3 Simple Ways to Win the Debate on Obamacare

Before March 2010, health care reform was already a divisive political issue. People chose sides for very personal reasons, which made it a difficult topic to discuss using an indoor voice.

Then Obamacare hit the scene. Promises made were not kept, and Americans are still facing the consequences—including higher premiums, fewer choices of doctors, and waiting periods.

With the first presidential debate and open enrollment season just around the corner, health care is poised to be a hot topic yet again.

Whether you’re talking to a neighbor about your increasing premiums or a co-worker about the latest health care debate on Capitol Hill, here are some tips for talking about Obamacare from a free-market, limited-government perspective that beats back socialism without beating down your opponent.

1. Find Common Ground

The common denominator on both sides of the argument is the desire for access to quality, affordable health care. Regardless of position, class, income, or location, health care should be cost-effective and accessible for everyone.

Furthermore, the part of the health care debate that nearly everyone agrees on is the need to address what happens to those with pre-existing conditions. For too long, those who suffered with a pre-existing condition were up against a nearly impossible task to find affordable, quality health care—those who needed it the most were often denied. A solution to this issue is something we can seek to solve together.

These well-known aspects of the health care debate create a common goal and make room for a discussion to work toward a solution.

2. Use Examples

There are numerous facts and statistics that prove Obamacare is not working as we were promised.

Just this year, average premium costs for an employment-based insurance family plan have skyrocketed to $15,500. In just a few years, those costs are projected to increase another 60 percent.

In March, on the sixth anniversary of the Affordable Care Act, The Daily Signal released this video, detailing six broken promises made by President Barack Obama regarding his health care plan.

Among other promises that were not kept, Americans were assured: you would be able to keep your current plan if you liked it; families making less than $250,000 would see no tax increase; Obamacare would not add to the deficit; premiums would decrease; and federal conscience laws would remain in place.

If you want to cite personal anecdotes, there are plenty. For example, I am a small business owner and therefore purchase my own health care. My premiums have tripled (while my health has remained the same) since the introduction of Obamacare. And I know my story isn’t unique.

Use stats and examples that prove Obamacare has achieved the opposite of what we were promised. Focus on the broken system, higher costs, longer wait times, and less choice.

3. Choose Your Words Carefully

The words and terms you use in this debate have the power to determine how your argument is received.

Even though the president embraced this legislation as his own, use the “president’s health care law” or the “Affordable Care Act” when talking to people who like it. Throwing “Obamacare” around will put liberals on the defensive, and then any chance for a reasonable conversation is harder to achieve.

While we may consider it unconstitutional to mandate that Americans buy a product whether or not they want it or need it, don’t focus on Obamacare being “unconstitutional.” That isn’t a winning argument for someone who is in favor of the health care law. Instead, focus on real-life implications like fewer choices, longer waits, and higher costs—all of which are happening and are the opposite of what we were promised. Proving injustice is easier, and fairness is a term they care a whole lot about.

Obamacare has not turned out to be a good deal for any of us, and this election season is an important time to discuss the law and its long-term implications. Civil discourse may be our best starting point to hold the president accountable and develop a health care system that truly works for all Americans. (For more from the author of “3 Simple Ways to Win the Debate on Obamacare” please click HERE)

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Government Watchdog: Obamacare Can’t Detect Fake Enrollees

Republicans are slamming the Affordable Care Act’s (ACA) lack of accountability in light of two new reports showing the health care law is vulnerable to fraud.

“This report unfortunately tells us more of what we already know — that the Obamacare federal exchanges have been riddled with problems since day one,” said House Ways and Means Committee Chairman Kevin Brady (R-TX) in a statement issued with several other GOP Committee Chairmen.

Brady and the other top GOP policymakers say they are concerned by the fact that undercover operations by the Government Accountability Office (GAO) in 2015 and 2016 got through the ACA’s fraud prevention measures. For its 2015 analysis, the federal investigative agency successfully used “fictitious applications for subsidized health plans” ten times, and was approved for Medicaid coverage in seven of eight other fake applications.

Four states were targeted for investigation — New Jersey, North Dakota, California and Kentucky.

The 2016 investigation found that in addition to approving eight fraudulent applications, four applications were approved despite lacking proof of eligibility from prior years’ investigations. The applications were submitted through federal exchanges in West Virginia and Virginia, and California’s state marketplace.

Federal and some state officials agreed to create systems for better oversight, according to the GAO.

Senate Finance Committee Chairman Orrin Hatch (R-UT) said in a statement that “Continuing to leave taxpayers vulnerable, years after the system was implemented, is a disgraceful way for the administration to leave our healthcare system. That the administration has been aware of this since 2014, and has failed to employ proper safeguards, is just the latest incompetence in the health law’s implementation.”

The law has faced other criticisms of late, as insurers are pulling out of many states and a majority of state-run healthcare exchanges have collapsed. (For more from the author of “Government Watchdog: Obamacare Can’t Detect Fake Enrollees” please click HERE)

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3 Reasons Why Obamacare Is Bad for Millennials

For many millennials, the fear of entering the “real world” is looming. We are preparing to face the financial challenges, often feeling like we are starting the trek up Mount Everest.

Many of us are scrambling to find jobs and avoiding moving back in with our parents. We recognize more and more that good jobs putting us on a promising career path are harder to find.

But our generation faces an additional challenge. Obamacare is jeopardizing our personal freedom and our financial future in ways few saw coming and many are unprepared to handle.

So many young people believe Obamacare is helping our society and will make health care more affordable, but now it is abundantly clear that the plan is harming young people.

Here are three ways Obamacare is hurting millennials:

Health Care Costs Skyrocket

Because of Obamacare, young people have seen up to a 44 percent increase in premiums because the new 3-1 ratio (older people can’t be charged more than three times the cost of a young person’s health care) forces the young to subsidize the old in the health insurance market. Not only are elderly individuals paying artificially lower prices for their insurance, but millennials are paying artificially higher prices.

This gives young people a strong monetary incentive to go without insurance and pay the annual fine for not buying insurance and then still “free ride” at the expense of the taxpayer with hospital emergency room care when they do get sick. If these regulations weren’t in place, young people’s premiums would be reduced by around $1,100.

That’s a lot of money for many young people starting in entry-level jobs, making only $10-15 an hour.

One aspect of Obamacare that seemed appealing to millennials on the surface was that if they are age 26 or younger they can stay on their parent’s plan—assuming their parents have employment-based coverage. However, if they don’t, they must enroll through the health insurance exchanges, where their choices are scarce. If they don’t do either, they must pay a fine. What we want to do is enroll in less expensive health plans of our choice. We can’t do that under these restrictions.

In addition, some options that were specifically designed for young people have been outlawed. Most college students only need and want basic coverage, which they could get through a limited benefit plan. Obamacare has abolished these minimum coverage caps (the plan’s minimum amount of money used to cover medical expenses) that characterizes these short-term, college plans. This desirable option of limited, short-term insurance coverage is now no longer available for students.

Instead of expanding coverage, some young people have decided to go without. That defeats the whole purpose of this law.

Harder to Keep Jobs

Because of Obamacare’s mandates on businesses, employers are increasingly forced to cut back on hiring and hours of work.

Employers are forced to purchase expensive insurance packages at the risk of being fined. The law mandates to anyone employing 50 or more full-time employees to purchase federally standardized health insurance. This coverage is often very expensive because of the inclusion of a wide range of government-mandated benefits.

If businesses don’t offer the federally-approved coverage, they can be fined at a rate of $2,000 to $3,000 for each employee who isn’t covered. Employers deal with this by not absorbing the costs, but passing it on to their workers. How? By slashing hours, cutting wages, rolling back other benefits, and firing people with the least seniority.

It’s not surprising that people have had to take multiple jobs just to support themselves. For young people entering the workforce, this doesn’t make our chances of securing jobs upon graduation any easier.

An Explosion of the National Debt

If the above two reasons weren’t enough to make a young person worry, this point will for sure.

As of March 2015, Obamacare has a net cost of $1.207 trillion over the next 10 years and will add an additional $17 trillion over the next 75 years in unfunded liabilities. Our national debt is over $19 trillion, so how is the United States supposed to pay for this? Oh, that’s right, it will increase taxes on the young people who will continue to pay for Obamacare, as well as the other giant federal entitlements—Social Security, Medicare, and Medicaid—for the rest of our lives.

Not only are the young subsidizing the old through Obamacare’s unfair insurance rating rules, they are also subsidizing a large and rapidly-growing elderly population—including wealthy retirees—through their payroll and income taxes.

Imagine how much that will end up costing. Imagine how much of our hard-earned money will go toward big entitlement programs like this one, which we might never benefit from. If the goal was simply to provide help for those who could not afford health insurance, we could have easily done it without incurring Obamacare’s massive cost and debt. But that wasn’t the goal. The goal was more government intervention, and less of the free market; sadly it seems to be working.

A Better Solution for Young People

There is a better way to help the millions of Americans struggling to find affordable coverage, but not at a debilitating cost to young people.

Congressional Republicans, led by House Speaker Paul Ryan, R-Wis., recently released a plan that embraces a free marketplace, respects personal freedom, allows Americans to keep more of their hard-earned paychecks, and embraces the diversity of this wonderful land we call America.

Ryan’s plan would reform the health care system, starting with the repeal of Obamacare. The plan states: “This law cannot be fixed. Its knots of regulations, taxes, and mandates cannot be untangled.”

The congressional Republican plan will allow people to buy insurance anywhere in America, creating a highly competitive national market for health insurance.

It would give Americans more options, better quality, and intense competition that would lower costs. States would be able to regulate their own health insurance markets, meaning that Washington could no longer force employers and individuals to purchase “Washington-mandated” health plans. It would mean that young people would be able to buy insurance that fits their needs, rather than pay artificially inflated insurance premiums.

Removing the employer mandate would mean that businesses would be able to purchase coverage that is best for them, and they would be able to balance health benefits with wages and other benefits. It would also open up job opportunities, enabling businesses to hire more full-time staff instead of many part-time staff, creating more job security and larger paychecks. That would be a direct benefit to young people entering the workforce.

Obamacare was supposed to lower costs and increase access to care. While insurance coverage has increased, health care costs have soared, particularly for the young. The most energetic new workers are being slammed with higher costs of insurance, including big deductibles—forcing many to go without.

President Barack Obama said his plan would not only expand coverage, but would also control costs, reduce typical family premiums, and expand competition. In fact, its biggest achievement has been to increase cost and expand government control.

Many of our peers don’t like conservatives very much, but they don’t realize that the Ryan alternative to Obamacare will lower insurance costs—especially for millennials. This plan was created with an understanding that young people shouldn’t bear the entire burden and recognizes that our future should be full of excitement and opportunity, not high taxes, suffocating bureaucracy, and crippling premiums. (For more from the author of “3 Reasons Why Obamacare Is Bad for Millennials” please click HERE)

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FEDERAL COURTS: Emperor Obama’s Executive Overreach Is Bullsh**

In another blow to President Obama’s flagrant executive overreach, a federal appeals court smacked down an ObamaCare rule requiring all indemnity health insurance plans to meet essential coverage minimum standards. The decision offered by the three-judge panel included Patricia Millet, an Obama nominated judge, who said the Administration “overreached” when it adopted a 2014 rule that “effectively eliminated” the plans by adding “additional criteria” to previous law.

The courts have repeatedly rebuked Obama for extending his executive pen too far. In May, a federal judge ruled Obama “exceeded his authority” and struck down an Obamacare provision giving billions of dollars to health insurers through subsidies.

Last month, an Obama-appointed federal judge struck down Obama’s overreach when it came to fracking regulations.

In the ruling on Tuesday, U.S. District Judge Scott Skavdahl said Congress had not granted the BLM that power, and had instead chosen to specifically exclude fracking from federal oversight. Skavdahl made it clear what he was — and wasn’t — considering in his ruling. ‘The issue before this Court is not whether hydraulic fracturing is good or bad for the environment or the citizens of the United States,’ he wrote. The question, instead, is ‘whether Congress has delegated to the Department of Interior legal authority to regulate hydraulic fracturing. It has not.’”

In June, an appeals court ruled Obama had wrongly bypassed Congress on his temporary government appointments.

“Congress did not want the president to install his chosen replacement unless the Senate approved,” SW General argued. “Allowing the permanent nominee to begin work immediately as an acting official would enable the president to advance his agenda without obtaining the Senate’s advice and consent.”

Last year, the Courts blocked Obama’s water rule not once, but twice for flexing executive power exceeding federal law.

Judge Ralph Erickson of the District Court for the District of North Dakota found that the 13 states suing to block the rule met the conditions necessary for a preliminary injunction, including that they would likely be harmed if courts didn’t act and that they are likely to succeed when their underlying lawsuit against the rule is decided. … Immediately upon the rule taking effect, the rule will irreparably diminish the states’ power over their waters’ he continued, calling the Obama administration’s interpretation of its jurisdiction “exceptionally expansive.”

“In a 2-1 ruling, the Cincinnati-based Court of Appeals for the Sixth Circuit delivered a stinging defeat to Obama’s most ambitious effort to keep streams and wetlands clean, saying it looks likely that the rule, dubbed Waters of the United States, is illegal.”

The court’s continued rebuke of Obama’s imperial presidency shows that no one is above the law when crafting irresponsible policies that go against the Constitution and hurt Americans. Sadly, the American people must continue to look to the courts to protect them from the damaging policies of the last 7 years. (For more from the author of “FEDERAL COURTS: Emperor Obama’s Executive Overreach Is Bullsh**” please click HERE)

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What’s the Real Reason Americans Hate Obamacare?

University professors, existing as they do in the rarified air of academia, tend to be too clever for their own good. They look for complicated explanations when simple ones would do perfectly well.

Case in point: professors Lawrence Jacobs and Suzanne Mettler recently coauthored a slightly befuddled sounding op-ed, in which they fret over the continued unpopularity of the Affordable Care Act, better known as ObamaCare. When a policy delivers benefits, they argue, it should be popular. So why do people continue to hate ObamaCare?

According the Kaiser Family Foundation, only 38 percent of Americans approve of the health care law, yet 49 percent disapprove. While there has been some fluctuation within the last year, the favorability gap has persisted over the last three years or so. In fact, the only tie when a majority of Americans consistently approved of the law was in 2010, before the actual effects of the government’s health care takeover could be felt.

To you and me, the reason for this widespread dissatisfaction is obvious, but not to Jacobs and Mettler, who conclude with obvious frustration that the real culprit is “partisanship.”

“Prevailing attitudes of distrust in government, strong partisanship and ingrained attitudes — not features of the law itself — are perpetuating the public’s negative opinion. The ACA remains highly politicized, to say the least. Republicans in the House have voted to delay, defund or repeal the law some 60 times, and its very nickname — ObamaCare — primes us to think of the ACA through a political lens.”

That’s right, gang. It’s those evil Republicans, poisoning our minds against Dear Leader’s health care law. Oh, if only we sheep weren’t so easily led astray by Fox News telling us what to think. Thank heavens for academics, selflessly leading us out of the darkness of our ignorance.

What never seems to occur to these people is that maybe Americans don’t like the law because it has made health care in America measurably worse. Deductibles for the least expensive ObamaCare plans have more than doubled since last year, and are now approaching $7,000 for an individual, an outrageous figure that few will be able to afford, much less the least fortunate, the very people the law was supposedly designed to help.

But even if you do manage to overcome the deductible hurdle, you’re not out of the woods, as many doctors and hospitals are now refusing to accept ObamaCare exchange plans, due to their low reimbursement rate. At the same time, health savings accounts, one of the few ways still possible of increasing price transparency and reducing medical costs, are being boxed out of the ObamaCare marketplace, and more than half of the co-ops created under the law have now gone out of business. Finally, United Healthcare Group, one of the nation’s largest insurance providers, is abandoning ObamaCare plans as unprofitable.

In short, everywhere you look, ObamaCare is reducing access to health care, not expanding it. Defenders of the Affordable Care Act keep boasting about how many more people are “covered” than before, but coverage itself means nothing if you can’t afford the deductible, and if your doctor won’t accept your coverage.

It’s insulting to imply that Americans are insensitive to these problems, incapable of feeling the pain that comes from mandatory reduced access to health care, and incapable of forming informed political opinions based on these observations. I shouldn’t have to point out that people dislike a bad policy because it is bad, but in today’s world of over-analysis and eagerness to ignore obvious truths, apparently such demonstrations are necessary.

Then again, when you consider that ObamaCare, like all big government programs, was passed by people who regard consumers as incapable of tending to their own well-being, and who need to be cared for by a paternalistic state, I suppose it isn’t all that surprising after all. (For more from the author of “What’s the Real Reason Americans Hate Obamacare?” please click HERE)

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Under Obamacare, Small Business Owner Forced to Get Rid of Health Care Benefits or Face Fine up to $500K

When Maryland business owner Thomas Kunkel first learned about the Affordable Care Act, he was excited about the prospect of the new health care law.

“From the small business standpoint, it was actually one of the first times I felt like a bit of a social program might actually benefit a small business,” he told The Daily Signal. “Usually it’s the opposite.”

Kunkel owns Full House Marketing and Print in Edgewood, Maryland, and employs 21 full-time workers and up to 10 part-time employees. While he doesn’t provide them with health insurance, Kunkel cuts his workers a monthly check through a Health Reimbursement Agreement.

Obamacare, he said, would allow a lot of his employees with pre-existing conditions conditions to get insurance, especially those who had trouble purchasing coverage in the past.

“That was the biggest positive I saw,” he said.

But Kunkel, who previously worked in the health care industry, anticipated premiums and deductibles were going to rise as insurers worked to adjust to the changes to the health care market.

Under Kunkel’s agreement with workers, he pays a set dollar amount each month, and employees are free to purchase plans on the individual market, putting the money Kunkel provides them toward the cost of their premiums.

“It was actually allowing me to offer a medical insurance benefit to my employees without having to go through all of the challenges of a group plan,” he said of the Health Reimbursement Agreement.

But in September 2013, the IRS and Treasury Department issued guidance prohibiting businesses from using Health Reimbursement Agreements, which help workers pay for health insurance plans purchased on the individual market and other medical expenses. Businesses that integrate Health Reimbursement Agreements with group plans can still offer the benefit.

The Treasury Department said Health Reimbursement Agreements failed to satisfy specific provisions of Obamacare, such as the prohibition on annual limits for health benefits and the requirement that plans must include preventive care.

And for Kunkel, that left him forced to do away with one benefit that helped him retain employees and gave him a competitive edge when hiring.

“Before, I could at least say we don’t offer health care because there are a lot of options available on the individual market, but we do reimburse up to ‘x’ number of dollars a month,” he said. “I could sell that as a better plan than a group plan. But of course now I don’t have that to offer. It makes it tougher to hire and retain and to be competitive.”

‘A Little Betrayed and a Little Misled’

Prior to the Obama administration’s announcement, many small business owner were under the impression the Affordable Care Act would have little to no impact on them, especially because the law’s employer mandate created requirements for businesses with more than 50 employees.

However, small businesses are now faced with having to do away with a vital tool used for their employees or face hefty fines.

Kevin Kuhlman, director of legislative affairs for the National Federation of Independent Businesses, called the Treasury Department’s rule for small businesses a “solution in search of a problem.”

“They feel a little betrayed and a little misled,” Kuhlman told The Daily Signal. “It just has reduced flexibility for a lot of small businesses. These businesses with fewer than 50 employees were told 100 times, ‘Oh, you have fewer than 50 employees, the law doesn’t apply to you,’ and then Treasury quietly put out regulations that say you can no longer do this flexible benefit that we’re offering instead.”

“You either have to offer expensive group coverage, which you can’t afford, or you’re completely on your own, and you can’t help your employees,” he continued.

Any business that violates the rule is subject to fines of $100 per day per employee, totaling $36,500 in a year. Businesses face a maximum penalty of $500,000 per year.

In February 2015, the Treasury Department delayed enforcement of the ban on Health Reimbursement Agreements until July 1, 2015. Despite the delay, Kunkel said many small businesses could be surprised with fines for not complying with the rule.

“I think many are not even aware of it still and could be subject to penalties,” Kuhlman said. “This is the first tax season that both employers and employees are filing their taxes. Discrepancies could appear there, and that could invite unwanted audits, which have costs in and of themselves, and then the potential penalties.”

In the wake of the Obama administration’s guidance banning the use of Health Reimbursement Agreements, a number of business groups have come out in opposition of the ban and are calling on Congress to reverse the rule.

In April, the U.S. Chamber of Commerce and 60 groups representing small businesses across a variety of industries sent a letter to Republican and Democratic leaders on the House Ways and Means Committee urging them to roll back the IRS’s regulation by taking up bipartisan legislation addressing the guidance.

That legislation, called the Small Business Healthcare Relief Act, has more than 90 Republican and Democratic cosponsors in both the House and Senate. It would allow small businesses to continue providing employees with a defined reimbursement for medical expenses and health coverage.

“This arrangement has worked well for small businesses that can’t afford group insurance or don’t have human resources departments to manage a health care plan,” Sen. Chuck Grassley, R-Iowa, a main sponsor of the legislation, wrote in an upcoming op-ed. “…It all made sense. Then Obamacare pulled the plug on it.”

Earlier this month, senators expressed concerns with the Obama administration’s decision to prohibit small businesses from helping employers through reimbursements.

During a Small Business Committee hearing, Sen. Kelly Ayotte, R-N.H., questioned Department of Health and Human Services Assistant Secretary for Planning and Evaluation Richard Frank about the administration’s position on tools like Health Reimbursement Agreements and Health Savings Accounts.

“As we look at the big picture, these are tools that we need to look at,” Ayotte said. “We can’t have one side of the federal government doing this, and the other side of the federal government interfering with other really important tools that people use that are very helpful in covering their health care costs.”

Similarly, Small Business Committee Chairman David Vitter, R-La., reinforced concerns small businesses have with the fines that could be levied against them by the IRS for continuing to assist workers through Health Reimbursement Agreements.

“This penalty is a big deal, and it’s a big part of the system, and it’s a big impact on health care,” Vitter said. “It’s there to penalize small businesses who want to do it one way versus the SHOP exchange. This is a big deal.”

Frank said any issues with the administration’s rule regarding Health Reimbursement Accounts were under the purview of the Treasury Department and not the Department of Health and Human Services, but said that his agency is focused specifically on expanding access to care.

“HRAs are not insurance They are other health accounts, and they don’t meet the definition of insurance so one issue is that I think people conflate the two,” he told lawmakers. “There are provisions that if you have insurance and you want to use additional funds through an HRA, that’s permissible. What gets conflated in many corridors is where the line between HRAs and insurance are drawn.”

Ed Haislmaier, senior fellow in health policy studies at The Heritage Foundation, stressed it’s not just the IRS’s rules surrounding Health Reimbursement Agreements that have hurt small businesses.

“What Obamacare has done in terms of small business coverage is, first, various provisions have increased the cost of the coverage through other regulations, including this one, and second, it has limited the available options for small business in terms of plan design and also possibly in same places the number of available insurers,” he told The Daily Signal.

Haislmaier also said that Obamacare is “premised on providing traditional kinds of insurance with traditional financing arrangements,” but added a layer of restrictions in terms of plans.

Taking It Away

After Kunkel learned of the IRS’s new rules regarding Health Reimbursement Agreements, he began exploring options.

Kunkel looked into purchasing plans through the SHOP, or Small Business Health Options Program, exchange. However, insurance brokers warned Kunkel enrolling in the SHOP exchange could prove to be confusing, time-consuming and costly.

He also looked into offering his workers a group plan and selected one through Evergreen Health, Maryland’s co-op.

Though the group plan through Evergreen Health was among the cheapest Kunkel could find, not a single employee decided to enroll, as it was more expensive than individual plans.

Kunkel even raised some of his employees’ pay to help compensate for their lost reimbursements, but that caused some workers purchasing coverage on Obamacare’s exchange to lose subsidies or qualify for less.

“They’re good people. They’re good friends of mine, and most of them have worked for me for years,” Kunkel said of his employees. “It’s always tough when you’re taking something away from them, especially something like health care. You feel compelled to try to help out in some other way.”

Already this year, Kunkel has had two employees leave his company, citing health insurance as a major reasons for leaving.

Now, he’s hoping Congress can provide some much-needed relief for small businesses.

“I’m vying for qualified staff just like everybody else. The fact that I was contributing, I felt I was going above and beyond,” he said. “Then I had to be the person to take it away.” (For more from the author of “Under Obamacare, Small Business Owner Forced to Get Rid of Health Care Benefits or Face Fine up to $500K” please click HERE)

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Why Obamacare Customers in Some States Might See Higher Rates in 2017

As insurance companies begin submitting their rates for health care coverage next year, consumers are seeing changes in the number of insurers selling plans on Obamacare’s exchanges.

And in some places, fewer choices on the exchanges can mean higher premiums.

So far, three states—Alabama, Alaska, and Wyoming—have just one insurer selling coverage on their Obamacare exchanges. And in Kansas, Insurance Commissioner Ken Selzer has been talking with carriers to convince them to sell coverage in his state. If Selzer isn’t successful in bringing other insurers on to the exchange in his state, Blue Cross and Blue Shield of Kansas will be the only option for consumers there.

Since Obamacare took effect in 2013, a number of studies have documented a decline in the number of insurers selling coverage on the exchanges.

A March report from The Heritage Foundation found that from 2015 to 2016, the number of insurers participating in Obamacare’s exchanges fell from 307 to 287. Additionally, prior to the Affordable Care Act’s rollout in 2013, 395 insurers sold individual-market coverage. In 2014, the number of insurance companies selling coverage on the exchanges fell to 253.

When comparing the number of insurers selling plans on the exchanges from 2015 to 2016, 22 states and the District of Columbia saw a decline in the number of carriers selling exchange coverage from 2015 to 2016, according to the report.

Just 10 states, meanwhile, have more insurers on the exchanges.

Additionally, a study conducted by the Kaiser Family Foundation found that more than 650 counties nationwide will have one insurance company on the exchanges next year. In states using the federal exchange,, 40 percent of counties will see just one or two insurers.

A Provider Monopoly

Insurer companies are in the midst of deciding whether to continue offering coverage on Obamacare’s exchanges, and some big players like Humana and UnitedHealthcare have already announced decisions to pull out of some exchanges.

These changes now have health policy experts warning that such a decline in insurer participation on Obamacare’s exchanges could impact how much consumers pay and how much providers charge.

“The focus has been on rural areas where you already have less insurer competition and are getting down to one or two [carriers],” Ed Haislmaier, a senior fellow in health policy at The Heritage Foundation, told The Daily Signal. “I think the effect, paradoxically, is somewhat less. The real issue isn’t the number of insurers. It’s the number of providers.”

In rural areas where there may be only one provider such as a hospital and two or three insurers, the provider could charge what it wants, causing insurers to post similar rates, he said.

“The competition issue in rural areas is more driven by provider monopolies than it is by insurers,” Haislmaier said.

Caroline Pearson, senior vice president of policy at Avalere Health, agreed that in rural areas, specifically, higher premiums from insurers can be tied to increased rates from providers.

“The two are sort of linked,” she told The Daily Signal. “The way that insurers have brought premiums down in some markets is by designing narrower networks where they’re including only a subset of providers with better negotiated rates.”

“In rural areas, there’s a dearth of providers,” she continued. “Plans are beholden to the physicians there, and they don’t have the leverage to drive rates down. I think the monopoly of providers is limiting plans’ ability to keep premiums low.”

Pearson said that though competition has “been effective” at lowering the cost of premiums, consumers can expect to see across-the-board rate increases for a variety of reasons and not just in areas where there is little to no choice of insurer on the exchange.

“People in the exchanges are sicker than insurers were expecting them to be, so it’s costing more to cover them,” she said. “Additionally, the fact that two of the risk mitigation programs [risk corridor and reinsurance] go away in 2017 will also increase rates. Those are the two primary drivers.”

A ‘Guiding Principle’

In a study from the American Journal of Health Economics released last year, Massachusetts Institute of Technology economist Jonathan Gruber and the study’s authors warned that a decline in competition among insurers leads to an increase in premium prices.

Using UnitedHealthcare’s decision not to sell insurance on Obamacare’s exchanges in 2014 as an indicator of how premium prices changed, the study’s authors found that had UnitedHealth decided to enter all markets, the cost for the second-lowest silver premium would’ve decreased by 5.4 percent.

The government calculates subsidies based on the cost of the second-lowest silver plan.

Additionally, had insurers sold coverage in all areas on the state’s exchange, the cost of premiums would’ve declined by 11.1 percent.

Gruber and the study’s authors further found that areas where Obamacare’s co-ops, or consumer operated and oriented plans, sold coverage had lower premiums than those that did not.

The co-ops launched in 26 states with $2.4 billion in startup and solvency loans from the Centers for Medicare and Medicaid Services and were intended to boost competition and choice in areas where few existed.

However, since their roll out in 2013, 12 of the 23 co-ops have since closed their doors.

In a speech before a joint session of Congress in September 2009, President Barack Obama warned about how decreased competition among insurers can impact consumers.

“My guiding principle is, and always has been, that consumers do better when there is choice and competition. That’s how the market works,” Obama told lawmakers. “Unfortunately, in 34 states, 75 percent of the insurance market is controlled by five or fewer companies. In Alabama, almost 90 percent is controlled by just one company. And without competition, the price of insurance goes up and quality goes down.”

While consumes in Alabama, Alaska and Wyoming will have just one insurer to select coverage from during next year’s open enrollment period, states have yet to encounter a situation where no insurer will sell on the exchange.

In 2013, before Obamacare’s launch, 34 counties in Mississippi were almost left with no carrier selling on its exchange, according to Vox. However, Humana decided to offer coverage to consumers in those 34 counties—albeit at a price, as premiums in the state were among the highest in the country.

“With only one plan, [insurers] certainly have pricing flexibility to make it work for them financially,” John McDonough, a professor of public health at Harvard University told Vox.

Having no insurers selling on an exchange doesn’t mean a consumer will go without coverage, Haislmaier said. Instead, carriers can and do sell plans off of the exchange.

In Mississippi and South Dakota, for example, Blue Cross and Blue Shield carriers are the largest insurers in those states. Neither, though, sell coverage on the exchanges.

“The key thing here is whether there’s an insurer willing to sell on the exchange,” Haislmaier said. “That’s important because that doesn’t necessarily mean there may not be coverage available off the exchange. But those with subsidies will be affected because they then have to pay full price.” (For more from the author of “Why Obamacare Customers in Some States Might See Higher Rates in 2017” please click HERE)

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House Republicans Win Court Fight over Obamacare

A major section of Obamacare that allows the federal government to subsidize costs for insurance plan enrollees has been struck down by a federal judge.

U.S. District Judge Rosemary Collyer ruled Thursday that the administration does not, on its own, have the power to spend money on what are termed “cost sharing reduction” payments without an appropriation from Congress. The administration is expected to appeal.

In light of that, the judge allowed Obamacare’s operation to continue unchanged until the appeal process ends.

House Republicans had filed suit, claiming subsidies paid to insurance companies so they, in turn, lower costs for people enrolled under Obamacare, were unconstitutional. House Republicans claimed that because Congress never authorized the expenditure, the executive branch could not spend the money.

In the court case, the administration said a section of law that funds tax credits to help people pay for coverage also was the legal source for paying the subsidies.

However, the judge ruled that cost-sharing reductions require a separate congressional appropriation. Congress has made no such appropriation.

“Such an appropriation cannot be inferred,” Collyer wrote. “None of Secretaries’ extra-textual arguments — whether based on economics, ‘unintended’ results, or legislative history — is persuasive. The Court will enter judgment in favor of the House of Representatives …”

“Authorization and appropriation by Congress are non-negotiable prerequisites to government spending,” she wrote.

In September, Collyer had ruled in favor of House Republicans in rejecting an attempt by the Obama administration to say House GOP members lacked standing to bring the suit.

“The House sues, as an institutional plaintiff, to preserve its power of the purse and to maintain constitutional equilibrium between the executive and the legislature,” Collyer said then. “If its non-appropriation claims have merit … the House has been injured in a concrete and particular way.” (For more from the author of “House Republicans Win Court Fight over Obamacare” please click HERE)

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Further Down the Spiral: How Much Longer Can Obamacare Last?

hqdefaultAs United Health Care, one of the nation’s largest insurers, announced it would withdraw from the Obamacare exchanges, the insurance industry as a whole seems to be falling apart. A number of high profile insurers, including Blue Cross Blue Shield, have been laying the groundwork for sizable premium increases next year. A study released last month found that costs for insurers had risen by 22 percent, a clear indicator that consumer prices are going to have to go up to prevent more companies from following United Health’s lead.

None of this is especially surprising. Back when Obamacare was first proposed, smart people who understood how insurance worked looked at the model and, with eyebrows raised, pointed out the obvious flaw that would prevent the program from working: the insurance death spiral. The death spiral works like this: When the pool of people who sign up for health insurance is older and sicker than insurance companies expect, costs end up being higher than projected. Companies have to raise their prices (premiums) in order to make a profit. Higher prices cause some people to drop their plans as being too expensive, and the people most likely to do this are the ones who need insurance the least. This makes the remaining pool still more costly than before, and the cycle begins again, until nobody can afford insurance anymore.

Like clockwork, this is what we have seen under Obamacare. Every year since the law’s enactment, the Department of Health and Human Services has fallen short of its enrollment goals, despite increasing penalties for those who choose not to be insured. Premiums have risen predictably and deductibles are soaring as well. In 2015, the average deductible for a Bronze plan obtained on the exchanges was $5,181. In 2016, it was $6,850. That’s an increase of more than 25 percent in just one year. That’s not going to be a sustainable model, especially since a third of people signed up for Obamacare don’t have the money to cover their deductibles now.

As for premiums, according to a project by the Manhattan Institute, at least eight states have seen their premiums double under the Affordable Care Act since 2013. Meanwhile, median weekly earnings have only increased about seven percent since 2013, so it’s not as if people are going to be able to shoulder these costs with ease.

The obvious question is: How much longer can this go on? It’s impossible to know for sure, but what is certain is that the insurance law destined to shape Barack Obama’s legacy is collapsing faster than anyone ever imagined. United Health will not be the last insurer to cut and run from a clear money-losing situation. Others will follow, and this will only accelerate the death spiral. But the even more important question is: What happens next? Will the Left be able to leverage Obamcare’s unravelling into a single payer system, as they have always wanted to do, or will the folly of government planning be evident enough to the average person that we are able to implement some market based solutions to the nation’s health care woes? Given that the frontrunners for president in both parties support universal health care, it’s going to be an uphill battle. (For more from the author of “Further Down the Spiral: How Much Longer Can Obamacare Last?” please click HERE)

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Deserting ObamaCare: UnitedHealth, Nation’s Largest Health Insurer, Bolts, Fears Huge Losses

maxresdefault (98)UnitedHealth has already decided to pull out of Arkansas, Georgia and Michigan in 2017, and Hemsley told analysts during a Tuesday morning conference call that his company does not want to take the financial risk from the exchanges into 2017 . . .

The state-based exchanges are a key element behind the Affordable Care Act’s push to expand insurance coverage. But insurers have struggled with higher-than-expected claims from that business.

A recent study by the Blue Cross Blue Shield Association detailed how many new customers nationwide under ObamaCare are higher-risk. It found new enrollees in individual health plans in 2014 and 2015 had higher rates of hypertension, diabetes, depression, coronary artery disease, HIV and Hepatitis C than those enrolled before ObamaCare.

On the heels of Tuesday’s announcement, Sen. Ben Sasse, R-Neb., said in a statement it’s a sign of “the President’s broken promise that families would have more choices under ObamaCare.”

The Kaiser Family Foundation, in an analysis on the prospect of United’s exit, said “the effect on insurer competition could be significant in some markets – particularly in rural areas and southern states” if it is not replaced. (Read more from “Deserting ObamaCare: UnitedHealth, Nation’s Largest Health Insurer, Bolts, Fears Huge Losses” HERE)

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