Beyond the Courts: The Exchanges AREN'T Working, The DC Decision 5/2016
Whether you're for Obamacare or not, the curious result of the Democratic hubris that insists Obamacare is here to stay, regardless of the negative impact it has on consumers is in no small part the reason that today, Repeal seems to be the only way out to protect consumers. Like a protective parent of creation, the government is willing to DO ANYTHING, SAY ANYTHING to preserve Obamacare, regardless of its stunning failures.
1-The reduction in the alleged number of uninsured due to Obamacare exchange plan enrollment on an annual basis has fallen short every year--This year the government disclosed it's only between 9.4 and 11.4 million (https://aspe.hhs.gov/affordable-care-act-research.)
2-The alleged ability to keep costs down as the bargaining power of the consumer was crippled by the individual mandate forcing us to purchase the consumer financial product of health insurance with the government pretending it would keep the costs of insurance down has failed as the Congressional Budget Office predicts: "Over the period from 2005 to 2014, premiums for employment-based insurance grew by 48 percent for single coverage and by 55 percent for family coverage. CBO and JCT expect them to grow at similar rates over the next decade," https://www.cbo.gov/publication/51130.
3-After years of people being shut out of their best option for health insurance from their employers because employers are constrained in how much they can charge for self-only health insurance but can price-gouge their employees for dependent family coverage, the so-called Family Glitch, there's still no fix (search Family Glitch).
4-After years of individuals experiencing the financial jeopardy of health insurance plans that leave them vulnerable to ever-increasing costs of copayments, coinsurance, and deductibles we see the government oblivious to this peril as every year it INCREASES our out-of-pocket maximums (search Increase in Out of Pocket Maximum).
5-After years of evidence indicating the defensive medicine and over-testing which often expose individuals to the physical and emotional wear and tear of essentially making healthy people feel like patients as they run through cascading experience of getting this thing tested and that thing tested, combined with the recent news confirming that MEDICAL ERROR is the THIRD LEADING cause of death in the US, Obamacare's fallacy of prevention heaviness is unchanged (search Third Leading Cause of Death).
Yet the government has spent millions in making sure the law continues, without making a single change to those policies that are injuring consumers. In King v. Burwell, the government FOUGHT AND WON the right to PAY MORE and keep the pot sweetened for ANY Obamacare enrollee rather than those enrollees through state exchanges (as provided by the Act) by paying out premium assistance.
This wasn't for consumers, this was for the preservation of the government's baby, Obamacare which admitted that without that money payout exchanges would fail. This wasn't about the quality of the insurance plans (which have repeatedly fallen short), it was about the QUANTITY--making sure insurance companies would buy into the exchange in order to get their hands on the enrollees through the exchanges which meant paying those enrollees to participate with premium assistance. BUT IT HASN'T WORKED--STILL, insurers didn't get enough enrollees or the right kinds of enrollees and they're threatening to leave the exchanges (see "Major Health Insurer Bailing On Most Obamacare Exchanges," 4/19/2016, Jeffrey Young, http://www.huffingtonpost.com/entry/unitedhealth-group-obamacare-exchanges_us_571554d9e4b0018f9cbade3b).
IT IS OF LITTLE SURRISE THAT THE GOVERNMENT'S REACTION, as expressed by Josh Earnest, TO THE US DISTRICT COURT FOR THE DISTRICT OF COLUMBIA was, "They've been losing this fight for six years. And they'll lose it again," https://www.whitehouse.gov/the-press-office/2016/05/12/press-briefing-press-secretary-josh-earnest-5122016 Obamacare is their baby and they'll do and say anything to save it regardless of how much it hurts consumers.
We've seen ample evidence that Obamacare can indeed be changed, the Administration has accommodated itself when it's come to changes to Obamacare in terms of reinterpreting it, changing it, delaying it, and apparently now taking on Congress' role of funding it. That's been the government's view--We decide all, you decide nothing, and in the face of that ongoing ultimatum, there may very well be little recourse besides repeal.
The issue in the decision is essentially the payouts by the government to keep insurers participating in the exchange, payments to insurance companies to keep enrollees from having to pay full price for health CARE (under 1402) as opposed to health INSURANCE (under 1401). Health CARE means the costs of cost sharing where the federal government kicks in money to insurance companies for the costs of health CARE such as copayments, coinsurance and deductibles IN ADDITION to payments it makes for premium costs.
May, 2016, the US District Court for the District of Columbia, decided against the Obamacare Administration and said that Yes, the House of Representatives has standing, a stake in bringing the lawsuit against the Federal government for basically stepping on Congress' toes and bypassing the requirement that the House handle appropriations for legislation that requires such appropriations where there is no permanent money pot from which the federal government can pay out benefits
AND that Yes, the federal government wrongfully paid out and pays out cost-sharing entitlement payments to insurance companies on behalf of eligible Obamacare enrollees.
Under the two ways the government pays insurance companies (portion of premiums and portion of CARE expenses), in the second instance which is at issue, in order to make sure those insurance companies keep buying into exchanges and also to make sure people keep buying into exchanges, Obamacare says to insurers--you'll get your full price, we'll pay a share of it, and to exchange enrollees it says, you'll pay less than full-price, we'll pay a share of it. This is what cost-sharing subsidies are.
The issue is for those people eligible for cost-sharing (which is a smaller number than even the estimated 85 percent of the lackluster 9.4 to 11.4 million enrolled on exchanges eligible for premium assistance). Can the government just keep paying out money to insurance companies for health CARE in addition to the money they pay for health premiums without violating the law? The answer according to the DC court was, "No, they can't," therefore those COST-SHARING billions paid by the federal government are illegal because they require annual appropriations from Congress.
Whether they win or lose, consumers lose because beyond the Executive's continued expenditures of anything by doing anything to preserve Obamacare, the LAW isn't working--All this money isn't keeping insurers from raising prices, it isn't increasing enrollment year after year, it isn't providing higher quality health insurance plans.
So, sacrificing our consumer right to choose in the marketplace an insurance plan (individual mandate), incentivizing employers to provide worse policies (by establishing minimum standards for benefits rather than rewarding through tax breaks, et cetera enhanced benefits to employees), removing incentives for insurance companies to IMPROVE plans (rather than promising them they'll have customers regardless of how bad those plans are) and finally grossly over-powering the Executive branch by bypassing the legislative branch's appropriations authority MERELY TO FEED OBAMA'S EGO, has created a legally sanctioned precedent of victimization of the American people by a rogue Executive Branch.
1-The reduction in the alleged number of uninsured due to Obamacare exchange plan enrollment on an annual basis has fallen short every year--This year the government disclosed it's only between 9.4 and 11.4 million (https://aspe.hhs.gov/affordable-care-act-research.)
2-The alleged ability to keep costs down as the bargaining power of the consumer was crippled by the individual mandate forcing us to purchase the consumer financial product of health insurance with the government pretending it would keep the costs of insurance down has failed as the Congressional Budget Office predicts: "Over the period from 2005 to 2014, premiums for employment-based insurance grew by 48 percent for single coverage and by 55 percent for family coverage. CBO and JCT expect them to grow at similar rates over the next decade," https://www.cbo.gov/publication/51130.
3-After years of people being shut out of their best option for health insurance from their employers because employers are constrained in how much they can charge for self-only health insurance but can price-gouge their employees for dependent family coverage, the so-called Family Glitch, there's still no fix (search Family Glitch).
4-After years of individuals experiencing the financial jeopardy of health insurance plans that leave them vulnerable to ever-increasing costs of copayments, coinsurance, and deductibles we see the government oblivious to this peril as every year it INCREASES our out-of-pocket maximums (search Increase in Out of Pocket Maximum).
5-After years of evidence indicating the defensive medicine and over-testing which often expose individuals to the physical and emotional wear and tear of essentially making healthy people feel like patients as they run through cascading experience of getting this thing tested and that thing tested, combined with the recent news confirming that MEDICAL ERROR is the THIRD LEADING cause of death in the US, Obamacare's fallacy of prevention heaviness is unchanged (search Third Leading Cause of Death).
Yet the government has spent millions in making sure the law continues, without making a single change to those policies that are injuring consumers. In King v. Burwell, the government FOUGHT AND WON the right to PAY MORE and keep the pot sweetened for ANY Obamacare enrollee rather than those enrollees through state exchanges (as provided by the Act) by paying out premium assistance.
This wasn't for consumers, this was for the preservation of the government's baby, Obamacare which admitted that without that money payout exchanges would fail. This wasn't about the quality of the insurance plans (which have repeatedly fallen short), it was about the QUANTITY--making sure insurance companies would buy into the exchange in order to get their hands on the enrollees through the exchanges which meant paying those enrollees to participate with premium assistance. BUT IT HASN'T WORKED--STILL, insurers didn't get enough enrollees or the right kinds of enrollees and they're threatening to leave the exchanges (see "Major Health Insurer Bailing On Most Obamacare Exchanges," 4/19/2016, Jeffrey Young, http://www.huffingtonpost.com/entry/unitedhealth-group-obamacare-exchanges_us_571554d9e4b0018f9cbade3b).
IT IS OF LITTLE SURRISE THAT THE GOVERNMENT'S REACTION, as expressed by Josh Earnest, TO THE US DISTRICT COURT FOR THE DISTRICT OF COLUMBIA was, "They've been losing this fight for six years. And they'll lose it again," https://www.whitehouse.gov/the-press-office/2016/05/12/press-briefing-press-secretary-josh-earnest-5122016 Obamacare is their baby and they'll do and say anything to save it regardless of how much it hurts consumers.
We've seen ample evidence that Obamacare can indeed be changed, the Administration has accommodated itself when it's come to changes to Obamacare in terms of reinterpreting it, changing it, delaying it, and apparently now taking on Congress' role of funding it. That's been the government's view--We decide all, you decide nothing, and in the face of that ongoing ultimatum, there may very well be little recourse besides repeal.
The issue in the decision is essentially the payouts by the government to keep insurers participating in the exchange, payments to insurance companies to keep enrollees from having to pay full price for health CARE (under 1402) as opposed to health INSURANCE (under 1401). Health CARE means the costs of cost sharing where the federal government kicks in money to insurance companies for the costs of health CARE such as copayments, coinsurance and deductibles IN ADDITION to payments it makes for premium costs.
May, 2016, the US District Court for the District of Columbia, decided against the Obamacare Administration and said that Yes, the House of Representatives has standing, a stake in bringing the lawsuit against the Federal government for basically stepping on Congress' toes and bypassing the requirement that the House handle appropriations for legislation that requires such appropriations where there is no permanent money pot from which the federal government can pay out benefits
AND that Yes, the federal government wrongfully paid out and pays out cost-sharing entitlement payments to insurance companies on behalf of eligible Obamacare enrollees.
Under the two ways the government pays insurance companies (portion of premiums and portion of CARE expenses), in the second instance which is at issue, in order to make sure those insurance companies keep buying into exchanges and also to make sure people keep buying into exchanges, Obamacare says to insurers--you'll get your full price, we'll pay a share of it, and to exchange enrollees it says, you'll pay less than full-price, we'll pay a share of it. This is what cost-sharing subsidies are.
The issue is for those people eligible for cost-sharing (which is a smaller number than even the estimated 85 percent of the lackluster 9.4 to 11.4 million enrolled on exchanges eligible for premium assistance). Can the government just keep paying out money to insurance companies for health CARE in addition to the money they pay for health premiums without violating the law? The answer according to the DC court was, "No, they can't," therefore those COST-SHARING billions paid by the federal government are illegal because they require annual appropriations from Congress.
Whether they win or lose, consumers lose because beyond the Executive's continued expenditures of anything by doing anything to preserve Obamacare, the LAW isn't working--All this money isn't keeping insurers from raising prices, it isn't increasing enrollment year after year, it isn't providing higher quality health insurance plans.
So, sacrificing our consumer right to choose in the marketplace an insurance plan (individual mandate), incentivizing employers to provide worse policies (by establishing minimum standards for benefits rather than rewarding through tax breaks, et cetera enhanced benefits to employees), removing incentives for insurance companies to IMPROVE plans (rather than promising them they'll have customers regardless of how bad those plans are) and finally grossly over-powering the Executive branch by bypassing the legislative branch's appropriations authority MERELY TO FEED OBAMA'S EGO, has created a legally sanctioned precedent of victimization of the American people by a rogue Executive Branch.
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