Editorial: ObamaCare costs keep soaring

Premiums for ObamaCare-eligible health insurance plans are soaring this year, according to an analysis by the Urban Institute.

The study, sponsored by the Robert Wood Johnson Foundation, found that the lowest priced of the so-called gold plans that cover 80 percent of medical expenses for a 40-year-old non-smoker increased 19 percent nationally this year and 25 percent in Nevada. The lowest cost silver plans for that individual, which covers 70 percent of medical costs, went up 32 percent nationally and 45.6 percent in Nevada. The second lowest priced silver plans jumped 34.3 percent nationally and 48.3 percent in Nevada.

But not to worry, the Nevada Appeal newspaper in Carson City reports that more than 85 percent of the nearly 100,000 Nevadans who are covered by such plans through the Silver State Health Insurance Exchange will not pay much if any of that premium increase because they receive federal subsidies. Guess who pays those federal subsidies? All of us.

The Appeal reports that, according to a recent report by the Congressional Budget Office, the nationwide increase in premiums will cost the taxpayers $10 billion more in subsidies this year.

Of course, a state health exchange executive blamed the premium spikes on “instability in the health insurance market — much of it caused by tactics designed to undermine the Affordable Care Act. That includes the decision to stop paying insurance companies for the Cost Sharing Reduction subsidies mandated by the ACA for consumers making between 138 and 250 percent of the poverty level,” the Appeal explained.

The taxpayers get stuck with the bill either way — subsidize the insurer or subsidize the rate payer. Six of one, a half dozen of the other.

During the debate this past year over those Cost Sharing Reduction subsidies, The Wall Street Journal reported, “In an ironic twist, stopping the subsidies would also wind up costing the federal government more in the end, the (Congressional Budget Office) report said. Higher premiums for mid-priced plans would require the government to pay larger tax credits to consumers to help offset coverage costs. The federal deficit would increase by $194 billion through 2026, the report said.” Instead of paying $7 billion in subsidies to insurers, we are paying $10 billion to ratepayers.

Pay no heed to the fact ObamaCare premiums have been rising sharply since the law was passed in 2010 without a single Republican vote and using dirty tricks devised by Nevada’s own Sen. Harry Reid. According to the website eHealth, from 2013, the year before ObamaCare went into effect, through 2017, health insurance premiums had already increased 140 percent. Forget repeal and replace, just repeal. Remember at the ballot box this fall just who brought us this expensive boondoggle and would vote to keep it.

A version of this editorial appeared this week in some of the Battle Born Media newspapers — The Ely Times, the Mesquite Local News, the Mineral County Independent-News, the Eureka Sentinel,  Sparks Tribune and the Lincoln County Record.

Editorial: Nevada should impose work requirement for Medicaid enrollees

Even though Congress could not find a way to repeal the budget-busting, economy-distorting Affordable Care Act, affectionately known as ObamaCare, there are still a few things the states can do to ameliorate its impact.

Chief among these, according to a report prepared for the Nevada Policy Research Institute and the Washington Policy Center by Dr. Roger Stark, is to implement work requirements for able-bodied Medicaid enrollees. The Trump administration announced recently that it is willing to accept waiver requests — known as 1115A waivers — from states that wish to impose a work requirement.

“Applying for a waiver to implement work requirements is a common-sense reform, and it’s one that’s already supported by the administration,” says NPRI policy analyst Daniel Honchariw. “Medicaid should help its able-bodied members who are willing to work, rather than encouraging an unsustainable and demoralizing cycle of dependency.”

Honchariw notes that 60 percent of the Nevadans who gained free Medicaid coverage under ObamaCare’s expansion of the program — approved by Republican Gov. Brian Sandoval, by the way — did not earn a penny of income in all of 2015. Expanded Medicaid now covers 600,000 Nevadans at annual cost of about $5,700 each.

“Such costs are unsustainable over the long-run without dramatic tax increases,” Honchariw states.

According to Dr. Stark, ObamaCare has resulted in only 20 million of the 50 million uninsured people before the law was passed — without a single Republican vote, by the way — to gain health insurance coverage. A large portion of those were handed Medicaid. In Washington state, 80 percent of the newly insured were placed on Medicaid.

“Obamacare has raised insurance premiums for virtually everyone in the country outside of the free Medicaid entitlement. Health care spending was 17 percent of the economy when the ACA became law,” Stark writes. “By 2021, with the ACA in place, estimates show that the country will spend 21 percent of the annual economy on health care.”

He said this past year the cost of Medicaid was $545 billion nationally and is projected to grow to $700 billion by 2020.

Studies have found that the health outcomes for people covered by Medicaid are no better than the uninsured.

We encourage Nevada’s lawmakers to take advantage of the work-requirement waiver and other options to curb the cost to taxpayers and break the cycle of dependency such entitlements foster. —TM

 A version of this editorial appeared this week in some of the Battle Born Media newspapers — The Ely Times, the Mesquite Local News, the Mineral County Independent-News, the Eureka Sentinel,  Sparks Tribune and the Lincoln County Record.

Taking the ‘affordable’ out of ObamaCare

Affordable Care Act? Only if someone else is paying the premiums.

According to an AP news account, middle-class Americans who get no subsidies under ObamaCare are going to get hammered again in 2018 with double-digit health insurance premium increases.

The report quotes one woman from Delaware whose monthly premiums are expected to increase from $740 to $1,000, and that’s for insurance with a $6,000 deductible.

 

The average 2018 premium hike is 25 percent for a midlevel plan on HealthCare.gov.

In Nevada, Health Plan of Nevada has proposed a 27.24 percent average rate increase for 2018, ranging from 19 percent to 36 percent, depending on the plan. Anthem had proposed increasing rates by 62 percent before it dropped out of coverage in the state altogether.

Silver Summit is to fill the void left by Anthem, but since the company was not previously in Nevada there is rate increase information.

In 2017 the average premium in the Nevada health insurance exchange was $379 a month, but 83 percent of those are getting subsidies that reduce their out-of-pocket premiums to $142 a month. But someone is paying the $237 difference every month and will pickup some portion of the 2018 premium increase.

We wonder who that will be?

 

 

Editorial: Congress needs to delay or repeal health insurance tax

You might not have said anything when they announced that ObamaCare-compliant health insurance premiums are going up nearly 40 percent next year, because you get your insurance elsewhere.

You might not have said anything when they announced there will be no ObamaCare-compliant health insurance policies available in 14 Nevada counties, because you get your insurance elsewhere.

You may have just shrugged about the tax on so-called Cadillac health insurance, because that is not your insurance.

You may not have spoken out when Congress failed to pass the “skinny repeal” that would have dropped the penalties for those who don’t buy health insurance, including 90,000 Nevadans, because you have health insurance.

Now they are coming for you.

If Congress fails to act soon, everyone who pays for health insurance will get hammered with a new tax in 2018. In 2015 Congress declared a one-year moratorium on the ObamaCare provision that imposes a health insurance tax of almost 3 percent — dubbed appropriately enough with the acronym HIT — in 2017, but that expires at the end of the year.

In 2016 the HIT tax cost insured Americans $11.3 billion, but that is to increase by 26 percent if reimposed in 2018.

If not delayed or repealed, HIT is expected to tap American wallets for $14.3 billion next year, and the hardest hit will be average Americans. One analysis of the tax estimates that fully half the tax will be paid by those earning between $10,000 and $50,000 a year.

A study by Oliver Wyman broke down the cost by state and found that in Nevada those with small group family insurance would pay $453 in HIT tax. Those with large group family policies would pay $519. Even Medicare Advantage users would have to pony up an additional $271, and Medicaid users would also be hit with $120 in taxes.

Grover Norquist, president of Americans for Tax Reform, has noted, “The health insurance tax directly impacts as many as 1.7 million small businesses, 11 million households that purchase through the individual insurance market, and 23 million households covered through their jobs. The National Federation of Independent Business estimates the tax could cost up to 286,000 in new jobs and cost small businesses $33 billion in lost sales by 2023.”

This is in addition to a tax on employer provided care, a tax on innovative medicines and treatments, a tax for failing to buy insurance, a tax on medical devices and taxes on health savings accounts, Norquist says.

“The trillion dollars in higher taxes have restricted health care choice, increased costs, made saving more difficult, and granted government more control over care at the expense of individual control,” the tax reform guru argues. “The passage of these taxes also broke President Obama’s promise not to increase any form of tax on any middle class family.”

Additionally, the higher cost is expected to result in people dropping their health insurance, resulting in an increase in the uninsured.

President Obama promised that his healthcare law would decrease premiums by $2,500 a year. Instead, it increased premiums by nearly $5,000. Still Congress has not been able to repeal it.

So, the very least Congress can do is repeal or delay the costly tax on health insurance premiums. And we do mean the least.

A version of this editorial appeared this week in some of the Battle Born Media newspapers — The Ely Times, the Mesquite Local News, the Mineral County Independent-News, the Eureka Sentinel,  Sparks Tribune and the Lincoln County Record.

Thanks for your lack of support, here take some money

This is what happens when the right hand doesn’t care what the left hand is doing after being stabbed in the back — to mangle a metaphor.

This past month Anthem Inc. announced it would stop selling ObamaCare-compliant health insurance plans in all but three Nevada counties. The decision left no company willing to sell ObamaCare policies in any counties except Clark, Nye and Washoe.

Gov. Brian Sandoval called the action devastating and unfortunate. His statement at the time read: “My administration is working diligently to identify solutions to ensure there is, at the very least, a safety net available to rural Nevada residents who will be left without any options for coverage in the wake of these devastating and unfortunate decisions. The reduced footprint of carriers on the exchange will leave more than 8,000 Nevadans with no coverage, and that is unacceptable.”

Heather Korbulic, the state’s health exchange director, called the situation a “health care crisis for rural Nevada.”

In pulling out of those 14 counties Anthem stated the “individual market remains volatile” and “planning and pricing for ACA (Affordable Care Act)-compliant health plans has become increasingly difficult due to a shrinking and deteriorating individual market …”

This week the state repaid Anthem’s decision with a huge tax abatement package.

According to a press release from Las Vegas Global Economic Alliance, the Governor’s Office of Economic Development has decided to hand Anthem $831,000 in tax abatements in exchange for leasing a customer service office in Las Vegas and hiring as many as 400 workers — at an average wage of $21.52 an hour or 1 percent more than the minimum requirement — over the next two years. That’s more than $2,000 per job.

Did anyone consider trying to use a little leverage for the rural counties? Or are they better off without ObamaCare policies, since the price is climbing by double digits.

In 2016 Anthem paid its top executive more than $16 million. The company’s gross profits in 2016 exceeded $18 billion.

 

 

 

No ObamaCare premium increases in 14 Nevada counties due to central plannig

The bad news for those who live in Clark, Carson City and Nye counties is that companies offering ObamaCare-compliant health insurance policies have requested 38 percent premium increases. The good news for those in the rest of Nevada is that their ObamaCare premiums will not be going up because there are no companies offering such policies.

In pulling out of those counties Anthem stated the “individual market remains volatile.” The company said that “planning and pricing for ACA-compliant health plans has become increasingly difficult due to a shrinking and deteriorating individual market, as well as continual changes and uncertainty in federal operations, rules and guidance, including cost-sharing reduction subsidies.”

As F.A. Hayek warned:

This is, perhaps, also the point where I should briefly mention the fact that the sort of knowledge with which I have been concerned is knowledge of the kind which by its nature cannot enter into statistics and therefore cannot be conveyed to any central authority in statistical form. The statistics which such a central authority would have to use would have to be arrived at precisely by abstracting from minor differences between the things, by lumping together, as resources of one kind, items which differ as regards location, quality, and other particulars, in a way which may be very significant for the specific decision. It follows from this that central planning based on statistical information by its nature cannot take direct account of these circumstances of time and place and that the central planner will have to find some way or other in which the decisions depending on them can be left to the “man on the spot.”

Congress should slow the slide down ObamaCare’s slippery slope

Darn you, Charles Krauthammer. Why do you have to write what I was going to write just before I write and say it so much better than I ever would?

Take the lede on today’s column in the local newspaper, which is actually his Friday column in the Washington Post:

The Lord giveth and the Lord taketh away, but for governments it’s not that easy. Once something is given — say, health insurance coverage to 20 million Americans — you take it away at your peril. This is true for any government benefit, but especially for health care. There’s a reason not one Western democracy with some system of national health care has ever abolished it.

I’ve already protested that RyanCare contains too many of the market manipulating machinations of ObamaCare, lamented the efforts to make sure no one ever has any handout taken away.

But I’m getting hoarse from screaming at the TV and printed page over the reporting that millions will “lose” health insurance cover, when in reality many of those millions will be gladly “throwing” away that pathetic and nearly useless coverage due to sky high deductibles. (Never mind that the CBO estimates of the uninsured under RyanCare are probably just as inflated as its estimate of the newly insured under ObamaCare.) And just what were those able-bodied millions added to Medicaid doing before the Democrats charity?

But, as the astute Krauthammer notes:

There is no free lunch. GOP hard-liners must accept that Americans have become accustomed to some new health-care benefits, just as moderates have to brace themselves for stories about the inevitable losers in any reform. That’s the political price for fulfilling the seven-year promise of repealing and replacing Obamacare.

Retrenching is better than leaving ObamaCare in place and letting it evolve in the single payer system Obama and Harry Reid wanted to begin with.

Reid, asked on public radio a couple of years ago if the country will eventually work beyond private health insurance, Reid enthusiastically replied, “Yes. Absolutely, yes.”

He was later quoted by the Las Vegas Sun insert in a rare local article: “What we’ve done with Obamacare is have a step in the right direction, but we’re far from having something that’s going to work forever. We had a real good run at the public option … don’t think we didn’t have a tremendous number of people who wanted a single-payer system,” but he could not get enough votes back then.

As Krauthammer points out, once that happens there will be no going back: “There’s a reason not one Western democracy with some system of national health care has ever abolished it.”

Nate Beeler, The Washington Examiner

When haggling over details, it is easy to forget what the rules are

When you are down in the scrum, butting heads and scrambling for the ball it is easy to forget the rules of the game or even what game you are playing.

Now, if it is wrong for Congress to mandate under pain of tax penalties that everyone buy insurance from privately owned and operated health insurance companies or through state or federally operated exchanges, isn’t it just as wrong for Congress to order those health insurers to charge a 30 percent premium penalty to those who let their insurance lapse?

The Commerce Clause has been stretched beyond any semblance of rationality when a person can be fined for growing grain to feed his own cattle because that disrupts interstate commerce, but health insurance is not commonly available across state lines.

Where does Congress derive the enumerated power to micromanage health insurance — whether via ObamaCare or RyanCare?

And why pray tell can you be given Medicaid — basically government insurance that dictates what allegedly private doctors and hospitals may charge for care no matter what it really costs — if your income is 138 percent of the poverty level, but you are on your own if you earn 139 percent of the poverty level?

Overturn the actuarial tables and whole concept of insurance when Congress dictates that those with pre-existing conditions and “children” to the age of 26 must be covered at the same rate as others. What is the difference between only allowing insurers to charge three times as much for older people than healthier younger people than only allowing them to charge five times as much.

Despite what you may have read in the morning paper, RyanCare does not repeal the tax on so-called Cadillac insurance plans. It merely delays it a couple of years.

When you are up to your arse in alligators it is hard to remember your objective was to drain the swamp.

 

 

 

 

GOP ObamaCare replacement bill seriously flawed, but this opportunity should not be missed

The GOP bill to replace ObamaCare landed with a thud. Of course, the Democrats hate it because it eliminates taxes on the wealthy, but conservatives are deriding the bill as ObamaCare 2.0, RINOcare and TrumpCare because it contains all new entitlements and is still too intrusive on the private health care insurance markets.

The Cato Institute’s Michael Cannon notes that the bill does little to derail the expansion of Medicaid and, even expands ObamaCare by appropriating funds for the law’s so-called “cost-sharing” subsidies and retains the very regulations “that are threatening to destroy health insurance markets and leave millions with no coverage at all.”

GOP ObamaCare replacement presented (AP pix via WSJ)

In a similar vein, Heritage’s Edmund F. Haislmaier says the bill tries to protect those who picked up subsidized coverage under ObamaCare but fails to remove the market damaging insurance regulations of ObamaCare that have driven up premiums.

“This bill misses the mark primarily because it fails to correct the features of Obamacare that drove up health care costs,” Haislmaier writes. “Congress should continue to focus on first repealing the failed policy of Obamacare and then act to offer patient-centered, market-based replacement reforms.”

Both writers criticized the decision to retain the Cadillac tax on expensive health insurance plans.

But a Wall Street Journal editorial, while admitting the bill is flawed, points out that Republicans have a narrow window for repeal and replace and failing to pass some kind of bill might doom efforts to rid the nation of ObamaCare at all.

“In other words, the House bill is the only heath-care show in town,” WSJ advices. “If conservatives join Democrats to defeat the measure, the result will be to preserve ObamaCare as is—and probably torpedo the rest of the GOP agenda including tax reform. Good luck running for re-election in 2018 with a record of failure.”

The 123-page bill is full of federal government interference. It could be trimmed to a few pages and simply allow health insurance premiums to be deducted from income taxes, and leave any insurance regulations to the states, while exercising its Commerce Clause role and allowing insurance to be sold competitively across state lines.

Cannon doesn’t agree with WSJ.

“The House Republican leadership bill does not replace ObamaCare. It merely applies a new coat of paint to a building that Republicans themselves have already condemned,” he writes. “Since the most important asset health reformers have is unified Republican opposition to ObamaCare, at least in theory, it would set the cause of affordable health care back a decade or more if Republicans end up coalescing around this bill and putting a Republican imprimatur on ObamaCare’s core features. If this is the choice, it would be better if Congress simply did nothing.”

But the bill can be drastically amended, and should be. Having health insurance is not the same as having access to healthcare. In fact, one study found that the health of those added to Medicaid roles in Oregon had no health improvement.

In most cases, ObamaCare has resulted in little more than cost shifting.

Pass the Obamacare repeal and replace and see what happens, Nancy

Nancy Pelosi once famously said of Obamacare: “But we have to pass the bill so that you can find out what’s in it.”

Now she says of the Republican repeal and replace bill: “Show us the numbers as to how many people will be thrown off.”

Why not wait and see? Can it be any worse than Obamacare, which has driven up costs and not lived up to its promised coverage and cost taxpayers billions of dollars and has driven doctors away?

A summary of the bill says it will dismantle Obamacare taxes that hamper job creation and increase insurance costs. It will keep children on parents’ insurance and not allow insurers to deny coverage for people with pre-existing conditions. It will give more power to states. Allow individuals to spend their health care dollars as they wish. It will provide tax credits for purchasing insurance, just as businesses get now.

Writing in The Wall Street Journal today, two of the bill’s authors say, “Our fiscally responsible plan will lower costs for patients and begin returning control from Washington back to the states, so that they can tailor their health-care systems to their unique communities. The bill will improve access to care and restore the free market, increasing innovation, competition and choice.”