Pipes: On Obamacare's 5th Birthday

Health care expert Sally Pipes marks the 5th birthday of Obamacare with a painful reality check of the changes the health care law has made.

Promise: lower premiums by up to $2,500 per year for typical family.

2014 insurance premiums are 24.4% higher than they would have been without Obamacare, according to the National Bureau of Economic Research.

Promise:  protect vulnerable patient populations from increases in drug prices.

Drug costs are being shifted to patients. In 2015, more than 40% of all 'silver' exchange plans -- the most commonly purchased -- are charging patients 30% or more of the total cost of their specialty drugs. Only 27% of silver plans did so last year.Drug costs for these patients have skyrocketed as costs of drugs were shifted to patients.

Promise:  more choice, more competition, lower costs for millions of Americans.

The Government Accountability Office reports that insurers have left the market in droves. In 2013, 1,232 carriers offered insurance coverage in the individual market. By 2015, that number had shrunk to 310.

Promise:  Government spending on Obamacare will be only $900 billion over 10 years.

This month, the Congressional Budget Office estimated the law's 10-year cost will reach $1.2 trillion.

Promise:  Obamacare will cover 34 million uninsured Americans by 2021.

The Congressional Budget Office revised that estimate to 25 million obtaining coverage by 2025. Moreover 89% of Americans who have signed up for Obamacare in 2013 were already insured and simply switched insurance plans.

Promise:  Obamacare will let you keep your doctor and your hospital.

McKinsey & Co. noted that roughly two-thirds of the hospital networks available on the exchanges were either "narrow" or ultra-narrow," meaning Obamacare plans refused to partner with at least 30% of the area's hospitals. Other plans exclude more than 70%. More than 60% of doctors plan to retire earlier than anticipated -- by 2016 or sooner, according to Deloitte. Coverage is worthless if patients can't find a doctor or hospital who will see them.

 "Time and again," writes Pipes, "Obama has been proven wrong about what his health law would accomplish. Quality hasn't improved, and costs continue to grow out of control.  So far at least, that's Obamacare's legacy."

Irony: Obama's Amnesty for Illegals Undermines His Obamacare Law

"In the president's zeal to rewrite yet another area of law—immigration—he's sabotaged one of Obamacare's primary goals: expanding employer-sponsored health care," argue constitution law professor Elizabeth Price Foley and former Justice Department attorney David B. Rivkin Jr.

Obama's executive amnesty to 6 million illegals would give them work permits, but it would not allow them to qualify for Obamacare. As a result, they would become "ideal" workers for employers to hire if employers are trying to avoid the massive "employer responsibility tax" — a $2,000 to $3,000 per-employee annual tax imposed by Obamacare on employers for each of their workers who qualifies for Obamacare subsidies through state exchanges.

Because the 6 million immigration beneficiaries aren't eligible for Obamacare tax subsidies, hiring them reduces employers' chances of triggering the employer responsibility tax. Employers have a powerful financial incentive to hire them in place of U.S. citizens and permanent residents. The president's unilateral grant of work permits, combined with the fact that these workers cannot trigger the employer responsibility tax, makes those workers significantly more attractive.  ...  The inevitable result is that more workers will lack employer-provided health insurance coverage. [snip]

The president isn't a one-person lawmaker. He doesn't have the power in our constitutional regime to fix laws he thinks are broken. When a president does so, he not only intrudes on Congress' power, but also creates unpredictable repercussions for other laws. It's no small irony, that, by unilaterally attempt to fix our immigration law, Mr. Obama has undermined his own signature legislative achievement.

Read When Bad Obama Policies Collide.

ObamaCare before Supreme Court Wednesday

"On Wednesday, the fate of ObamaCare is in front of the Supreme Court again," writes former NY Lt. Gov. Betsy McCaughey. "At stake are the subsidies intended to make ObamaCare plans 'affordable'."

The letter of the law allows consumers to get subsidies only in the 14 states that set up their own exchanges, not in the rest that didn't. But the Obama administration is ignoring that and doling them out in all 50.

The administration claims that if the court rules against it in King v. Burwell, it will cause a national disaster. Don't believe it. The biggest losers will be insurance companies.

The losers, should the Court rule against the Obama Administration:

• about 5.5 million middle-class Americans who get questionable subsidies and who will see their insurance premiums quadruple if taxpayers are no longer required to pay three-quarters of their plans' actual costs; and
• big insurance companies who have seen their stock prices soar since the Healthcare.gov rollout — Humana up 66%, Cigna up 53% and Aetna up 52%.

The biggest winners, should the Obama Administration lose:

• people and businesses in the 36 non-exchange states:
• uninsured people would no longer be forced to pay the Obamacare penalty;
• 250,000 business with 50 or more full-time workers would no longer face Obamacare penalties; and
• job-seekers and part-timers hoping for full-time work from businesses that would no longer have an powerful incentive to keep their workforce below 50 full-time employees;
• the Rule of Law, if the Obama Administration is forced to "faithfully execute" his health care law; and
• the entire nation, "if Obama is forced to negotiate changes to his unworkable, expensive, overbearing law."

The court's decision, expected in June, will have no impact on the poor — about 90% of all Obamacare sign-ups — since the poor will continue to be subsidized through the federal Medicaid welfare program regardless of the court's decision.

Vermont Abandones Single-Payer Health System

Vermont was the only state to undertake the liberal dream of a state-wide single-payer health care system in lieu of Obamacare (as the Affordable Care Act permitted). After discovering how much it would cost, Vermont has abandoned the idea.

Designed by Jonathan Gruber, the Green Mountain Care plan enacted in 2011 (to take effect in 2017):

• abolished all private health insurance except those provided by multi-state employers;
• offered substantially higher benefits: i.e., the state would pay 94% of health costs, compared to 90% under ObamaCare's most expensive plan; and
• was to be funded entirely by tax collections, with no individual premium payments. 

But "Vermonters were stunned to discover how much their new free health care was going to cost," writes Michael Tanner in the New York Post.

•  Paying for Green Mountain Care would have required a 160% increase in state taxes by 2019, as much as $2.9 billion annually.
• The state's top income tax rate would have been raised from 8.95% to an astounding 18%. For high earners that would mean a combined federal-state income tax burden of 56%. Even lower-income Vermonters would have seen a substantial tax hike.
• Businesses would have been hit with an 11.5% state payroll tax (on top of a federal payroll tax of 15.3% to 16.2%).
• Payments to doctors and hospitals would have been cut by an estimated 16%, forcing some to leave the state and threatening the viability of local hospitals.
• And even with all of that, according to numbers released by the governor's office, the plan would be running in the red within four years.

Although "Vermont Gov. Peter Shumlin, a Democrat, announced that the state was giving up and abandoning its plans for Green Mountain Care, reports Tanner, other states are currently considering legislation similar to Vermont's, including Illinois, Massachusetts, Ohio, Oregon, Pennsylvania and Washington.

Source: Liberal Dream of Single-Payer Health Care Dies in Vermont, New York Post, January 18, 2015

Less-costly Alternative to Obamacare Insurance

"A fast-growing, short-term alternative to ObamaCare that allows customers to get cheap, one-year policies could put the government-subsidized plan into a death spiral," reports Fox News.

The plans, the only ones allowed for sale outside of ObamaCare exchanges, generally cost less than half of what similar ObamaCare policies cost, and are increasing in popularity as uninsured Americans grapple with the requirements of the Affordable Care Act. The catch -- that the policies only last for a year -- is not much of a deterrent, given that customers can sign up for ObamaCare during open-enrollment periods if their short-term coverage is not renewed.

These short term plans, which have a typical premium of $100 per month, are less costly than Obamacare plans with an average cost of $271 per month, and they allow the patient to choose any doctor or hospital.

Health Insurance Innovations estimates that the short-term insurance industry as a whole has grown at 20-30 percent over the last year since ObamaCare was implemented. McLean, of eHealthInsurance.com, said the plans appeal to young people.

“They're particularly popular with young adults," she said. "Forty-six percent of our short term policy holders are between the ages of 25 and 34.”

One conservative youth advocacy group, Generation Opportunity, specifically endorses buying short-term plans as a way to get around ObamaCare.

“We think it is an excellent option for young people,” the group’s president, Evan Feinberg, said, though he added that it isn’t perfect.

“We don’t think this is an ideal way to do health insurance in general. People should be free to insure themselves both against short-term catastrophic costs and the long term need for permanent medical care,” he said. “Unfortunately there are people who take away that choice from us based on a misguided idea that they can run a healthcare system from Washington that meets the needs of hundreds of millions of Americans.”

Middle-Class Squeeze

A weekend Washington Post article laments the fact that "fewer Americans find themselves in the heart of the middle class with every passing year." The article is long on statistics, sociologists, and sad human examples to illustrate the problem, but short on the underlying causes of the problem and possible solutions to help the middle class. Perhaps we can offer one.

Sociologist Joseph Cohen makes two comments about the middle class squeeze worth pondering.

• “One of four biweekly checks can go to child care, if it’s done illegally,” he added. “If it’s done legally, it’s much more.”

Interestingly, child care was often a family, friend or neighborly endeavor forty years ago. One young mom often stayed home with her own children and chose to care for her neighbors' children to make a little extra money. It was a cost-effective beneficial solution for families, until government regulations in many states made these personal arrangements "illegal." Today a lot of families have only two "legal" choices: expensive professional nannies or state-certified child care centers.

• “America is a place where luxuries are cheap and necessities costly. A big-screen TV costs much less than it does in Europe, but health care will sink you.”

Cohen's choice of contrasts is ironic. With little government regulatory oversight, television innovation and manufacturing are largely a product of a more pure free-market system, and prices for TVs have continued to go down. In contrast, health care is a product of ever-expanding government central planning-and-control that began with government's Medicare program in 1965 and grows exponentially under Obamacare. Not surprisingly, health care prices are soaring.

WashPo writers seem to suggest that one solution to the middle class squeeze is for them to lower their expectations.

One factor behind the financial squeeze is that the middle class’s expectations — a house, music and dance lessons for the kids, the latest in home entertainment — have stayed the same or increased even as costs have soared.

Conservatives and libertarians might offer a more middle class-friendly solution: substantially reduce government's regulatory interference in consumer transactions like child care, health care, housing, and a host of other areas in which "costs have soared," and let the free-market do for the middle class in these areas what it has done for them in televisions.

Dunn: Obama is Bursting the Left's Bubbles

Conservatives live adult-like in a world as it is. Liberals live child-like in a world of their dreams, and Obama is bursting the left's bubbles, writes J.R. Dunn.

Everyone, without exception, lives in a bubble, an area of individual consciousness made up of education, experience, and worldview. ...

But left-wing intellectual bubbles have been cold, desolate places since the Reagan era. With the catastrophe of the Great Society, the undeniable success of Reaganism, and at last the collapse of the USSR, leftist illusions were shattered, leaving little but blasted dreams and bitterness,  expressed as PC and related programs that amounted to little more than gestures of revenge.

Then came Obama, who brought it all back to life again.

Under Obama, however, Leftists' glorious dreams have turned to nightmares, and Dunn cites several examples: the military 'illusion', foreign policy, the 'surveillance state', 'climate change', and government-run health care.

The best way to undermine leftism is to let it operate for awhile. Expose the country at large to the nightmare realities of life under a Lyndon Johnson, a Jimmy Carter, or an Obama, and you will inoculate the citizenry for a generation to come.

This is occurring. We are seeing the utter collapse of the leftism program as it exists in the U.S., a collapse merely intensified and sped up by the fact that the Messiah has cut every corner and broken every rule of American governance. His abuse of pen and phone have so far produced only chaos. There is no reason to believe the next two years will be any different.

And all those bubbles?  They’ll begin to dim and cool down once again. The inhabitants -- the millions of true-believing Birkenstock wearers across the country -- will attempt to keep their spirits up with tales of betrayal and racism, but it won’t last. Eventually they will reach the same state they were in before Obama ever appeared. There they will remain, because the one thing Obama will have done is reinforce the legend of a leftist rebirth. These people will now never emerge into a real America. Instead they will wait for the appearance of a true messiah, sleeping until Der Tag in the same manner as Charlemagne or Barbarossa.

Percent Uninsured Worse Under Obama than Bush

Commenting on Gallup's graphic of the percentage of uninsured people (right), Charlie Martin at PJTatler writes:

At the start of the Obama Administration, the rate was 15.6 percent; the peak was 18 percent — in roughly the third quarter of last year. Remember that, when people were objecting because they'd had their insurance canceled? Harry Reid said all those people were lying, but Gallup says different. In fact, 1 percentage point on this chart is, roughly, 3 million people. The change from Q1 to Q3 was about 2 percent — or roughly 6 million people who became uninsured.

And now for the punchline: Since Obama was inaugurated in 2009, the net change is from 15.4 percent uninsured to 15.6 percent. So the net effect has been that by the Gallup Survey the number of uninsured has improved in the last year, but gotten worse since Obama was inaugurated, and is 1.2 percent worse than under Bush.

Why Large Employers Won't Be Hiring

From Paul Mirengoff @ powerlineblog.com:

"...it’s time for a sober look at the costs of [Obama's] signature program. Our friend Tevi Troy, head of the American Health Policy Institute (AHPI), provides that look in a study called “The Cost of the Affordable Care Act to Large Employers.”

The study is based on internal cost data from more than 100 large employers (10,000 or more employees each) doing business in the United States. ...The study’s main findings are that over the next decade:

Obamacare will cost large U.S. employers between $4,800 to $5,900 per employee.

Large employers expect overall Obamacare-related cost increases of between $163 million and $200 million per employer, or an increase of 4.3 percent in 2016 and 8.4 percent in 2023 over and above what they would otherwise be spending.

Based on these data, the total cost of Obamacare to all large U.S. employers will amount to between $151 billion and $186 billion, or 5.9 percent more than what they would otherwise be spending.

Tevi concludes that “these data demonstrate that the added mandates, fees and regulatory burdens associated with the ACA are increasing the cost of employer-sponsored health care plans, with implications for both employers and employees.” I’ll say.

Staffing decisions will, of course, be among the “implications.” If the estimates contained in the AHPI study are even close to accurate, Obamacare will likely prove to be a significant job-killer.

In a related story, Elizabeth Harrington reports @ the Washington Free Beacon:

Health care costs have already been increasing for large businesses, which spend $578.6 billion each year to provide health coverage for 170.9 million employees, retirees, and dependents. However, numerous studies suggest that Obamacare is adding to employers’ burdens.

For instance, a report by the Urban Institute found that Obamacare increased large employer health costs by $11.8 billion in 2012, and the Joint Committee on Taxation estimated that the excise tax on high-cost plans would cost $32 billion from 2018 to 2019.

The novel survey by the American Health Policy Institute asked companies directly what their costs will be, rather than “speculating from the outside.”

Gallup: Govt Itself Cited as Top U.S. Problem

If conservatives are unhappy with their leaders, imagine how unhappy liberal/progressives must be at what Obama and Democrat politicians are doing to them and their big-government-solves-all-problems ideology.

Gallup released its most recent poll results yesterday, and this chart was among them. One year ago — before Obamacare was implemented — only 4% of Americans thought "healthcare" was the most important US problem. Today, 16% think so.

"Dissatisfaction with government/Congress/politicians; poor leadership/corruption/abuse of power" now leads the pack, with 21% believing it is the nation's greatest problem.

Dr Carson Speaks

In the video below, Johns Hopkins University Hospital pediatric neurosurgeon Dr. Benjamin Carson addressed many topics, from political correctness and good education to health care and fair taxation, at the National Prayer Breakfast this month. One audience member, President Obama, doesn't seem particularly comfortable with Dr. Carson's remarks.

What's Next if Obamacare Goes Down?

NRO's Kathryn Jean Lopez interviews health care expert Sally C. Pipes on the Future of Health Care Reform in America, whether Obamacare stays or goes. Pipes, who will be a featured speaker at the Institute's Western Women's Summit this month in Santa Barbara CA, is the author of "The Pipes Plan: The Top Ten Ways to Dismantle Obamacare."