As we begin “living with it,” when it comes to all the President’s provisions of the 2010 Obamacare, Patient Protections and Affordable Care Act, that conveniently made many of its less pleasant provisions hibernate until after his reelection, I ask you whether I had ESP?
In 2008, specifically on Monday, July 28, 2008, in my post, “AHIP: The Insurance Company Lobby starts PR campaign,” (http://conoutofconsumer.blogspot.com/2008/07/ahip-insurance-company-lobby-starts-pr.html) I knew what was coming, “As stakeholders, we know that insurance companies have the goal of MAKING MONEY BY REDUCING THEIR LIABILITY FOR ACTUALLY COVERING EXPENSES FROM PAYING OUT ON INSURANCE. Not rocket science, the more they take in and the less they pay out the more money they make.” A few sentences later I wrote, “In this industry, the devil is in the details.”
OK, I don’t have ESP, but what I do have is a good understanding of the health insurance industry. In 2008, I started trying to share my insights to avoid some of what was codified by Obamacare and now is being imposed on us, American consumers.
I went through what was sold by insurance companies, and then the President in subsequent posts including my post of July 30, 2008, “AHIP Insurance Company Road Trip: Comparative Effectiveness=Less Coverage,” (http://conoutofconsumer.blogspot.com/2008/07/ahip-insurance-company-road-trip.html) and May 1, 2008, where I discussed the inevitable push towards, “High Deductible Health Insurance: Evolution of a Scam?” (http://conoutofconsumer.blogspot.com/2008/05/high-deductible-health-insurance.html)
It was in fact the insurance company recommendations that were strongly adhered to by Obamacare. Yeah, still no ESP.
So, now we’re here, with all the surprised headlines regarding how crappy Obamacare is likely to be for those outside its entitlement zone (those eligible to participate in health exchanges and get subsidized premiums and/or co-insurance and co-payments). But even those who get those freebies should be forewarned, their entitlement is only as good as the next piece of legislation that cuts into it.
The cost of Obamacare has currently been described as less than anticipated. In my post of December 3, 2013, “Do Two Wrongs Make a Right? Obamacare,” (http://conoutofconsumer.blogspot.com/2013/12/do-two-wrongs-make-right-obamacare.html) I wrote about the fact that the COST of Medicaid expansion was part of the “cost” of Obamacare and SINCE the Supreme Court made Medicaid expansion optional and only half the states chose it, OBVIOUSLY it won’t cost the government as much.
So the government has wiggle room because the expansion provision for Medicaid in the PPACA of 2010 was stricken down and made OPTIONAL. But how long will that money last? We know that this program right now is focusing on getting people enrolled. I wonder whether Obama’s SYMBOLIC enrollment is being tallied among the enrolled, or whether his family, friends and everyone else who supports him is also “symbolically” enrolling to puff up the numbers.
But, again without ESP, what I anticipate is a HUGE amount of wrongfully paid out money by the government, because I don’t see a reasonable way that the PPACA tackles getting money it’s owed.
Specifically, if a person gets some premium assistance and is required to pay some of their own premium, under the PPACA the government doesn’t stop contributing to their insurance until THREE MONTHS after they stop paying premiums. How does the government get that money back?
Also, if a person’s household income increases, that person is supposed to report that increase to the government which could affect how much government money contribution they get from the government under the Obamacare entitlement. Again, how are those amounts being collected when a person earns more than anticipated and therefore owes more than he or she is currently paying on the Obamacare entitlement?
I don’t see an effective “process” for the government getting back those payments. Also, I wonder that the quickest fix, hinging payments to a checking account for automatic monthly drafts isn’t made part of the system as it is for the rest of us who buy insurance who either have amounts deducted from our paychecks or taken from our checking accounts in monthly drafts.
The government’s and the insurance companies fail at fraud control and waste because they just get the money to make up for the fraud from us, charging us more or providing less. It’s time for consumers to hold insurance companies and the government responsible for their own waste and that we STOP being held accountable for these entities’ bad practices so that we pay for their bad choices.
Fraud, sloppiness, non-enforcement is their problem, but as long as they can be lazy and charge us to make up for these amounts they lose rather than addressing them themselves, neither the government nor the insurance companies have an incentive to fix it.
