On July 7, 2016, Stephanie Armour wrote for the Wall Street Journal in, "Affordable Care Act Battle Returns to Court and Capitol Hill," about the Affordable Care Act's court challenge regarding the funding of governmental cost-sharing provisions which Republicans claim bypassed Congress.
The cost-sharing provisions are part and parcel of the premium assistance and cost-sharing provisions that provide federal money to WORKING individuals that meet income requirements for government help in paying premiums and in some cases the costs of copayments and coinsurance.
One of the main reasons we cannot improve Obamacare and why the Democrat Hillary Clinton is emboldened to propose not only coverage for anyone, changing the provision of the law that promised the government's benefits of premium assistance and cost-sharing would be reserved for citizens, as well as her proposal to further sweeten the pot by providing a new tax CREDIT to Obamacare enrollees (not others) is because the Democrats relentlessly lie that Obamacare helps the POOREST Americans.
Much like parading out every cause based on "THE CHILDREN," or "puppies" for that matter, when we read about the POOREST AMERICANS, how can we argue that there should be no safety net for them? Of course, we cannot. There's only one problem--premium assistance and cost-sharing are not Obamacare programs designed to help the POOREST AMERICANS. That is a lie.
The poorest Americans are the unemployed, a number that's been "adjusted," but that most reasonable people know is MILLIONS of Americans in spite of the Democrats' self-congratulation that the number of unemployed is lower because changes in how they count who is unemployed resulted in lowering the number of unemployed by drastically taking the long-term unemployed off the books, so to speak.
That's why the double whammy of reducing the duration of unemployment benefits, therefore excluding individuals who were unemployed from being "counted" among the numbers of unemployed, cleverly was exploited by the Obama Administration to "improve" their numbers of unemployed.
For the POOREST AMERICANS, Obamacare intended to expand Medicaid by forcing states to expand Medicaid by providing that all federal Medicaid dollars would be withdrawn from states that did not agree to the Obamacare Medicaid expansion. The Supreme Court struck that provision down in 2012 and so, states had the "option" of expanding Medicaid.
While some of the POOREST AMERICANS gained health insurance once Medicaid was expanded since they were eligible for near-free health insurance AND health care as a result of their enrollment in that program, Medicaid was a program that existed BEFORE Obamacare, and the expansion, like everything else exaggerated to justify Obamacare was UNNECESSARY for millions who didn't know they were already eligible for Medicaid, (http://www.usnews.com/news/articles/2016-05-02/obamacare-rolls-swell-with-sign-ups-who-didnt-need-the-law).
But that's NOT what the court case is about. It's about the crux of Obamacare, the idea of the marketplace offerings of participating health insurers with the availability of government payments towards premium and cost-sharing depending on an individual's INCOME.
Obviously, WORKING Americans are NOT the poorest Americans.
Under Obamacare, the federal government undertook to pay for this premium assistance and cost-sharing in order to keep INSURANCE companies happy with LOTS AND LOTS of new paid enrollments. To achieve the lots and lots of enrollment promised to insurance companies, the federal government made it illegal NOT to have health insurance with a tax penalty attached (the individual mandate) AND promised to help anyone who enrolled via the exchanges with premium assistance and in some cases cost-sharing. The federal government also promised temporary additional payments to insurance companies that would participate in the form of reinsurance and risk corridor payments essentially protecting them from losing money by participating.
But those federal monies to insurance companies are set to expire (Reinsurance, Risk Corridors, and Risk Adjustment Final Rule http://www.cms.gov/cciio/resources/files/downloads/3rs-final-rule.pdf) and as we've seen, insurers are already responding by opting out of participation on Obamacare exchanges.
And the lots and lots of enrollment has continued to disappoint health insurance companies who still complain that there aren't enough young healthy people buying their more expensive silver plans even with the federal money paid to individuals in the form of premium assistance and cost-sharing (cost sharing is only available under more expensive plans).
Obviously, provisions of cost-sharing that ONLY apply to more expensive plans (silver and better) which cost individuals more are NOT about THE POOREST Americans. Obviously, the individual mandate which forces people with income to purchase health insurance is NOT about the POOREST Americans.
But STILL insurance companies, dissatisfied with the number of young and healthy enrollments in their more expensive plans needed to exploit their deal with the Obama Administration now egotistically attached to the law regardless of consequence and this year we saw INCREASES across the board in Obamacare plans, bigger increases in cheaper plans than the increases in more expensive plans (an average of 8.5 percent this year) to further push people into the more expensive plans. After all, then people would be eligible for the cost-sharing payments and the government would have satisfied the insurance companies once again.
Obviously, pushing people into more expensive insurance plans is NOT about helping THE POOREST AMERICANS.
And STILL insurers complained--neither enrollment overall nor the number enrolled in their more expensive plans on exchanges was making them happy. So, the government had to figure out a way to further sweeten the pot for insurers, once again INCREASING the amount of money all of us must pay before reaching the out-of-pocket maximum.
Increasing the out of pocket maximum which is absurdly up to levels for 2017 of $7,150 for an individual and
$14,300 for a family is NOT about THE POOREST AMERICANS.
As Hillary Clinton readies to step in as President, she's aware of the problem and the Obamacare citizen only provisions present no barrier to her offer to insurance companies to give them MORE under Obamacare, more enrollment AND more enrollment in richer plans. How? By opening up Obamacare purchases and entitlements to illegal immigrants AND by providing yet more entitlement money to exchange enrollees in the form of a $5,000 tax credit for insurance expenses that exceed five percent of their income (the rest of us get no rescue from self-only amounts of 9.5 percent of our incomes).(https://www.hillaryclinton.com/issues/health-care/). In other words, MORE people with INCOMES will be able to buy in regardless of immigration status and the government will pay more on their behalf so they can get better insurance plans.
Obviously, these provisions do nothing for THE POOREST AMERICANS.
The government was so worried about failing in their promise to give insurers lots and lots of enrollment that it went to the Supreme Court to argue it could pay MORE in people's premium assistance, (those who enroll in an Obamacare plan even if their state doesn't have an exchange) just to keep Obamacare running, and won that right to PAY MORE in King v. Burwell.
But still the government's promise of lots and lots of enrollment--even with paying for more and more working Americans' (NOT the poorest Americans') health premium and cost-sharing costs, enrollment in cheaper plans and enrollment in Obamacare overall has failed, this year's annual enrollment amounting to estimates of between 9.4 and 11.1 million only and that's IF people who enroll keep paying their share of insurance premium costs.
No, these provisions for working Americans where the government has shown a willingness to pay anything and do anything are NOT protections for THE POOREST Americans but for Obamacare, the program.
Still believe that any of this is about THE POOREST AMERICANS? Keep looking. Obamacare's failure to force states to expand Medicaid happened in 2012. What was the solution? Those people were given the right not to be taxed for NOT having health insurance--once again, they no longer count. Obamacare's (exemptions see healthcare.gov) as a matter of fact made it clear how little the POOREST AMERICANS "count." Obamacare makes it abundantly clear that it is NOT about the POOREST AMERICANS. Who's outside of Obamacare (and its provisions of the individual mandate)?
The homeless, those who can't pay their medical bills, those whose utilities have been shut off, those who have been evicted (see healthcare.gov exemptions), in other words, IF you are among the POOREST AMERICANS.
For most of us buying into the untruthful Obamacare arguments satisfies our desires to feel like good people and stick it to the Republicans, after all, though the lawsuit is about whether the Administration could bypass Congress for funding of cost-sharing payments, the argument is presented as another case of MEAN Republicans trying to take something away from the POOREST AMERICANS. Sure, Republicans are trying to argue that without authorization the Administration should not be funding cost-sharing for working Americans enrolled in Obamacare, but it's NOT about THE POOREST AMERICANS.
The POOREST AMERICANS have been left out in the cold by Democrats and Obamacare, especially those in non Medicaid expansion states and in spite of years since the Medicaid fiasco (2012), the government which DOES have the money to fight for the right (and won) to pay more WORKING people premium assistance and cost-sharing (King v. Burwell), which does have the money to pay MORE in premium assistance to WORKING Americans made necessary by insurance companies' steady rise in what they charge for their plans, which DOES have the money to FORGIVE fraudulent payments they wrongfully made under Obamacare (http://www.gao.gov/products/GAO-14-705T), has never found a cent to help THE POOREST AMERICANS.
The moral high-ground is not nearly as high as Democrats suggest. After all, with all the money they're spending, there are some obvious questions which I don't think anyone would dare ask a Democrat about the POOREST AMERICANS:
Why not simply change the income guidelines LOWER, to near zero so that individuals ineligible for Medicaid can get their premiums paid for by the Federal government and EXTEND the cost-sharing to EVERY PLAN on exchanges not merely those SILVER OR BETTER? After all, if there's money to fight for the right to change who gets premium assistance, if there's money to pay over 90 percent of Medicaid costs for those under expanded Medicaid forever, since the law has already been butchered in the name of flexibility, typos and the like, why not?
Unfortunately, the answer is obvious, Obamacare is NOT ABOUT THE POOREST AMERICANS.
Why not close the loophole that allows millionaires and richer to purchase Obamacare plans as long as they can somehow fudge their income to fall within Obamacare requirements by adding an ASSETS test and perhaps using that money to restore food stamp availability to what it was before Obama's tenure (2014)?
Sadly, because the government doesn't care about THE POOREST AMERICANS, paying out fraudulent premiums that artificially pump up "enrollment" is more important.
Why not, instead of "EXEMPTING" those who are homeless, destitute, unable to pay for their utilities, from the Obamacare tax, therefore "letting them legally have no health care coverage," re-establish the pre-Obamacare levels of Disproportionate Share Hospital Payments, (ACA section 1203) which provided for federal dollars for hospitals that treated THE POOREST AMERICANS?
Unfortunately, in the over four years since forced Medicaid expansion was struck down by the Supreme Court, the Obama Administration in spite of all the changes they've made to Obamacare (see Galen Institute) have NOT restored those disproportionate share payments to hospitals, further worsening the options for THE POOREST AMERICANS.
So, let the Republicans and Democrats spend taxpayer money fighting over the cost-sharing payments, but DO NOT be silly enough to argue that the issue addresses THE POOREST AMERICANS, ignorant enough to think that the cost-sharing payments effect more than some number LESS than the dismal enrollment numbers of 2016 of between 9.4 and 11.1 million, or foolish enough to think that there is ANY protection for anyone outside the corrupt, imperfect and special entitlement program that is Obamacare.
