December, 2013, The Unfolding Disaster That Is Obama Care Update, Part 3: Nullifying Obama Care At The State Level, No Access To Top Hospitals and Other Smack The Mole Failues

This is a third in what is likely going to be a long series of updates and analyses of the unfolding disaster that is Obama Care. We have been doing these mini-series every month for the past four months for the simple reason that this legislation is so bad, that the bad news from its rollout just keeps on coming.

Millions of Americans are losing their jobs, their current insurance policies, access to their favorite doctors, access to their preferred hospitals, and possibly access to life saving drugs not covered in their Obama Care insurance policies. The monthly premiums are generally much than they were prior to Obama Care’s rollout and the deductibles are also escalating dramatically. The President’s promises that you can keep your insurance policy, your doctors, and your hospitals is turning out to be either the biggest lie in Presidential history or the biggest piece of ignorance about what was supposed to be his landmark legislation.

Today’s insanity from Obama Care includes the following updates and crises:

1) Yesterday, we talked about the effort in the South Carolina state government to “nullify” an impact of Obama Care in the state of South Carolina. A piece of legislation to that effect has already passed in the House part of the state government, the state Senate will take it up early next year and if the Senate passes it, it will likely be signed by the Republican governor.

Well, it turns out that a trend might be starting to terminate the legislation since four state legislators in Georgia have introduced legislation in that state to do the same nullify action as South Carolina: 

• “The bill’s main thrust is to prohibit state agencies, officers and employees of the state from implementing any provisions of the Affordable Care Act, leaving implementation entirely in the hands of the federal government, which lacks the resources or personnel to carry out the programs it mandates,” said Rep. Spencer in a press release.
• Again, I am not a Constitutional lawyer or expert by an stretch of the imagination so I have no idea if this is a valid state government tactic to use. However, apparently this nullify option is a long-standing legal principle, the so-called anti-commandeering doctrine, and thus some in the legal profession think that both states’ nullify efforts are on strong legal grounds.
• In four major legal cases from 1842 to 2012, the Supreme Court has consistently held that the Federal government cannot “commandeer” states, forcing them to enforce or expend state level government resources to participate in Federal law or regulatory programs. 

So who knows, maybe the Constitution will save us from this disaster after all.

2) According to a recent analysis from the folks at Americans For Tax reform:

• Health and Human Services Secretary (HHS) Kathleen Sebelius recently provided an updated dollar amount for the cost of HealthCare.gov in Congressional testimony: $677 million.
• In addition to the $677 million spent on the Federal Obama Care website, the Centers for Medicare and Medicaid Services (CMS) have already paid out a whopping $4.5 billion of taxpayer money to promote Obama Care on the state level.
• HHS also provided updated Obama Care enrollment results: 364,682 Americans have “selected a plan” from the Obama Care exchanges, the equivalent of putting an item in your online shopping cart and leaving it there. 
• Doing some simple math, we find that the taxpayer cost per potential “enrollee” is over $14,000 per potential shopper ($4.5 billion + $677 million = $5,177,000,000 ÷ 364,682 = $14,196)
• $14,000 to get one person interested in Obama Care. However, interest so far is not actually policy confirmation. Many of these people have not yet paid for the policy they may have selected on the exchange so there may be some “slippage,” i.e. people do not follow through and actually close the deal. In the presence of slippage, the cost per person would actually go higher than the obscene $14,000 per person.
• In fact, other news sources are saying only 30,000 people have actually paid for their Obama Care insurance policies vs. 365,000 of so who indicated they would. Thus, the cost for an actual paying Obama Care policy is more than ten times higher than the $14,000 (364,682 divided by 30,000 equals about 12).

How many businesses would be able to survive if the cost of acquiring a customer was hundreds of thousands of dollars? Not many but that is what the Obama Care legislation has cost us so far, billions of dollars for thousands of customers. Pathetic.

3) In a November 28, 2013 article we found out that the Obama administration was pushing back the ability of small businesses to comparison shop for small business Obama care insurance policies for twelve months because the government website to do so is still busted. 

One of the main selling points of Obama Care several years ago was going to be the ability of small businesses and their employees to get reasonably priced insurance via small buisness Obama Care exchanges. Due to gross incompetence of the Federal government, another Obama Care promise is broken and delayed. However, given how bad the non-small business/personal insurance side of Obama Care is turning out to be (lost coverage, lost access to favorite doctors, hospitals, and needed medicine) maybe American small businesses should be grateful for the broken promise.

4) According to a document put out by the Health And Human Services (HHS) Department in mid August, the Federal government is looking up to spend $7 billion dollars to find ways to reduce government incurred medical costs and expenses:

The purpose is to develop a Research, Measurement, Assessment, Design, and Analysis (RMADA) IDIQ [Indefinite Delivery, Indefinite Quantity] to respond to expanded needs of the Patient Protection and Affordable Care ACT (ACA) and Health Care reform ACT (HCERA). The work awarded under the RMADA will involve the design, implementation and evaluation of a broad range of research and/or payment and service delivery models to test their potential for reducing expenditures for Medicare, Medicaid, CHIP, and uninsured beneficiaries while maintaining or improving quality of care.

But weren’t we told that Obama Care by itself would reduce the cost of insurance policies, the cost of medical care, and the national debt by itself? Weren’t those the promises? Then why are we spending an incremental $7 billion (about $60 for every U.S. household) to do what Obama Care was billed to do? Something sounds very fishy or hypocritical or deceptive, or….take your pick of insanity.

The actual HHS call for quotes can be accessed at:

https://www.fbo.gov/?s=opportunity&mode=form&tab=core&id=663626dbd2b100854c7b5ebc41d9a584&_cview=0

5) Two more stories were recently published by the Associated Press verifying that many insurance policies and companies working through the Obama Care exchanges are restricting access to some of the best doctors and hospitals in the country in order to reduce costs. The first story was about the Obama Care exchange policies in New York state, as described by the AP article:

• New Yorkers buying a health plan on the state’s new insurance exchange should read the fine print if they’re interested in getting care at some of the city’s top hospitals.
• Not all are participating in the new plans created by Obama Care.
• As of early December, not one of the plans for sale on New York’s health benefit exchange would cover treatment at Memorial Sloan-Kettering Cancer Center, one of the world’s largest and most respected cancer hospitals.
• That could mean that the 615,000 individuals and 450,000 small business employees expected to eventually get their insurance through the exchange would have to go someplace else for treatment, or pay the bill out of their own pockets.
• Other premier city hospitals are in the networks of just a few of the new plans.

A similar but slightly different situation was reported by the AP out in Washington state. While some hospitals are opting not to serve Obama Care insurance policies like Sloan Kettering in New York, in Washington, in order to keep costs down, it is the insurers that are preventing some world class medical facilities from being available in the Obama Care insurance policies:

• The Obama administration made it a priority to keep down the cost of insurance on the exchanges, the online marketplaces that are central to the Affordable Care Act. But one way that insurers have been able to offer lower rates is by creating networks that are far smaller than what most Americans are accustomed to.
• The decisions have provoked a backlash. In one closely watched case, Seattle Children’s Hospital has filed suit against Washington’s insurance commissioner after a number of insurers kept it out of their provider networks. “It is unprecedented in our market to have major insurance plans exclude Seattle Children’s,” said Sandy Melzer, senior vice president.
• The result, some argue, is a two-tiered system of health care: Many of the people who buy health plans on the exchanges have fewer hospitals and doctors to choose from than those with coverage through their employers.
• The last AP paragraph from the Washington state example starts to explain what will able happen in this country as a result of Obama Care. The more affluent, the wealthier people in this country will continue to have access to the best doctors the best facilities the best health insurance policies (e.g. gold, platinum), the full array of medicine. The rest of us will devolve down to the more cut rate doctors and hospitals, the more limited access to needed drugs and medicine, and less robust insurance plans (e.g. bronze and Medicaid).

This all because the Obama Care architects and writers never understood the root causes of the high health care costs in this country:

• Americans are obese.
• Americans eat too much of the wrong kinds of food. 
• Americans do not exercise enough.
• Americans smoke too much.
• Americans are getting older on average, resulting in more age related diseases and health care costs.
• There is a significant need for tort reform in the medical industry.
• There is a significant need to allow cross state border insurance company competition.
• There is a critical need to cut down the $100 billion worth of taxpayer that is paid out in criminal fraud and waste every year.

Obama Care never really addressed these root causes, the resolution of which would take major costs out of the health care business in this country. Instead, the have contrived a Rube Goldberg-like health insurance hidden ball trick that only moves costs and expenses around within the industry, not reducing the overall levels of costs and expenses. 

It’s like playing the “Smack The Mole” game at your favorite arcade. You can smack down a cost mole in one area but those costs just appear again somewhere else on the board. Smack down those costs, and another cost mole sticks his head up. As a result, we start to see the bifurcation of health care with the rich getting better care and the rest of us getting worse care. 

The cost moles and other calamities of Obama Care will pop their heads up again tomorrow as we continue to review the worst piece of legislation ever enacted by the most inept set of politicians Washington has ever seen.

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