- Jun 6, 2007
- 852
- 483
- 910
The critics of the White House are absolutely right, the Obama administration with their postponing of the employer mandate for Obamacare and accepting Americans representation on what their income is without checking IRS records when these people apply for insurance subsidies on the exchange is going to result in huge numbers of people not entitled to subsidies by the law actually getting them. This criticism is spot on when it says what the Obama administration is doing here is they are trying to get all the people they can get away with on the exchanges because the current huge amount of public discontent with the law with people not thinking its right the government forcing them to buy health insurance and the unplanned high cost of the exchanged offered health insurance really seems to be shaping up to bring an outcome where there is mass non-compliance on this requirement amongst the American people. If this happens, and the Whitehouse isn't able to manipulate the enrollment numbers like it is trying to do, the Obamacare's plan to hold down the price of individual health insurance on the exchanges by spreading the cost across high numbers of enrollees will collapse insurance premiums will skyrocket and public pressure to repeal Obamacare will grow!
The Whitehouse critics on these decisions need to do a better job of flagging to the American people the outrageous disregard of the Affordable Care Act (ACA) law the Whitehouse is trying to pull off here! What the White House is doing here is opening up the subsidy program for one year to all Americans whether or not your employer offers health insurance in violation of an express condition of the ACA; to put it bluntly they are creating a one year universal access a one-year free ride for all Americans on the exchange with its subsidy program. The House of Representative hearings yesterday on the ACA essentially said as much; this hearing consisted of a group of government officials who will be administering the exchange program. One panelist, Ms. Marilyn Tavenner (Administrator from the Center for Medicare and Medicaid Services (CMS)) said she expects people applying for health insurance on the exchanges to tell the truth on the exchange application if their employer offers health insurance and this self-attestation would be used to screen out subsidy ineligible enrollees. Hello, does anyone in Washington have a clue, not only does an employer have to offer health insurance to preclude an applicant from getting a subsidy the employer health insurance has to offer minimum essential coverage, it has to offer minimum actuarial coverage on medical claims and it has to be affordable to the employee; these are issues one has to be a health insurance expert to answer ordinary Americans can't be expected to know these answers and provide them to the exchange. Ms. Tavenner said there will be checks on this self-attestation issue as it relates to the employer sponsored health insurance condition but she doesn't know what the checks are; another panelist said there will be no software field in the exchanges computer system come October 1 of this year when open enrollment begins for employers to report to the exchanges that they offer health insurance to their employees and who their employees are (moreover the decision has already been made that employers don't "have to" report this information until 2015); in addition, even if there was such a field employers should not be trusted to make this determination on whether the insurance offered to individual employees is satisfactory to exclude an insurance subsidy the ACA law puts this determination duty on the exchange and it is such an important duty to ordinary Americans wanting to participate in the exchange that it should not be passed on to employers. This is no minor issue because people whose income is less than four hundred percent of the poverty level are eligible for an exchange subsidy, tens of millions of Americans fall into this income category. Americans aren't fools we can see through the Washington double talk the administration is not prepared to screen subsidy applicants on the employer sponsored insurance condition of the ACA law. The bottom line is that this failure in the administration's implementation system will lead to many people getting an insurance subsidy the ACA law did not intend to!
This opening of the exchange's barn doors to large numbers of Americans not intended by the ACA could have catastrophic consequences for the continuation of employer sponsored health insurance by America's employers. Think about this from a practical standpoint, many Americans who have employer sponsored health insurance have not that great health insurance they have high co-pays, high deductibles, yearly coverage limits, limited treatment claim coverage, etc.. Now with this Whitehouse decision they have an opportunity to get a great health insurance plan granted it is only for a year but it sure would be nice from their vantage point to have the peace of mind for a year of having a great insurance plan this human nature behavior indicates that significant numbers of these Americans will avail themselves of this exchange offered insurance for 2014. This is especially the case for Americans who themselves or family members have serious medical problems where they are sure or pretty sure they will use a lot of medical care over the next year and there is always the consideration that quite a few employers across America will encourage these pre-existing condition employees to jump on the exchange for a year because it will likely lower their total premium cost for 2015 because most health insurance providers probably use the preceding year's claims cost to determine the premium charge for the following year and if a significant number of the claim costly enrollees aren't on the plan it will make the claims cost be a low number.
What is going to happen in 2015 if this development plays out where a large group of Americans avail themselves of the one year loophole and come 2015 are forced back onto their employer sponsored health insurance plan, many American employers are going to see a huge increase in their health insurance premium expense because they are going to have to pay the employer portion of the premium for each of these returning employees premium expenses they did not have to pay for in 2014. The phraseology that is often used to describe this employer experience will be "health insurance bill shock" and common sense indicates that a lot of employers will conclude the bill is too high and terminate offering health insurance to their employees which will throw these employees onto the exchanges and increase the Federal government exchange subsidy expense which America can't afford.
This Whitehouse scheme likely culminating in a significant number of employers dropping their employer sponsored health insurance isn't just another matter where the Federal government has an expense that is unaffordable causing the government to run deficits that are significantly unfair for future generations who will have to pay these debts. No this scheme will likely result in millions and millions of Americans getting stuck with health insurance they hate. This is so because as this premium expense increases on the government the government will likely keep the growth of this expense down by keeping the subsidy low so that millions of enrollees on the exchanges will only be able to afford the least expensive insurance plans on their exchanges which are HMO types of plans where enrollees are restricted to providers in one health system, since no one system is great in all health care fields this will result in these enrollees getting stuck with lower quality health care and less freedom. History makes this point crystal clearly back in the 1980's and 1990's the health insurance industry in conjunction with employers tried to save money on health care costs by pushing these HMO plans on employees and American workers hated it big-time as a matter of fact the insurance industry has spent a decade or longer since then distancing themselves from these plans in the aftermath they really emphasize in their marketing that their plans offer great provider choices!
This writer is not a litigation lawyer but one would have to think that groups of Americans could bring lawsuits against the administration to get injunctions against them to stop them from operating the exchanges in 2014 because the administration clearly is not ready to comply with the ACA law they should be at least enjoined until 2015. Media reports indicate a person or person(s) has to suffer harm or will likely suffer harm for them to have standing to bring a lawsuit. I would think if your an employee in an employer sponsored plan where there is a high number of your fellow employees who make well under four hundred percent of the poverty level and stand to gain a big subsidy in this one-year open door policy for the exchanges so that in high numbers will likely go into the exchanges and because the ACA law will be followed in 2015 resulting in these people having to go back to their employer sponsored plan and their employers then being faced with an unaffordable health insurance bill causing many employers to drop their plans the employees in these plans have this legal standing; under the same rationale some of the businesses that administer these employer sponsored plans who face losing this business if the employer shuts down the plan as stated likewise should have legal standing.
This is so serious where the well-being of the country's employer sponsored health care system is at stake that I would like the Republicans to go to the Democrats and the White House and say listen lets make a deal here we will agree to fund this Obamacare modestly but sufficiently so you can implement it true to the intent of the ACA legislation but you have to agree to postpone beginning the individual mandate and the exchanges until 2015 because your not ready it is going to be a train wreck. Republicans agree to spend $3 to $4 billion for the first year implementation and $1.5 to $2 billion for each of the next four years of implement even throw in $2 to $3 billion to extend funding for a year for the state insurance programs that help people with serious pre-existing medical conditions buy health insurance. Republicans and Democrats need to consider that using one's brain indicates without a doubt the rollout of the exchanges and this entitlment program this year is going to be an epic disaster one for the history books don't stand around and just let it happen, compromise for a solution!
Some other points this writer noticed on watching this House of Representative hearing on the ACA law. It has been well reported that the Obama administration plans to allow self-attestation on income for applicants on the insurance exchanges to determine the subsidies these applicants will get. What doesn't make any sense is why is the administration is just giving up on any preliminary cursory analysis on the subsidy applicants are entitled to? In the hearing the panelists stated straight forward we do this income analysis all the time for medicaid and chip applicants, the states have portals to access the IRS files to do this income analysis it doesn't make any sense why can't the exchanges do this same checking its utilization of the same data from the IRS files. What also is perplexing is that in the hearing the American public heard from many of the panelists and Democrat House members that spoke at the hearing statements to the effect American public don't worry about overpaying on the subsidies because when these applicants file their 2014 taxes the IRS will compute precisely the subsidy the applicant was entitled to and any overpayment of subsidy the applicant taxpayer will be charged for. What specifically perplexis me is that we are not dealing with very small amounts of money here, some of these insurance subsidies will likely be around two-thousand, four-thousand and six-thousand dollars, these taxpayer applicants could very well see tax bills that adjust for the oversubsidy in the amounts of thousands of dollars in all likelyhood many of these taxpayers won't be able to afford these tax bills it sure seems like this is a plan that is just going to turn a lot of Americans into federal tax delinquents, good judgment indicates that the better plan is to make sure that federal government isn't overpaying on the subsidies!
During the hearing it was testified to that the Federal Government doesn't have the authority by law to impose Federal protections on state entities like exchanges, protections that safeguard taxpayers confidential information and other sensitive private information the Federal government holds from being misappropiated. The administration's plan to protect this sensitive information is to get the state officials in charge of the exchanges to provide a written promise to safeguard the information. The American public regularly hears about bad employees in a variety of businesses misappropiating peoples personal identification and using it fraudulently. Now were going to create this state exchange system where thousands of state employees will have access to peoples personal identification records and at least some if not all of their IRS records and the protections consist of only a promise by state officials to protect the information, Washington use some sense here it is only a matter of time before some big misappropiation of exchange enrollees private information takes place with this arrangement. Congress and the President should at least pass a federal law requiring at minimum background checks for these state employees and a ban on people with theft or fraud related convictions in their background from getting these exchange jobs!
The Whitehouse critics on these decisions need to do a better job of flagging to the American people the outrageous disregard of the Affordable Care Act (ACA) law the Whitehouse is trying to pull off here! What the White House is doing here is opening up the subsidy program for one year to all Americans whether or not your employer offers health insurance in violation of an express condition of the ACA; to put it bluntly they are creating a one year universal access a one-year free ride for all Americans on the exchange with its subsidy program. The House of Representative hearings yesterday on the ACA essentially said as much; this hearing consisted of a group of government officials who will be administering the exchange program. One panelist, Ms. Marilyn Tavenner (Administrator from the Center for Medicare and Medicaid Services (CMS)) said she expects people applying for health insurance on the exchanges to tell the truth on the exchange application if their employer offers health insurance and this self-attestation would be used to screen out subsidy ineligible enrollees. Hello, does anyone in Washington have a clue, not only does an employer have to offer health insurance to preclude an applicant from getting a subsidy the employer health insurance has to offer minimum essential coverage, it has to offer minimum actuarial coverage on medical claims and it has to be affordable to the employee; these are issues one has to be a health insurance expert to answer ordinary Americans can't be expected to know these answers and provide them to the exchange. Ms. Tavenner said there will be checks on this self-attestation issue as it relates to the employer sponsored health insurance condition but she doesn't know what the checks are; another panelist said there will be no software field in the exchanges computer system come October 1 of this year when open enrollment begins for employers to report to the exchanges that they offer health insurance to their employees and who their employees are (moreover the decision has already been made that employers don't "have to" report this information until 2015); in addition, even if there was such a field employers should not be trusted to make this determination on whether the insurance offered to individual employees is satisfactory to exclude an insurance subsidy the ACA law puts this determination duty on the exchange and it is such an important duty to ordinary Americans wanting to participate in the exchange that it should not be passed on to employers. This is no minor issue because people whose income is less than four hundred percent of the poverty level are eligible for an exchange subsidy, tens of millions of Americans fall into this income category. Americans aren't fools we can see through the Washington double talk the administration is not prepared to screen subsidy applicants on the employer sponsored insurance condition of the ACA law. The bottom line is that this failure in the administration's implementation system will lead to many people getting an insurance subsidy the ACA law did not intend to!
This opening of the exchange's barn doors to large numbers of Americans not intended by the ACA could have catastrophic consequences for the continuation of employer sponsored health insurance by America's employers. Think about this from a practical standpoint, many Americans who have employer sponsored health insurance have not that great health insurance they have high co-pays, high deductibles, yearly coverage limits, limited treatment claim coverage, etc.. Now with this Whitehouse decision they have an opportunity to get a great health insurance plan granted it is only for a year but it sure would be nice from their vantage point to have the peace of mind for a year of having a great insurance plan this human nature behavior indicates that significant numbers of these Americans will avail themselves of this exchange offered insurance for 2014. This is especially the case for Americans who themselves or family members have serious medical problems where they are sure or pretty sure they will use a lot of medical care over the next year and there is always the consideration that quite a few employers across America will encourage these pre-existing condition employees to jump on the exchange for a year because it will likely lower their total premium cost for 2015 because most health insurance providers probably use the preceding year's claims cost to determine the premium charge for the following year and if a significant number of the claim costly enrollees aren't on the plan it will make the claims cost be a low number.
What is going to happen in 2015 if this development plays out where a large group of Americans avail themselves of the one year loophole and come 2015 are forced back onto their employer sponsored health insurance plan, many American employers are going to see a huge increase in their health insurance premium expense because they are going to have to pay the employer portion of the premium for each of these returning employees premium expenses they did not have to pay for in 2014. The phraseology that is often used to describe this employer experience will be "health insurance bill shock" and common sense indicates that a lot of employers will conclude the bill is too high and terminate offering health insurance to their employees which will throw these employees onto the exchanges and increase the Federal government exchange subsidy expense which America can't afford.
This Whitehouse scheme likely culminating in a significant number of employers dropping their employer sponsored health insurance isn't just another matter where the Federal government has an expense that is unaffordable causing the government to run deficits that are significantly unfair for future generations who will have to pay these debts. No this scheme will likely result in millions and millions of Americans getting stuck with health insurance they hate. This is so because as this premium expense increases on the government the government will likely keep the growth of this expense down by keeping the subsidy low so that millions of enrollees on the exchanges will only be able to afford the least expensive insurance plans on their exchanges which are HMO types of plans where enrollees are restricted to providers in one health system, since no one system is great in all health care fields this will result in these enrollees getting stuck with lower quality health care and less freedom. History makes this point crystal clearly back in the 1980's and 1990's the health insurance industry in conjunction with employers tried to save money on health care costs by pushing these HMO plans on employees and American workers hated it big-time as a matter of fact the insurance industry has spent a decade or longer since then distancing themselves from these plans in the aftermath they really emphasize in their marketing that their plans offer great provider choices!
This writer is not a litigation lawyer but one would have to think that groups of Americans could bring lawsuits against the administration to get injunctions against them to stop them from operating the exchanges in 2014 because the administration clearly is not ready to comply with the ACA law they should be at least enjoined until 2015. Media reports indicate a person or person(s) has to suffer harm or will likely suffer harm for them to have standing to bring a lawsuit. I would think if your an employee in an employer sponsored plan where there is a high number of your fellow employees who make well under four hundred percent of the poverty level and stand to gain a big subsidy in this one-year open door policy for the exchanges so that in high numbers will likely go into the exchanges and because the ACA law will be followed in 2015 resulting in these people having to go back to their employer sponsored plan and their employers then being faced with an unaffordable health insurance bill causing many employers to drop their plans the employees in these plans have this legal standing; under the same rationale some of the businesses that administer these employer sponsored plans who face losing this business if the employer shuts down the plan as stated likewise should have legal standing.
This is so serious where the well-being of the country's employer sponsored health care system is at stake that I would like the Republicans to go to the Democrats and the White House and say listen lets make a deal here we will agree to fund this Obamacare modestly but sufficiently so you can implement it true to the intent of the ACA legislation but you have to agree to postpone beginning the individual mandate and the exchanges until 2015 because your not ready it is going to be a train wreck. Republicans agree to spend $3 to $4 billion for the first year implementation and $1.5 to $2 billion for each of the next four years of implement even throw in $2 to $3 billion to extend funding for a year for the state insurance programs that help people with serious pre-existing medical conditions buy health insurance. Republicans and Democrats need to consider that using one's brain indicates without a doubt the rollout of the exchanges and this entitlment program this year is going to be an epic disaster one for the history books don't stand around and just let it happen, compromise for a solution!
Some other points this writer noticed on watching this House of Representative hearing on the ACA law. It has been well reported that the Obama administration plans to allow self-attestation on income for applicants on the insurance exchanges to determine the subsidies these applicants will get. What doesn't make any sense is why is the administration is just giving up on any preliminary cursory analysis on the subsidy applicants are entitled to? In the hearing the panelists stated straight forward we do this income analysis all the time for medicaid and chip applicants, the states have portals to access the IRS files to do this income analysis it doesn't make any sense why can't the exchanges do this same checking its utilization of the same data from the IRS files. What also is perplexing is that in the hearing the American public heard from many of the panelists and Democrat House members that spoke at the hearing statements to the effect American public don't worry about overpaying on the subsidies because when these applicants file their 2014 taxes the IRS will compute precisely the subsidy the applicant was entitled to and any overpayment of subsidy the applicant taxpayer will be charged for. What specifically perplexis me is that we are not dealing with very small amounts of money here, some of these insurance subsidies will likely be around two-thousand, four-thousand and six-thousand dollars, these taxpayer applicants could very well see tax bills that adjust for the oversubsidy in the amounts of thousands of dollars in all likelyhood many of these taxpayers won't be able to afford these tax bills it sure seems like this is a plan that is just going to turn a lot of Americans into federal tax delinquents, good judgment indicates that the better plan is to make sure that federal government isn't overpaying on the subsidies!
During the hearing it was testified to that the Federal Government doesn't have the authority by law to impose Federal protections on state entities like exchanges, protections that safeguard taxpayers confidential information and other sensitive private information the Federal government holds from being misappropiated. The administration's plan to protect this sensitive information is to get the state officials in charge of the exchanges to provide a written promise to safeguard the information. The American public regularly hears about bad employees in a variety of businesses misappropiating peoples personal identification and using it fraudulently. Now were going to create this state exchange system where thousands of state employees will have access to peoples personal identification records and at least some if not all of their IRS records and the protections consist of only a promise by state officials to protect the information, Washington use some sense here it is only a matter of time before some big misappropiation of exchange enrollees private information takes place with this arrangement. Congress and the President should at least pass a federal law requiring at minimum background checks for these state employees and a ban on people with theft or fraud related convictions in their background from getting these exchange jobs!
