Tag: obamacare implementation

Aside From That, Mrs. Lincoln, How’s ObamaCare Implementation Going?

The Washington Post has published a remarkable exposé on the Obama administration’s foundering efforts to implement ObamaCare.

The article paints a picture of a White House that did not know what it was getting into, either in terms of public opposition or the technical challenges of implementation. It likens the task of getting young adults to buy ObamaCare’s health plans to getting young adults to vote, despite a glaring difference between those challenges. (Hint: one of them requires young adults to shell out hundreds of dollars per month.) But this exposé is most remarkable for not exposing two lawsuits that by far pose the greatest challenge to ObamaCare’s survival.

One indication that implementation is not going well is what the Post quotes ObamaCare’s supporters as saying:

“In 2011, there was this ‘we’re going to save the world’ mentality. In 2013, it focuses more on how do we deliver on the requirements of the law.”

“It’s pretty much a black box.”

“They tell us, ‘It’s freakishly on schedule.’ They use those exact words. But only the people who work in this can tell you if it’s actually running on time.”

“Advocates on the ground are really struggling with that group. They want to have a positive message but don’t know what to say.”

“We’re in an environment [now] where 40 percent are against it, 35 percent are for it and neither side knows what’s actually in it.”

“How hard does the insurance department or Medicaid department in a red state [that opposes the law] make it to implement this?”

“Everybody is having sleepless nights given the magnitude of the effort and the short amount of time.”

“It’s like building a bridge from both ends and hoping, in the end, they connect.”

“I read [the delay of the employer-mandate] as an admission that not all of the components of the [data] hub are working.”

“Some of the guidance from the federal government is still coming. That means we can’t get to our wishlist.”

As bad as these evaluations are, things are actually quite a bit worse.

For one thing, the HuffingtonPost/Pollster.com polling aggregator currently shows that 52.5 percent of Americans are against ObamaCare, compared to 40.5 percent are for it. That’s a 12-point gap, not a five-point gap. It’s also the largest gap that aggregator has ever measured.

For another, the Washington Post acknowledges that if young adults don’t sign up for ObamaCare’s over-priced insurance “the law will fail,” and acknowledges the difficulty of getting young adults to over-pay for insurance. But it still downplays that challenge:

When…asked in a recent survey whether a $210 premium was affordable, only 29 percent of likely marketplace enrollees said yes. [Marketers then told] participants that, with their tax credits, they would save “$1,908 a year compared to what you would pay on your own.”

All of a sudden, 48 percent of the participants thought that insurance was affordable. But 48 percent is still less than half.

That number will turn out to be even lower when young adults realize they’re still shelling out that $210 they already said they cannot afford.

But the Post neglects to mention the greatest threat to the law’s survival: those tax credits may not even be there in two-thirds of the country.

The attorney general of Oklahoma, and a group of small employers and individuals from various states, have each filed lawsuits challenging the Obama administration’s plans to issue those tax credits in the 34 states that have opted not to establish one of ObamaCare’s health insurance “exchanges” themselves. The statute quite clearly authorizes those credits (and related subsidies) only “through an Exchange established by the State.” Nowhere, and in no way, does federal law allow the administration to issue entitlements through the 34 state-based Exchanges established and operated by the federal government. Yet the White House is trying to spend an estimated $700 billion over 10 years in those states without congressional authorization.

Both the non-partisan Congressional Research Service and Harvard Law Review have acknowledged these lawsuits are credible. Plaintiffs in one of the suits have asked the court to block that illegal spending before it begins in 2014. Supporters of the law admit that if that happens, ObamaCare doesn’t just fail, it collapses.

So the question this supposed exposé really answers is: aside from that, Mrs. Lincoln, how’s ObamaCare implementation going?

Is Kathleen Sebelius Barack Obama’s Oliver North?

I blogged earlier about how HHS Secretary Kathleen Sebelius is unethically, and possibly illegally, shaking down industries she regulates to get them to fund ObamaCare’s implementation.

Sen. Lamar Alexander (R-TN), the ranking member of the Senate’s Health, Education, Labor, and Pensions Committee, says this is “arguably an even bigger issue [than] Iran-Contra,” and ably defends his position against the Washington Post’s Sarah Kliff.

Excerpts from Alexander’s comments:

[I]n Iran-Contra, you had $30 million that was spent by Oliver North through private organizations for a purpose congress refused to authorize, in support of the rebels. Here, you’re wanting to spend millions more in support of private organizations to do something that Congress has refused…

The cause in the first case was the cause of rebels in Nicaragua.  And the cause here is to implement Obamacare. Congress has refused to appropriate more for that cause. The administration seems to be making a decision that’s called augmenting an appropriation. Its a constitutional offense that’s the issue…

If you read the report of the Iran-Contra select committee, it said that the executive cannot make an end run around Congress by raising money privately and spending it. That seems to be happening here. That was essentially the problem. There the money came from a different place, but if you look at my statement [the Iran-Contra report said] “a president whose appropriation requests were rejected by Congress could raise money from private sources or third countries for armies, military actions, arms systems, and even domestic programs.” [Emphasis added.] It’s the same kind of offense to the Constitution. It’s the same kind of thumbing your nose at Article 1…

If that’s what they’re saying…that Congress has refused to appropriate the money, then you can’t do it. That’s a curb on the executive.

Alexander has sent a letter to Sebelius requesting information about her extracurricular fundraising activities.

More Questions for Secretary Sebelius

Given the growing concern even among Democrats that ObamaCare will result in a “huge train wreck” later this year, I have a few questions for Health and Human Services Secretary Kathleen Sebelius to add to my previous list:

  1. What happens if a federal court (say, the Eastern District of Oklahoma) issues an injunction barring HHS from making “advance payments of tax credits” in the 33 states with federal Exchanges?
  2. Has HHS done any planning for that contingency? If so, what are those contingency plans?
  3. If HHS has not, why not? Given that the Congressional Research Service and Harvard Law Review both say there’s a credible case that the PPACA forbids tax credits in the 33 states with federal Exchanges, how could HHS not have a contingency plan ready?

For more on how HHS is violating federal law by planning to issue advance payments of tax credits through federal Exchanges, read my Cato white paper, “50 Vetoes: How States Can Stop the Obama Health Care Law,” and my Health Matrix article (with Jonathan Adler), “Taxation Without Representation: The Illegal IRS Rule to Expand Tax Credits Under the PPACA.

Will the Last ObamaCare Supporter Please Turn off the Lights?

Senate Finance Committee chairman Max Baucus (D-MT) was the primary author of the Patient Protection and Affordable Care Act, known colloquially and affectionately as ObamaCare. Today, he predicted his own law would cause a “huge train wreck” when the federal government begins implementing it fully later this year. He’s not the only one who’s worried. Other Democratic senators have expressed concerns. An Obama administration official recently offered this vote of confidence:

We are under 200 days from open enrollment, and I’m pretty nervous…The time for debating about the size of text on the screen or the color or is it a world-class user experience, that’s what we used to talk about two years ago…Let’s just make sure it’s not a third-world experience.

How could Baucus come to fear his own bill? Maybe because he never read it, as he admitted to his Libby, Montana, constituents in 2010:

Naturally, a Baucus flack later clarified what he meant:

Senator Baucus wrote the bill that passed the Finance Committee and then worked with his colleagues to write the health care bill that is law today. He has spent years crafting this policy and hundreds of hours reading and perfecting it. There is simply no question that he understands the provisions in the health care law…

If so, perhaps Baucus could explain the law to his colleague, Sen. Jay Rockefeller (D-WV). Rockefeller may have spent more time studying health care than any other U.S. senator, Baucus included. For example, Rockefeller founded the Alliance for Health Reform and headed the organization for more than a decade. And yet Rockefeller finds ObamaCare to be “the most complex piece of legislation ever passed by the United States Congress” and “just beyond comprehension”:

But can we really blame Baucus if ObamaCare supporters – including himself – didn’t understand the bill they were passing? After all, he warned us that not all of them would understand it:

So to recap: Baucus wrote an early draft of the law, helped to write subsequent drafts, didn’t read the final law, totally understands it, and now fears it.

Will the last ObamaCare supporter please turn off the lights?

How to Tell When ObamaCare Takes a Beating in the Kaiser Poll: the Headline Is about Something Else

Consider these charts from the latest Kaiser Family Foundation tracking poll, released today.

Even when pollsters tell the public that ObamaCare is “reform,” the public still doesn’t like it.

ObamaCare’s slip in this month’s poll is the result of a simultaneous drop in support among both Democrats and Independents.

The people who hate ObamaCare are really, really angry. And they are not going away.

The following shares of voters believe ObamaCare will either be of no use or will be harmful to the following groups: children (47 percent), young adults (51 percent), women (50 percent), the country as a whole (55 percent), themselves and their families (68 percent).

Bear in mind, ObamaCare has always fared better in the Kaiser tracking poll than other polls.

ObamaCare: a Federal Takeover, No Matter Who Runs the Exchanges

Merrill Goozner read my article in the March 21 National Review, in which I argue that states should refuse all ObamaCare funds and refuse to erect an ObamaCare Exchange that would execute the law’s many health-insurance regulations. Since ObamaCare provides that the feds will set up and administer an Exchange in states that don’t do so themselves, Goozner concludes that I’m actually advocating a federal takeover of health care. Really?

Goozner either completely missed the point of my article, which I sort of doubt, or he’s trying to be cute.  Let’s assume it’s the former.

As I explain in that article, under ObamaCare the feds will write all the rules governing health insurance, so who administers the Exchanges is well-nigh irrelevant. ObamaCare is a federal takeover of health care, no matter who runs these new government bureaucracies that we call health insurance Exchanges.

Then again, there is reason to suspect that Goozner is just trying to be cute. ObamaCare apologists know that if states stop implementing the law, it will be easier for Congress to repeal it or for the Supreme Court to strike it down.  They know that if states don’t set up their own Exchanges, HHS may not be able to set them up itself, which would jeopardize the federal government’s ability to start doling out ObamaCare’s hundreds of billions of dollars in new debt-financed entitlement spending in 2014.  So it makes sense to attack or ridicule me for suggesting that states should obstruct ObamaCare because he suspects that could bring the whole miserable operation down.  But surely Goozner can come up with something more plausible than  suggesting that I’m advocating a federal takeover of health care.