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.”

 

Nevada ObamaCare 2017 premium increase less than half of national average

Perhaps you’ve heard, ObamaCare premiums are going up 25 percent on average next year for the most common coverage. It was in all the papers.

But in Nevada the rates are only going up 8 percent — which was not in all the papers. That’s good news, better news and bad news. It is good for those purchasing insurance on Nevada’s health insurance exchange that the rates aren’t up as much as the national average and nowhere close to Arizona’s skyrocketing 145 percent. The better news for the vast majority of ObamaCare customers is that the out-of-pocket expense is increasing by zero percent. The bad news is that the taxpayer is picking up the increase.

The Kaiser Family Foundation used the second-lowest silver premium for a 40-year-old non-smoker to analyze the changes state by state. Here is the chart:

aca-by-state

Actually, the Nevada health insurance exchange reported the likely insurance rate changes back in August.

Health Plan of Nevada (UnitedHealthcare’s HMO) is increasing rates in 2017 by 10.4 percent increase for its 50,000 members. Prominence (formerly Saint Mary’s HealthFirst) is going up 17.51 percent increase for its 11,000 members. Anthem (HMO Colorado/HMO Nevada), which is the only plan available in 10 rural Nevada counties is going up 8.58 percent for its nearly 10,000 members. Anthem (PPO, also called Rocky Mountain Hospital and Medical Service) is increasing 13.8 percent for 19,000 members.

The overall weighted average proposed rate increase for the entire individual market in Nevada (including the exchange carriers) works out to 15.02 percent for 2017, which is higher than the 9.58 percent hike in 2016.

 

No one is yet reporting, so far as I can find, the total hit the taxpayers will be absorbing for the premium increases.

AP noted that the spike in premiums generally does not affect the employer-provided plans that cover most workers and their families.

According to a recent editorial, ObamaCare is particularly affecting rural Nevadans.

(AP photo via WSJ)

(AP photo via WSJ)

Editorial: Rural residents being harmed by health care changes

From the beginning under ObamaCare rural residents throughout the nation have had fewer choices for health care coverage and have been charged considerably higher premiums than those in urban areas.

As insurers flee the ObamaCare market there is even less competition and still higher rates.

It has reached the point that in 2017 a majority of Nevada counties — Esmeralda, Mineral, Humboldt, Pershing, Churchill, Lincoln, White Pine, Eureka, Lander, and Elko — will have only one firm offering coverage under the ObamaCare program.

To ameliorate the blow to residents of single-provider counties nationwide, Nevada Republican Reps. Joe Heck, Mark Amodei and Cresent Hardy a couple of weeks ago introduced a bill that amends the Internal Revenue Code to exempt those residents from the requirement to pay a tax penalty if they fail to maintain minimum health coverage under ObamaCare, or as it is laughably titled, the Affordable Care Act.

Heck is running for the Senate seat being vacated by the retirement of Harry Reid, who rammed through ObamaCare — using deals such as the Cornhusker Kickback and the Louisiana Purchase — without obtaining the vote of a single Republican.

The bill is called Protection from Insurance Exchange Monopolies Act, H.R. 6049. It has been referred to the House Ways and Means Committee.

In the coming year there will be only three companies offering ObamaCare coverage in Nevada — Anthem, Health Plan of Nevada, and Prominence Health Plan (formerly St. Mary’s). In the 10 counties listed above the only carrier option is Anthem.

All three congressmen commented on the necessity of their bill in a press release.

“The better way to solve rural Nevada’s access to health care is to replace Obamacare with a fairer and more patient-centered approach,” Hardy said. “But as long as ObamaCare is the law, Nevadans shouldn’t be forced to pay a tax on a monopoly caused by a government mandate that forced out other competition. All Nevadans, and particularly those in our rural communities, deserve access to more health care choices and lower health care costs.”

“The Affordable Care Act promised Nevadans more healthcare choices and lower costs but, as expected, we now know those promises were empty” Heck said. “Nevadans in 10 counties will be living under an ObamaCare insurance monopoly in 2017 and it is unfair to inflict a penalty tax on residents in counties with only one carrier option. This is yet another example of the failures of the ACA and highlights the urgent need to replace the broken parts of the law with healthcare reforms that actually expand access to quality, affordable care.”

“President Obama promised his healthcare law would bring Americans ‘more choice’, ‘more competition’, and ‘real health care security,’” Amodei said.  “Despite the president’s assurances, ObamaCare has delivered nothing more than higher premiums and less choices – with millions of Americans having even fewer choices in 2017. In Nevada, ObamaCare will soon be leaving residents in 10 counties with only one choice – choose what Washington says is right for them – or pay the penalty. By allowing people who reside in areas with less than two provider options to be exempt from the individual mandate, our bill provides much needed relief to those who have been left with no alternative.”

Repealing ObamaCare is the preferred solution, but this is a worthy patch in the meantime.

Adding further problems for rural communities, in January the Centers for Medicare and Medicaid Services changed the reimbursement process for medical suppliers. CMS is now using bids from metro areas to start cutting reimbursement rates in rural areas.

But providing care in rural areas can be more expensive due to distances between patients and providers and the time and expense it takes to cover those distances. The Medicare reimbursement rate has been cut by more than 50 percent for many items.

Health care providers are hoping Congress remedies the devastating cuts to Medicare reimbursement rates that are impacting medical suppliers throughout the country. Many providers are cutting services or refusing to take new patients. Some are even closing their doors.

Congress needs to act on both of these problems for rural America.

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.

Where is the nearest doctor?

Where is the nearest doctor?

Nevada leads the nation in individual health insurance premium hikes

Nevada leads the pack in increase in premiums for individual health care insurance.

The Manhattan Institute has released a study of individual health insurance premiums under ObamaCare and found those premiums are increasing by 41 percent on average nationally, according to Forbes. The highest increase — of course — was found in Nevada, up 179 percent.

The other states with the highest increases are New Mexico up 142 percent; Arkansas up 138 percent; North Carolina up 136percent; Vermont up 117.

Tell me again why Nevada sent the powerful Harry Reid to Washington to help us. With help like this, who needs a boot on the neck?