World Debt

New Study

New report shows administration lagging far behind ObamaCare enrollment goals

In the final stretch of enrolling Americans in ObamaCare, the administration is lagging far behind its own goals -- leaving uncertain whether the program is attracting enough people for the system to work. 
The Department of Health and Human Services reported Tuesday that more than 940,000 people signed up in February, bringing the total enrollment number to 4.2 million. That's well short of the unofficial goal of signing up 7 million by the end of open enrollment on March 31.
The numbers renewed calls from Republicans to push off the looming penalty for not buying insurance. And they revived accusations that the administration still is not telling the whole story behind those numbers.  
"Given these dismal enrollment numbers, the president needs to work with Congress to get rid of this year's individual mandate penalty," said Brendan Buck, spokesman for House Speaker John Boehner.
Hoping for a surge in the final weeks, administration officials are going to new lengths to promote the law and encourage people to sign up -- including President Obama plugging HealthCare.gov during a YouTube appearance with comedian Zach Galifianakis.
"During this final month of open enrollment our message to the American people is this: you still have time to get covered, but you'll want to sign up today," HHS Secretary Kathleen Sebelius said in a statement on Tuesday.
The administration recently has backed off the goal of enrolling 7 million by month's end. But the government also is coming up short in attracting young adults into the system. The government wanted roughly 40 percent of enrollees to be between 18 and 34 years old; the latest report shows just a quarter of those who have selected a plan are in that coveted age group.
The government, and the insurance industry, wants to attract a high percentage of young adults in order to offset the costs of taking on older, less-healthy customers. Failure to attract enough younger customers could result in higher premiums for everyone else.
It is possible that many participants could be waiting until the final few days and weeks of the month to enroll -- after March 31, most of those who do not have insurance will be required to pay a penalty. But Republicans were skeptical.
"It seems the president's push to enroll young adults is far too little, too late," Buck said. "The administration won't tell us how many people have actually paid for a plan or how many were previously uninsured. But what we do know is that young adults -- those who the White House repeatedly said are critical -- are deciding the health care law is a bad deal. Now, millions stand to be forced to pay a new tax because of this law."
Republicans on the House Energy and Commerce Committee echoed those concerns, and alleged that the president's recent media appearances "suggest that the administration is panicked as the March 31 deadline fast approaches."
Lawmakers say the numbers are still confusing. Though the administration has reported the number of sign-ups, it has not said how many of those individuals have paid their premiums. Further, the administration has not said how many of those enrolling through the ObamaCare exchanges were previously uninsured.
That figure matters because the health care overhaul was originally pitched as a way to cover the nation's estimated 47 million uninsured. But a newly released study suggested many of those people are not being reached. The study by McKinsey & Co. showed that of the uninsured eligible to sign up for an ObamaCare private plan, just 10 percent said they had done so. Further, it found that just a quarter of those who did sign up for coverage in the marketplaces were previously uninsured. That suggests the bulk of those signing up are simply switching from one plan to another.
HHS and supporters of the health care law countered Republicans' skepticism with a more upbeat view.
"Now that over 4.2 million Americans have enrolled in private coverage through the Health Insurance Marketplace, on top of the millions who have received coverage through Medicaid, more and more Americans are gaining the peace of mind and financial security that comes with having health insurance," Anne Filipic, president of Enroll America, said in a statement. "With 83% of consumers receiving financial assistance to help pay for their plans, quality health care has finally become a reality for millions, and we're confident that enrollment will continue to accelerate as we approach the March 31st deadline for coverage."
While millions are joining through the state and federal insurance exchanges, millions more are signing up through Medicaid. In another wrinkle to emerge from the law's implementation, prison inmates are apparently being signed up via the expanded Medicaid as well.
The New York Times reported this week that jails and prisons are taking advantage of the new Medicaid criteria to cover single, childless inmates for certain hospital stays -- in turn transferring the cost from the states to the federal government. Those individuals can also remain covered once they leave jail or prison.

Administration drops controversial proposed Medicare changes

The Obama administration says it's pulling the plug on proposed changes to the Medicare prescription program that ran into strong opposition on Capitol Hill. 
Among other changes, the regulation proposed to remove three classes of drugs from a special protected list that guarantees seniors access to a wide selection of critical medications. 
The three classes of drugs facing removal were antidepressants, antipsychotics and drugs that suppress the immune system to prevent rejection of a transplanted organ. 
The administration hoped to save a total of $729 million by 2019 with the change. But patient groups including the National Kidney Foundation and the National Alliance on Mental Illness pushed back hard. 
Medicare administrator Marilyn Tavenner said Monday in a letter to Congress that the administration will not move forward with the changes.

Immigration change gives legal status to undocumented relatives of US military

Immigration reform may be stalled in Congress, but a new Obama administration policy is extending legal status and military benefits to thousands of illegal immigrants who are the spouses, parents and children of American military members. 
Supporters say the policy -- which applies to active-duty military, reservists and veterans -- is long overdue. 
"Those veterans and those men and women who serve in the National Guard certainly deserve the peace of mind that their family members will not be deported," immigration attorney Faye Kolly said. 
But critics say the policy is tantamount to backdoor amnesty. 
"A whole class of aliens with no right to be in the United States are suddenly going to be allowed to live and work here on the basis of their relationship with military and veterans," said Dan Cadman, with the Center for Immigration Studies. 
The exemption, called parole in place, came in the form of a U.S. Citizenship and Immigration Services "policy memorandum." It was not submitted to or approved by Congress, and the regulations were not published in the Federal Register, which allows for public comment prior to a rule taking effect. 
"I don't want to overstate it, but it sounds very similar to imperial decree if you ask me," Cadman said. "The public had no chance to comment on this new policy. I believe the way this was done was illegal." 
Obama administration officials say the new rules do not require congressional action because they're based on existing statutes. 
"It's clearly within the president's authority to enforce the law and choose which immigrants he thinks are the priority," said Brent Wilkes of the League of United Latin American Citizens. "These folks aren't threats. They've got a relative that's serving our nation." 
One face of this new policy is Christian Gonzalez, a retired Marine who has been recommended for a Purple Heart. He was attacked five days in a row by improvised explosive devices (IED's) in Afghanistan. The last one nearly claimed his life. 
"For a brief period, I was paralyzed from the waist down. I suffered a pretty traumatic brain injury from that," said the San Antonio resident, sitting alongside his wife Laura, who was brought to the U.S. illegally as a child. 
"Without her, you know, I'd be lost with my disabilities. Critics only look at her as an illegal alien. They're not looking at her as the spouse of a veteran," he said. 
Christian and Laura met in middle school. He enlisted in the Marines during high school. They got married when he returned from multiple tours in Afghanistan and Iraq. Under the new policy, tens of thousands of illegal aliens like Laura will be offered a green card and legal residency. 
As the wife of a veteran, she would be entitled to his health care, education and survivor benefits, as well as simple things like a Social Security number and driver's license. 
"I'm covered, my kids are covered, but the woman that runs the house, she's not covered. So that's probably the hardest part," Gonzalez said. "Now she'll be able to get a job, go to school. It would make her feel like she contributes more to the family."

‘Gaming the system’? States use trick to undo food stamp cuts

Bailey Comment: "The three states that are doing this crap have a large Democratic majority of Voters."

States are using what critics call a "perverse" legislative maneuver to partly undo congressional cuts to food stamps, despite efforts by some U.S. lawmakers to stop it. 
The Washington Post reported Monday that three states so far are finding a way to avoid or minimize the cuts. The bill passed by Congress last month was supposed to save $8.6 billion over the next decade in food stamps. But New York, Connecticut and Pennsylvania have figured out how to trigger additional spending anyway. 
The trick, as many states have discovered, is for them to devote a relatively modest amount of funding to home-heating assistance. Under the law, states that give a certain amount to families could then qualify those families for additional food stamp money. 
Lawmakers, reportedly concerned that states were "gaming the system," had raised the threshold in the new law -- but states have responded by simply spending more money on home-heating assistance. In turn, this triggers more food stamp funding. 
The move, which supporters hail as a way to keep feeding families in need, also threatens to undermine the savings from the hard-fought farm bill. Fiscal conservatives have long worried that food stamp funding -- formally known as the Supplemental Nutrition Assistance Program -- has surged to dangerous levels, reaching nearly $80 billion last year. 
According to the Post, it's not clear how long the latest gambit will last. 
"Some states will be able to do it, some states will not be able to. No one knows for how long they'll be able to do it," Rep. Rosa DeLauro, D-Conn., told the Post. "They have jumped into the breach where the federal government abdicated its responsibility." 
But so far, New York State reportedly raised home-heating spending by $6 million, resulting in an extra $500 million in federal food stamp money. 
Connecticut and Pennsylvania took similar steps. 
Rep. Steve King, R-Iowa, told the Post that lawmakers would have expressly prohibited this if they had expected it. He called the move "perverse," despite being legal.

ObamaCare will hasten income inequality, union report says

A new report from a major U.S. union says ObamaCare will hasten income inequality.
Although it defends the intent behind the Affordable Care Act, the report, entitled “The Irony of ObamaCare: Making inequality worse,” concludes that the law will transfer a billion dollars in wealth to insurance companies, uneven the playing field in the market, force employers to cut back on hours and result in pay decreases, Ralston Reports said.
“The promise of Obamacare was the right one and the hope for extending healthcare coverage to the un-and under-insured a step in the right direction,” the report says. “Yet the unintended consequences will hit the average, hard-working American where it hurts: in the wallet.”
The report says it’s “ironic” that the Obama administration is publicly discussing income inequality though it has yet to make the changes to ObamaCare that Unite Here believes are necessary to avoid exacerbating income disparity.
“Having already made efforts to accommodate businesses, churches and congressional staff, it is ironic that the administration is now highlighting issues of economic inequality without acting to preserve health plans that have been achieving the goals of the ACA for decades,” the report concludes. “Without a smart fix, the ACA will heighten the inequality that the Administration seeks to reduce … We cannot sit idly by as the politicians carve up our health plans while they carve out exceptions for themselves and every special interest feeding at the trough in Washington.”
The report comes about three weeks before the enrollment deadline for ObamaCare. While officials say 4 million have signed up for private insurance on the exchanges so far, the program is still short of its unofficial 7 million goal.

Even Obama seems to be losing faith in Obamacare

 

If you’d like the government to change something about Obamacare, give the White House a ring. They’re in a flexible mood.

President Obama this week approved yet another delay to provisions in the Affordable Care Act, giving insurers until 2016 to sell a type of insurance policy that’s supposed to be banned under the health-reform law. The ban, which was supposed to begin this year, would prevent insurers from selling bare-bones plans that might be affordable but don’t abide by 10 “essential service rules” required under the new law.

When insurers began canceling such coverage last year, however, several million Americans were forced off plans they had chosen, with most alternatives being more expensive. That undermined Obama’s frequent claim that “if you like your health insurance, you can keep it,” and turned into one of the most controversial elements of a law that hardly lacks detractors.

In November, Obama announced a one-year delay in the ban on “substandard” plans, as he used to call them. Now, extending the delay to 2016 will “provide consumers with choices so they can decide what is best,” the government says. Yet these limbo plans — temporarily allowed but bound to vanish at some point — defy the whole intent of Obamacare, as if the president is losing faith in his own plan. “This is a political move to minimize the impact of this as an argument against Democratic candidates,” says Sean Nicholson, a management professor at Cornell University.

Obama and his fellow Democrats certainly need some political cover as the November midterm elections approach. Support for the ACA has never risen above 45% and it actually weakened as the law went into effect. A recent Gallup poll shows 23% of Americans say they’ve been hurt by the law, while only 10% say they’ve been helped. That may overstate the ACA’s actual impact — since 16% of people said the ACA harmed them a year before it even went into effect — yet the negative impression alone is a big problem for Democrats who voted for the law and now must defend it as they run for reelection.
People with bare-bones insurance plans tend to be healthy enough to feel comfortable skimping on coverage. Yet it’s critical to get such people to enroll in the new federal program, so the premiums they pay will help offset the cost of older, sicker enrollees. If the ACA exempted everybody who wanted a cheap, limited plan, it could thwart the whole program, since it would include too many costly patients and premiums would be prohibitively high.
Obama now seems to be backing off one of the key planks of the whole reform effort. Yet many of the people “allowed” to keep a substandard plan will be forced to enroll in Obamacare anyway. The pressure, however, comes from three sources other than the federal government:
States. Insurance commissioners in each state must explicitly allow insurers to offer the limbo policies, and only about half of the states have said they will. So people in many states won’t be able to get a limbo plan even though Obama has said they can.

Insurers. Insurance companies spent three years preparing for the onset of Obamacare, including the ban on bare-bones plans. While reinstating old policies might earn them a few extra bucks, it’s also a hassle to cancel policies, then reinstate them only to cancel them again in a couple of years. “I would expect insurers that have already decided not to offer these are not going to change their minds in great numbers,” says Tim Jost, an expert on health law at Washington & Lee University law school.

Healthcare consumers. Bare-bones plans are the type consumers drop most frequently, as they get new jobs that offer better coverage, go onto a spouse’s plan or simply drop their insurance. Since insurers are only allowed to carry over plans that were offered in 2013 — not offer new ones — turnover alone should quickly reduce the number of people who have such plans, diminishing the importance of limbo plans.

The change means Democrats will be able to say Obamacare really does let you keep your insurance plan (wink, wink). But Jost says even that strategy carries risks. “By delaying it until 2016, that means some people might get cancellation notices right before the next presidential election," he says. “That doesn’t seem very smart.”

Of course, Obama could always extend the deadline.

Rick Newman’s latest book is Rebounders: How Winners Pivot From Setback To Success. Follow him on Twitter: @rickjnewman.