Stanley Feld M.D., FACP, MACE Menu


Health Insurance Exchanges And The Federal Government

 Stanley Feld M.D., FACP,

Insurance Exchanges
are supposed to be state-regulated
and standardized health care plans in the United
, from which individuals may purchase health insurance
coverage eligible for federal subsidies.

All exchanges must be fully certified and
operational by January 1, 2014 under federal law.[1]

The health insurance
exchanges in all states are not going to be operational on time.

However, Americans of
all income brackets are experiencing the increases in 20 hidden taxes in
Obamacare right now. The increase in taxes is supposed to amount to $1.2
trillion dollars.

The health insurance
exchanges, are supposedly one of the centerpieces of President Obama’s health care law,

Their formation is failing
despite President Obama’s publicity.

If they are created President
Obama will have a clear path to the Democratic Party’s cherished Public Option.

This will be a giant
step to achieving a single party payer healthcare system.

Unfortunately, the
single party payer system will in turn fail because it will be unaffordable for

Individual states and
the healthcare insurance industry will do everything they can to undermine the
success of health insurance exchanges.

Federal officials never
thought they would end up running the Health Insurance Exchanges. President
Obama’s plan was to dump this formidable and complex task on the states. Half
the states have refused to participate.

administration officials are getting ready to set up
and operate new 
health insurance markets
in about half the states, where local officials appear unwilling or unable to
do so.”

“So far, Governors of 13 states with nearly
one-third of the United States population have sent letters to the Obama administration
saying they intend to set up exchanges. Complete applications are due on Nov.
16, 2013.”

In other words, 37 states have not signed up
t. Once those 13 states that have signed up and start calculating their costs
for setting up and running the health insurance exchanges I suspect they will
also withdraw.

The Secretary of Health and
Human Services, Kathleen Sibelius
’ plan was to complete the regulations for the
states to start the health insurance exchanges by January 1,2014. 

The Secretary of Health and
Human Service has emphasized that states must meet her standards of transparency
and accountability.

The federal government requires
state exchanges to develop budgets and project operating costs, revenues and
expenditures to the central government’s satisfaction.

States must explain how the
revenue will be generated and how the exchange will address any financial

The federal government wants to
set up the rules and require the states to execute these rules at the states
expense. President Obama promised to “fund” the exchanges for the states for
two years. After that they are on their own.

The health exchange programs
will be delayed because the government pledged to set up the health exchanges
in the states that opted out of the program. It has not started to set up these

of Health Insurance Exchanges is a complex and expensive task. States are
required to operate under a balanced budget. States cannot balance their
budgets with health insurance exchanges unless they further increase taxes.

 “Federal and state officials and health policy experts expect that
the federal government
will run the exchanges in about half of the 50 states.”

guess is it will be closer to 35 states. Federal officials are preparing to do
the job. It will be poorly executed and difficult politically.

President Obama knows the
public fears a federal takeover of the healthcare system. He realizes the
public understands the health Insurance exchanges are one more step toward a
federal takeover of the healthcare system.

The Obama administration
does not want to encourage that fear by taking over the Health Insurance

Neither does the Obama
administration want to alienate state officials whose help they need to execute
the federally run healthcare exchanges.

The federal government
does not have the manpower to run all these exchanges. It is outsourcing the
work to private contractors.

We have seen the
disastrous abuse to physicians by outsourcing fraud and abuse investigations to
private contractors.

“The Obama
administration has invited advertising agencies to devise an elaborate
“outreach and education campaign” to publicize the federal exchanges and their
potential benefits for consumers.”

The Federal officials
are hiring private contractors to provide “in-person assistance” to consumers
and to operate call centers.

President Obama’s
administration has attacked Mitt Romney and Bain Capital for outsourcing of

President Obama is now outsourcing
these jobs to a foreign company, while America desperately needs jobs here.
This is duplicity to its highest degree.

He better keep it out of
the mainstream media or Mitt Romney out to get it in the mainstream media

Federal officials
have turned to the American subsidiary of a Canadian company,
the CGI Group, to
provide information technology services to the federal exchanges under a
contract that could be worth $93.7 million over five years.

Kathleen Sibelius has demanded total transparency
of state health insurance exchanges yet planning for the federal exchanges has been done
almost entirely behind closed doors.

“We have gotten
little bits of information here and there about how the federal exchange might
operate,” said Linda J. Sheppard, a senior official at the Kansas Insurance

“I was on a panel at
Rockhurst University here, and I was asked, ‘Where is the Web site for the
federal exchange?’ I chuckled. There really isn’t any federal exchange Web

In New Hampshire, Thomas
M. Harte, the president of Landmark Benefits, which arranges health insurance
for 300 employers of all sizes, said:

“Nobody has any idea
what the federal exchange will look like. There has not been much communication
between officials drafting plans for the federal exchange and the people who
will use it: consumers, employers, brokers and insurers.”

Administration officials
have not set forth a budget for the federal exchanges.

“They said they
intended to charge “user fees” to the participating health insurance plans.

It is unclear whether
the fees are subject to approval by Congress or whether insurers could pass the
costs on to consumers.”

The Federal Government
is not telling us what they are going to do. It is not following its call for transparent

It is pretty clear to me
this will be one of many steps toward the destruction of the healthcare system.
The healthcare system will self implode. At that point everyone will be begging
the government to take over.

It will be impossible
for President Obama to take over a business the government cannot afford.

A key to Repairing the
Healthcare System is to decrease the outsourcing and bureaucratic complexity.

It is to let Americans
be independent, own their healthcare dollars and their health and not be
dependent on government complexity, inefficiency and rationing of care.

Entitlements do not save

The opinions expressed in the blog “Repairing The Healthcare System” are, mine and mine alone

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