Stanley Feld M.D., FACP,MACE
As we get closer to the implementation date of Obamacare it becomes
more and more obvious that there are more and more things we do not know about
Something we do know is that the law gives all the decision-making discretion
to the head of the Department of Health and Human Services. This is an obvious
defect in Obamacare as new regulations are produced by the Secretary of HHS
The new rules are a huge black box
secret. The steps being taken to implement Obamacare have also been a secret.
None of what is going on with Obamacare is transparent.
Health and Human Services has not
provided coherent answers to congressional oversight committees that have
requested answers to certain questions. Neither have comprehensive answers to
questions been provided to the press.
The Government Accountability Office
released the results of two investigations of Obamacare. The implementation of
Obamacare has blown deadlines and has improvised on regulation. There has been general
chaos at HHS.
The GAO said HHS isn't close to being ready to launch in October.
The Obama administration has told
congress and the press that it will be ready.
HHS has already announced it is throwing in the
towel on small business health insurance exchanges. These exchanges were
supposed to allow employees to choose from competing healthcare insurance
These small business health insurance exchanges have been put off
for at least one year. It is not clear whether these exchanges are the same as
those that are supposed to launch on October 1,2014.
The employees must choose from their employer’s private
plan options. However it is not clear if employers are going to stop offering
healthcare coverage and pay the “tax” penalty Obamacare imposes.
Employees will have to buy healthcare insurance
from the health insurance exchanges with after tax dollars. Prior to Obamacare employers
bought healthcare insurance with pre-tax dollars.
This is another Obamacare hidden tax increase.
If everyone is driven into health insurance exchanges
and the healthcare industry drops out of the health insurance exchange because
of the tax it will have to pay for every policy sold, America will have a
single party payer (the government) system by default.
This is President Obama’s goal.
The healthcare insurance industry will continue to
make its money with a single party payer because it is the government’s
administrative service provider. As administrator service providers the healthcare
insurance industry still takes its 40% off the top.
Consumers will be the ones that get penalized
through increased taxes.
HHS will be forced to run 34 of the 50 health
insurance exchanges and pay for the cost overruns expected. These cost overruns
are not in the healthcare budget. There are more than 100 “key activities”
necessary to set up exchanges.
Sixteen states have opted to run their own exchange
and take the money the federal government has offered. These states still have
between 16-52% of the key activities undone in order to qualify as a health
The complete set of regulations for these
key activities has not been completely written by HHS.
Two states, Massachusetts and Utah, have had functioning health
insurance exchanges. These exchanges were developed pre Obamacare. These
exchanges might have to be redone once all the rules and regulations are
written and federal requirements are known.
“HHS has insurance premium filings for the 34 federal exchanges
but it decreed in a May memo that it would keep that information secret until
media have declared that there will be lower rates in the health insurance
exchange in California. The facts are the opposite.
An interesting observation using the Covered California calculator is
that a family earning $38,000 a year would
be entitled to a tax credit of $11,448 after they file their tax return for the
previous year. The yearly outlay for the health insurance exchange silver plan
for this family of four would be $13,164.
This family would have a theoretical cost of $1716 dollars per year for
silver plan healthcare insurance plus deductibles which are significant.
This family making $38,000 a year pays no income tax. I tried to figure
out how the government applies the tax credit if they pay no income tax.
Does the government write a check of $11,448 dollars for their tax
credit after they file their income tax return the following year? This is not
the definition of a tax credit.
This family earning $38,000 a
year cannot afford to pay the $1,097 a month for the insurance the first year.
It is thirty-three percent of their salary.
Second, the tax credit is worthless because they do not pay any tax to
I wonder if Kathleen Sibelius thought of this?
The CBO originally estimated that setting up all the 50
exchanges would cost $5-10 billion dollars. California has spent $900 million
dollars so far and they are not completely set up.
The Obama administration has been taking money out of other
federal health budgets to find more money to help states develop the health
“In June Kaiser
Family Foundation health tracking poll—which also found that public support for
ObamaCare hit a new post-passage low of 35%—reports that nearly one of three
Americans between the ages of 18 and 30 do not believe that insurance "is
worth the money it costs."
“And persuading young, healthy people to sign
up for coverage requires them to act against their own economic interest, since
they can always enroll later when they need it as a result of ObamaCare's
The health insurance plans are expensive and the exchanges will
malfunction. Physicians won’t participate because the reimbursement fees have
not been published. If someone files a claim wrong, they will not get paid.
These are just a few of the issues that can and will come up
that have not been explained.
The public must become
aware of the facts and not buy into the Obama administration propaganda
campaign that Obamacare is the greatest.
It is time for Americans to stop being passive. The protest
must start now before implementation is a disaster and taxes and premiums
escalate because of massive cost overruns.
The opinions expressed in the blog “Repairing The Healthcare System” are, mine and mine alone
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