In 2014, one of Obama's architects of Obamacare, Jonathan Gruber, revealed that it was in part the "stupidity" of the American voter that got Obamacare passed. This year, Democrats are resurrecting the falsehoods and spin (yeah, that's also falsehoods) used to sell us Obamacare. But are we still "stupid"?
Yes, having health insurance is what most Americans would prefer, pre-, during and post- Obamacare. But the law did little for the problems for consumers from our health industrial complex. Prices for health insurance and medical needs have gone up with only the vague imaginings that they would have "gone up more" without Obamacare. People still file for bankruptcy with the NUMBER ONE reason of medical expense. Prescription drugs have skyrocketed, with some drugs rising in the past five years over 10 times the rate of inflation. Insurance companies are still using the barriers of small provider lists and minimal or no coverage of items to maximize profits.
There are a few changes to Obamacare under the Republicans, but they do nothing for Democrats. For Benefits Year 2019, there is no individual mandate.
That's right, we're no longer going to be taxed extra if we fail to purchase the consumer financial product of health insurance. That's not a loss for most consumers. The end of the individual mandate removes the tax penalty charged to individuals who find themselves unable or unwilling to purchase health insurance. The CHOICE is restored, choose health insurance, including Medicaid if you qualify or exchange plans, but for working Americans meeting income thresholds, the REQUIREMENT of purchasing health insurance or pay a tax penalty is removed.
Are we stupid? Arguing, "Buy it or else," was never persuasive, but here come the Democrats arguing that the Obamacare ultimatum is somehow beneficial.
As for the chump statistics about how many people will lose their insurance if not forced to purchase it under the individual mandate, that's nonsensical because first, most people do want to have health insurance and secondly because it's likely we'll see continued penalties for gaps in coverage, eg through the insurance companies imposing continuous coverage requirements. Also, the warnings of the millions who will "LOSE" insurance are not about LOSS, but choice, based on numbers of people who MIGHT MAKE THE CHOICE, for whatever reason, not to purchase the consumer financial product of health insurance.
Then there's the Democratic warnings that the reduction of $5 million in Obamacare advertising will also somehow "jeopardize" Americans seeking health insurance on exchanges. How stupid are we? Most of us know that Healthcare.gov is available by phone, tablet or computer. If you call any insurance company and ask about a plan for your tax bracket they'll often steer you towards that same website. It's been almost a decade since Obamacare passed.
Then there's the "shortening" of the Obamacare exchange open enrollment period, which in order to garner maximum enrollment was weeks longer for Obamacare than for any other health benefits election. Now it's more in line with the rest of America with a six week election period. The complaint here is that exchange "navigators" won't be able to help as many people. That could be true, there could be longer waits, but then again, the "navigators," are not great in my experience. They have limited knowledge, cannot recommend anything and have provided misinformation to me, such as documentation required, etc. Use the website.
OK, so what about the reduction in those cost-sharing subsidies? First, you should know what they are. They're government entitlement payouts only available for people who choose an Obamacare exchange plan, which at its highest was about 11 million people, even with the Obama Administration using any means possible to pump up those numbers.
Of those 11 million people, it was ONLY available for people who purchased the SILVER level or above plans. Cost-sharing is not available for BRONZE plans. Cost sharing is also only available if you meet low income parameters AND use your health insurance (versus simply purchase it with premium money).
Under Obamacare, this cost sharing is federal entitlement payouts for a portion or all of a person's expenses in USING their health insurance that pays for the OUT OF POCKET EXPENSES OF DEDUCTIBLE, COINSURANCE, and COPAYMENT for individuals enrolled in exchange plans at a SILVER LEVEL AND ABOVE who MEET certain low income parameters.
At its most inflated, this number is ESTIMATED to reflect about 6 million people. These are working Americans who have health insurance but may be deterred from using it because of the enormous cash outlays required in terms of deductibles, copays, and coinsurance, JUST LIKE THE REST OF US. Still, Department of Health and Human Services could address this with lower OOP maximums but instead has raised the OOP maximum every year, including for benefits year 2019, to $7,900 for self-only coverage and $15,800 for other than self-only coverage.
Then there's the availability of Short Term Limited Duration Plans, touted by the Democrats as Armageddon because these plans do not have many of the features of other health insurance. These plans have been used before and during Obama's Administration by people in between jobs who could not afford COBRA payments to bridge their health insurance until they found new coverage, for students who used school health insurance which did not cover them during vacations or by people who wanted to make sure they had some coverage for whatever reason arose.
Under the Obama Administration, these plans were restricted only in 2016, six years after Obamacare's enactment because the Administration wanted to make sure young-healthies were paying more into other insurance plans.
As CMS said, "Some issuers are now offering short-term limited duration plans to consumers as their primary form of health coverage for periods that last nearly 12 months, allowing them to target ONLY THE HEALTHIEST CONSUMERS while avoiding consumer protections. As highlighted in recent press accounts, BY KEEPING THESE CONSUMERS OUT OF THE ACA single risk pool, such abuses of limited duration coverage increase costs for everyone else…"
That was the Obama Administration's motivation, not the "worry" about whether people had good enough health insurance coverage.
So, for 2019, there are more short term limited duration plans available and they can be used for a longer period of time to help prevent gaps in health insurance coverage. They are not as extensive as other plans, that is the caution.
Then there's the claims about the contraception mandate, a little piece of Obamacare that I personally find offensive because it covers female sterilization and not male sterilization in a sexist way. The objections are that more employers and organizations under Trump's executive order will be able to avoid providing contraceptive coverage based on religious beliefs. This is another, "How stupid are we?" moment.
The biggest inroads to the erosion of the contraception mandates under Obamacare occurred under Obama's Administration. In Burwell v. Hobby Lobby, the Supreme Court case of 2014, under Obama, held that closely held for profit corporations could not be compelled to provide contraception. The issue had already arisen with 2012 opt-out options created by the Obama Administration for religious institutions and organizations associated with religious institutions that are anti- birth control.
Another objection is that birth control pills have become more affordable because insurance companies pay for them under Obamacare. With Obamacare's horrendous and glaring omission of any controls on the cost of life-saving drugs and potentially life-saving drugs, this is hardly the prescription drug argument starting point for most Americans.
If you still "worry," about "losing" Obamacare, consider the flagrant rejection of Obamacare by public employees, who sang the praises of Obamacare and simultaneously made sure that they're not thrown into it, with the twisted version of making their employer the federal government and too bad for you, their employer gives them superior benefits options. This is still the case and therefore should make you doubt any public employee speaking to what they're doing to us re health insurance.
The fact that we pay up to 72 percent of their premiums should mean that WE'RE their employer, but that didn’t happen and Obama's Administration simultaneously passed a provision that made sure those cushy public employee benefits stayed in place. Now that's relying on the stupidity of the American voter.
Essentially, the lawmakers told us, "Obamacare's good enough for you, not for us, and you'll pay for our superior benefits." This is still the law.
Consider that the effective dates for the rollout of Obamacare's individual mandate didn't occur until AFTER Obama's re-election, when in 2013, we began seeing what these 2014 "plans" really were all about, earning Obama liar of the year for one of his lies, if you like your plan you can keep it. Now that's relying on the stupidity of the American voter.
Consider that both premiums, the cost of obtaining health insurance AND copayments, deductibles and coinsurance rose every year and that enrollment in Obamacare exchange plans disappointed even using the doubtful numbers released by CMS because the Obama Administration-Insurance Company partnership created the opportunity to do so. Well, that's still going on and blaming Republicans for this almost decade long trend, that's relying on the stupidity of the American voter.
Oh yeah, those enrollment numbers? Removing the numbers of people who opted into expanded Medicaid, near free insurance and near free treatment, and addressing those exchange participants, those numbers are chump stats, because we were already TOLD that CMS didn't consider the number of people who already had insurance but were dumped into Obamacare exchanges because…That's right, you couldn't keep your plan if you liked it after all. We don't know how many people were NEWLY insured, because IT'S NOT COUNTED.
Heck, the Obama Administration also told us that they overestimated the number of uninsured in the first place. In 2015, the CBO stated that in terms of enrollment, "fewer people would be likely to be uninsured in the future in the absence of the ACA..." (CBO, March 2015, publication 49973, page 22).
This wasn't the only set of chump stats. It turns out that the number of people who required expanded Medicaid was also overestimated. In 2016, after the release of a growth of Medicaid enrollees, Jonathan Gruber, originator of the "stupidity of the American voter," re getting Obamacare passed stated the bursting Medicaid enrollment included millions of people who were ALREADY eligible for Medicaid who came "out of the woodwork" and enrolled.
More on the chump stats of the young healthies being forced into more expensive insurance to "even out" the payouts insurance companies would have to make on behalf of people who typically purchased more expensive insurance because those people anticipated based on their age and health that they might NEED health insurance. Well, President Obama was honest about letting young-healthies know they were the tools for this "protecting of the profits" of insurance companies and it didn't work.
Young-healthies who weren't young enough to be on their working parents' plans, who didn't have enough money to pay for the more expensive insurance coverage, even when they used Obamacare exchange plans chose the less expensive bronze level plans.
This made sense for young-healthies based on the fact that insurance election is only one year long, that they'd been told their "odds" of needing more extensive coverage were statistically less and because the "benefits" of cost-sharing of expenses for USING health insurance on exchanges, only available on more expensive "silver" and higher level plans didn't in their minds justify the higher costs of insurance plans, since they were less likely to "use" their health insurance or qualify for these cost-sharing benefits.
So we saw young people choosing the cheaper bronze plans on exchanges which still offer premium tax credits (offered to offset the cost of purchasing health insurance, premiums), and opt out of the more expensive silver and above plans. The Obama Administration responded with raising the price MORE for benefits year 2015 on bronze plans than the increases for silver plans, hoping young-healthies would opt for the better buy of silver plans. They didn't, and in 2016 we saw the above-cited short term limited duration plan restrictions designed to force young people into more expensive plans. Premium tax credits are still available for benefits year 2019 on silver level and above exchange plans.
This election year, Democrats are still relying on the stupidity of the American voter, just as Jonathan Gruber, one of Obama's Obamacare architects revealed in 2014. They're doing a second act that's a repeat of the first, twisting, lying and ultimately hoping to trick voters into believing that their election will mean a new age of quality, affordable, accessible care, the identical promises to President Obama's false promises that we'd all have health insurance like his family has.
It's the Democratic language of ultimatum, "Go along with Obamacare or else," that has kept Obamacare in place and kept it unmodified in its most consumer-unfriendly provisions, including the public employee de facto exemption from its provisions. But it's not 2010, and I don't believe we're still that "stupid."
