Stanley Feld M.D.,FACP,MACE
Have the increased Obamacare taxes added enough value to the healthcare system to be worth the costs?
The answer is no.
Are the increased taxes becoming painful yet?
The answer is yes.
The yearly cost of Obamacare has not been transparent. There have been multiple delays in the implementation of Obamacare.
Favored businesses and unions have received waivers and exemptions from the laws required coverage. All the while taxes have increased and less than 10 million people have received healthcare coverage from the healthcare insurance exchanges. Eighty-five percent of those people enrolled are receiving federal subsidies.
No one has explained how a tax credit becomes a federal subsidy.
The public has no idea what the costs of Obamacare are or will be in the future. The CBO has revised its estimates several times.
Are all the Obamacare pronouncements confusing?
Yes. I believe they are intentionally confusing.
All the stakeholders are dissatisfied. Neither President Obama nor his administration is listening to the primary stakeholder (patients).
Why are there so many waivers and exemptions being handed out by the Obama administration? I believe it is because President Obama is listening to his political base.
He is delaying the implementation of his agenda so his goal of socialized medicine is not obvious to all Americans.
President Obama and his administration have mislead us about the exact number of enrollees since the very beginning of the first enrollment period, October 1,2013.
The American public was mislead about ,
- The disastrous website development, reason for website crashes and cost of website development.
- The exact number of enrollees the first year. (9.5 million correct to 8 million and then down to 6.8 million)
- The resulting further correction by a decrease in 800,000 more people losing insurance because of discovered ineligibility for subsidies.
- Decreasing the original predicted enrollees for 2015 from 13.5 million to 9.5 million.
- The change in the start of enrollment from October 1,2014 to November 15th to avoid discussion of enrollment around the time of the November 2014 elections.
- Extending the 2014 enrollment three months.
- Extending enrollment for 2015 for one to three months.
- Finally in 2015 announcing the back end of the website sending information to the IRS was still not complete.
- Rehiring CGI the same Canadian company that built the disastrous healthcare.gov to fix the back end of the website.
- Discovering that 1.2 million were counted that should not have been because they got dental insurance bringing the number of enrollees down from a recalculated 8 million to 6.8 million enrollees for 2014.
- Announcing that 11.5 million people have enrolled for 2015 (these numbers seemed shaking at the time of enrollment. It seemed to be closer to 9.5 million or less.)
- Eight hundred thousand (800,000) enrollees lost their subsidy because they lied on their application
- Announcing that the group market Obamacare enrollment is being delayed a year or two while the mandate penalty for employers was to start January 1,2015.
Along the way I got the feeling that none of the enrollment numbers could be trusted. HHS and CMS keeps on modifying and lowering them.
The Obama administration keeps telling us how great the enrollment is and that Obamacare is a success.
However, only ten million people have Obamacare insurance. Eighty five percent of those on Obamacare are receiving subsidies and still cannot afford the deductibles.
The rest of the enrollees have a pre-existing illness. They cannot find private insurance to buy. What about the 330 million people who might have subpar healthcare insurance? How many employers might discontinue employee insurance?
After five years with all these new Obamacare taxes, I would not call this a successful healthcare reform program.
All of these enrollees were in the individual market. These numbers do not include the group insurance market.
14 million lost their healthcare insurance on the individual market. 10 million gained insurance on the healthcare insurance exchanges.
Several states healthcare insurance exchanges have failed.
An unknown number of enrollees in 2014 did not re-enroll in 2015 because of the loss of the subsidy and the high deductibles.
Other enrollees did not sign up again because they could not afford the high deductible.
The following is President Obama’s next trick play.
At the end of 2015 enrollment the Obama administration declared that 11.5 million people were enrolled.
On March 16,2015 the administration said about 16.4 million people have gained health insurance coverage since the Affordable Care Act became law nearly five years ago.
Please notice the tricky wording. The Obama administration is counting children under 26 that now can be included in their parents’ group insurance plans and the additional Medicaid recipients added by some states.
The count is not only the people who enrolled in Obamacare through the healthcare insurance exchanges.
The present discussion is about the success of the healthcare insurance exchanges not the increase in Medicaid coverage.
Confirmed Exchange QHPs: 11,699,473 as of 3/18/15
Estimated: 11.95M (9.06M via HCgov) as of 3/18/15
Estimated ACA Policy Enrollment: 33.1M (10.46M Exchange QHPs, 8.20M OFF-Exchange QHPs, 330K SHOP, 14.1M Medicaid/CHIP)
There are two possible reasons for the Obama administration’s pronouncement at this time.
The first is the Republicans are about to announce its alternative plan to Obamacare. The administration’s goal would be to blunt the impact of the alternative plan by announcing the false success of Obamacare.
The second reason is to play mind games with the Supreme Court.
Justice Kennedy’s questioning at the hearing of King vs. Burwell expressed his concern for 85% of 10 million people who would loss their federal subsidy. Justice Kennedy did not address the letter of the law in his questioning.
Only the state healthcare exchanges can provide subsidies not the federal exchanges according to the written law. This is executive overreach of power granted by the constitution. President Obama should have asked congress to rewrite the law’s provision.
In an attempt to pressure the Supreme Court to vote in President Obama’s favor the administration has given the impression of confidence the Supreme Court will act in its favor.
The Obama administration has announced, a few times, that it does not have an alternative plan if the Supreme Court rules against it.
This is not true. The Obama administration has at least three alternative plans in the works.
It looks as if President Obama cannot help himself from trying to manipulate the American public and now the Supreme Court.
The opinions expressed in the blog “Repairing The Healthcare System” are, mine and mine alone
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