Obamcare missteps continuing to 2015

Once again the Affordable Care Act (ACA or Obamacare) is gaining headlines as reports surface of the next shoe to drop for 2015. In the short existence of Obamacare there has been no shortage of news delineating the multiple departures the law has from the promises and hopes sold to the public before its light speed passage by a supermajority of Democrats. But the latest findings are an example of the stark contrast between supporters and detractors. The information is the same but the reactions are amazingly different.

As even the most casual political observer is aware, ACA was sold to the public (even as all polls showed a majority of Americans rejecting the law continuously since June 2009) via some of the key points that:

1) Every American must have health care coverage
2) The cost of healthcare will be lowered
3) Health care coverage will be improved for the average American
4) No American will be denied coverage
5) Anyone who likes the coverage they have, can keep that coverage

The ACA ignores the fact that, for whatever reasons, not all Americans want health care coverage. A point highlighted by the fact that some 15 million or more (depending on the estimate and source you use) Americans remain uninsured. This is sure to be a bigger issue as April 15, 2015 approaches and fines for not having coverage are forced upon the public.

Millions of Americans also have found issue with the fact that Obamacare requires everyone to have coverages that re not necessarily useful. Men are required to have and pay for prenatal care and OBGYN coverage that is physically impossible to ever use. Older Americans are required to have and pay for pediatric coverage that they may be well beyond realistically using. The list goes on, and includes the Hobby Lobby Supreme Court decision where religious objections to certain forms of contraception will shift the burden of payment and coverage from employers to the Federal exchanges (and thus the general public).

Little more needs to be said at this point, beyond quoting President Obama, on keeping the coverage and/or doctor you may like

But perhaps the most important feature, the underlying root cause of creating Obamacare, was cost savings. It was part of the promise made to the public on the 2008 campaign trail to reduce healthcare costs by $2500 (a promise that was broken long before the law took effect according to ?Politifact).

Sadly, Obamacare and its promise of lower cost, does not include the $1.2 trillion in waste that is a key component of the increase in healthcare costs. In fact, the ACA is likely contributing to that waste. The current cost of launching and running the Healthcare.gov site, do date, is approximately $840 million and growing. Of that amount, $175 million has been spent on Accenture, the company hired to replace CGI who created and presided over the failed launch in 2013. The Accenture cost alone represents in overrun of $84 million or 89% increase in cost.

The nearly $1 billion price tag for the website would be bad enough, if it were the end of the costs there but it is not. According to William Woods of the GAO, unless Government

“improves contract management and adheres to a structured governance process, significant risks remain that upcoming enrollment periods could encounter challenges.”

But that is not the worst of it.

Setting aside the waste and continuing issues of Healthcare.gov, the latest targets for health care costs are on the rise again for 2015. According to Andrew Slavitt, deputy administrator at the Centers for Medicare and Medicaid Services (CMS), the positive news is that costs may only increase by mid-single digit percentages. Of course this is based on projections by several States (he named only 3) and he added the caveat

“While this isn’t going to be true for every single individual and every single county in America, by and large the early results look very positive.”

That estimate of increase does not take into account the latest “bump” in the road. The fact that the Government subsidy does not apply to Federal exchanges in 36 States. This is the current issue created by a decision of the U.S. Court of Appeals for the D.C. Circuit – and countered by the decision of the U.S. Court of Appeals for the 4th Circuit, essentially setting up a Supreme Court review and decision.

Most interestingly is the point made by Johnathan Gruber, one of the creators of the Obamacare legislation, on the fact that the law directly prevents the subsidy that is a key component of the cost structure of the ACA, Jan. 18, 2012,

“The federal government has been sort of slow in putting up its backstop, I think partly because they want to sort of squeeze the states to do it…I hope that that’s a blatant enough political reality that states will get their act together and realize there are billions of dollars at stake here in setting up these exchanges. But, you know, once again the politics can get ugly around this.”

The loss of the subsidy would mean massive increases to the general public at all income levels. A situation created by the desire of the 2010 Democrat supermajority to gain political ground on the back of legislation that was purely partisan in its design.

Which brings us to the summation based on support and opposition of the ACA.

For the defenders of the ACA, they point to the reduction in the number of uninsured – while avoiding the fact that millions remain uninsured. They point to the slowdown in health care cost increases – while avoiding the fact that healthcare is increasing as opposed to the promise of decreases. They point to improvements in capability and reach – while desperately avoiding the failure of the launch and the continued excessive costs in trying to fix significant issues in the current function of Healthcare.gov. Defenders are also pointing to the supposed implied intention of the law – as adjusted for the realities of the present as opposed to the partisan political desires of the past.

For opponents of Obamacare, they highlight all of the failures and costs. They note the law as written and the original political intentions. They note the public’s perception of progress to date and disapproval. Opponents cite the very words of the key Democrats that rammed through the legislation, as time and again those words are proven to be misguided at best and lies at worst. Lastly, opponents have taken the action to seek resolution in the Court, expressly for the haphazard management of Obamacare and the deviation for law that has enveloped that management.

Two diametrically opposed views based on facts that are widely reported and confirmed. Positions deeply seated in the partisanship that gave birth to this law, and which has caused ramifications that the speed of passage and lack of co-operation prevented from being fixed. All to the detriment, short- and long-term, of the American people.

Perhaps it is well past time that both sides finally sit and fix the problem before the Affordable Care Act becomes an incurable cancer to the nation.

About the Author

Michael Vass
Born in 1968, a political commentator for over a decade. Has traveled the U.S. and lived in Moscow and Tsblisi, A former stockbroker and 2014 Congressional candidate. Passionate about politics with emphasis on 1st and 2nd Amendments.

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