Posted by William Duncan
on Jul 1st, 2012 | 13 comments
There are dozens of reasons to repeal the legislation now known as Obamacare. Remember that this is the legislation that was so bad, it could only be passed with the out-and-out purchase of votes referred to in the press as “the Cornhusker Kickback” and “the Louisiana Purchase.” While there are undeniably desirable elements in the legislation, such as coverage for pre-existing conditions, the bad far outweighs the good. Here are 6 of the dozens of reasons that Obamacare should be repealed as soon as possible. For much more detail, I refer you to an excellent series of articles on this topic at: http://www.heritage.org/research/projects/the-case-against-obamacare.
- Fines will be assessed on those who choose not to buy health insurance. There is absolutely no reason, now, that the Federal Government cannot require us to buy anything they deem to be “in our best interests”. Under Section 1501, individuals will be assessed a monetary penalty if they do not purchase a health insurance plan that meets the federal definition of “minimum essential benefits.” Congress finds, in Section 1501(a), that health care is inextricably connected with interstate commerce thus claiming a constitutional power to require that citizens purchase a specified level of coverage. (Of course we now know that even the US Supreme Court admits this is a lie.) The penalty for failure to make such a purchase is to be the greater of a flat dollar amount or a percentage of income, phased in from 1 percent to 2.5 percent of income by 2016.It bears restating: There is now nothing that the United States Government cannot now require its citizens to buy – either through taxation of fines. NOTHING.
- Obamacare contains 18 separate tax increases that will cost taxpayers $503 billion between 2010 and 2019.Three major tax hikes make up nearly half of the new revenue raised by Obamacare:
- Section 1401 imposes a 40 percent excise tax on “Cadillac” health insurance plans. This new tax will apply to health plans valued in excess of $10,200 for individuals and $27,500 for families. Those thresholds will grow annually by inflation plus 1 percent. The tax takes effect in 2018 and is projected to raise $32 billion by 2019.
- Section 1411 increases the Medicare Hospital Insurance (HI) portion of the payroll tax. This provision will increase the employee’s portion from 1.45 percent to 2.35 percent for families making more than $250,000 a year (and for individuals making more than $200,000). Combined with the employer’s portion, the total rate will be 3.8 percent on every dollar of income over $250,000 when the tax hike takes effect in 2013.
- Section 1411 also imposes a new payroll tax on investment. This tax provision applies the new higher 3.8 percent Medicare tax to investment income—including capital gains, dividends, rents, and royalties—and is scheduled to become effective in 2013. Together, the Medicare tax hikes will raise $210 billion between 2013 and 2019
- Obamacare is built on fallacious accounting. CBO must assume that current law will be enacted as written, even in cases where this is improbable. For instance, Obamacare makes $575 billion in projected cuts to Medicare, threatening seniors’ access to care. Regarding these and the existing planned cuts in payments to physicians under what is known as the “sustainable growth rate” formula, CBO Director Douglas Elmendorf wrote: “Current law now includes a number of policies that might be difficult to sustain over a long period of time. For example, PPACA and the Reconciliation Act reduced payments to many Medicare providers relative to what the government would have paid under prior law. On the basis of those cuts in payment rates and the existing “sustainable growth rate” [SGR] mechanism that governs Medicare’s payments to physicians, CBO projects that Medicare spending (per beneficiary, adjusted for overall inflation) will increase significantly more slowly during the next two decades than it has increased during the past two decades. If those provisions would have subsequently been modified or implemented incompletely, then the budgetary effects of repealing Obamacare and the relevant provisions of the Reconciliation Act could be quite different—but CBO cannot forecast future changes in law or assume such changes in its estimate.” Medicare’s Chief Actuary echoed this concern in his own analysis. If Medicare savings do not materialize, new spending under Obamacare will be added to the deficit.
- Obamacare severely reduces current Medicare benefits. Medicare Advantage (MA) plans are private insurance options available to Medicare beneficiaries. Obamacare cuts deeply into the projected payments to MA plans. Millions of Medicare beneficiaries enrolled in MA plans, or who would have been enrolled if not for the cuts, will experience very substantial reductions in the value of health care services provided to them by the Medicare program. Obamacare cuts payments to MA plans in two ways. First, in Section 3201, the new law modifies the formula for making payments to MA plans by tying maximum rates to measured fee-for-service (FFS) costs in a county. Second, the new law cuts payments made by FFS to hospitals and other providers of medical services, and these cuts are automatically passed through to MA in the form of even lower maximum MA rates. The cuts in MA begin in 2011 with a freeze in plan payment rates at their 2010 levels. Then, beginning in 2012, the law will implement a new formula for paying MA plans by tying payment “benchmarks”—or the maximum rate an MA plan can be paid in a county—directly to the average per-beneficiary spending under the FFS program as measured by the Medicare actuaries. These new benchmarks are scheduled to be phased in from 2012 to 2017. On a dollar basis, the average nationwide cut in services provided to MA enrollees, or to those who would have been enrolled in MA if not for the cuts, will total $3,700 per beneficiary in 2017, or nearly 27 percent below what would have been provided under prior law. This reduction is from the combined effect of the MA formula changes and the pass-through effect of FFS cuts. When just the effect of the MA payment formula is considered, the average per-beneficiary reduction in 2017 will be about 13 percent, or $1,800.
- Obamacare enables tax dollars to be spent for elective abortions. PPACA includes at least three problematic provisions with respect to the federal role in funding elective abortion. First, Section 1303 facilitates massive federal subsidies for private health care plans that are offered through health insurance exchanges and will cover elective abortions. Under separate law—specifically, the Hyde Amendment to the annual Labor–Health and Human Services (HHS) spending bill—federal funds appropriated to HHS by Congress cannot be spent for health benefits coverage that includes elective abortion. Section 1303 bypasses this limitation. Second, Section 1101 allows the Secretary of HHS to decide whether certain appropriated funds that are not covered by the Hyde Amendment will be used to subsidize elective abortions through temporary high-risk insurance pools. While HHS has announced its intention not to allow such subsidies, the decision is subject to reversal unless there is further action by Congress to block it permanently. Moreover, the Obama Administration has explicitly stated that this discretionary limitation should not be regarded as “precedent” for future executive branch decisions regarding coverage of elective abortion. Third, Section 10503 directly appropriated $11 billion over five years to underwrite the operation and construction of community health centers under Section 330 of the Public Health Service Act. Because these funds are not appropriated in the annual Labor–HHS spending bill and are therefore not subject to the Hyde Amendment, their potential use for grants that pay for elective abortions is also a matter of executive branch discretion. President Barack Obama issued Executive Order 13535 in an effort to assure that the Hyde Amendment will be applied to this new community health center funding. As is the case with federal funds for high-risk insurance pools, unless Congress acts to make the application permanent, this decision is subject to reversal by either executive decision or judicial intervention. Section 1303 of PPACA also includes language that provides only limited protection for the conscience rights of health care providers and facilities that are unwilling to participate in abortions. Language that was included in the version of the bill adopted by the House of Representatives in November 2009 that would have protected the conscience rights of health care entities and personnel from infringement by government at all levels was omitted from PPACA as finally adopted. As a result of these defects in PPACA, longstanding federal policy to provide health care assistance to the poor that favors maternity care over elective abortion has been subverted in several ways, with both short-term and long-term consequences. For the first time, a federal tax credit will be made available to assist in the purchase of private health plans that cover elective abortion. By 2019, according to the Congressional Research Service, an estimated 19 million Americans will use these “affordability credits” to buy insurance through the new state health insurance exchanges mandated by the bill. Unless a state has adopted new legislation by that date, taxpayer dollars will flow via these credits to health insurers who pay for elective abortion procedures.
What do you think?