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5 Reasons to Repeal Obamacare

 

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 Here are 6 of the dozens of reasons that Obamacare should be repealed as soon as possible.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.

  1. 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.
  2. 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:
    1. 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.
    2. 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.
    3. 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
  3. 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.
  4. 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.
  5. 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?

 

 

13 Responses to “5 Reasons to Repeal Obamacare”

  1. Marie Luft says:

    I worked in the insurance industry for many years. All insurance is currently regulated by the states, to some extent.

    Life insurance certainly is not mandatory, just a matter of conscience. In my opinion, life insurance has the most
    reasonable rate structure… the rates are figured actuarially and stay the same over the life of the policy. I really enjoyed my time with the life insurance company.

    States do require the purchase of auto insurance (tho there is no penalty for not purchasing it, proof of insurance and driver’s license are the first thing that the police ask for at a traffic stop of any kind). If one does not have insurance, there are consequences and they can be harsh, depending on the circumstances.

    All other types of insurance may be a good idea or not, and so are purely voluntary. Only auto insurance can be considered compulsory by the states (not sure if that is even true in all states). It’s too bad that the states have not done a better job in that regard, with health insurance.

    I saw a presentation on TV the other day about national health insurance in England, Japan, etc. and they do admit to paying taxes for their health care … on the other hand, they seem to be satisfied with the care they receive. I have also heard complaints over the years about Canadian services. I’m sure there are pros and cons on the issue.

    Our hospitals (Genesis and Trinity) are both happy about the affordable health care, and are moving ahead on implementing it .. including joining with other health care providers such as the University Hospital at Iowa City. From their point of view, they can concentrate on care for everyone without spending time on fund raising to cover the costs of people ending up in the emergency room with no insurance.

    We currently have the MA insurance plans and we have seen that benefits have changed, but it is mostly one thing is less and another is more … no big loss so far. I understand that there are a lot of people that cannot afford insurance as it is now presented, so I think we would be willing to give up a little to help them out.

    Let’s face it … we need revenue, and taxes is a bad word but it is revenue. I think congress would be better served by overhauling the existing tax structure than continuing tilting at windmills over health care. The current method of handing out tax breaks on this and that as we go along only ends up with no one paying taxes and no revenue to run the government.

    • Thanks for your post! Excellent job! However, it’s only guaranteed premium whole life insurance where premiums don’t go up. With term insurance, the premiums rise regularly as we age, and rapidly become completely prohibitive around age 55.

    • The short answer to equating states requiring people to purchase auto insurance & now the feds requirement for everyone to purchase health insurance is as follows:

      1. No state in the union requires all residents to purchase auto-insurance. They only require drivers in the state to have insurance. This is a major difference as you have to actually do something to get in trouble (drive a car) for not having insurance, as opposed to Obamacare, where you actually be imprisoned for simply being born and living a life where you harm no one but fail to buy health insurance. At its core, a person can simply get in trouble for simply existing under the new federal law – something that is purely unprecedented.

      #2. State laws requiring auto-insurance (which Florida and a few other states do not) are in place to protect everyone else in society from you. Obama’s requirement for health insurance is in an effort to protect you from yourself. Not cool!

      #3. STATE LAWS require you to purchase auto-insurance for a very clear reason – The FEDERAL GOVERNMENT has never (prior to Obama) felt that the constitution provided them with such an authority. Think about it – with all the Federal regulations of our highway systems and interstates, etc. wouldn’t the federal government have already required drivers in all “57 states” to have auto-insurance by now if they truly had such power?

  2. Ed Darrell says:

    Your sixth reason is in error. There is no provision to exempt either the president or Congress from the act. There is no language in the bill such as you describe. Language from page 114 can be found here:

    http://timpanogos.wordpress.com/2012/04/17/obamacare-making-stuff-up-to-complain-about/

    • Ed:
      Thank you for the correction on point #6. I have gone back and looked at this, and you are absolutely right. Although the Wall Street Journal and folks like Sean Hannity reported that the President and members of Congress are exempt from participation in the Affordable Care Act, in the end that did NOT make it into the language of the legislation. I have deleted point #6 from the post as a result. Thank you for the correction. Now, if you copuld only prove me wrong on the rest of the points listed…. Unfortunately, this remains a bill the the American public did not want, and was purchased by shenanigans that the Administration should be ashamed of.

  3. Ed Darrell says:

    Disproof?

    What makes you think Americans didn’t want it? There was a whale of an anti-health care campaign after the act passed, but when it passed, it enjoyed a majority of support. And, when we take each provision of the bill and ask people about that provision, they approve overwhelmingly.

    For example, not even you are opposed to continuing the Reagan-era program that encourages medical schools to train more general practitioners. No one seriously objects to the provisions that pay physicians to practice in under-served areas, like West Texas, Iowa, and West Virginia. No one objects to the provisions that train more nurses. Only the most rabid racists complain about continuing and expanding the health care clinics on Indian reservations.

    The law has dozens of provisions like those, and no one in their right mind objects to them.

    Your other five points?

    1. The Supreme Court killed that one for you. They said that, even if you call it a fine, it’s a tax. And at that, it’s a helluva bargain. For those who do not purchase health insurance because they can’t afford to, they must pay $695 additional tax, per year. That’s about what I’d pay monthly on the open market.

    In any case, there are no fines, according to the Supreme Court.

    But I can’t imagine why you oppose bargains in health care, especially when they lower the costs of health care to the insured, who will no longer pay the 15% to 25% premium to cover indigent care.

    2. With all the “new taxes,” CBO, the non-partisan group that scores these issues for Congress, projects the bill will decrease federal spending and cut the deficits annually, when fully enacted in 2014 and all out years.

    Do you oppose deficits or not?

    All the other taxes are fair, strike only the tippy-top income tiers, and are cheap at that.

    These taxes make the system more fair. It’s stacked against anyone making less than $150,000 a year, now. That’s most of us. I don’t like it when government helps the rich, at the expense of the poor — that’s contrary to moral standards my church holds, for example, and it tends to damage the economy.

    So I think more fair taxes, and lower costs, will be quite popular, once we see them.

    So, new taxes aren’t a good justification to oppose the law.

    3. Speaking of fallacious accounting — CBO, the group you cite, says the bill will reduce the deficits. You assume the Law won’t work, while small portions of it have already slashed inflation in health care costs, from 20% in 2009 to 4% in 2011 and 2012.

    But, what about repeal? CBO looked at that, too — repeal of the law will increase deficits, not decrease them. It’s only $109 billion increase in deficits, but these number directly refute all claims that repeal would be cheaper. See the analysis gateway here: http://www.cbo.gov/publication/43471

    4. This Medicare issue was hashed out, accurately and well I thought, in the campaign. Medicare costs will be reduced by holding costs down — benefits will not be reduced. Eric Cantor and Paul Ryan ran into some difficulty with this, because their budget plans assumed the savings from the Affordable Care Act, while eliminating the law that produced the savings.

    I’m sure there will be some adjustments required. Medicare seems a little ham-fisted when it comes to dealing with local and regional cost differences, but nationwide, over the past 40 years, enormous savings have been realized by reducing some reimbursements for procedures that once were uncommon and expensive, to a less expensive rate, now that they are more common. On the whole, over 40 years, over thousands of procedures, physicians have changed their expectations, and things have worked fine. Oh, there have been grumblings, I know. But the cuts in costs, without cuts in benefits, have stuck.

    Under the Affordable Care Act, we hope a lot more people will move to company plans from Medicare, or at least to the exchange plans offered in each state.

    One of the changes already introduced is working. Rather than pay providers for each procedure, Medicare now reimburses hospitals for effective hospitalization — that is, when a patient is discharged and then re-enters a hospital for the same complaint, the hospital will lose money. Hospitals are keeping patients a few days longer on many procedures, to insure that one hospitalization is all that is required. Savings are already being made in costs, while improvements have resulted in the health care – better health in the patients!

    In all, CBO says costs will come down with the Affordable Care Act, as advertised, and costs will rise and deficits will rise if the Act is repealed.

    5. Your abortion argument is too metaphysical, and not enough real-world. Do you want to reduce the number of abortions? Then provide health care, make sure contraception is freely available (not for free, but freely), and stand back. Those two things reduce abortions, as they did during the Clinton administration.

    Restrictions on abortion, on the other hand, make it more likely a woman will choose to terminate a pregnancy under a number of circumstances: She doesn’t have health care coverage, her coverage does not cover pre-natal care, her coverage won’t cover a new infant, the pregnancy is unplanned due to lack of good information on family planning or lack of access to affordable contraception.

    You can choose: Restrict abortions and increase the number of abortions, or provide health care, and reduce the number of abortions.

    It may be a bit counter-intuitive, but you’d better study the issue. The Affordable Care Act’s provisions, Obamacare, have over the years reduced abortions where applied; cutting off that care has increased the number of abortions.

    My advice would be, don’t kill the babies to make a political point.

    I am concerned that you don’t appear much familiar with what the bill actually does. Here are a few reasons to keep the law.

    1. We need more physicians, and the bill provides them.
    2. We need more physicians in underserved areas, and the bill provides them.
    3. We need more nurses, and the bill provides them.
    4. We need more community clinics in underserved urban areas, where illnesses and injuries frequently go untreated until extreme trauma results, and the victim must get extremely expensive care in an emergency room. This will be one of the biggest cost savers — and the law provides those clinics.
    5. The law will cut the private bureaucracy, and completely dismantle the private death panels set up by insurance companies, saving at least 10% of every health care dollar, applying that money to care instead of bureaucracy. This is already occurring.
    6. Preventive care under the Act is greatly encouraged — if we can boost flu vaccines by another 10%, it will save thousands of lives annually, and millions of dollars in hospitalization costs. Flu shots came with no co-pay this year — did you notice? — so that anyone with any insurance at all could drop by any pharmacy offering flu shots and get one with no out-of-pocket expenses.

    This is huge. Everyone agrees the cheapest health care is for healthy people. The Affordable Care Act changes the way health care is delivered, to emphasize prevention of disease and injury, instead of triage. Prevention usually costs about 10% what the triage would cost.

    7. Removing the lifetime cap on insurance payments, per patient, will save a few thousands of lives, annually. It should kill the phenomenon where many families, hit with a costly disease or accident, had to declare bankruptcy as a result. A significant portion of all bankruptcies have been “not adequately-insured” cases. Those should almost disappear.
    8. Allowing children to stay insured, on a parent’s plan, for those critical years after high school and college and into the second job, with benefits has already benefited millions of Americans, saving millions of dollars and probably a few lives.

    I cannot imagine why anyone would want to go back to 20% annual health care cost inflation, the highest per capita health care costs in the world by a factor of two, while leaving one out of every seven people uninsured even though we were paying amounts more than the insurance would have cost.

    Obamacare reduces the deficits, and puts our health system on the path to catch up to the rest of the industrialized world, with better care for less cost.

    I’ll keep it, thank you.

    (See this, too: “More good news about Obamacare: CBO says it will save money”

  4. Ed:
    Thanks for your thoughtful and thorough response. I sincerely appreciate your willingness to engage on the topic in a meaningful and intelligent way. Most responders are unwilling to invest the time and energy, even in a topic as important as this one. I must say that I do not agree with any of your conclusions, though.

    First of all, you have asked “What makes [me] think that Americans didn’t want ObamaCare?” The answer is that first of all, that’s what most of the polls say. http://hotair.com/headlines/archives/2012/03/19/poll-67-hope-supreme-court-throws-out-obamacare-mandate-or-entire-law/

    ABC
    Poll: 67% hope Supreme Court throws out ObamaCare mandate or entire law
    This ABC News/Washington Post poll finds that Americans oppose the law overall by 52-41 percent. And 67 percent believe the high court should either ditch the law or at least the portion that requires nearly all Americans to have coverage.
    The high court opens hearings on the law’s constitutionality a week from today…
    Intensity of sentiment is more negative as well: Forty-one percent strongly oppose the law, while only a quarter strongly support it.

    http://www.realclearpolitics.com/epolls/other/obama_and_democrats_health_care_plan-1130.html

    Polling Data
    Poll Date Sample For/Favor Against/Oppose Spread
    RCP Average 7/9 – 11/18 — 42.3 48.5 Against/Oppose +6.2
    CNN/Opinion Research
    11/16 – 11/18 RV 42 52 Against/Oppose +10
    Rasmussen Reports*
    11/4 – 11/4 1000 LV 44 50 Against/Oppose +6
    CBS News/NY Times
    9/8 – 9/12 1162 LV 42 50 Against/Oppose +8
    Resurgent Republic (R)
    8/16 – 8/22 1000 LV 43 47 Against/Oppose +4
    NBC News/Wall St. Jrnl
    7/18 – 7/22 1000 A 40 44 Against/Oppose +4
    NPR
    7/9 – 7/12 1000 LV 43 48 Against/Oppose +5
    All Obama and Democrats’ Health Care Plan Polling Data

    Secondly, if ObamaCare had been supported by most Americans, it would not have been necessary for the Obama administration to procure the necessary votes using tactics such as the “Louisiana Purchase” and the Cornhusker Kickback”. And of course that infamous quote from Nancy Pelosi: “We’ll just have to pass the bill in order to see what is in it.” ObamaCare popular with the American people? Nope. Sorry; I’m not buying it for a second. While I realize that it’s possible to find some poll somewhere to support just about any position, it takes a special view of the world to believe that this kind of process generates popular and beneficial law. I’m just not that “special”.

    On point #1, the only reason the Supreme Court chose to call the fine a tax was to find some way around admitting that it is unconstitutional. Deciding to call “a horse of a different color” and “equine of a variant hue” doesn’t mean that it isn’t a horse. It’s still a horse. A fine is a fine, and this law is – whether Justice Roberts was persuaded to find a way around it or not – not constitutional in my view. And referring to the point above, I believe I am in the majority here. But whether I am in the majority or in the minority, I believe that on this point I am right.

    On Point #2: Do I oppose deficits? Of course I do. Which is why I oppose a president and an administration who have achieved a higher national debt level eclipsing the national debt of every single president before him COMBINED. This president is also now trying to get the debt limit removed entirely, so that he can borrow without constraint, when America already borrows 43 cents of every dollar we spend.
    As for opposing “bargains in health care”, you might want to check out Forbes magazine this month. http://www.forbes.com/sites/sallypipes/2013/01/07/obamacare-guarantees-higher-health-insurance-premiums-3000-higher/ . “health insurance isn’t any cheaper. In fact, it’s more expensive. Premiums have increased by an average of $3,065. And they’re about to go up even more, as Obamacare takes effect during the president’s second term. At the end of 2012, Mark Bertolini, the CEO of Aetna, the third-largest health insurer in the country, warned that many consumers would face “premium rate shock” with the advent of Obamacare’s major insurance regulations in 2014. He predicted that unsubsidized premiums would rise 20 to 50 percent, on average. For some people, premiums would double. “We’re going to see some markets go up as much as 100 percent,” Bertolini told Bloomberg News. Aetna isn’t the only company forecasting higher health-insurance premiums. In California, Blue Shield has asked regulators to approve premium increases of up to 20 percent. Obamacare’s new regulations were a factor in the request. A spokesperson for the company said the new law “will bring a lot of volatility” into the market.”

    On Point #3, where you state that the CBO says ObamaCare will reduce the deficit, you are citing only half the story, and reaching what I perceive to be an inaccurate conclusion. There are a lot of articles about this, but one of them http://blog.heritage.org/2012/08/22/obamacare-loses-again-in-deficit-reduction-debate/ says: “Niall Ferguson poked a hornet’s nest Sunday with his Newsweek cover story, in large part for its claim that Obamacare would increase the budget deficit. “Anyone who actually read, or even skimmed, the CBO [Congressional Budget Office] report knows that it found that [Obamacare] would reduce, not increase, the deficit,” wrote liberal economist Paul Krugman (referencing an outdated CBO analysis), “because the insurance subsidies were fully paid for.” As usual, however, Krugman missed the more fundamental point underlying Ferguson’s argument: It’s ObamaCare’s spending that matters. In government budgeting, spending comes first; it drives all other fiscal consequences. Spending is how government programs and agencies do what they do. “In a fundamental sense, the federal government is what it spends,” says longtime budget expert Allen Schick. So it is with Obamacare. Its core is a pair of huge new entitlements: health insurance subsidies and expansion of Medicaid and the Children’s Health Insurance Program. They will add $1.683 trillion in new spending from now through 2022, according to CBO’s latest estimate (which helpfully isolates these components in a stand-alone table). Even after including $515 billion in associated tax hikes, the net cost increase totals nearly $1.2 trillion. The new spending is the one certainty of the President’s health care takeover; without it, ObamaCare doesn’t exist. To hide this cost, at least on paper, ObamaCare’s authors tacked on a series of extraneous offsets that give the appearance of deficit reduction under the conventions of CBO’s estimates. These “savings,” however, turn out to be unreal or unrealistic. For example, the package assumes more than $700 billion in Medicare cuts, most of which are unachievable. Why? Because they rely on implausible productivity gains by Medicare providers—hospitals, skilled nursing facilities, and home health agencies. As a result, reimbursements to these providers would fall increasingly below their costs—as much as 15 percent by 2019 and 40 percent by 2050—according to the 2012 Medicare trustees report. Providers could not sustain these negative margins, the trustees say, and “would have to withdraw from serving Medicare beneficiaries.”Yet even if these savings were real—indeed, especially if they were real—Congress would probably end up rescinding them. Exhibit A: the “doc fix.” The doc fix refers to a formula change Congress enacted in 1997 for annually updating Medicare physicians’ payments to slow the program’s cost growth. But when the new arrangement actually started reducing the doctors’ payments, Congress backed off. Since 2003, lawmakers have adopted a series of temporary delays, shielding physicians from payment cuts and wiping out growing amounts of assumed Medicare savings—more than $300 billion worth over the next 10 years, CBO estimates. Any other assumed savings in Medicare’s government-based price-fixing system will undoubtedly be subject to a similar fate. Unless ObamaCare is repealed, it will add $1.7 trillion in new spending. That much is certain. Any offsetting reductions are dubious, at best. Budgetary analysis and historical experience point to the same conclusion: If fully implemented, ObamaCare will drive up health costs for all Americans and widen the river of government spending and debt.”

    On Point #4, you said that Medicare costs will be reduced through holding costs down – benefits will not be reduced. In a recent Forbes article, http://www.forbes.com/sites/aroy/2012/10/02/the-ratio-of-obamacares-medicare-cuts-to-new-benefits-is-fifteen-to-one/ Avik Roy points out: “Whether you decide ObamaCare’s offsetting cuts are $768 billion or $786 billion, there can be no doubt that those cuts do affect seniors’ benefits. The President’s own Medicare actuary, Richard Foster, wrote in 2010 that the law’s substantial cuts to Medicare Advantage would “result in less generous benefit packages,” cutting Medicare enrollment by half. In addition, by slashing payments to health-care providers, Foster projected that 15 percent of hospitals would become permanently unprofitable. It will become much harder for seniors to gain access to doctors, more and more of whom will bail out of the program due to its decreasing reimbursements. There’s an intellectually honest case to make in support of ObamaCare’s Medicare cuts. If you believe that taking money out of Medicare in order to expand subsidies of coverage for younger Americans is a good thing, then you have every reason to support what ObamaCare did to Medicare. But it’s not intellectually honest to claim that these cuts are inconsequential, or that they’re offset by relatively trivial spending on “new benefits.” As President Obama recently put it, “You can’t just make stuff up.” In other words, benefits are indeed reduced.

    On point #5, I certainly don’t consider the abortion issue to be a metaphysical one. Stopping a human heartbeat is murder, not contraception and it is certainly not health care. Organizations like Planned Parenthood provide a sliver of family planning and contraception compared to a massive number of abortions. Funding them with Federal tax dollars is morally wrong. I realize this is not a politically or socially popular position in America these days, and that as the general public becomes increasingly liberal and wanton in lifestyle, this perspective moves me increasingly further from mainstream thinking. Nothing new there. But again, as recent reportage http://blog.heritage.org/2013/01/09/planned-parenthood-sets-record-for-abortions-and-government-funding/ has documented: “The nation’s largest abortion provider maintained its infamous title, performing 333,964 abortions—a record for the organization that received 45 percent of its revenues from taxpayer-funded government sources during the 2011–2012 fiscal year. According to analysis by the Susan B. Anthony List, Planned Parenthood has performed almost 1 million abortions in the past three years alone. While Planned Parenthood affiliates performed a record number of abortions in 2011, the organization made only 2,300 adoption referrals and provided fewer than 30,000 prenatal services. Roughly 40 percent of the organization’s reported contraceptive services last year were the provision of more than 1.4 million emergency contraception kits, which many believe can cause an abortion in early pregnancy. To solidify its place as the top abortion provider, Planned Parenthood recently announced that all local affiliates would have to begin providing abortion services starting in 2013.”
    You have said that your advice is: “Don’t kill babies to make a political point”. My advice is much simpler than yours; my advice is just “Don’t kill babies.”
    With regard to your summary, you assert that ObamaCare provides more physicians and nurses. Most physicians and a lot of industry pundits disagree with you. One example is this article http://www.forbes.com/sites/paulhsieh/2012/11/13/5-ways-to-protect-yourself-against-obamacare/ which says: “ObamaCare will worsen the current physician shortage. The law will also drive physicians to become hospital employees or to join large Accountable Care Organizations (ACOs), where their treatment decisions will be monitored with mandatory electronic medical records. Government and private insurers will increasingly link payments to adherence to “comparative effectiveness” practice guidelines. Physicians will face significant conflicts-of-interest when their patients might benefit from treatments outside the guidelines, but the physician risks nonpayment (or losing his ACO contract) as a result.” NPR also has a pretty good discussion narrative on this topic at http://www.npr.org/2012/11/30/166248515/what-obamacare-means-for-patients and part of the discussion was as follows: “The first issue actually Margaret brought up, which is the National Health Service Corps increasing in numbers and the number of federally funded clinics. I find that interesting that she mentions that because I actually think that’s a very good thing, but I don’t think that that’s anywhere near as prominent part of this plan as it should be, probably for political reasons. I mean maybe a lot of people would have liked that. But I think my first point is if the federal government wants to provide more care for poor people or underserved people, they should provide care, and the way to do that is to provide doctors. I have a lot of concerns about the insurance model here because I think it’s based on comprehensiveness. Dr. Blumenthal talks about preventive services, but I’m concerned that it’s too easy to overuse this type of insurance. Now, that’s not ObamaCare’s fault. We had that problem before this was extended nationally, meaning if you have the insurance card, if you can find a physician to see you, you can go in to see that doctor even if you don’t actually have a medical problem. That costs a lot of money. And if we cover people with pre-existing conditions, which we should do, but we don’t differentiate who’s paying more, I’m concerned about people that have self-destructive lifestyles, that get very ill, and essentially they pay the same premium. I’m glad about covering people up to the age of 26, but a lot of those people would probably prefer a policy that wasn’t so comprehensive. So as ObamaCare is laid out, and more and more regulations come into play about what kind of insurance is allowed on the state exchange, I’m very concerned about that insurance, not having enough options about what you can actually have, not having high enough deductibles, not having high enough co-pays as a disincentive for overuse of this insurance. I don’t like the one-size-fits-all concept here. I think we need more choices. I think physicians in general have a problem taking insurance. I’m a primary care physician. I continue to practice. Dr. Blumenthal said, you know, there’s a shortage in Massachusetts. Well, Massachusetts has more great medical schools than anywhere in the country. What’s going to be in North Dakota if we have a problem with primary care docs in Massachusetts?”

    The bottom line is that from my perspective and the perspective of a host of other analysts and pundits, ObamaCare increases spending, contributes to the deficit, raises taxes, and is likely to fail to deliver on most if not all of the promises you have listed in your concluding remarks.
    Bill

  5. Ed Darrell says:

    Support for a bill like the Affordable Care Act, among the general public, has stuck at about 50% since it was proposed seriously by Richard Nixon. That dipped after a propaganda campaign against Bill Clinton’s work on health care reform, but it rose back up to about 50% at the time the bill passed. We don’t do national legislation by referenda — by the grace of God — and Congress passes a lot of stuff that a plurality but not a majority favors.

    So what.

    Still, as people learn what is really in Obamacare, opposition to it keeps plunging.

    HuffPo carried this a while back:

    Support for Obamacare repeal hits all time low, poll shows.

    A week after President Barack Obama’s reelection, opposition to one of his signature first term accomplishments has reached a low ebb, according to a Kaiser Family Foundation Poll released Tuesday.

    Just a third of Americans said they’d like to see the Affordable Care Act repealed — the lowest percentage that Kaiser has measured and down from 40 percent in a pre-election survey, as ThinkProgress notes. Support for keeping or expanding the bill remained steady at 49 percent, while the percentage of those who weren’t sure about the law ticked up to 18 percent.

    Declining enthusiasm about a repeal might signal resignation, rather than any major change of opinions on the law itself. In the latest poll, 43 percent of Americans had a favorable opinion of the ACA, and 39 percent an unfavorable one — not all that different from the 46-to-40 split in opinion a month after the law’s passage in 2010.

    House Speaker John Boehner (R-Ohio) called Obamacare “the law of the land” last Thursday, before quickly seeking to clarify that he still favored repealing it.

    Although health care has been hotly debated, it wasn’t the foremost election issue for backers of either Obama or GOP presidential candidate Mitt Romney, Kaiser found. Only 16 percent of Obama’s supporters and 13 percent of Romney’s supporters cited health care as the top factor in their choice for president, with the economy and the candidates’ records seen as significantly more important.

    Voters who did put health care first voted heavily for Obama — by a 3-to-1 margin, according to national exit poll results, and by 14 points in Kaiser’s November survey. Those specifically concerned about Medicare or women’s health also favored Obama, while those who said the ACA was a “major factor” in their vote narrowly preferred Romney.

    The Kaiser Health Tracking Poll surveyed 1,223 adults by phone between Nov. 7 and Nov. 10, with a 3 percent margin of error.

    Gasoline taxes are unpopular, too, but good roads are very popular. What’s a Congress to do?

    Public support is not a serious argument either way. We are a republic, and we have elected representatives who make the laws. Unless someone conducts a grotesque disinformation campaign against this law, its popularity hangs in there, over time.

    • Ed:
      You said that “as people learn what is really in Obamacare, opposition to it keeps plunging”. So I googled “Most recent poll on Obamacare. The first entry that came up was a Rassmussen poll (http://www.rasmussenreports.com/public_content/politics/current_events/healthcare/health_care_law) which says:
      Monday, January 14, 2013
      “Voters continue to have mixed feelings about President Obama’s national health care law but still strongly feel that individuals should have a variety of choices when it comes to health insurance. Forty-six percent (46%) of Likely U.S. Voters view the health care law favorably, while 48% have an unfavorable opinion of it, according to a new Rasmussen Reports national telephone survey. This includes 16% with a Very Favorable opinion and 33% with a Very Unfavorable one. These attitudes are unchanged from a month ago.”
      I do agree with the article that says support for repeal has ebbed, but my working theory here is that it stems from dispirited Republicans after the recent defeat in the presidential race. That’s a lot different than the view that Americans actually wanted this bill. And as I said, it wouldn’t have required all these shenanigans by the administration to get the law passed before anyone could even determine what it contained if it had been solid (admittedly my own perspective). That speaks to your point about being a Republic. Things like the Cornhusker Kickback and the Louisiana Purchase simply demonstrate that our representatives’ votes are for sale, or at least available for barter to get some pork for the constituency in question, in order to offset the natural resistance, I believe, to a government takeover of what should be a private set of services. I lived and worked in Canada for a few years, Ed, and this is not a direction that is good for America.
      And to your point about the health care initiative during the Clinton years, I have a personal story to share. In those days I was Director of Materials Management at McDonnell Douglas Helicopter Company. One day, my boss, the VP of Operations, asked to come and address my staff in our weekly staff meeting. He announced that senior executives at McDonnell Douglas had had determined that “Hillary Care” was going to take care of the health care needs of retired McDonnell Douglas employees. As a result, the company had decided to terminate the health care benefits of all employees not already retired from the company. I remember it as though it was yesterday, and as I get older, that kind of clarity is increasingly rare for me. “So Mark,” I asked him, “I presume that if Hillary is not successful in her effort to establish nationalized health care, then McDonnell Douglas will reinstate this benefit?” He looked me in the eye, and said: “Riiiiiiiiiiiiiiiiiiiiiiiiiiiiiight….”. The meaning was clear. As long as the Federal Government was offering an alternative – whether it was better, worse, or just plain awful, it didn’t matter. McDonnell Douglas was all too happy to shift the burden away from private enterprise (their enterprise) and onto the backs of American taxpayers. You may dismiss this little anecdote, or re-interpret it as you wish – the end result was that by the time I left the company (which had been subsumed by Boeing at that point) – every employee who was retiring had to figure out how to set aside at least $6,000 per year for him/herself and their spouse for the remainder of their lives for health care – not including long term care arrangements when those are required.
      I have been a US Federal Government employee, Ed, and I know it to be one of the most bureaucratic, inefficient, and debilitating organizations in the world, surpassed in a few cases by other national governments. Turning health care over to this behemoth is – I strongly believe – a terrible course for America.
      Nevertheless, while we disagree on this point, I respect your position and the remarkable clarity with which you have presented it. Thank you again for your responses to my post.

  6. July 3, 2013

    Obamacare is so helpful, so ready for action, so vital to the nation’s health, that… the Obama Administration is delaying another major part of it.
    News broke yesterday that the Administration is delaying the employer mandate, which would force businesses with 50 or more full-time workers to provide government-approved insurance, until 2015.

    When Obamacare was engineered, the Administration and its allies in Congress made sure that the major parts affecting all Americans would be delayed until after the 2012 presidential election. Now, however, the Obama Administration is delaying one of the most well-known elements of Obamacare until after the 2014 midterm congressional election.
    Douglas Holtz-Eakin, the former director of the Congressional Budget Office, described the announcement as “deviously brilliant,” even as Obama’s senior adviser Valerie Jarrett assured people that this merely means the Administration is “listening” to our concerns.

    But Obamacare bombshells are dropping daily. Health insurance companies are exiting the market. Premiums could double.

    Heritage Foundation

  7. Even Unions Are Turning on Obamacare
    07/16/2013 – Heritage Foundation
    http://blog.heritage.org/2013/07/16/morning-bell-even-unions-are-turning-on-obamacare/?roi=echo3-16264445638-13697356-eb27e268d1ddf17c1979df9ed2d628f4&utm_source=Newsletter&utm_medium=Email&utm_campaign=Morning%2BBell

    It’s not every day that union bosses sound like policy experts at The Heritage Foundation.
    But the beginning of the Obamacare letter from the heads of three major unions—the Teamsters, the United Food and Commercial Workers, and UNITE-HERE—to Senator Harry Reid (D-NV) and House Minority Leader Nancy Pelosi (D-CA) is eerily similar to our experts’ writings.

    The unions, of course, were heavy supporters of Obamacare, but even they can’t deny its effects now.

    “When you and the President sought our support for the Affordable Care Act, you pledged that if we liked the health plans we have now, we could keep them,” they wrote. “Sadly, that promise is under threat.”

    It gets worse:
    The unintended consequences of the ACA are severe. Perverse incentives are already creating nightmare scenarios: First, the law creates an incentive for employers to keep employees’ work hours below 30 hours a week. Numerous employers have begun to cut workers’ hours to avoid this obligation, and many of them are doing so openly. The impact is two-fold: fewer hours means less pay while also losing our current health benefits.

    We couldn’t agree more. In fact, not only did Heritage experts predict these outcomes, but the non-partisan Medicare actuary also concluded the law would raise health costs by hundreds of billions of dollars. The Congressional Budget Office noted that Obamacare’s employer mandate “will probably cause some employers to respond by hiring fewer low-wage workers.”

  8. From Heritage Foundation, July 17, 2013:

    “Last week, the Obama Administration attempted to spin its announcement of a one-year delay in Obamacare’s employer mandate as an effort to implement the law “in a careful, thoughtful manner.” Don’t be fooled. Even Democrats have admitted the law has turned into a massive “train wreck,” with delays, glitches, and problems aplenty. Here are a dozen more Obamacare implementation failures.

    1. The CLASS Act: ABANDONED, THEN REPEALED

    One Democrat famously called this new long-term care entitlement “a Ponzi scheme of the first order, the kind of thing that Bernie Madoff would have been proud of”—and so it proved. In the fall of 2011, the Department of Health and Human Services (HHS) admitted CLASS could not be implemented in a fiscally sound manner—and Congress eventually repealed the program outright.

    2. Exchanges: MISSED DEADLINES

    Most states resisted Obamacare’s call to create insurance exchanges, choosing to let Washington create a federally run exchange instead. However, a Government Accountability Office report released last month noted that “critical” activities to create a federal exchange have not been completed, and the missed deadlines “suggest a potential for challenges going forward.”

    3. HHS mandate: DELAYED; UNDER LEGAL CHALLENGE

    Last year, the Administration announced a partial delay for Obamacare’s anti-conscience mandate. However, many employers have filed legal actions against the mandate, which forces them to fund products they find morally objectionable or pay massive fines.

    4. Small business plan choice: DELAYED

    The Administration announced in April that workers will not be able to choose plans from different health insurers in the small business exchanges next year—a delay that liberal blogger Joe Klein called “a really bad sign” of “Obamacare incompetence.”

    5. Child-only plans: UNINTENDED CONSEQUENCES

    A drafting error in Obamacare has actually led to less access to care for children with pre-existing conditions. A 2011 report found that in 17 states, insurers are no longer selling child-only health insurance plans, because they fear that individuals will apply for coverage only after being diagnosed with a costly illness.

    6. Basic health plan: DELAYED

    This government-run plan for states, created as part of Obamacare, has also been delayed, prompting one Democrat to criticize the Administration for failing to “live up” to the law and implement it as written.

    7. High-risk pools: UNDERPERFORMING; FUNDING LOW

    This program for individuals with pre-existing conditions faced higher costs and lower enrollment than advertised. Though it was originally projected to cover up to 700,000 individuals, only about 110,000 have enrolled—yet the Administration had to halt new enrollment and take other radical measures to prevent the $5 billion program from running out of money.

    8. Early retiree reinsurance: BROKE

    The $5 billion in funding for this program was intended to last until 2014—but the program’s money ran out in 2011, two years ahead of schedule.

    9. Waivers: UNINTENDED CONSEQUENCES

    After the law passed, HHS discovered that some of its new mandates would raise costs so much that employers would drop coverage rather than face skyrocketing premiums. Instead, the Administration announced a series of temporary waivers—and more than half the recipients of those waivers were members of union health insurance plans.

    10. Co-ops: DEFUNDED

    Congress blocked additional funding to this Obamacare program in January, and with good reason: In one case, a new health insurance co-op was called “fatally flawed” by Vermont’s state insurance commissioner.

    11. “Employee free choice”: REPEALED

    This provision, which would have allowed certain workers to use contributions from their employers to buy exchange health plans, was repealed in April 2011, as businesses considered it too complex and unworkable.

    12. Medicaid expansion: REJECTED BY MANY STATES

    Last year, the Supreme Court made Obamacare’s Medicaid expansion optional for states, ruling that Obamacare as written engaged in “economic dragooning” that puts “a gun to the head of states.” Many states are resisting Obamacare’s call to expand Medicaid, knowing that expansion will saddle them with additional, unsustainable costs.

    As these examples demonstrate, it’s not just the employer mandate that’s flawed—it’s the entire law. Recognizing these myriad, massive failures, Congress should hold the line and refuse to spend a single dime on Obamacare implementation.”

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