The Obamacare Saga and You

As you should well be aware of, the Affordable Care Act (ACA) aka Obamacare is ramping up to officially launch on January 1, 2014.  The state and federal exchanges are slated begin operations in less than 2 months on October 1, 2013.  This massive, unipartisan piece of legislation has been extremely controversial since its initial drafting and the controversy/unpopularity continues to grow.  It appears that the “wheels may be coming off” already.  The law is simply not ready for “prime-time” and will require numerous adjustments.  The federal data hub which essentially will be the confluence where marketplaces can access lots of information on who qualifies for what programs is behind schedule.  This hub includes income data from the Internal Revenue Service and citizenship records from Homeland Security, alongside additional data from Health and Human Services and the Office of Personnel Management.  The amount of data collection and storage will be massive and the undertaking to prepare is gargantuan.  In a recent update, Medicare spokesman Brian Cook emails, “We are on schedule and will be ready for the Marketplaces to open on October 1.  We have made significant progress in the last three months. The Centers for Medicare & Medicaid Services (CMS) has extensive experience building and operating information technology systems that handle sensitive data.  This experience comes from many years administering the Medicare, Medicaid, and CHIP programs.”  Don’t hold your breathe as time will tell over the next 48 days.

In addition to the law’s logistical challenges, there have been several delays in the law’s provisions including:

  • delay of Obamacare Medicare cuts until after the election
  • delay of the law’s employer mandate
  • delayed enforcement of many key eligibility requirements for the law’s health insurance subsidies thus establishing reliability on the “honor system” instead
  • delay in the caps on out-of-pocket insurance costs; by banning lifetime limits, mandating lower deductibles and capping out-of-pocket costs, premiums must increase to reflect these changes; these limits will apply to both individually-purchased insurance and employer-sponsored coverage

Other concerns about the law’s provisions have been discovered.  Do you remember when former House speaker Pelosi issued the arrogant and ludicrous statement that “we have to pass this [health care] bill so you can find out what’s in”?  We are now finding out! 

Peggy Noonan, a well respected author and weekly columnist for the Wall Street Journal, wrote a piece entitled “The High Cost of Obamacare”.  The article links to another by Yuxing Zheng of the Oregonian to discuss a complicated subject.  “A woman in Cornelius, Ore., takes care of her disabled 22-year-old daughter. The daughter has cerebral palsy, spina bifida and a condition called automonic dysreflexia. She requires 24-hour care. The mother provides it, receiving for this $1,400 a month. The mother fears—and is apparently right to fear—a provision of the Affordable Care Act that will, as Zheng reports, “largely prohibit guardians from serving as the paid caregiver of an adult child with developmental disabilities.” The mother is afraid this will mean foster care for her daughter, or a lengthy and costly process in which she herself will be forced to transfer legal guardianship to someone else. The provision, the paper says, will likely cause hardship for hundreds of Oregon families in which the guardian and the caregiver are the same person.”

Oregon officials are asking the administration for an exemption to the provision.

“Four points. First, no mother or child should be put in this position by a government ostensibly trying to improve their lives. Second, everyone in America knows health care is a complicated and complex subject, that a national bill will have 10 million moving parts, and that when a government far away—that would be Washington, D.C.—decides to take greater control of the nation’s health care it will likely get many, maybe a majority, of the moving parts wrong. A bill that is passed and is meant to do A will become Law U—a law of unforeseen, unplanned and unexpected consequences. And that’s giving Washington the benefit of the doubt, and assuming they really meant to honestly produce Law A. Third, because health-care legislation is so complex, it is almost impossible for people to understand it, to get their arms around what may be a given bill’s inadequacies and structural flaws. Stories of those inadequacies and flaws dribble out day by day, in stories like this one. They produce a large negative blur, and a feeling of public anxiety: What will we find out tomorrow? The administration reacts, as the president has, with protestations about how every large, life-enhancing bill has hitches and bumps along the way. But this thing looks now like one large hitch, one big and never ending bump. Fourth, when a thousand things have to be changed about a law to make it workable, some politician is going to stand up and say: ‘This was a noble effort in the right direction but let’s do the right thing and simplify everything, with a transparent and understandable plan: single payer.'”  I totally agree with her poignant assertion.  Senate majority leader Harry Reid said recently that he thinks the country has to “work our way past” insurance-based health care during a Friday night appearance on Vegas PBS’ program “Nevada Week in Review.”

“What we’ve done with Obamacare is have a step in the right direction, but we’re far from having something that’s going to work forever,” Reid said.

When then asked by panelist Steve Sebelius whether he meant ultimately the country would have to have a health care system that abandoned insurance as the means of accessing it, Reid said: “Yes, yes. Absolutely, yes!”  There it is folks, the ultimate goal for progressives in regards to health care in America.

As a medical professional and provider myself, I’m not an advocate of this law.  I agree with the premise but not the tactics.  I however would like to see the following in regards to government intervention: facilitation of a better medical/health savings account program, requirement of self-pay rate charges by providers to be the lowest rate they accept, and requirement that providers post their prices for their services publicly.

Much further discussion on Obamacare and resultant provisional changes will ensue over the next several weeks. Stay tuned for more news and insight here on the Nitroblog.

~ by Nitro on August 14, 2013.

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