The Affordable Care Act Nobody Can Afford

I was just handed the Phreesia computer tablet by the receptionist under the guise of updating my medical and insurance information. I had seen this orange notebook in another doctor’s office and I became suspicious. Is this really meant to verify, as the website claims, my insurance eligibility automatically and help doctors collect on their insurance while easing the load of paperwork? Or is it forced electronic data compliance to Obamacare?

As soon as I started reading each screen, I realized that it was asking me to consent to third parties to obtain my medication prescription history from my pharmacy and to my entire medical history.

I had the right to request and restrict as to how my protected health information was used or disclosed. However, when I declined to sign, the computer stopped, and prompted me to talk to the receptionist. She informed me that diagnosis and/or treatment “may be conditioned upon my consent.”

The electronic screen and the paper copy the receptionist gave me said, “The [name withheld] is not required to agree to the restrictions that I may request and may refuse treatment based on my restriction as permitted by Section 164.506 of the Code of Federal Regulations.”

Suddenly, because I refused the IRS and HHS meddling in my personal health affairs, I had become persona-non-grata (unwanted person) to my doctor who had sworn a Hippocratic Oath to care for me and any patient who comes across his/her path.

In other words, I would not be treated if I did not sign yes. I had the right to say no, don’t’ give my medical information and history to anyone else but the doctor is not required to honor my request and may refuse treatment to me as permitted by Section 164.506 of the Code of Federal Regulations.

What if I said no, do not release my medical history to a third unapproved party and I paid cash? The doctor would not see me. Welcome to the destruction of our stellar healthcare and patient/doctor confidentiality, compliments of Obamacare.

How affordable is this Obamacare, the unfortunately named, the Affordable Care Act? The Democrats and the President said that costs would be so much lower; it would save the typical family $2,500 per year.

The cheapest category of Obamacare is the Bronze Plan which costs $20,000 per year for a family of two adults and three children and it pays only 60% of medical costs after the deductibles for the year have been met. And the deductibles are high per person and per family. The following tiers are Silver (70%), Gold (80%), and Platinum (90%).

During my 30 year teaching career, I seldom had to pay more than $3,600 a year premium for private insurance for my family. Even a retirement private plan did not cost more than $8,000 per year with 80% reimbursement as opposed to only 60% reimbursement under the Obamacare Bronze Plan. Is Obamacare really affordable? The answer is a resounding no.

According to the IRS, the penalty for not buying insurance is capped for now at either the annual Bronze premium, 2.5% of taxable income, or $2,085 per family in 2016.

President Obama said, “If you are one of the more than 250 million Americans who already have health insurance, you will keep your insurance.” Heritage’s Amy Payne estimated that “more than 11 million people will no longer have their employer-sponsored health coverage once Obamacare is fully implemented.” (Businesses Cutting Hours, Bracing for Costs of Obamcare, December 6, 2012)

Obamacare employer mandate is killing jobs. An employer with 50 employees must provide coverage or pay $2,000 penalty for each employee after the first 30 workers. It is easy to see how an employer would have to cut back employees to 30, replacing full-time employees with part-time ones, in order to avoid the penalty or the skyrocketing premiums for private coverage. These private insurance premiums rose significantly because Obamacare mandates insurance for all children up to 26 years old and for those insured with pre-existing conditions whose treatment can be costly.

Breitbart News reported that Pennsylvania Community College of Allegheny County had already cut the hours of 400 adjunct professors, staff, and part-time teachers, saving $6 million in potential Obamacare fees. (Wynton Hall, Obamacare Layoffs, Hiring Freezes Begin, January 5, 2013)

Because of the Obamacare medical device 2.3 percent excise tax, Stryker medical supply cut 1,170 employees (5%). Boston Scientific, Welch Allyn, Medtronic, Kinetic Concepts, and Smith & Nephew are also contemplating cuts in their work force. Zimmer Holdings, makers of hip replacement implants, laid off 450 workers in expectation of a $60 million tax bill in 2013. (Bob Unruh, Democrats in Congress ‘want out’ of Obamacare)

Everybody’s private insurance has been disrupted and private premiums have escalated, in addition to adding the “Cadillac tax” to plans that are judged too generous. According to Jonathan Gruber of MIT and the actuarial firm Milliman, non-group premiums rose 19-30% in some states and 55-85% in others.

The federal government has built a data hub to be used only for Obamacare without saying how it will be run. The HHS has released 13,000 pages of regulations with only 30 days for public comment while attempting to re-engineer 17% of the economy. (WSJ, It’s a Mad, Mad, Mad Obamacare, December 13, 2012)

On the deadline of December 14, 2012 states had to declare health insurance exchanges. At that time, only six states (Colorado, Massachusetts, Maryland, Oregon, and Washington) received conditional approval from the Department of Health and Human Services (HHS) to operate their own exchanges. Twenty-six states stated that they will not set up exchanges.

If a state operates its own exchange, it must come up in 2015 with its own source of revenue to run the exchange, making a state a vendor to HHS. The state running an exchange must also expand Medicaid to “able-bodied, low-income, childless adults” in spite of the fact that the Supreme Court ruled the Medicaid expansion voluntary. The federal government was not planning on covering the full cost of such Medicaid expansion. “Half of the reduction in the number of uninsured promised under Obamacare was based on mandating that states expand Medicaid.” (Heritage’s Morning Bell, December 13, 2012)

Several states asked Sibelius, the HHS Secretary, if they could expand Medicaid less. The answer was that only full compliance with the law will garner 90% reimbursement from the federal government. Nine states have refused to expand Medicaid to cover new populations. The feds will set up their own exchanges in those states but final regulations and specifics for the federal exchanges are not made public yet. Oklahoma and Maine have sued over Medicaid expansion and over statutory language and Medicaid expansion, respectively.

Three deadline extensions of implementing health exchanges have passed. Most states will share responsibilities with the federal government or default to a federal-run exchange. Only a minority of states have agreed to run their own exchanges.

A 3.5 percent administrative fee on coverage sold through federally-run exchanges will be levied. An additional $63 fee per employee must be paid in federal fees to cover people with pre-existing conditions.

Government funds will be set aside to promote/advertise [on primetime] Obamacare. Critics of the unaffordable health care law call such advertising “political advocacy.”

Practicing medicine will become more and less a government-run monopoly instead of the current monopolistic competition where patients are free to choose what doctors they go to, based on preference, doctor qualifications, specialty, reputation, insurance types, and premiums they choose to pay.

Doctors will either merge with hospitals, insurance companies, and specialty management firms or become “concierge” doctors, serving a reduced number of patients for a set fee. Consolidation will have a negative effect on patient access, price, and competition. Mergers in the 1980s and 1990s had negative effects in terms of patients being restricted or blocked from access to specialists and procedures.

More than $719 billion will be taken from Medicare over the next ten years to pay for Obamacare. According to Rep. Wally Herger, Chairman of the House Ways and Means Subcommittee on Health, the Independent Payment Advisory Board established by Obamacare is authorized to unilaterally impose price controls and de facto rationing of medical care.

Medicare is already in trouble. Taking $719 billion over ten years from Medicare to fund Obamcare will exacerbate financial problems. Medicare benefits are not a return on taxes paid into the system over time because Medicare is run as “pay as you go” – today’s wage earners pay taxes to fund benefits for today’s retirees. Since people live longer, “Medicare payroll taxes cover only 38 percent of current benefits.” (Rep. Wally Herger)

Obamacare depends on bringing young, healthy people into insurance markets to help offset the costs of insuring the old and the sick. If young people do not participate in the program and elect to pay the fine instead, Obamacare will not be able to make coverage affordable for the uninsured.

Most young Americans do not have insurance. Young people who do have insurance purchase less coverage. Under Obamcare, young Americans must get more coverage and pay more whether they want the added coverage or not. Private insurers have increased their premiums because the law prohibits them from rejecting the sick, and are no longer allowed to charge higher premiums to older customers. Premiums for a young, healthy male could go up as much as three times. Young adults could then opt out of private coverage, causing the market to implode. (Washington Post, Insurers Warn of Health Law ‘Rate Shock,’ N.C. Aizenman, February 16, 2013)

To make matters worse, government officials announced on February 15, 2013 that state-based “high-risk pools” under Obamacare will be closed to new applicants on February 16 through March 2, depending on the state, because funding is running low. The existing 100,000 enrollees will not be affected. If the funding is running low now, what will happen by the time Obamacare is fully in force?

There is a glitch in Obamacare that could leave more than 500,000 children uninsured. Congress defined “affordable” in the Affordable Care Act as coverage not exceeding 9.5 % of family income. If people have coverage that fall under this 9.5% affordable, they cannot get subsidies to go into new insurance markets. This restriction was put into place to prevent people from switching from employer coverage to exchanges in droves. “Affordable” was calculated based on self-only, individual worker, with an average market cost of $5,600. But the current market family coverage, according to the Kaiser Family Foundation, is $15,700 per year. IRS announced on January 30, 2013, that employers are not required to pay for dependents, leaving the employee to pay the family premium since he/she will be locked out of subsidies in the federal exchanges.

Betsey McCaughey wrote that Congressional Budget Office (CBO) prediction that Obamacare would leave only 30 million people uninsured in 2016 was predicated on the assumption that kids would be covered by employees. If a parent is covered at work, no subsidies will be provided for the child in the health exchange.

Millions of people will remain uninsured because their states are choosing [wisely] not to expand Medicaid. The states do not have the money to expand Medicaid.

By the time the uninsured will be counted, almost as many Americans (40 million plus) will be left without insurance as the number of uninsured before the Democrats passed their signature monstrosity, the Affordable Care Act. Having sat in a drawer for decades, the bill was dusted off, repackaged, and polished. Nobody took the time to publicly debate or read the bill that passed after some arm-twisting. The Democrats, who had promised free health care for all, feverishly proceeded to spend trillions of dollars we did not have to re-engineer our health care system in the name of social justice.

The states that refuse to set up health exchanges are expected to sell the government-mandated plans and to give out taxpayer-funded subsidies to those who enroll. Betsey McCaughey identifies the glitch:

“The law says that in states that refuse, the federal government can set up an exchange. But the law empowers only state exchanges, not federal ones, to hand out subsidies. The Obama administration says it will disregard the law and offer subsidies in all 50 states anyway, but the case will likely go to the Supreme Court.”

To safeguard from disaster, take care of your body, eat right, exercise if you can, and pray very hard that you will not get sick. There is a good chance that there will not be enough highly qualified doctors to deliver care when needed even if you do have insurance. Should you need specialists, expensive drugs or surgery, you are out of luck. Rationing will tell you, “no, you can’t have it.” The emergency rooms will be filled to capacity with confused, desperate, sick people, and new illegal alien arrivals.

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