural or man-made,
– filed for bankruptcy within the past six months,
– medical expenses within the last 24 months that you couldn’t afford to pay,
– unexpected increases in expenses due to caring for a family member who was ill, disabled or aging,
– a child has no medical coverage because some other person is responsible (by court order) but has not paid,
– ineligibility for Medicaid because your state did not expand eligibility under Obamacare, or
– your individual insurance plan was cancelled and you believe other marketplace plans are unaffordable.

If … somehow … one of those categories doesn’t cover your particular exemption situation, the regulations allow you to make up your own category. Yeah, that’s right. Any other hardship that prevented someone from obtaining health insurance will be reviewed and accepted as necessary.

The effect of the hardship exemption has been to eliminate any financial pressure on millions of individuals to buy health insurance under the ACA. The Congressional Budget Office issued a report in June of 2014 that said:

30 million non-elderly residents will be uninsured in 2016 but … 23 million uninsured people in 2016 will qualify for one or more of those exemptions.  Of the remaining 7 million uninsured people, CBO and JCT estimate that some will be granted exemptions from the penalty because of hardship or other reasons[.] …  All told, CBO and JCT estimate that [only] about 4 million people [out of the 30 million uninsured] will pay a penalty because they are uninsured in 2016.

In other words, about 90% of the national’s 30 million uninsured won’t pay a penalty under the Affordable Care Act in 2016 because of a growing number of exemptions to the health-coverage requirements.

Image result for image of crap hitting a fanSo, is Obama and his administration just incompetant or are they master manipulators? They got the decision they wanted from the Supreme Court by conjuring the specter of a death spiral, then directed the issuance of regulations shielding almost all of the uninsured from the individual mandate, thus guaranteeing the very death spiral that they warned against before the Supreme Court.  Now, as insurers are announcing their departure from Obamacare due to lack of participation by healthy individuals, Obama is leaving the White House, so it’ll be someone else’s problem.

If it weren’t for the fact that this thing is tangled through the economy like a brain aneurysm, I’d be preparing my cheer outfit for when the time bomb goes off. It doesn’t really matter who is holding it when it goes “boom”. Hillary Clinton richly deserves it and Trump has been a great booster for this disaster too. Maybe Gary Johnson would like to step out of the race now before he gets any of the fecal matter on him.

Posted August 30, 2016 by aurorawatcherak in economics, Uncategorized

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GOP – Please Don’t Prove You Can Govern   Leave a comment

I wasn’t going to post anytihing on political philosophy while continuing my talk to Christians, but listening to television news at a friend’s house last night changed my mind.

The Republicans won big this week in a repudiation of Democratic politics. Voters gave Republicans control of the Senate, a deeper control of the House, and more governors across the country. Look at the electoral map and it’s a sea of red with a few tiny patches of blue … and they don’t know what to do with Alaska because we apparently elected a non-affiliated governor.

For the record, I voted for only one party politician – Don Young and then only because the Libertarian candidate against him and Forest Dunbar ran such a stealth campaign that I didn’t know he existed until I got into the voting booth and I don’t vote for pigs in a poke. I went looking for this alternative candidate and never found him. As I couldn’t vote for Forest Dunbar, I voted for Don Young. Still hoping he will come to his senses and retire and allow Governor Walker to appoint a good replacement. I am not writing this in support of the Republicans. I am writing this in hopes that one of them will read it and  resist the urge to act like a Democrat now that they’re in control of Congress.

The pundits on CNN and an NPR report featuring a likeminded Republican Senator were very grave last night, offering the advice that now the Republicans must “prove they can govern”. They suggested various ways to do that – mostly involving the people’s money being spent on very “essentials” like trade-promotion authority, comprehensive immigration reform and corporate tax reform.

STOP! Please don’t go haring off after new ideas for a moment and think about what the GOP base –mostly employed and retired conservatives –have been demandiing for more than five years … and do that first.

What is the one thing conservatives have been demanding since April 2009? Right! Stop Obamacare. I get that the Republicans couldn’t do that at the time. They lacked the power because the people stupidly gave all the power to the Democrats. What did you folks expect – for the Democrats to not immediately enact the agenda they were working on when they lost control of Congress in 1994? Of course not. They did exactly what they had been promising voters they would do if they ever regained power.

But it was an ill-conceived idea and it has saddled the nation with a mountain of debt and a looming catastrophy in the health care field. Everybody has coverage now, but few will have actual health care if we stay this course.

Unfortunately, ObamaCare did become a reality and there is no way to completely get rid of it. I think the American people are ready to consider a patient-centered, market-driven alternative to what has gone before. My expert on these things – my cousin the research doctor who gets paid a salary, so this debate doesn’t affect him at all financially – supports the Coburn Plan. He supports market driven approaches to health care because he believes they are more flexible to the individual than a government-centered approach that limits choice and increases costs. Of course, Rick’s ideal system is universal castrophic coverage with health savings accounts that can be rolled over from year to year and given to one’s heirs, but the American public has been so brainwashed into believing they need health insurance to cover every little sniffle that we can’t go back to a completely free market system as existed before the 1950s, where my parents negotiated with their doctor (or their billing representative) for what they wanted to pay and the doctor wanted to earn. I could do that quite happily. But that’s not likely to happen before the Collapse comes, so what do we do in the interim? What should Republicans do to prove they can govern? Take care of the big issue first.

Repeal and replace ObamaCare with something less unwieldy and disasterous and then work on how to empower the free market to replace it entirely. If they do nothing else for the next two years, they will have done enough.

Tom Coburn of Oklahoma, Richard Burr of North Carolina, and Orrin Hatch of Utah put forth a contructive replacement plan in 2014. It won’t substantially reduce the debt or deficit spending, but they believe it won’t add to it either. It may modestly reduce the amount of federeal spending and taxation.  It would preserve some of the law’s most popular features, such as its ban on lifetime limits on insurer payouts and its requirement hat insurers cover adult children young than 27.

It would replace ObamaCare’s premium hike on young people (the so-called age-based community rating) with a more tradition 5:1 rating band. It would discontinue ObamaCare’s individual mandate and its requirement that insurers offer coverage to everyone regardless of pre-existing conditions. Instead, the plan would require insurers to make offers to everyone who has maintained “continuous coverage” while aiding states in restoring the high-risk pools that served those who insurers would not otherwise cover. Subsidy-eligible individuals who failed to sign up for a plan would be auto-enrolled in one priced at the same level as the subsidy for which they qualified.

It would encourage medical malpractice reform by “adopting or incentivizing states to adopt a range of solutions to tackle the problem of junk lawsuits and defensive medicine” and it would strive to expand price transparency and the supply of physicians.

Most importantly, the Coburn-Burr-Hatch bill plan would make substantial changes to tax exclusion for employer-sponsored coverage. It would cap the tax exclusion for employee health coverage at 65% of an average plan’s cost (tied to the Consumer Price Index) and use that cap to offer tax credits for the uninsured, so long as their incomes were below 300% of the federal poverty level. These subsidies would be on a sliding scale so that they would adjust with income over time. They would also increase as you get older, taking pressure off Medicare. This is a substantial improvement from previous “repeal and replace” plans that offered uniform tax credits regardless of prior health or wealth.

Younger, healthier people would pay lower premiums, but be subsidized at a lower level as well. The subsidy would be means-tested.

The plan would also reform Medicaid using per-capita caps. The federal government would give states a fixed amount of money per person enrolled in Medicaid and then let the states decide how best to use that money to provide cost-efficient health care. In some states, that might mean a regular private-sector insurance plan.

Of course, this plan won’t satisfy my desire to get rid of health insurance altogether, but it would make a good stop-gap while we figure out a better way to do this. One thing it does that is highly attractive for me is the substantial deregulation of the health insurance market.

Oh My! Yes, I’m one of those! And with good reason!

Deregulation lowers costs and less costly health insurance will reduce federal spending on health insurance over time. And, whether or not I believe people should get health coverage they haven’t paid for, this replacement plan coveres approximately the same number of people as ObamaCare, meaning that Republicans wouldn’t create a crisis before they’re prepared to deal with it.

So, get to it, GOP. Get  rid of ObamaCare. It is what you were elected to do. Please do it using Constitutional means and not the insane system that was used to put it in place in the first place. Yes, Obama will veto it. Go back and override his veto. Do it until he has a Bill Clinton moment and decides to cooperate.

The second thing the GOP Congress should do is pass a companion act allowing a test of national insurance coverage. Allow indiividual plans to be purchased across state lines. I believe we would see a reduction in individual premiums and then allow group insurance to be purchased similarly and watch the cost of health insurance drop substantially.

Competition is a good thing, in pretty much anything.

The Cost of ObamaCare   Leave a comment

Things are not as bad as they could be in Alaska insurance rates, according to the Bradner Economic Report, an Alaska publication by long-time instate observers and reporters Tim and Mike Bradner, who are/were vocal supporters of the uh-Affordable Care Act. Group insurance rates are only expected to go up around 10% in 2014. Whew, what a relief! That’s still a 50% increase over rates from five years ago, but the precipitous climb seems to have slowed.

Of course, the ACA was designed to insure the uninsured by controlling premiums in the individual market. Those rates have more than doubled in the last five years (in Alaska). Now, for 2015, they’re only going to increase 37%. The brothers Bradner explain that the rise is due to all the people with health problems who were in the state high risk pool (ACHIA) jumped into the exchanges to get lower-cost coverage which has resulted in big losses for Premera and Moda Health, the two insurers offering polices in the exchanges.

Wow, where would we have been without the ACA?

Maybe if instead of this insanity Congress had opened medical insurance up across state lines, we’d be looking at lower rates. That’s right. There are 37 medical insurance companies in the nation. Only three are licensed to over policies in Alaska. Some of them have been caught in the past coordinating premiums. That’s what happens in a monopoly/duopoly/oligopoly. While I’m sure that Premera and Moda have suffered losses from the chronically ill jumping onto their polices, I’m also equally sure that they are making good profits and keeping those profits healthy by raising their rates to health people. The question is, why should healthy people who use medical care (and therefore medical insurance) much less have to pay higher rates for insurance they don’t use so that unhealthy people who use medical insurance more get low-cost rates?

With 37 companies all competing, it would be much harder for them to coordinate with one another. Someone would want to get a larger market share by offering lower cost policies and that competition would force the other companies to lower their rates.

Basic economics, but apparently lost on our government. Just words in the wind.

Breaking News!   5 comments

There is not one Alaskan confirmed to have successfully signed up for the ObamaCare exchanges.

http://hotair.com/archives/2013/10/15/alaska-we-cant-confirm-one-obamacare-enrollee-yet/

When the fight over ObamaCare was in full swing, I was still working in Lefty-Loony Central (social workers are not all liberals, but most are a little loony). It was common discussion in the mailroom how with so many Alaskans uninsured, ObamaCare would be highly popular even as our governor was fighting against it. I disagreed, but when you’re outnumbered, it’s easy to doubt.

Alaskans are a pretty computer literate bunch. We get most of our goods from distant states. We shop on line. We buy cars over the Internet. We pay bills electronically. And we buy insurance that way.

Yeah, the health exchange website has problems. Only about 5,000 people nation wide have managed to sign up through it, but less than 50,000 people have signed up nation-wide calling and talking to people. Those states that set up exchanges themselves are reporting better numbers, but nowhere near the 30 million who were just foaming at the mouth for insurance.

I don’t buy that Alaskans can’t figure out the website and don’t like to talk on the phone. I think it’s something simpler than that. The majority of Alaska’s 100,000 uninsured are actually insured through Bureau of Indian Affairs. Others have catastrophic insurance policies and nice savings accounts. Many Alaskans live out in the woods and “treat” their ills with marijuana and Fox Springs water. Alaska set up an in-state high-risk pool (ACHIA) before President Obama was President Obama. In other words, the “problems” ObamaCare was meant to address didn’t exist in the first place.

Or ….

Every anarchist-volunteerist I know who isn’t insured (many are) are planning not to sign up. I know some self-employed folks who are planning to refuse to pay the tax penalty. Maybe this is the ultimate civil disobedience from a state of people who tend toward civil disobedience. What if the government mandated you buy a product you don’t think you need and you simply refused to cooperate? What if we all did that?

My anarchist friends may be on to something here! What will the government do if we refuse to cooperate in the restrictions of our liberties.

And, yeah, that’s a bigger topic than just ObamaCare.

Posted October 15, 2013 by aurorawatcherak in Administrative State

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The Issue in a Nutshell   2 comments

Alaska’s Rep. Don Young voted in favor of the House bill that led to the government “shutdown” and issued a statement Monday evening Alaska time critical of the Senate.

“Hours away from a government shutdown, House Republicans have shown a willingness to come to the table, compromise, and put forward an actual solution,” Young said. “This is the third time we have offered them something different, but the Democrat-controlled Senate remains entrenched, demanding their way or the highway and risking the livelihood of thousands of hard-working government employees, all to prove a political point.

“Our latest proposal is simple: Delay the individual mandate of Obamacare by one year, which is consistent with what the Obama administration has already done for big business,” Young said. “We also believe that members of Congress and political appointees in the White House should not get any extra help in paying their skyrocketing health-care bill resulting from this new and flawed health-care system that each and every American must now join.”

What America Wants   6 comments

The majority of Americans do not necessarily know what they want. They have opinions on specific issues, but they haven’t thought about how those issues work together or the ultimate outcome of some of those opinions. This lack of serious thought about our national condition explains the current public opinion on defunding ObamaCare by tying it to the budget.

Americans still overwhelmingly HATE ObamaCare. I know, NPR says we don’t want it defunded per a Hart-McInturff survey, but let’s look at this clearly. HM Polls surveyed 800 Americans. I checked out the poll, which is questionable given the small sample size and the results were that the tiny little fraction of Americans surveyed didn’t want a government shutdown in order to defund ObamaCare. They found that 59% oppose defunding ObamaCare if it means a government shutdown and 44% oppose defunding ObamaCare under any circumstances. I found those numbers suspect, mainly because 800 people do not speak for 330 million.

So, I went over to Rasmussen, which typically surveys larger slices of the population to insure accuracy, and found a clear picture.

Most voters still don’t like the ACA and inspect it to increase, not reduce, health care costs. That’s 53% of those polled view it unfavorably, with 38% viewing it very unfavorably. Fifty-six percent favor delaying the individual mandate and 53% think the ACA will increase the deficit.

Forty-two percent of Republic-affiliated voters favor using the shutdown strategy to stop funding the ACA. At the same time, 56% of those polled think a government shutdown would be bad for the economy, even though payments for things like Social Security, Medicare and unemployment continued.

Interestingly 58% favor a federal budget that cuts spending. This might explain why 53% overall favor a partial government shutdown until Democrats and Republicans can agree on what spending to cut. Fifty-one percent (51%) favor having a partial government shut down until the two major parties agree on what spending for the health care law to cut.

So what we’ve learned here is that polls can be manipulated and that pundits will draw the conclusion they want from the polls and that the American people know what they don’t like, but they aren’t willing to do what it takes to fix things.

I don’t really care which party is “hurt” by this battle. I think tough choices need to be made and if I vote for a major party candidate in the future, it will be the candidates who voted to defund ObamaCare. I don’t fear a government “shutdown” because it’s a misnomer. The military will still get paid and entitlement checks will still go out.

Denali National Park is closing for the winter anyway, so what do I care if the Parks Service is furloughed?

And, that’s really the important thing to recognize. Most of the services that will be affected by a shut down are non-essentials like the Smithsonian Museums and the national parks. So what if you can’t go to them for a few weeks? Compared to the future ObamaCare will visit upon us all, that’s a small price to pay.

House Does What Americans Want   Leave a comment

It was good to open the Internet this morning to news that the House was passed a spending bill that will fund the government IF ObamaCare is defunded.

http://www.usatoday.com/story/news/politics/2013/09/20/house-republicans-defund-obamacare-shutdown/2842199/

Yeah, it has no chance in the Senate, but that’s not the point. It’s the right thing to do. The American people have polled consistently against the “Affordable” Care Act since it was first put forth in 2009. It was shoved down our throats through Senatorial procedural sheninegans. The Supreme Court destroyed all pretense to being a constitutional body by upholding it.

Polls show that a majority of Americans support a government shutdown if ObamaCare is not defunded.

http://www.thenewamerican.com/usnews/health-care/item/16568-poll-most-americans-support-federal-shutdown-to-defund-obamacare

It’s the right thing to do. We survived the horror of sequestration. We’ll survive this and we’ll be the better for it without this albatross hanging around our necks.

Posted September 20, 2013 by aurorawatcherak in Common sense

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A Great Reason to Live in a Yurt   1 comment

If health insurance coverage is such a big deal and the uninsured are so desperate to be covered, why is the Obama finding it necessary to create a “nonpartisan” organization to help the uninsured navigate the exchanges?

Get Covered America is the long-anticipated propaganda campaign launched by Enroll America, an Obama administration front group funded with money extorted from the insurance industry.

What? You’re surprised that the most corrupt presidential administration since the Nixon administration is using a shell corporation of extortionists to cajole Americans who don’t want insurance into getting it? Given the IRS, NSA, and Fast and Furious scandals, why would you be shocked? Have you been living in a yurt in the Alaskan wilderness? That’s probably not an excuse because I know yurt-dwellers who know about this and are moving their yurts deeper into the wilderness in hopes of remaining uninsured.

The fact is that America’s uninsured problem was and remains largely a work of fiction, created when the advocates of socialized medicine realized their claim that government could provide health care more efficiently than could the private sector was not getting much traction with the general public. Only cognitively dissonant progressives were naïve enough to believe that fantasy, so something else was needed.

I know reporters who were ordered by their editors to find people going bankrupt and even dying for lack of health insurance. Many of them tell me that this was not an easy task until a tiny group called Physicians for a National Health Program (PNHP) began sending out news releases. The PNHP’s microscopic membership has always been even less representative of health care community sentiment than the American Medical Association, which doctors I know tell me is virtually irrelevant. PNHP, however, is representative of the Ivy-League community in that many of its members teach at prestigious institutions and thus are able to get allegedly “scientific studies” published in the major media with little question.

Remember, Ivy League attendance is often a precursor of administrative statism.

My former journalism colleagues admit that nobody questioned one study that claimed 45,000 Americans die every year from lack of health coverage. Health policy experts immediately exposed the creaming that produced that absurdly high number, but that didn’t stop the advocates for government-run health care from parroting the PNHP report.

PNHP was also the source for the claim that 54% of all bankruptcies were caused by medical bills. A group of experts at U.C. Davis (which isn’t exactly the Heritage Foundation) demonstrated that the correct figure was about 5% of all bankruptcies. Of course, Obamacare advocates and the mainstream news media continued to use the 54% figure.

I can’t find an actual source for the oft-quoted figure of 47 million uninsured in America, all of whom couldn’t afford coverage. It was never supported by census data, I know. After subtracting illegal immigrants, people already eligible for government programs, and those who could obviously afford coverage but prefer to pay for it directly, the actual number of involuntarily uninsured Americans was about 14 million (which is less than 5% of the nation). Not coincidentally, this is about the number of people who will be newly eligible for Medicaid under ACA’s expansion of that program. Hmmm???? Now that’s interesting …. What a coincidence!

Let’s be honest. If the actual number of uninsured really were 47 million and truly constituted the human tragedy broadcasted in the media before Obamacare passed, Get Covered America would not be necessary. The uninsured would be lining up for insurance coverage like shoppers waiting for Walmart to open on Black Friday. So why do we need Enroll America?

WE don’t. The progressives need them. Most of the people they guide through the exchanges will not end up buying private insurance because it’s too expensive. Enroll America will instead guide them to voter registration, preferably as Democrats, and extol the virtues of Medicaid expansion and how the Democrats made it all possible. And, many of these people will be so foolish to think that the slum-lord medicine of the Medicaid system is living well. Soon, we’ll all think that Medicaid is the best we can do.

In the meantime, some independent-minded self-sufficient Alaskans are moving their yurts deeper into the wilderness so they don’t have to talk to Enroll America.

Dog Training for Democrats   Leave a comment

In training retrievers, I learned the Koehler dog training. No, this is not an ad, but if you need a well-training dog ….

Really, what I’m about is one lesson from the Koehler method. We all know puppies chew and they usually pick your favorite and most expensive shoes to chew. I know people who have lost multiple pairs of shoes. I’ve only lost one pair per pup. Ron Koehler, who trained Rin Tin Tin in the movies (among others) advocated a form of aversive therapy to stop the chewing. You take the item the pup chewed and you place it crosswise in the dog’s mouth and hold it there until the dog starts drooling and gagging. It’s most effective if you do it with duct tape because the dog doesn’t associate the unpleasant experience with you, but instead associates it with the shoe (or whatever) in their mouth. Eventually, they paw off the tape, which usually causes some pain and that’s a good thing too. The next day, you offer the dog the shoe. If it backs away with a whine, lesson learned. If it accepts it, you repeat the aversive therapy. I’ve only had one dog accept the shoe the third day.

So, what does that have to do with politics, Lela?

The Democrats have created this lovely “shoe” called Obama Care. In fact, they’ve littered the playground of society with all sorts of tasty treats. But when your mouth is stuffed to overflowing, even with a food you REALLY LIKE, and you start to gag, all of a sudden that food doesn’t seem so tasty anymore.

Obama Care is gag-worthy. Some of us were like my current yellow Lab who only needed the shoe in her mouth once for five minutes to swear off footwear for life. Other of us were more like my husky who needed two hours on the third night of ripping duct tape off her face before she realized that footwear wasn’t so tasty. The Democrats crammed our national mouth full to the brim of what they thought was a tasty concoction, but as our fellow humans hold it in their mouth a bit longer, I think they’re going to start to gag and by Fall 2014 they’ll be ready to hurl … Democratic incumbents out of office.

That doesn’t solve our problems, but it does give us an opportunity to elect leaders rather than rulers who may be willing to represent our interests for a change.

Maybe ….

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