Health care woes are just beginning

[Sea Six]

Cliffs: embrace the suck.

By MICHAEL J. BOSKIN
Dec. 15, 2013 6:24 p.m. ET


The White House is claiming that the Healthcare.gov website is mostly fixed, that the millions of Americans whose health plans were canceled thanks to government rules may be able to keep them for another year, and that in any event these people will get better plans through ObamaCare exchanges. Whatever the truth of these assertions, those who expect better days ahead for the Affordable Care Act are in for a rude awakening. The shocks—economic and political—will get much worse next year and beyond. Here's why:

The "sticker shock" that many buyers of new, ACA-compliant health plans have experienced—with premiums 30% higher, or more, than their previous coverage—has only begun. The costs borne by individuals will be even more obvious next year as more people start having to pay higher deductibles and copays.

If, as many predict, too few healthy young people sign up for insurance that is overpriced in order to subsidize older, sicker people, the insurance market will unravel in a "death spiral" of ever-higher premiums and fewer signups. The government, through taxpayer-funded "risk corridors," is on the hook for billions of dollars of potential insurance-company losses. This will be about as politically popular as bank bailouts.

The "I can't keep my doctor" shock will also hit more and more people in coming months. To keep prices to consumers as low as possible—given cost pressures generated by the government's rules, controls and coverage mandates—insurance companies in many cases are offering plans that have very restrictive networks, with lower-cost providers that exclude some of the best physicians and hospitals.

Next year, millions must choose among unfamiliar physicians and hospitals, or paying more for preferred providers who are not part of their insurance network. Some health outcomes will deteriorate from a less familiar doctor-patient relationship.

More IT failures are likely. People looking for health plans on ObamaCare exchanges may be able to fill out their applications with more ease. But the far more complex back-office side of the website—where the information in their application is checked against government databases to determine the premium subsidies and prices they will be charged, and where the applications are forwarded to insurance companies—is still under construction. Be prepared for eligibility, coverage gap, billing, claims, insurer payment and patient information-protection debacles.

The next shock will come when the scores of millions outside the individual market—people who are covered by employers, in union plans, or on Medicare and Medicaid—experience the downsides of ObamaCare. There will be longer waits for hospital visits, doctors' appointments and specialist treatment, as more people crowd fewer providers.

Those with means can respond to the government-driven waiting lines by making side payments to providers or seeking care through doctors who do not participate in insurance plans. But this will be difficult for most people.

Next, the Congressional Budget Office's estimated 25% expansion of Medicaid under ObamaCare will exert pressure on state Medicaid spending (although the pressure will be delayed for a few years by federal subsidies). This pressure on state budgets means less money on education and transportation, and higher state taxes.

The "Cadillac tax" on health plans to help pay for ObamaCare starts four years from this Jan. 1. It will fall heavily on unions whose plans are expensive due to generous health benefits.

In the nearer term, a political iceberg looms next year. Insurance companies usually submit proposed pricing to regulators in the summer, and the open enrollment period begins in the fall for plans starting Jan. 1. Businesses of all sizes that currently provide health care will have to offer ObamaCare's expensive, mandated benefits, or drop their plans and—except the smallest firms—pay a fine. Tens of millions of Americans with employer-provided health plans risk paying more for less, and losing their policies and doctors to more restrictive networks. The administration is desperately trying to delay employer-plan problems beyond the 2014 election to avoid this shock.

Meanwhile, ObamaCare will lead to more part-time workers in some industries, as hours are cut back to conform to arbitrary definitions in the law of what constitutes full-time employment. Many small businesses will be cautious about hiring more than 50 full-time employees, which would subject them to the law's employer insurance mandate.

On the supply side, medicine will become a far less attractive career for talented young people. More doctors will restrict practice or retire early rather than accept lower incomes and work conditions they did not anticipate. Already, many practices are closed to Medicaid recipients, some also to Medicare. The pace of innovation in drugs, medical devices and delivery is expected to slow significantly, as higher taxes and even rationing set in.

The repeated assertions by the law's supporters that nobody but the rich would be worse off was based on a beyond-implausible claim that one could expand by millions the number of people with health insurance, lower health-care costs without rationing, and improve quality. The reality is that any squeezing of insurance-company profits, or reduction in uncompensated emergency-room care amounts to a tiny fraction of the trillions of dollars extracted from those people overpaying for insurance, or redistributed from taxpayers.

The Affordable Care Act's disastrous debut sent the president's approval ratings into a tailspin and congressional Democrats in competitive districts fleeing for cover. If the law's continuing unpopularity enables Republicans to regain the Senate in 2014, the president will be forced to veto repeated attempts to repeal the law or to negotiate major changes.

The risk of a complete repeal if a Republican takes the White House in 2016 will put enormous pressure on Democratic candidates—and on Republicans—to articulate a compelling alternative to the cost and coverage problems that beset health care. A good start would be sliding-scale subsidies to help people buy a low-cost catastrophic plan, purchasable across state lines, equalized tax treatment of those buying insurance on their own with those on employer plans, and expanded high-risk pools.



Mr. Boskin, an economics professor at Stanford University and senior fellow at the Hoover Institution, was chairman of the Council of Economic Advisers under President George H.W. Bush.



Boskin: ObamaCare's Troubles Are Only Beginning - WSJ.com

[Yerf Dog]

Sebelius: Yes, Some Will Pay More for Health Insurance Under Obamacare

On a recent trip to Miami, Health and Human Services Secretary Kathleen Sebelius admitted that, yes, some people will be paying more for health insurance under Obamacare:

"More back tracking now from the Obama administration admitting that some Americans will pay more for health insurance under the Affordable Care Act," said the Florida news anchor. "During a visit to Miami, Health and Human Services Secretary Kathleen Sebelius stopped at a local library to talk to local residents about enrolling on the health insurance website. She also acknowledged that some people will pay higher premiums under Obamacare."

Said Sebelius, "There are some individuals who may be looking at increases. I think you cannot make a statement based on cost unless you compare what they had to what they're going into."

Sebelius: Yes, Some Will Pay More for Health Insurance Under Obamacare | The Weekly Standard

[Cybercowboy]

You know all those people who tried to sign up only to have their information lost? Never sent to the insurers and the government doesn't know what happened to the records? They sent an email to the insurance companies the other day essentially telling them to just cover the people anyway. Or something. Whatever it takes, just make shit up as they go.

[DAB]

also heard the gov is sitting on about 50,000 paper applications. yeah, sure, you are covered...

[Giraffe (He/Him)]

TL;DR

Thanks Red.

[Sea Six]

Originally Posted by Cybercowboy

You know all those people who tried to sign up only to have their information lost? Never sent to the insurers and the government doesn't know what happened to the records? They sent an email to the insurance companies the other day essentially telling them to just cover the people anyway. Or something. Whatever it takes, just make shit up as they go.

Can the gov force the insurers to cover those who they don't have fully completed (and approved) applications for?

I suppose if they can force individuals to buy insurance, they conceivably could..

God, I hate this law.

[BigJoe]

The only thing good about this law is is MAY wake people up and give us a Republican House and Senate. Then we'll see how many times Obama can use the veto.

[Sea Six]

Originally Posted by BigJoe

The only thing good about this law is is MAY wake people up and give us a Republican House and Senate. Then we'll see how many times Obama can use the veto.

I've given up on elections saving this country.

[bsmith]

Originally Posted by BigJoe

The only thing good about this law is is MAY wake people up and give us a Republican House and Senate. Then we'll see how many times Obama can use the veto.

The Republicans need to make the motherf**king Democrats OWN this piece of shit legislation at this point.
De-funding is a lost cause.

[CP]

I'm still waiting for my $2,500 lower premium.

[Sea Six]

Mine was supposed to be 3,000% lower.

I have that on high authority.

[DJ_Critterus]

Originally Posted by Sea Six

I've given up on elections saving this country.

The American population along with the illegals, the dead who keep voting somehow and those who vote early and often can never pick politicians who have even the slightest desire to do the right thing despite what the party line says (and yes, I mostly refer to the DEMS and the RINOs).

[Bingo Fuel]

[G8rDMD]

Originally Posted by BigJoe

The only thing good about this law is is MAY wake people up and give us a Republican House and Senate. Then we'll see how many times Obama can use the veto.

Originally Posted by Sea Six

I've given up on elections saving this country.

Originally Posted by bsmith

The Republicans need to make the motherf**king Democrats OWN this piece of shit legislation at this point.
De-funding is a lost cause.

As much as I am a Conservative, I don't believe that ANY politician in Washington has the people's best interests at heart. Rep or Dem. The 2 party system is for shit any more.

[DJ_Critterus]

Originally Posted by G8rDMD

As much as I am a Conservative, I don't believe that ANY politician in Washington has the people's best interests at heart. Rep or Dem. The 2 party system is for shit any more.

I wish a vote for none of the above didn't translate into a vote for a dem. They are the worst of the evils, IMO, and we see proof of it every day.

[69camfrk]

Originally Posted by Sea Six

I've given up on elections saving this country.

I don't think anyone we elect is going to have the best interest of the country in mind. It is mostly self interest, thus the problem. They enrichen themselves to the point they almost pop at our expense and the expense of the nation. It will fall apart sooner or later. Probably sooner.

[69camfrk]

Originally Posted by G8rDMD

As much as I am a Conservative, I don't believe that ANY politician in Washington has the people's best interests at heart. Rep or Dem. The 2 party system is for shit any more.

I didn't even make it down to your post and we said almost the same thing. Must be some truth to it.

[OddBall]

It's getting downright comical watching Jay Carney up there like Baghdad Bob.

[Sea Six]

Looks like we now have three states calling for an Article V Convention Of States.

34 are needed to call the convention for the purpose of proposing amendments to the Constitution. If any are proposed, 38 states would need to vote to approve them in order to validate the amendments.

What amendments could a COS propose that could not just stop the progressive trampling of our Constitution, but to reverse course and put us on the road to recovery?

I'm thinking:

1. Term limits. I like twelve as a round number, to be used as a total for all federally elected offices. You get twelve years, no more. You only have three left? No presidency or Senate office for you.

2. Balanced budget. You can't come up with a budget, and one that is balanced? Sorry folks... every member of Congress is fired, pending a new election. Anyone fired from public office is in eligible for the ballot. Good luck with your write-in campaign.

3. Everyone is subject to new laws. No exceptions for you, Congress.

Others?

[JRD77VET]

Originally Posted by Sea Six

I've given up on elections saving this country.

Especially when the one in the highest office uses the IRS to intimidate everybody that opposes him.

Nothing quite like buying votes with entitlement programs