Author and senior editor at The Federalist, David Harsanyi, says in his recent post on Human Events (online, Jan. 9), “The idea that lifting subsidies for a relatively small number of newly insured Americans would result in collapse of the entire state insurance markets or create unmanageable havoc is not only risible but transparently political.” Harsnyi adds, “so needless to say, the pending Supreme Court challenge over the Affordable Care Act via King v. Burwell is the most significant decision since Hobby Lobby or perhaps Citizen United — or whenever the most recent time was when the world was going to come tumbling down around us.” Harsanyi feels many liberal pundits are pushing the United States Supreme Court to consider aspects of the Affordable Care Act having nothing to do with the (healthcare) law. He clarifies, Republicans and libertarians argue that a “replacement healthcare bill,” creates an atmosphere where it is “easier for the court to act.” If that were the case, would the U.S. Supreme Court simply be “surrendering to the politics of the day,” Harsanyi’s Human Events report asks.
Kimberly Leonard is a health care reporter at U.S. News and World Report. A recent post by her in that publication (online, Jan. 12) quotes Michael Cannon, director of health policy studies at the Cato Institute, “The fact that the subsidies are causing controversy among the very people they’re intended to help is “evidence that the government doesn’t do charity very well.” As 2015 begins, this also means that questions of ethics emerge. What about those persons eligible for health insurance – as determined by their income – who in reality completely possess the means to “pay their own way.”
According to Ed Haislmaier, who is a senior research fellow at the Heritage Foundation, “There is no question that we are enrolling people through these programs who would otherwise be considered middle-class or even affluent.” He adds, “We are seeing people with enrollment in these programs that have significant assets, but for whatever reason – usually a temporary reason – fall below the income line.”
Dave Klemencic, who owns Ellenboro Floors in W. Va., is one person who has elected to not have health insurance. He could be in for a tax subsidy. Yet, because of his own beliefs, he will not be taking it. He feels it’s not in the county’s “best interests,” according to U.S. News and World Report. For his part, Klemencic sees such subsidies as a handout – which runs counter to his own personal beliefs. He also questions the validity of the government’s constitutional standing to offer such funds.
Will single-payer health insurance coverage and care ever work in the United States? Some argue the only way that it can is through what amounts to healthcare “rationing.” For Medicaid recipients this becomes quite the cruel joke. In an online (CNBC) posting “Street Signs” supervising producer Jake Novak says, “[W]e’re talking about millions of poor people who won’t even get in the door to see a doctor in the first place. And that also means breaking the promise that emergency rooms will get some kind of traffic relief thanks to Obamacare. Those rejected Medicaid patients are going to have to go somewhere, and the ER will remain the only places that can’t turn them away.”
As of late, finding a doctor willing to accept Medicaid payments is now even more difficult, due to a severe decrease in reimbursements to doctors treating such patients. Novak says, “The reasons are the same as they are for Medicaid: The reimbursements are going down just as demand is getting higher.”
Novak also advises us (especially physicians) that is unlawful for doctors to “write-off” the dispensing of healthcare for free. Translation? “[M]ore and more Americans are “covered,” but fewer and fewer Americans will actually be able to get health care.” Novak calls that, “The Great Obamacare Bait ‘n’ Switch.”
Perhaps one constant about federal income tax returns, and the IRS who oversees them, “Everything you put in your tax return is something that they’re trusting that you’re telling the truth” . . . “And of course if they audit you, you will have to prove it.” This quote comes from Jeffrey Porter, an Accountant with Porter and Associates.
While tax filing season is just around the corner, some may find this tax season more aggravating – - due to provisions in the Affordable Care Act. This is according to a recent report in the Washington Post (online, by Jonnelle Marte, Jan. 12).
Another accountant, Michael Greenwald, a partner with Friedman LLP, offers his view of filing taxes in 2015 – - when it comes to healthcare matters relating to Obamacare, “The Internal Revenue Service, in addition to being a tax collection agency, is now a health care agency.” The reason? According to the Washington Post report, “[T]axpayers will now have to say on their tax returns if they did — or did not — have health insurance last year. Those who received insurance subsidies or who went without insurance altogether are also going to face new forms, additional questions and some complicated math.”
Still, these scenarios may not automatically add up to IRS horror stories for Americans. Literally, millions who have health insurance coverage courtesy of their employers – or who have it, through for example, Medicare, Medicaid, or even COBRA, will simply check off on an additional box on their federal income tax return.
Accountant Jeffrey Porter adds, “If you didn’t purchase [insurance] on a market place and did not get a subsidy, you’re pretty much done.”
The majority of Americans who purchased health insurance on the healthcare exchanges (or marketplaces, as they are also known) were additionally in receipt of subsidies – assisting in the reduction of their insurance expenditures. Yet, Jonnelle’s Washington Post report tellingly adds, “But come tax time, people will find out just how much of a subsidy they received — and if they have to pay part of it back.”
At least one anti-Obamacare argument goes something like this – - that hospitals should literally compete for patients’ business. According to a recent report in Forbes (online, Jan. 12) Avik Roy explains, “Republicans talk about letting patients buy insurance across state lines. But the real solution is to allow patients to buy hospital care across state lines. Furthermore, it’s important for federal and state governments to pursue anti-trust proceedings against hospital mergers that would create regional monopolies. To date, the Federal Trade Commission and the Department of Justice have done precious little to stop the trend of hospital consolidation, and often when they try, they’ve been stymied by the courts.”
Apart from being the Forbes Opinion Editor, Avik Roy is also a senior fellow at the conservative Manhattan Institute.
Vivian Ho, a contributor to The Hill.com, asks (online, Jan. 14) “So are the economic downturn and stagnant wages to blame for workers’ healthcare cost problem?” It may be other factors. This recent article also cites information from USA Today which in turn recites Kaiser Family Foundation findings which say, “Health care costs have risen substantially for middle-class workers. Apparently, Kaiser also found that the amount of the deductible (on average) for individual health insurance coverage has “more than doubled in eight years, from $584 to $1,217.”
The Hill report additionally cites to Journal of The American Medical Association (JAMA): . . . “research estimates that at least 21 percent, and perhaps 34 percent, of U.S. healthcare spending is waste. The sources of this waste are many, including overtreatment, failures of care coordination and failures of execution in care processes.” Ho also asks, “Why do we passively accept the waste caused by healthcare providers, which is making healthcare increasingly unaffordable for middle-class workers?”
Alex Wayne and John Lauerman write on a Jan. 8 web post (in Bloomberg) that those businesses reasonably described as “large employers” are more and more terminating their most luxurious health-care plans. This is due to the fact a tax is looming on such commonly known “Cadillac” insurance plans, and that levy is courtesy of the Affordable Care Act. According to the Bloomberg article this spells a transfer of increased costs to a noticeable variety of workers — inclusive of college professors, at Harvard, for example.
Some businesses are ushering in increased deductibles and co-pays, coupled with more costly premiums The introduction “wellness programs” are now also a looming reality, ones with an unpleasant component — penalties for non-compliant employees.
Wayne and Lauerman postulate that, “Requiring employees to shoulder more of the cost burden may undermine public support for Obamacare just as Congress, now firmly under Republican control, considers new ways to gut the law.”
According to the Bloomberg article, a recent report by New York’s Commonwealth Fund says increases in premiums for employer-based health coverage “slowed markedly” in just over 30 U.S. states — since 2010, the year the Affordable Care Act became law, the New York-based Commonwealth Fund reported today. The Commonwealth Fund report also says nationwide “premium growth fell by about a percentage point after the law, to 4.1 percent a year on average, the report said,” according to Bloomberg.
At the time of a post by Forbes contributor, Michael F, Cannon, (online, 1/7) a congressional vote was looming on literally the definition of “full time work” in the U.S. Why? To specifically address the ACA’s “Employer Mandate.” Passage could well mean that redefinition spells a 40 hour work week, versus a 30 hour one. Yet, Cannon says there are presently questions remaining, ones which need to be asked. “The measure is likely to pass,” according to Cannon. The reason? Per Cannon, “Now that Republicans have a majority in the Senate, there’s a chance the measure could clear both chambers of Congress.” If this winds up happening, the legislation could “reduce the burden of Obamacare’s employer mandate. But it would also increase government spending by making more workers eligible for health-insurance subsidies through Obamacare’s Exchanges.” Cannon asks, “How is that a policy victory?”
Other points to consider about the congressional employer mandate legislation include:
Noted conservative commentator Michelle Malkin’s recent post in Human Events (online, Dec. 31, 2014) recalls President Obama as having “promised that he’d “lower premiums by up to $2,500.00 for a typical family per year.” Yet, as Malkin points out, premiums for individual healthcare consumers have appreciably increased during the past 12 months. Malkin cites noted Forbes health policy writer Avik Roy and his Manhattan Institute’s analysis of over 3,100 counties in the United States. The findings? Individual market premiums went up by just under 50 percent.
The Human Events Report also says further implementation of the ACA in 2015 will wind up presenting taxpayers with a $2 trillion tab over the next 10 years. “That’s just the direct costs. Obamacare’s job-killing regulations continue to discourage businesses from expanding and force more bosses to slash hours to avoid the employer mandate,” according to Malkin.
Malkin also says, “The worst is yet to come. Before the midterms, panicked and politically driven Obama bureaucrats delayed premium payment deadlines, high risk insurance cancellations and onerous “meaningful use” mandates on health insurance providers grappling with Obamacare’s disastrous top-down electronic medical records rules. Those chickens will come home to roost in 2015.”
A recent report on Bloomberg Businessweek (online, Jan. 6) says approximately one year ago, in the North Star State, PreferredOne, an insurance plan, possessed all the hallmarks of an Obamacare success story. PreferredOne’s appeal had been offerings of reduced health insurance coverage premiums. Its enrollment levels stood at 60 percent — of a pool of 55,000 applicants. Yet in a recent surprise move (Fall, 2014) the insurer steeply hiked costs for coverage for 2015. Then they decided to altogether drop out or abandon the Minnesota’s Affordable Care Act (Obamacare) health insurance marketplace.
The Bloomberg Businessweek report by John Tozzi adds, “Minnesotans who got subsidies last year to help them buy Preferred One plans will see their premiums more than double if they don’t switch plans, according to an analysis by Wakely Consulting Group.”