Category Archives: Obamacare

Tolerance, The Amish And Hobby Lobby

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Pamela Harris, shown here with her disabled son, prevailed at the Supreme Court this week in her challenge to an Illinois law requiring her to pay union dues. [Credit: Heartland Institute]

Pamela Har­ris, shown here with her dis­abled son, pre­vailed at the Supreme Court this week in her chal­lenge to an Illi­nois law requir­ing her to pay union dues. [Cred­it: Heart­land Institute]

For a brief time dur­ing the 1980s, I was Direc­tor of Pol­i­cy Devel­op­ment for the Social Secu­ri­ty Admin­is­tra­tion.  The title is more glo­ri­fied than the real­i­ty.  Social Secu­ri­ty is a big and ossi­fied pro­gram that resists “pol­i­cy devel­op­ment.”  Con­gress, ever cog­nizant of the polit­i­cal risks of tam­per­ing with the pro­gram, had been forced by its loom­ing insol­ven­cy to pass a mas­sive law hik­ing pay­roll tax­es and rais­ing the retire­ment age just a few years before.  They were in no mood to enter­tain addi­tion­al legislation.

But my job was to pre­pare options for the Commissioner’s con­sid­er­a­tion, so I met with career staff who had an idea: why not advo­cate for a bill requir­ing self-employed Amish farm­ers to pay social secu­ri­ty tax­es? Con­tin­ue read­ing →

Was Speaker Boehner Right About Obamacare?

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House Speaker John Boehner (R-OH) was heavily criticized for saying last month that Obamacare cancelations had outnumered enrollments. Now a new study touted by the Administration shows that he had a point. [Credit: Politico]

House Speak­er John Boehn­er (R‑OH) was heav­i­ly crit­i­cized for say­ing last month that Oba­macare can­ce­la­tions had out­nu­mered enroll­ments. Now a new study tout­ed by the Admin­is­tra­tion shows that he had a point. [Cred­it: Politico]

“When you look at the 6 mil­lion Amer­i­cans who have lost their poli­cies and some — they claim 4.2 mil­lion peo­ple who have signed up — I don’t know how many have actu­al­ly paid for it — that would indi­cate to me a net loss of peo­ple with health insur­ance.”  House Speak­er John Boehn­er (R‑OH)

Boehner’s state­ment last month that few­er peo­ple had gained cov­er­age through health exchanges than had lost their insur­ance due to can­ce­la­tions required by the health care law was met with wide­spread deri­sion. The state­ment earned him 4 Pinoc­chios from the Wash­ing­ton Post’s Fact-Checker.

But a new sur­vey released by the RAND Cor­po­ra­tion at least par­tial­ly vin­di­cates the Speaker’s claim. Con­tin­ue read­ing →

Obamacare By The Numbers: Medicaid

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Obamacare supporters are greatly inflating estimates of the number of previously uninsured people that have gained coverage because of the new law. Here's sensible look at the numbers. [Credit: CNN/Money]

Oba­macare sup­port­ers are great­ly inflat­ing esti­mates of the num­ber of pre­vi­ous­ly unin­sured peo­ple that have gained cov­er­age because of the new law. Here’s sen­si­ble look at the num­bers. [Cred­it: CNN/Money]

Near­ly 13 mil­lion Amer­i­cans now have health insur­ance thanks to Oba­macare. Tell Repub­li­cans to stop vot­ing to take their cov­er­age away. – Demo­c­ra­t­ic Leg­isla­tive Cam­paign Com­mit­tee peti­tion drive

Hyper­bole over how many peo­ple have pre­sum­ably gained health cov­er­age as the result of Oba­macare won’t sub­side any­time soon. At its cur­rent pace, we seem des­tined to reach the point where the num­ber of peo­ple who are alleged to have gained cov­er­age because of Oba­macare sur­pass­es the num­ber that lacked cov­er­age in the first place. Con­tin­ue read­ing →

Obamacare By The Numbers: Exchange Enrollment

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Some Obamacare supporters claim that 10 million uninsured Americans have so far gained coverage thanks to the new law. Are they right? (Credit: AP)

Some Oba­macare sup­port­ers claim that 10 mil­lion unin­sured Amer­i­cans have so far gained cov­er­age thanks to the new law. Are they right? (Cred­it: AP)

“Let’s look at the bot­tom line. The bot­tom line is this: 10 mil­lion Amer­i­cans have health insur­ance today who would not have had it with­out the Afford­able Care Act. Ten mil­lion.”  — Sen. Richard Durbin (D‑IL)

Oba­macare crit­ics have tak­en con­sid­er­able plea­sure in point­ing out the law’s short­com­ings — can­celed poli­cies, high­er pre­mi­ums and cost-shar­ing, nar­row net­works — the list goes on.

Now that the web­site’s worst prob­lems have been resolved and enroll­ment num­bers look more respectable, you can hard­ly blame the law’s embat­tled advo­cates for using favor­able num­bers a bit loose­ly. After all, if those who find fault with the law have some­times behaved irre­spon­si­bly, why should­n’t its defend­ers stretch the truth a bit? Con­tin­ue read­ing →

Obamacare: Should Taxpayers Take the Risk of Subsidies?

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I testified on Obamacare yesterday before the House Oversight and Government Reform Committee.

I tes­ti­fied on Oba­macare yes­ter­day before the House Over­sight and Gov­ern­ment Reform Committee.

I tes­ti­fied yes­ter­day before the House Over­sight and Gov­ern­ment Reform Com­mit­tee on a some­what tech­ni­cal pro­vi­sion of Oba­macare.  The pro­vi­sion estab­lish­es “risk cor­ri­dors,” which lim­it prof­its and loss­es of insur­ers that sell through the exchanges.  Plans that make “excess prof­its” must pay into the risk cor­ri­dor fund; those that suf­fer “excess loss­es” receive mon­ey from that fund.   Con­tin­ue read­ing →

Curly Howard And Our Health Care System

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Curly Howard didn't design our healthcare system, but his plumbing misadventure helps explain why it's such a mess -- before and after Obamacare. [Credit: wondersinthedark.com]

Curly Howard did­n’t design our health­care sys­tem, but his plumb­ing mis­ad­ven­ture helps explain why it’s such a mess — before and after Oba­macare. [Cred­it: wondersinthedark.com]

Curly Howard didn’t design the US health­care sys­tem. Or Oba­macare. Or Repub­li­can pro­pos­als to replace it. But he could have.

Howard, the most cre­ative of the Three Stooges, set out to fix a leak­ing pipe. His solu­tion: add a length of pipe. Each time he did, the flow of water was tem­porar­i­ly inter­rupt­ed, only to resume, this time out of the pipe he’d just added. Unde­terred, he added anoth­er length of pipe. By the end of the episode, a frus­trat­ed and sog­gy Curly is enmeshed in pipes. And still the water flows.

So it is with health­care. The leak, in this case, is the basic premise of insur­ance – that risk is inevitable and its cost must show up some­where. Curly’s pipe is reg­u­la­tion – the unceas­ing attempts by gov­ern­ment to divert and dis­guise the cost of that risk. The sys­tem that result­ed from per­pet­u­al inter­ven­tion resem­bles the one Curly pro­duced – cost­ly, cum­ber­some, inef­fi­cient and con­fus­ing. Con­tin­ue read­ing →

A Modest (And Potentially Bipartisan) Obamacare Proposal

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Here are three changes Congress should make to Obamacare: 1) no cancellations; 2) no bailouts; 3) no tax on the uninsured. [Credit: thinkquest.org]

Here are three changes Con­gress should make to Oba­macare: 1) no can­cel­la­tions; 2) no bailouts; 3) no tax on the unin­sured. [Cred­it: thinkquest.org]

Here’s a crazy idea: Repub­li­cans and at least some Democ­rats say they sup­port mak­ing changes to Oba­macare; why doesn’t Con­gress give vot­ers a pleas­ant sur­prise and change it?

These changes would be polit­i­cal­ly pop­u­lar, rel­a­tive­ly mod­est and enjoy at least some bipar­ti­san sup­port. Although the pre­vail­ing polit­i­cal cli­mate makes it hard for law­mak­ers to do any­thing of sub­stance, mak­ing the health care law more friend­ly to con­sumers and less accom­mo­dat­ing to cor­po­rate inter­ests would appeal to vot­ers across the spec­trum. Con­tin­ue read­ing →

Should Obamacare Evolve Into “Medicare for All?”

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Federal agents storm a Los Angeles hospital engaged in a scheme to defraud Medicare. Such fraud is rampant, raising the question of whether "Medicare for All" is a good idea. [Credit: LA Times]

Fed­er­al agents storm a Los Ange­les hos­pi­tal engaged in a scheme to defraud Medicare. Such fraud is ram­pant, rais­ing the ques­tion of whether “Medicare for All” is a good idea. [Cred­it: LA Times]

Estill Mitts, a 68-year-old from Los Ange­les, came up with an enter­pris­ing idea some years back that made him mil­lions: pay home­less peo­ple from the city’s “Skid Row” dis­trict who were eli­gi­ble for Medicare or Med­ic­aid to check into local hos­pi­tals, even if they didn’t need to be there.

Set­ting up shop at a faux med­ical facil­i­ty that he dubbed the ”Assess­ment Cen­ter,” Mitts hired what he called “stringers” to pay home­less peo­ple small sums of mon­ey to go to one of three med­ical facil­i­ties that were in on the scam – City of Angels, LA Met­ro­pol­i­tan and Tustin Hos­pi­tal and Med­ical Cen­ter – where they were admit­ted whether or not they actu­al­ly required care. The hos­pi­tals billed Medicare or Med­ic­aid for the inpa­tient stays and made kick­back pay­ments to Mitts. Con­tin­ue read­ing →

How The Budget Deal Could Threaten Obamacare

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An angry John Boehner (R-OH) lashed out at conservative groups who opposed the budget deal. The deal strengthens his hand with his caucus and in negotiations over changes to Obamacare. [Credit: Washington Post]

An angry John Boehn­er (R‑OH) lashed out at con­ser­v­a­tive groups who opposed the bud­get deal. The deal strength­ens his hand with his cau­cus and in nego­ti­a­tions over changes to Oba­macare. [Cred­it: Wash­ing­ton Post]

“Frankly, I think they’re mis­lead­ing their fol­low­ers. I think they’re push­ing our mem­bers in places where they don’t want to be. And frankly, I just think that they’ve lost all cred­i­bil­i­ty.” – House Speak­er John Boehn­er (R‑OH), com­ment­ing on oppo­si­tion by con­ser­v­a­tive groups to the bud­get deal.

Last week’s over­whelm­ing House vote to rat­i­fy a mod­est bud­get agree­ment has been var­i­ous­ly depict­ed as a defeat for the Tea Par­ty, a rare instance of bipar­ti­san­ship, and a moment of ratio­nal­i­ty in an oth­er­wise chaot­ic and dys­func­tion­al bud­get process. It is all of those things and some­thing more: a new threat to the already trou­bled imple­men­ta­tion of Oba­macare. Con­tin­ue read­ing →

Obamacare’s Comfort Food For The Insurance Industry

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The President huddled with health insurance executives last month, part of a White House effort to assure them that the government has their back. (Credit: LA Times)

The Pres­i­dent hud­dled with health insur­ance exec­u­tives last month, part of a White House effort to assure them that the gov­ern­ment has their back. (Cred­it: LA Times)

The healthcare.gov web­site now works to the Admin­is­tra­tion’s sat­is­fac­tion.  While only 30 per­cent of users could enroll when the site first launched, it’s now up to 80 per­cent.

Frus­trat­ing one in five poten­tial cus­tomers, evi­dent­ly the gold stan­dard for the White House, is viewed less favor­ably by pri­vate insur­ers.  It’s among the rea­sons that the health care law is caus­ing such anx­i­ety in the C‑suites of insur­ance com­pa­nies that are hop­ing to prof­it by sell­ing poli­cies through the exchanges. Which is why White House meet­ings with insur­ance exec­u­tives are hap­pen­ing more fre­quent­ly than Cab­i­net meet­ings. Con­tin­ue read­ing →