Obamacare Now ScotusCare

Obamacare Now ScotusCare

Obamacare Now ScotusCare

Chief Justice Roberts Comes Thru For Obamacare Again

Obamacare Now ScotusCare

Obamacare Now ScotusCare

Supreme Court upholds ObamaCare subsidies

Published June 25, 2015FoxNews.com

The Supreme Court on Thursday upheld ObamaCare subsidies nationwide, in the second major court victory for President Obama on his signature health care law.

In a 6-3 decision, the court ruled that subsidies are valid even in states that did not set up their own insurance exchanges.

A ruling against the administration would have threatened subsidies worth millions in nearly three-dozen states and imperiled the program itself. For months, though, the administration said it had no back-up plans, confident the Supreme Court would rule in its favor.

The Supreme Court previously upheld the law’s individual mandate in 2012, in a 5-4 decision. This time, the justices said the subsidies that 8.7 million people currently receive to make insurance affordable do not depend on where they live, under the 2010 health care law.

Chief Justice John Roberts again voted with his liberal colleagues in support of the law. Roberts also was the key vote to uphold the law in 2012. Justice Anthony Kennedy, a dissenter in 2012, was part of the majority on Thursday.

“Congress passed the Affordable Care Act to improve health insurance markets, not to destroy them,” Roberts wrote in the majority opinion.

Conservative-leaning justices, though, issued a scathing dissent to the decision, referencing the several times the high court has had to rule on the health law.

“We should just start calling this law SCOTUScare,” Justice Antonin Scalia wrote, joined by Justices Clarence Thomas and Samuel Alito.

The challenge devised by opponents of the law relied on four words — established by the state — in the more than 900-page law. The passage technically said subsidies were for those exchanges established by the state.

The law’s opponents argued that the vast majority of people who now get help paying for their insurance premiums are, therefore, ineligible for their federal tax credits. That is because roughly three dozen states opted against creating their own health insurance marketplaces, or exchanges, and instead rely on the federal Healthcare.gov to help people find coverage if they don’t get insurance through their jobs or the government.

In the challengers’ view, the phrase “established by the state” demonstrated that subsidies were to be available only to people in states that set up their own exchanges. Those words cannot refer to exchanges established by the Health and Human Services Department, which oversees Healthcare.gov, the opponents argued.

But the majority opinion effectively said Congress intended the subsidies to be available for all.

“Had Congress meant to limit tax credits to State Exchanges, it likely would have done so in the definition of ‘applicable taxpayer’ or in some other prominent manner,” Roberts wrote. “In this instance, the context and structure of the Act compel us to depart from what would otherwise be the most natural reading of the pertinent statutory phrase.”

He added: “Those credits are necessary for the Federal Exchanges to function like their State Exchange counterparts, and to avoid the type of calamitous result that Congress plainly meant to avoid.”

Scalia wrote that if that’s the case, “words no longer have meaning.”

Nationally, 10.2 million people have signed up for health insurance under the Obama health overhaul. That includes the 8.7 million people who are receiving an average subsidy of $272 a month to help pay their insurance premiums.

Of those receiving subsidies, 6.4 million people were at risk of losing that aid because they live in states that did not set up their own health insurance exchanges.

The case is King v. Burwell, 14-114.

Obamacare Now ScotusCare

Obamacare Individual Premium Tax Credit

Obamacare Individual Premium Tax Credit

Going Back To Catch Up On The Background

Obamacare Individual Premium Tax Credit

Obamacare Individual Premium Tax Credit

So you think the Affordable Care Act (Obamacare) is convoluted and screwed up?

Here’s a little background you may have missed presented by Tony Nitti – Contributor to Forbes

 

Obamacare Individual Premium Tax Credit

 Tony Nitti – Contributor Forbes

Let’s be clear: Congress deserves much of the scorn heaped upon it for its gross mismanagement of the tax law. No greater example of its negligence need be given than the fact that sometime this week, 55 provisions of the law that expired on January 1, 2014 will be retroactively extended….through the end of 2014, a move that completely defeats the purpose of extending the provisions in the first place. Because the last time I checked, tax provisions can’t provide incentive for businesses and individual taxpayers if, you know…the provisions are only part of the law for two weeks out of the year.

Sometimes, however, Congress tries to do the right thing regarding the tax law, and still winds up the target of public vitriol. For example, in 2010 Congress voted to temporarily reduce an employee’s share of Social Security payroll taxes by 2%, a tax cut that resulted in up to $2,200 of extra cash making its way into the annual income of salaried workers. The reduction was always intended to be temporary, however, and when it finally expired on January 1, 2013, America collectively freaked out over what it termed to be a covert ”tax increase.”

Why is any of this news? Because I’ve got a strong feeling that in a few months, another well-intentioned tax benefit is going to backfire in spectacular fashion on the President and members of Congress: the Premium Tax Credit.

What is the Premium Tax Credit? As you may have read somewhere in the past four years – or if you happen to double as a Supreme Court Justice, as you may have come across as part of your day job– starting in 2014, individuals are required to pay a penalty tax  penalty? to the IRS if we don’t hold “minimum essential health insurance coverage.” This is the so-called “individual insurance mandate,” and it was the greatest source of controversy in the controversy-laden Affordable Care Act (ACA), eventually landing the Act in front of the nation’s highest court where it was ultimately blessed as constitutional.

But this isn’t about the penalty side of things. This is about the good news: if we do carry such coverage, however, and if we meet certain conditions, the government is going to help subsidize our insurance premiums in the form of a tax credit.

Section 36B provides that an individual is entitled to the “Premium Tax Credit” if you meet the following conditions:

  • You must have purchased insurance through the Health Insurance Marketplace. (More on this later, but generally, under the ACA, each state was required to set up an exchange so that those residents who were neither offered employer-provided health insurance nor eligible for insurance through a government program could go out and get the minimum essential health insurance coverage necessary to avoid imposition of the individual insurance mandate directly from the state.)
  • As mentioned above, you must not have been otherwise eligible for employer-provided insurance or coverage through a government program such as Medicaid, Medicare, CHIP, or TRICARE.
  • You cannot be claimed as a dependent by another person.
  • Except for very limited circumstances, you can’t file a tax return using the Married Filing Separately filing status.
  • Your household income must be within 100% and 400% of the federal poverty line. Household income is defined as your adjusted gross income plus any tax-exempt interest income, plus nontaxable Social Security benefits, plus any foreign earned income excluded under Section 911. The federal poverty line for 2014 starts at $11,490 for a single taxpayer, $15,510 for a family of two, and $23,550 for a family of four, and 400% of the poverty line is reached at $45,690, $62,040, and $94,200, respectively.

So How Does the Credit Work?

The credit is only intended for lower or middle-income taxpayers or families, hence the requirement that household income be between 100% and 400% of the federal poverty line. From there, it’s helpful to conceptualize the premium tax credit in the following manner:

If we assume that EVERYONE your age were on the same insurance plan and paying the same premiums (called the second-lowest silver cost plan), let’s compute how much you should have to pay for that premium out of your own pocket based on your income. Once we’ve determined that amount, you should get a credit for the difference between the imaginary premiums for this standard-bearer of a plan, and the amount you should have to pay out of pocket for such premiums.

If you prefer a step-by-step approach, the Form 8962, which will be used to calculate the credit, works like so:

Step 1: Determine the household income for you and any other individual in your family you can treat as a dependent and who is required to file a federal tax return.

Step 2: Measure what percentage that household income is of the federal poverty line. Only if it is between 100% and 400% are you eligible for the credit.

Step 3: Based on the percentage determined in Step 2, go to the form instructions and find your “applicable percentage.”

Step 4: Multiply the applicable percentage from Step 3 by the household income in Step 1. This is the most you should have to pay out of pocket for the entire year, if you were on the second lowest silver cost plan. Because the credit is computed on a monthly basis in most cases, however, you must divide this number by 12 to determine your maximum monthly outlay.

Step 5: Determine what your actual premiums were for each month. This is where the insurance exchange you bought the insurance from comes into play: the exchange will be required to mail you a Form 1095-A by the end of January 2015. Included on the form will be your actual premiums for the year. Your actual premiums factor into the credit because remember, the credit is the difference between the cost of the second lowest cost silver plan and the maximum you should have to pay out of pocket as determined in Step 4 above. If your actual premiums exceed the cost of the second lowest cost silver plan, however, well…you’re footing that extra cost yourself. On the flip side, if your actual premiums are LESS than the cost of the second lowest cost silver plan, your credit will only be for the difference between your actual premiums and your maximum out-of-pocket costs as determined in Step 4.

Step 6: Determine the monthly premiums for the second lowest cost sliver plan. Once again, this is going to be provided by the exchange on Form 1095-A.

Step 7: Your credit (for the moment) for each month is the premium from Step 6 less your monthly out-of-pocket costs determined in Step 4. As mentioned in Step 5, however, if your actual premiums from Step 5 are less than the premiums from Step 6, your credit will be the difference between Step 5 and Step 4.

The Premium Tax Credit is refundable; as a result, even if you owe no tax liability for the year, the credit will increase your refund and wind up in your wallet in the form of cash.

So What’s the Problem?

Fundamentally, the credit works fine. I’ve got a strong suspicion, however, that many of the people who have read about the credit don’t realize that instead of getting extra cash with their return, the Premium Tax Credit will actually cause them to pay more over to Uncle Sam come tax time.

How can that be? What kind of credit increases your tax liability?

Here’s the thing: many taxpayers eligible for the credit have already gotten it.

That’s because the Premium Tax Credit is one of the rare credits that is generally paid in advance. When you purchased insurance from the exchange, thereby making you eligible for the credit, you had the option of receiving the credit in advance. If you chose that option, whether knowingly or unknowingly, your exchange than went about the task of estimating what your Premium Tax Credit would be. Once it determined that amount, the government paid those amounts directly to the exchange on your behalf, reducing the amount you were required to pay for your insurance premiums.

But there’s a catch… In order to calculate your anticipated credit, the exchange obviously needed certain financial income in order to compute, for example, your household income. You provided that income when you signed up for the exchange, but in many cases, that financial information was from 2012.

Can you guess what the problem with that is? As we discussed above, the credit is driven by your income as a percentage of the federal poverty line. As your income increases, your credit decreases. As a result, if the 2012 information you provided the exchange when you signed up reflected lower income than what you actually earned in 2014, the advance credit the exchange computed on your behalf was greater than what you are truly entitled to when you file your 2012 return. This means that the amount the exchange received from the government to subsidize your premiums was more than what you were entitled to. And this means that you’ve got a problem. Because if your advance premium tax credit exceeds what you are actually entitled to when you compute your credit using 2014 numbers, you have to pay the difference back to the IRS on your tax return.

To illustrate, assume you earned $20,000 in 2012, and this is the information you supplied the exchange when you purchased insurance. Using this information, the exchange estimated your Premium Tax Credit to be $1,500. The exchange then goes out and collects $1,5o0 throughout the year from the federal government, reducing your need to pay your premiums by this amount.

In 2014, however, you earn $28,000. When you get around to filing your return, you’re giddy about the prospect of this additional credit you’ve read about that’s going to pay for next Christmas. When you fill out Form 8962, however, you find that based on your 2014 income, your credit is only $1,100, as opposed to the $1,500 that you received in advance. As a result, on your tax return, you have to pay the difference, or $400, back to the government.

Now of course, this makes total sense. You received the benefit of $1,500 and were only entitled to $1,100. It’s not a problem of fairness, but rather one of communication. How many people who have heard about the credit understand that they’ve already received it, and are very likely — due to the ability to use old information when signing up for the exchange — to have to pay part of that advance credit back?

To help ease the pain, the amount you have to pay back is capped based on your filing status and income as a percentage of the federal poverty line; for example, in 2014, a single taxpayer with income of between 200% and 300% of the federal poverty line cannot be required to pay back more than $750 of advance credit. But it’s still going to hurt, particularly if you didn’t know it was coming, and had budgeted on receiving extra cash, not paying an additional liability over to the IRS. Of course, if your advance credit was LESS than what you are due on your 2014 return –which might happen, for example, if your income went down from 2012 to 2014 or you elected not to receive the credit in advance– you will get a credit for the excess amount you are owed.

If all of this news has you turned off at the credit, keep in mind, it could get a whole lot worse for a lot of you.

The Supreme Court is set to hear whether the Premium Tax Credit is even valid in 36 states. This is because, as mentioned above, to facilitate the availability of insurance to all Americans, each state was required to set up an exchange. Only 14 did, however. The other 36 did not, forcing the federal government to establish a marketplace in those states.

That’s a problem, because the statute at Section 36B provides that you are only eligible for the credit if you purchased coverage on a “state exchange.” Once the IRS recognized that only 14 states had set one up, however, the language in the regulations expanded the credit eligibility to anyone who acquired the insurance on a “state or federal exchange.”

And that started a flood of lawsuits arguing that the IRS can’t change an unambiguous statute, and thus only people in the 14 states that set up an exchange are eligible for the credit. Why would people sue to get rid of a tax credit, you might ask?

There are two reasons, actually. First, starting in 2016, employers with more than 50 employees will be required to pay a penalty to the IRS if they don’t provide health insurance coverage to their employees. The law, however, states that the employer is only subject to the penalty if “at least one of its employees is eligible for the Premium Tax Credit.” Thus, if there’s no credit in 36 states, there’s no employer penalty.

In addition, the penalty for not carrying insurance only applies if the “cost of the insurance” does not exceed 8% of your household income. The “cost of the insurance” is treated  as the excess of your premiums “reduced by your Premium Tax Credit.” Thus, if there’s no credit in 36 states, there’s a greater likelihood that the cost of insurance for certain taxpayers in those states will exceed 8% of their household income, and the taxpayers will avoid the individual insurance mandate.

In November, the Supreme Court announced that it will decide whether the Premium Tax Credit stays or goes in 36 states. Until that time, however, be warned that this particular credit may have you writing checkscome tax time. And Congress, be warned that you might have (another) public perception problem on your hands.

Obamacare Individual Premium Tax Credit

U.S. faces 90,000 doctor shortage

U.S. faces 90,000 doctor shortage

U.S. faces 90,000 doctor shortage

Suspect More As Result Of Affordable Care Act (Obamacare)

U.S. faces 90,000 doctor shortage

U.S. faces 90,000 doctor shortage

We suspect that the effect of Obamacare on this figure is grossly understated in the following article posted in The Washington Post.

It is our opinion that the AAMC (the association that represents medical schools and teaching hospitals) is probably under the influence of the Federal Government as most organizations are today.

It becomes harder every day to ferret out the truth.

U.S. faces 90,000 doctor shortage by 2025, medical school association warns

By Lenny Bernstein March 3

Washington Post

Dr Shortage Nationwide

The United States faces a shortage of as many as 90,000 physicians by 2025, including a critical need for specialists to treat an aging population that will increasingly live with chronic disease, the association that represents medical schools and teaching hospitals reported Tuesday.

The nation’s shortage of primary care physicians has received considerable attention in recent years, but the Association of American Medical Colleges report predicts that the greatest shortfall, on a percentage basis, will be in the demand for surgeons — especially those who treat diseases more common to older people, such as cancer.

[How long you’ll wait for a doctor’s appointment in 15 U.S. cities]

In addition to the growing and aging population, full implementation of the Affordable Care Act in all 50 states would increase demand for doctors as more people are covered by insurance. But Obamacare’s impact will be small — just 2 percent of the projected growth in demand, the organization said. The supply of doctors also will grow but not nearly as quickly as the need, officials said.

“An increasingly older, sicker population, as well as people living longer with chronic diseases, such as cancer, is the reason for the increased demand,” Darrell G. Kirch, the AAMC’s president and chief executive, told reporters during a telephone news briefing.

Dr Shortage Break Down

Under numerous scenarios, demand for doctors will outstrip supply, the Association of American Medical Colleges reported Tuesday. (AAMC)

The organization called on Congress to raise the federal cap on slots for medical residents at teaching hospitals by 3,000 annually, at a cost it estimated would be about $1 billion per year. The government provides its $40,000 share of the cost of training each U.S. physician — estimated at about $152,000 annually — via the Medicare program. Currently, those hospitals train 27,000 to 29,000 doctors each year.

In 2013, there were about 767,000 doctors practicing in the United States, according to the report.

Policymakers have debated the doctor shortage for years, with some arguing that certain types of doctors are clustered in cities and affluent areas, leaving rural and poor Americans critically underserved. The government runs programs to encourage doctors, especially primary care physicians, to practice in shortage areas. Some states help doctors pay off their medical school debt, which can run into six figures, if they agree to practice in underserved parts of the country.

In a 2013 paper in the journal Health Affairs, Linda Green, a mathematician who studies the health care system, argued that the projected shortage of primary care doctors may not occur. The move toward larger practices, which enable physicians to share support staff and office space, can allow them to take on more patients. And the increasing use of physician assistants and nurse practitioners will have the same effect, she wrote.

[Once again, U.S. has most expensive, least effective health care system]

The new AAMC report actually predicts a smaller shortage than a similar report written five years ago. In 2010, the organization said the nation would face a shortfall of 130,600 physicians by 2025. But revised population projections by the U.S. Census and a small increase in the number of doctors have brought the predicted shortfall down, according to the report.

Under a better-case scenario, the doctor shortage 10 years from now would be 46,100, the report notes. That would reflect growth in the number of advanced practice nurses and physician assistants. If the shortage is 90,400, the country would need 31,100 primary care physicians and 63,700 non-primary care doctors — including oncologists, neurologists, psychiatrists and others — to meet the demand.

The AAMC represents all 141 U.S. medical schools and 17 in Canada, as well as 400 major teaching hospitals and health systems, including 51 Department of Veterans Affairs medical centers.

U.S. faces 90,000 doctor shortage

Alternative To Obamacare

Alternative to ObamaCare

Alternative to ObamaCare

Short-Term Health plans grow as cheap alternative

 “We Will Take Whatever We Can Get”

 

Death spiral? Short-term health plans grow as cheap alternative to ObamaCare

By Maxim Lott
Published October 29, 2014
FoxNews.com

Alternative to ObamaCare

 

Alternative to ObamaCare

 

A fast-growing, short-term alternative to ObamaCare that allows customers to get cheap, one-year policies could put the government-subsidized plan into a death spiral.

The plans, the only ones allowed for sale outside of ObamaCare exchanges, generally cost less than half of what similar ObamaCare policies cost, and are increasing in popularity as uninsured Americans grapple with the requirements of the Affordable Care Act. The catch — that the policies only last for a year — is not much of a deterrent, given that customers can sign up for ObamaCare during open-enrollment periods if their short-term coverage is not renewed.

“Applications rose 30 percent compared to last year,” eHealthInsurance.com Enrollment Specialist Carrie McLean told FoxNews.com.

Other providers said they also see rapid growth in the plans, which have a typical monthly premium of just over $100, compared to traditional plans that cost an average of $271.

“It’s because the product is typically half the cost of ACA plans, and you can chose any doctor or hospital,” Health Insurance Innovations CEO Mike Kosloske told FoxNews.com.

“It’s because the product is typically half the cost of ACA plans, and you can chose any doctor or hospital.”

– Health Insurance Innovations CEO Mike Kosloske

As long as customers stay healthy, they can renew the short-term plans. If patients get sick while covered, the plans provide for their care until the end of the term, when customers can be declined. But such plans can work well with ObamaCare, because if stricken policyholders can still buy insurance through the Affordable Care Act, where insurers must charge sick and healthy people the same rate.

Some people with these plans just buy them as a stop-gap between jobs or to wait until ObamaCare-approved plans go on sale again on Nov. 15. But Health Insurance Innovations says that 40 percent of people are repeat customers who buy one short-term plan after another.

In theory, if enough young and healthy people switch to short-term, non-ObamaCare plans, it could cause a “death spiral” for ObamaCare plans where prices soar and healthy customers look elsewhere.

“If the ObamaCare health insurance exchanges are to function properly, it is crucial that a substantial number of people ages 18-34 join them,” the National Center for Public Policy Research wrote in a study last year. “This age group that is young and relatively healthy must purchase health insurance on the exchanges in order to “cross-subsidize” people who are older and sicker. Without the young and healthy, the exchanges will enter a “death spiral” where only the older and sicker participate and price of insurance premiums will increase precipitously.”

However, supporters of ObamaCare say the program’s taxpayer-funded subsidies will keep customers from bolting.

“I really don’t think a lot of people are going to buy these policies because with these, people can’t get the financial assistance they can get in the [ObamaCare] marketplace,” Cheryl Fish-Parcham, Private Insurance Program Director at the pro-ObamaCare Families USA told FoxNews.com.

She added that, except for people in unusual circumstances, the short-term plans are not a good deal.

“There are a lot of protections that they are missing out on. For instance if you have pre-existing condition, you are going to be rejected. If you get pre-existing condition while on the plan, that insurer is not going to sell to you again.”

There is another catch to having short-term insurance: Customers still have to pay the tax penalty for not having ObamaCare insurance. That fine is $95 annually per person, although it has been waived for those who lost their insurance due to ObamaCare. But by the year 2016, it will rise to a more substantial $695 per person or 2.5 percent of your income (whichever is greater.)

But Kosloske of Health Insurance Innovations says even with the fine, it is still worth it for most people to go with temporary insurance for now, unless their income is low enough to qualify for the largest subsidies.

“Basically, people making $37,000 or less should go on ObamaCare. People with serious pre-existing conditions — they should go on ObamaCare. But for everyone else, including the penalties and including the subsidies [for ObamaCare plans], we cost 30-50 percent less and have that freedom of choice with providers.”

Health Insurance Innovations estimates that the short-term insurance industry as a whole has grown at 20-30 percent over the last year since ObamaCare was implemented. McLean, of eHealthInsurance.com, said the plans appeal to young people.

“They’re particularly popular with young adults,” she said. “Forty-six percent of our short term policy holders are between the ages of 25 and 34.”

One conservative youth advocacy group, Generation Opportunity, specifically endorses buying short-term plans as a way to get around ObamaCare.

“We think it is an excellent option for young people,” the group’s president, Evan Feinberg, said, though he added that it isn’t perfect.

“We don’t think this is an ideal way to do health insurance in general. People should be free to insure themselves both against short-term catastrophic costs and the long term need for permanent medical care,” he said.

“Unfortunately there are people who take away that choice from us based on a misguided idea that they can run a healthcare system from Washington that meets the needs of hundreds of millions of Americans.”

Maxim Lott can be reached on twitter at @maximlott or at maxim.lott@foxnews.com

Alternative to ObamaCare

Gruber Exposes Obamacare Origin

Gruber Exposes Obamacare Origin

Gruber Exposes Obamacare Origin

“The Stupidity Of The American Voter'” Led Us To Hide Obamacare’s True Costs From The Public Says Jonathan Gruber

Gruber Exposes Obamacare OriginGruber Exposes Obamacare Origin

Note: When we fist saw the above picture of the author of Obamacare

we thought that was a VULTURE on his shoulder

PERFECT !!!

If you watch all the “Gruber Videos” you should get chills. It is truly sinister and shows how we American voters have been manipulated by our own government.

The following article taken from Forbes gives a real insight into the dark underbelly origins of The ACA “Obamacare”.

While Gruber had a big part in the engineering of ACA, we believe that he received his orders directly from the White House.

And of course, our thanks to

 

ACA Architect: ‘The Stupidity Of The American Voter’ Led Us To Hide Obamacare’s True Costs From The Public
Avik Roy Avik Roy , Forbes Staff

You’ve got to hand it to MIT economist Jonathan Gruber. The guy dubbed the “Obamacare architect” is a viral YouTube sensation. A few months back, he was caught on tape admitting that Obamacare doesn’t provide subsidies for federally-run insurance exchanges; it’s now the topic of a new case before the Supreme Court. Today, new video surfaced in which Gruber said that “the stupidity of the American voter” made it important for him and Democrats to hide Obamacare’s true costs from the public. “That was really, really critical for the thing to pass,” said Gruber. “But I’d rather have this law than not.” In other words, the ends—imposing Obamacare upon the public—justified the means.

The new Gruber comments come from a panel discussion that he joined on October 17, 2013 at the University of Pennsylvania’s Leonard Davis Institute of Health Economics. He was joined on the panel by Penn health economist Mark Pauly. Patrick Howley of the Daily Caller was the first journalist to flag Gruber’s remarks, which were unearthed by Rich Weinstein.

In fairness to Gruber, American voters are not the only people whose intelligence he questions; elsewhere in the discussion, he describes New York Sen. Chuck Schumer (D.) as someone who “as far as I can tell, doesn’t understand economics” and calls a staffer for Sen. Olympia Snowe (R., Maine)—presumably William Pewen—an “idiot.”
The Case Against Obamacare: An eBook From Forbes
Don’t be fooled. The new health law has disrupted coverage for millions, and driven up costs for millions more.

Representatives of the Leonard Davis Institute tried to pull the video of Gruber’s remarks, but they were too late. Phil Kerpen and others had already clipped them for public consumption.

Obamacare’s opacity was a deliberate strategy

Gruber made an argument that many of Obamacare’s critics have long made, including me. It’s that the law’s complex system of insurance regulation is a way of concealing from voters what Obamacare really is: a huge redistribution of wealth from the young and healthy to the old and unhealthy. In the video, Gruber points out that if Democrats had been honest about these facts, and that the law’s individual mandate is in effect a major tax hike, Obamacare would never have passed Congress.

“Mark [Pauly] made a couple of comments that I do want to take issue with, one about transparency in financing and the other is about moving from community rating to risk-rated subsidies. You can’t do it politically. You just literally cannot do it, okay, transparent financing…and also transparent spending.” Gruber said. “In terms of risk-rated subsidies, if you had a law which said that healthy people are going to pay in—you made explicit that healthy people pay in and sick people get money, it would not have passed, okay. Lack of transparency is a huge political advantage. And basically, call it the stupidity of the American voter or whatever, but basically that was really, really critical for the thing to pass…Look, I wish Mark was right that we could make it all transparent, but I’d rather have this law than not.”

UPenn took down the video of Gruber saying deception was crucial to Obamacare’s passage http://t.co/GZW3dQ8Wf9 pic.twitter.com/Wvy17VvtPX

— Lachlan Markay (@lachlan) November 10, 2014

The Forbes eBook On Obamacare
Inside Obamacare: The Fix For America’s Ailing Health Care System explores the ways the Affordable Care Act will affect your health care and is available for download now.

Gruber also points out that Obamacare’s individual mandate—the provision that requires most Americans to buy government-approved insurance, or pay a fine—was described in the law as a “penalty” instead of as a “tax” in order to hide the mandate’s effects. “I mean, this bill was written in a tortured way to make sure CBO did not score the [individual] mandate as taxes,” said Gruber. “If CBO scored the mandate as taxes, the bill dies. Okay, so [the law is] written to do that.”

To a large degree, the tactic of opacity worked. Not only did Obamacare get passed, but its complex system of cross-subsidies attracted less notice on the Right than did the law’s tax hikes and spending increases. But what progressives figured out—and conservatives are just learning—is that government regulation of health insurance can serve as yet another way to redistribute money from one group to another.

In Louisiana, Obamacare hiked rates for young men by 108%

If you look at the Manhattan Institute’s Obamacare cost map—in which we analyzed how the law’s health insurance regulations affect people of different ages and genders—you’ll see that for most of the country, young people who shop for coverage on their own have far steeper gross insurance costs under the law than they did before.

For example, in Louisiana—home to a hotly contested Senate race between incumbent Mary Landrieu (D.) and Rep. Bill Cassidy (R.)—the underlying cost of insurance increased by 108 percent for 27-year-old men, and 46 percent for 27-year-old women.

Obamacare Impact

 

ACA rate map Louisiana

This doesn’t count as a tax increase for official purposes. But for the 27-year-old who is now being forced to pay for costlier coverage, it has basically the same effect as a tax. But age-based community rating attracted almost no attention in the run-up to passage of the health care bill.

Repeal age-based community rating

It’s for this reason that I’ve argued that the new Republican Senate majority should repeal age-based community rating, or modify it considerably. Under Obamacare, insurers can only charge their oldest customers three times as much as they charge their youngest ones. Because 64-year-olds consume about six times as much health care as 21-year-olds, this provision has the net effect of jacking up prices for the young.

Age Based Community Rating

TA figure 11

That is to say, let’s replace what wonks call the “3:1 age band” with a “6:1 age band” or get rid of age bands altogether. That way, young people—the people who’ve been most harmed in the Obama economy—can once again pay a fair price for health insurance. There’s no better way for Republicans to start engaging younger voters—and to take a principled stand against Obamacare’s obfuscations.

Also on Forbes:
The Best Jobs In Health Care In 2014
1 of 12
AP Photo/Bebeto Matthews/AP Photo/Bebeto Matthews 1. Biomedical engineer
1. Biomedical engineer

Annual Median Salary: $87,000
Projected job growth: 62%[note: salary and job growth numbers are from the Bureau of Labor Statistics]

* * *

UPDATE 1: Keith Hennessey critiques the dishonest pattern of Congress enacting non-transparent methods of financing health care subsidies. Richard Weir of the Boston Herald reached out to Gruber, but Gruber repeatedly replied “I have no comment.”

UPDATE 2: After 24 hours, and presumably some conversations with PR types, Gruber came out of hiding and attempted to explain his remarks on MSNBC’s Ronan Farrow Daily:

David Weigel has a piece on the “mild-mannered investment advisor,” Rich Weinstein, who has been responsible for highlighting the Gruber videos.

UPDATE 3: Rich Weinstein has released two more Gruber videos, in which the economist boasts of Obamacare’s “exploitation of the lack of economic understanding of the American voter.”

AVIK’S NEW HEALTH-REFORM PLAN, Transcending Obamacare: A Patient-Centered Plan for Near-Universal Coverage and Permanent Fiscal Solvency, is available online. Follow @Avik on Twitter, Google+, and YouTube, and The Apothecary on Facebook. Or, sign up to receive a weekly e-mail digest of articles from The Apothecary.

INVESTORS’ NOTE: The biggest publicly-traded players in Obamacare’s health insurance exchanges are Aetna (NYSE:AET), Humana (NYSE:HUM), Cigna (NYSE:CI), Molina (NYSE:MOH), WellPoint (NYSE:WLP), and Centene (NYSE:CNC), in order of the number of uninsured exchange-eligible Americans for whom their plans are available.

NOTE: Our congratulations to the folks a Forbes that put together this very complete article. Do you think any of “The Main Stream Media” will publish this info? 

And of course, our thanks to Professor Gruber – – –  Gruber Exposes Obamacare Origin

Gruber Exposes Obamacare Origin

Obamacare Alternatives

Creative Obamacare Alternatives

When Obamacare Survival Becomes A Necessity

Maybe there is a ray of hope in the Obamacare nightmare.

Maybe that ray of hope is in the free market.

Here is the story of one family that found a solution.

Family Who Ditched Obamacare Has Found an Interesting Way to Pay Its Medical Bills

Jun. 20, 2014 1:21pm Liz Klimas

A Texas couple expecting their third child turned to Obamacare earlier this year, thinking it was the answer to their lack of insurance. Instead, they were frustrated when they couldn’t find a doctor who suited their needs and ended up turning to an alternative method of paying for medical expenses that’s been gaining interest since the Affordable Care Act went into effect.

(AP/Charlie Riedel)

Rachel Robinson, who lives in Dallas with her husband and children, flipped from wanting an insurance-paid hospital delivery to a home delivery with a midwife, paid for through a medical cost-sharing program.

Robinson remembered when she initially wrote off a friend who had suggested a home birth after Robinson voiced that she was having a hard time finding a doctor and hospital to accept her Blue Cross Blue Shield insurance purchased through Obamacare.

“I wasn’t quite ready to hear all the no’s I was hearing,” Robinson told TheBlaze. Starting down the list of insurance-approved doctors, “they would say things like, ‘Well we have to pay these high premiums so we can’t always take the Obamacare patients. … It was all very vague. Some would come out and say, ‘We just don’t take Obamacare even though we’re on the list.’ It was very weird.”

After two days of calling and not finding a doctor that would accept her insurance or be in an area where she was willing to travel, Robinson and her husband wondered: “Why am I paying all this money a month for basically nothing?”

Dropping Obamacare and Daring to Share

That’s when the Robinsons dropped their insurance plan, selected a midwife and prepared for a medication-less home birth that was just a few weeks away.

Looking back, Robinson said she wouldn’t change it: not only her home birth, but the choice they made to join the cost-sharing program, Samaritan Ministries.

“We love it so much because we don’t go to the doctor that often. With the sharing program, you only have to pay up to $300 for regular visits,” Robinson explained.

The Robinsons pay $375 every month for the program. If a medical bill exceeds the $300 cap that they would pay at the doctor’s office, that’s when the cost-sharing component comes into play.

Anthony Hopp, Samaritan Ministries’ director of membership development, told TheBlaze that if someone had a $100,000 medical bill, there would first be a strict process to vet the medical need and accuracy of the billing. After that, the organization allocates various members to send their monthly checks directly to the recipient, making sure the right amount gets to that person to pay off their bills. The recipient knows who is supposed to be supporting them with their monthly membership fees (the Robinsons, for example, send their $375 check to a specific person) and keeps a log of who they’ve received money from to report back to the organization as well.

Hopp said that there has “certainly been an uptick” of a least interest, if not membership, in Samaritan Ministries after Obamacare’s changes to the health system went into effect. But he said it’s not the only driver.

Hopp called it a “perfect storm.”

Cost-sharing programs use to be “somewhat of a new concept, but I think the fact that it has been established for 20 years, it has taken people a while to see it as a viable option.”

Samaritan Ministries has about 35,000 households or families representing about 115,000 individuals, and Hopp said they’ve seen their net growth hover around 18 to 24 percent in the last few years. Hopp said Samaritan Ministries is one of three Christian-oriented cost-sharing programs.

Liberty HealthShare, while based on a religious tradition, more loosely adheres to a set of shared beliefs that it asks its members to have without specifying religion.

“We are just simply making ourselves available to like-minded Americans so long as they agree with our shared beliefs. Whereas the other groups do require you be active Christian, we just simply say, ‘Here’s our set of shared beliefs,’” Liberty HealthShare Executive Director Dale Bellis said.

Bellis said he believes Obamacare has been a driver in such cost-sharing programs.

“The Affordable Care Act obviously has raised awareness regarding health costs but also options and opportunities for ways to do so on a grassroots level. That’s really what Liberty HealthShare represents,” Bellis said.

‘The Financial Part Is Just the Tip of the Iceberg’

Hopp said it’s not just religious or political factors that have people turning to a cost-sharing program either.

“More and more people are questioning where their health care dollars are being sent,” he said. “There’s no way to know.”

With Samaritan Health Ministries, members know exactly where their money is going, because they write a check to a specific person each month. For some people, he thinks, this personal support aspect is attractive for sharing programs.

“I’m writing a check directly to another Samaritan member, I feel good about that,” Hopp said. “The financial part is just tip of iceberg. The concept, the intent is to go much deeper than just financial need. Our members are sending cards, notes of encouragement. Community is what makes this whole thing spin.”

But Hopp pointed out that even if the demand of such cost-sharing programs increases as people seek options outside of traditional health care for whatever reason, new programs will not be started due to a provision preventing them in the Affordable Care Act.

Cost-sharing programs, like Samaritan Ministries and Liberty HealthShare, were an exemption because they were in operation before Dec. 31, 1999. Bellis speculated that keeping cost-sharing programs “as limited as possible … would seem to be the motivation” of the government setting this date.

As for the Robinsons, they plan to stick with Samaritan Ministries for now and hope to continue in the future, even if her husband’s job takes them elsewhere where traditional insurance options are available.

“We really want to talk to his next employer, want to talk about insurance, because we want to stay on cost-sharing. We like to know where our money is,” Robinson said.

Front page image via Gil C/Shutterstock

Obamacare Is Awful

“Obamacare Is Awful,” Says Michael Moore

Michael Moore Is Right For Once

From the beginning some that could look behind the curtain could see that the ultimate end game for Obamacare was the total government control of the health care system in the USA with the “Single Payer System”.

Michael Moore Is Right: Obamacare Is Awful, But Single-Payer Would Be Much Worse

Sally Pipes, Contributor 2/03/2014 @ 8:00AM

“Obamacare is awful,” filmmaker Michael Moore recently wrote in the New York Times.

He went on to say that President Obama “knew in his heart that a single-payer, Medicare-for-all model was the true way to go.”

And he’s not wrong about President Obama’s true feelings. Years before taking the White House, Obama told a union crowd, “I happen to be a proponent of a single-payer, universal healthcare plan.”

Other supporters of the president have begun beating the drum for single-payer — with Obamacare serving as a way station on the path there. In January, The New Republic published an article entitled “How Obamacare Actually Paves the Way Toward Single Payer.” The article was even filed under the header “Trojan Horse.”

This trend should trouble Americans. Single-payer systems in other countries arbitrarily ration care — and yield health outcomes far worse than those in the United States.

That reality hasn’t dissuaded single-payer cheerleaders from trying to use Obamacare to install their preferred model of healthcare delivery

Vermont’s Democratic governor Peter Shumlin signed a single-payer bill into law in 2011. The law hinges on section 1332 of Obamacare, which allows states to apply for waivers from health care regulations and get federal funding to enact their own plans.

States won’t be able to apply for section 1332 waivers until 2017. But some folks in Hawaii, Oregon, New York, Washington, California, Colorado, Maryland, and Massachusetts are already agitating to get special dispensation to implement single-payer systems.

Then there’s the federally ordered expansion of Medicaid. Twenty-six states are complying; the rest have chosen to take advantage of the U.S. Supreme Court’s ruling that they’re not required to do so.

Between Medicare and Medicaid alone, more than one in three Americans now receives health care through a government-run program. Government already accounts for nearly half of all health care spending in this country.

Those two figures will only grow as states and the feds put more people on the public-insurance rolls — and as the Baby Boomers age.

Obamacare also creates two new bureaucracies — the Patient Centered Outcomes Research Institute (PCORI) and the Independent Payment Advisory Board (IPAB) — that look an awful lot like the rationing bodies other nations use to try to keep their own healthcare costs down.

PCORI is supposed to sponsor research comparing the relative effectiveness of various medical treatments. Of course, the federal government has a strong incentive to “discover” that older, cheaper treatments are just as effective as newer, more expensive ones. Such a finding could save the government — as one of the nation’s largest healthcare payers — a significant amount of money.

That’s exactly what happens in Great Britain. Just last week, the National Institute for Health and Care Excellence (NICE) — which decides whether the British government will pay for drugs — ruled that a new prostate-cancer drug that can extend lives by five months wasn’t worth its price. Cancer patients will have to try a cheaper therapy first. Of course, they may die in the interim.

PCORI’s proponents try to rebut charges that it’ll ration care by citing Obamcare’s text: “The Patient-Centered Outcomes Research Institute shall not develop or employ a dollars-per-quality adjusted life year (or similar measure that discounts the value of a life because of an individual’s disability) as a threshold to establish what type of health care is cost effective or recommended.”

But as University of Michigan law professor Nicholas Bagley has postulated, PCORI could “compile cost information about the treatments that it studies” or “rank the cost-effectiveness of alternative treatments.”

IPAB, meanwhile, is essentially charged with rationing care. This 15-member, unelected, and yet-to-be-appointed board must come up with cost-cutting recommendations if Medicare spending exceeds certain levels. It’s forbidden from changing the program’s fee-for-service structure or adjusting the level of benefits that seniors receive — but the Board can ratchet down reimbursement rates for doctors and hospitals.

Doctors may respond by limiting the number of Medicare patients they see — or opting out of the program entirely. More seniors competing for fewer doctors’ appointments will result in longer wait times and lower-quality care.

Wait times are facts of life in Canada’s single-payer system. The average wait time from referral by a general practitioner to actual treatment by a specialist is 18.2 weeks. Nearly 700,000 Canadians are on a waiting list for surgery or other procedures. Preventative care is also less available — Canadian women are almost 25 percent less likely to have had a mammogram than American women.
The Peculiarities Of Obamacare: Politicians Must Sue President Obama To Get Him To Enforce The Law Sally Pipes Sally Pipes Contributor
The Obamacare Law Devours Itself With Exemptions Amid 5 Million (And Counting) Cancellations Sally Pipes Sally Pipes Contributor
Don’t Be Fooled By Kathleen Sebelius’s Healthcare.gov ‘Progress’ Report Sally Pipes Sally Pipes Contributor
It’s Not Just Healthcare.gov: Obamacare Has A Serious Age Discrimination Problem Sally Pipes Sally Pipes Contributor

It’s no wonder that almost 40,000 Canadians cross the border and pay out of pocket to get treated in U.S. hospitals every year.

Even as America moves toward single-payer, other nations are doing the opposite. According to the Swedish publication The Local LOCM +0.6%, about one in 10 Swedes now has private insurance. Svensk Försäkring, Sweden’s insurance industry trade group, reports “most of these people have their policy paid by their employer.”

Why are Swedish employers picking up the tab when the government provides free health care?

The Local reports that even cancer patients can wait a year for treatment. “It’s quicker to get a colleague back to work if you have an operation in two weeks’ time rather than having to wait for a year,” privately insured Anna Norlander told a Swedish radio station. “It’s terrible that I, as a young person, don’t feel I can trust the health care system to take care of me.”

Unless Obamacare is repealed and replaced, Americans may soon be saying the same thing.

Sally C. Pipes is President, CEO, and Taube Fellow in Health Care Studies at the Pacific Research Institute. Her latest book is The Cure for Obamacare (Encounter 2013).

 

Another Day Another Delay for Obamacare

Another Day Another Delay for Obamacare

Small Business Is Just At The Whim Of The Federal Government

The latest delay in enforcement of the Affordable Care Act was most likely done as a political move to try and soften the impact of Obamacare for the coming elections in 2014.

 For Businesses, It’s Another Day, Another Aggravating Obamacare Delay

BY Abigail Tracy

The latest announcement of a delay of the Affordable Care Act’s health insurance mandate for employers may alienate even the law’s biggest supporters.

Although the latest delay in enforcement of the Affordable Care Act was meant to help out small and medium-size businesses by giving them more time to figure out their health care plans, the continual changes to the deadline might lead even the staunchest supporters of the mandate to question whether it actually has teeth.

On Monday, the Obama administration announced that most employers won’t face fines until next year for not offering their employees health insurance. Under the original terms of the Affordable Care Act passed in 2010, companies with at least 50 full-time workers would have had to start paying fines at the beginning of this year if they failed to comply. Last year, the administration delayed that deadline until the beginning of 2015.

According to the most recent announcement, companies with 50 to 99 full-time workers will have until 2016 to begin providing insurance to employees and avoid fines. Larger companies will be able to avoid some penalties until 2015, as long as they provide coverage to at least 70 percent of their workers, The Wall Street Journal reported.

White House officials say the latest delay was in response to the need of businesses and aimed at allowing federal and state exchanges more time to get their Small Business Health Options Programs (SHOPs) ready. But the more the administration delays enforcement of the Affordable Care Act, the less likely employers will be to believe the new deadlines for compliance will actually be enforced. A boy-who-cried-wolf situation seems to be developing, and if you scrambled to hit the 2014 deadline, this new delay has to be an aggravating development.
IMAGE: Getty Images
Last updated: Feb 11, 2014

 

Obamacare Strkes

 Obamacare Strkes

Part-Time Jobs Surge To All Time High; Full-Time Jobs Plunge By 240,000

An excellent article from Zero Hedge which points out the long term results of Obamacare.

Obamacare Strikes: Part-Time Jobs Surge To All Time High; Full-Time Jobs Plunge By 240,000

Zero Hedge
July 5, 2013

As a reminder: jobs have quantity and quality components. The quantity component was good enough to convince the 10 Year the taper is imminent (if not stocks, which continue to trade dislocated from any and all fundamentals). But how about the quality? In a word: not good. In June, the household survey reported that part-time jobs soared by 360,000 to 28,059,000 – an all time record high. Full time jobs? Down 240,000.  And looking back at the entire year, so far in 2013, just 130K Full-Time Jobs have been added, offset by a whopping 557K Part-Time jobs. And there is your jobs “quality” leading to today’s market euphoria (if only for now).

June full-time vs part-time:

Obamacare Strikes: Part Time Jobs Surge To All Time High; Full Time Jobs Plunge By 240,000 June%20Full%20vs%20Part%20Time%20Jobs 2 0

And the divergence historically:

Obamacare Strikes: Part Time Jobs Surge To All Time High; Full Time Jobs Plunge By 240,000 June%20Full%20vs%20Part%20Time%20Jobs%20historic 0

Obamacare Strikes

Obamacare Repealed Before The 2014 Elections?

Obamacare Repealed Before The 2014 Elections?

One Can Only Hope This Prediction Comes To Pass

The article in Forbes re-posted below stopped us cold – We had to read it!

Upon reading – we find it’s makes a lot of sense.

Obamacare Will Be Repealed Well In Advance Of The 2014 Elections

Repeal ObamaCare

Prediction: even if HealthCare.gov is fixed by the end of the month (unlikely), Obamacare is going to be repealed well in advance of next year’s election.  And if the website continues to fail, the push for repeal—from endangered Democrats—will occur very rapidly.  The website is a sideshow: the real action is the number of people and businesses who are losing their health plans or having to pay a lot more.  Fixing the website will only delay the inevitable.

It is important to remember why it was so important for Obama to promise repeatedly that “if you like your health insurance/doctor, you can keep your health insurance/doctor.”  Cast your mind back to the ignominious collapse of Hillarycare in 1994.  Hillarycare came out of the box in September 1993 to high public support according to the early polls.  This was not a surprise.  Opinion polls for decades have shown a large majority of Americans support the general idea of universal health coverage.  But Hillarycare came apart as the bureaucratic details came out, the most important one being that you couldn’t be sure you’d be able to keep your doctors or select specialists of your choice.  The Clintons refused to consider a compromise, but even with large Democratic Senate and House majorities the bill was so dead it was never brought up for a vote.
Ronald Reagan Predicted The Obamacare Disaster Back In 1961 Steven Hayward Steven Hayward Contributor
The Obamacare Rollout Debacle Is A Hayekian ‘Teaching Moment’ Capital Flows Capital Flows Contributor
What The Tea Party Needs Now Is Its Own Abraham Lincoln Steven Hayward Steven Hayward Contributor
James Madison Would Know Who Today’s Extremists Are, And They’re Not The Tea Party Capital Flows Capital Flows Contributor

Remember “Harry and Louise”?  Obama did, which is why he portrayed Obamacare as simply expanding coverage to the uninsured, and improving coverage for the underinsured while leaving the already insured undisturbed.  But the redistributive arithmetic of Obamacare’s architecture could never add up, which is what the bureaucrats knew early on—as early as 2010 according to many documents that have leaked.  The wonder is that Obama’s political team didn’t see this coming and prepare a pre-emptive strategy for dealing with the inevitable exposure of the duplicity at the heart of Obamacare’s logic.  Now that people are losing their insurance and finding that they may not be able to keep their doctor after all, Obamacare has become the domestic policy equivalent of the Iraq War: a protracted fiasco that is proving fatal to a president’s credibility and approval rating.  The only thing missing is calling in FEMA to help fix this Category-5 political disaster.

Senate Democrats endangered for re-election will lead the charge for repeal perhaps as soon as January, after they get an earful over the Christmas break.  They’ll call it “reform,” and clothe it in calls for delaying the individual mandate and allowing people and businesses to keep their existing health insurance policies.  But it is probably too late to go back in many cases.  With the political damage guaranteed to continue, the momentum toward repeal will be unstoppable.  Democrats will not want to face the voters next November with the albatross of Obamacare.

The politics of the repeal effort will be a game theorist’s dream.  Tea Party Republicans will resist “reforms” to Obamacare in favor of complete repeal.  Democrats will try to turn the tables and set up Republicans as obstacles to reform, hoping to inoculate themselves prospectively from mayhem at the polls next November. The House might want to insist that the Senate go first; after all, it was the Senate version of the bill that the House had to swallow after Scott Brown’s election in January 2010.  The House can rightly insist that the Senate needs to clean up the mess they made.  Obama may well give Capitol Hill Democrats a pass on a repeal vote, and veto any bill that emerges.  He’ll never face the voters again.

This wouldn’t be the first time that a health care entitlement was repealed.  The same thing happened in the late 1980s with catastrophic coverage for seniors.  Because seniors were made to pay for their benefits under that scheme, the uproar forced Congress to repeal the measure barely a year after it went into effect.  Obamacare looks to be on the same political trajectory, and for the same reason.  Obamacare represents the crisis of big government; the limits of administrative government have finally been breached.  For the first time ever, some polls are showing a majority of Americans doubting the goal of universal health coverage.

The hazard of the moment is that a compromise “reform” that drops the mandate and attempts to restore the insurance status quo ante could leave us with an unfunded expansion of Medicaid and a badly disrupted private insurance market.  Republicans should avoid both the political traps and a new fiscal time bomb by being ready with a serious replacement policy, based on the premium support tax credit ideas that John McCain advocated (poorly) in 2008.  While anxious liberals are in dismay, they should recognize that Obamacare may well have achieved its chief purpose of making universal or at least greatly expanded health coverage a fixture of American social policy.  The cost to liberalism may prove fatal, however.