It’s unlikely that 2016 candidates can avoid a discussion of Obamacare but the last thing consumers need is more bumper stickers whether it’s REPEAL or REPAIR or RECONSIDER, we need more than single words or phrases.
It’s time to get our lists of questions in order, what we would ask and what we need to know to perhaps even force a discussion at a higher level than treating citizens like imbeciles and selling something that for many of us has caused a lot of buyer’s regret.
Without dramatic and likely false promises, consumers can influence this conversation based on OUR experience with Obamacare. Here I’ll propose three questions that would HELP consumers:
FIRST: Would you urge a balance billing amendment to the Affordable Care Act in the form of a hold-harmless provision for services where an enrollee in a qualified health plan where a patient did not and could not have known that a provider was out-of-network?
This feature is critical to patients whose expenses from balance billing could easily bankrupt them in instances where a provider is out-of-network. States have had sufficient time to address the financial jeopardy in which they place patients yet have done little to nothing to address this big “UNKNOWN” in the amount of money that patients will pay out-of-pocket for services.
SECOND: How will you strengthen the oversight and accountability of agencies and individuals within HHS for their role in the implementation of the ACA?
For consumers the tremendous authority given to HHS without timely and constant oversight leaves the government free to do essentially whatever it wants (and it has) until it’s A-caught B-challenged C-Given a ridiculous amount of time to address the issue and has D-No personal accountability or agency accountability that effectively disincentivizes future misconduct.
Whether through incompetence or design such as the IRS rewriting its own provision through regulation creating the circumstance of King v. Burwell or selective delays of implementation of various parts of the ACA such as moving full speed ahead with advance premium payments BEFORE the provisions for verification of eligibility for those payments as prescribed by the Act were being enforced, this “We’ll do what we want,” attitude leaves the provisions of the ACA undiscoverable for citizens since they can be changed on an administrative whim.
THIRD: What are you going to do to change the direction of government action for saving government money WITHOUT reducing Medicare, Medicaid, social security or Veterans Benefits?
Since issues within government, the mismanagement and fraud in spending our money is NOT effectively addressed, government employees keep going to “easy fixes” which for them means reducing payments to citizens for entitlement programs.
While some people may support government employee entitlement in the form of wasted money, fraud, mismanagement AS PREFERENTIAL to citizen “entitlements” that we pay into for our whole lives such as Medicare, many of us don’t and would rather see the governmental steps to save money through stronger consequences for the endless evidence of misspending, waste, fraud and mismanagement within the federal government not merely empty promises to “do better.”
For instance, the Office of the Inspector General “…is focused on promoting the economy, efficiency, and effectiveness of Affordable Care Act1 programs across the Department of Health and Human Services (HHS or the Department),” has a “WORK PLAN for 2015, http://oig.hhs.gov/reports-and-publications/archives/workplan/2015/WP15-9-Apx1%20ACA.pdf.
As far as I can tell, the whole of the leadership staff should have been replaced. They promise that for 2015, “…we will continue to address key risks in the areas of payments, eligibility and enrollment, management and administration of marketplace programs, and security of information technology and consumer information. Many reviews will address questions in multiple areas.”
This is not good enough for consumers who will likely be told that Medicare is again the target of “cuts” by lazy legislators looking for cheap ways to save money by reducing money used for citizens rather than government.
Last year the GAO cited an alarming number of fake enrollees who were also determined to be eligible for Obamacare (GAO, July 2014), and as far as I can tell, nothing was done about it. There were massive overpayments of premium assistance and instead of going after every penny of those overpayments the IRS instead enacted “relief” provisions limiting recoveries of such amounts. Overly thin networks leaving individuals without physician choice have also been cited as a systemic problem, “Plans initially offered through the exchanges appeared to have, in general, lower payment rates for providers, narrower networks of providers…” CBO, Pub. 49973, March, 2015.
As candidates campaign, it’s beyond time for consumers to address the hard issues of what we’ve been living with, what laws we’re stuck with and what specifically we require changed rather than sweeping student government promises of, “I’ll make sure everyone gets…”
