Government Watch

ObamaCare Madness

The law’s implementation is turning into one pratfall after another –

from the Wall Street Journal – For sheer political farce, not much can compete with ObamaCare’s passage, which included slipping the bill through the Senate before dawn three Christmas eves ago. But the madcap dash to get ready for the entitlement’s October 2013 start-up date is a pretty close second.

The size and complexity of the Affordable Care Act meant that its implementation was never going to be easy. But behind the scenes, even states that support or might support the Affordable Care Act are frustrated about the Health and Human Services Department’s special combination of rigidity and ineptitude.

To take one example, for the better part of a year states and groups like the bipartisan National Governors Association and the National Association of Medicaid Directors have been begging HHS merely for information about how they’re required to make ObamaCare work in practice. There was radio silence from Washington, with time running out. Louisiana and other states even took to filing Freedom of Information Act requests, which are still pending.

Now post-election, new regulations are pouring out from HHS—more than 13,000 pages so far and yet nuts-and-bolts questions are still unanswered. Most of what we know so far comes from a 17-page question-and-answer document that HHS divulged this week, though none of the answers have the force of law and HHS says they’re subject to change at any moment.

HHS is generally issuing rules with only 30 days for public comment when the standard is 60 days and for complex regulations 90 days and more. But the larger problem is that HHS’s Federal Register filings reveal many of the rules were approved in-house and ready to go as early as May. Why the delay?

To take another example, the feds are building a data hub to determine who is eligible for Medicaid and ObamaCare’s “exchanges,” the bureaucracies that will dispense insurance subsidies and police the market. Many states have cut administrative costs by combining the application process for Medicaid, food stamps, cash assistance and other antipoverty programs, but HHS’s privacy rules say the hub can only be used for ObamaCare. So HHS will force states to become less efficient and flatly refuses to reconsider.

In a word, HHS is treating the states not as the partners it needs to give ObamaCare any chance of success, but as serfs.

HHS did finally if “conditionally” approve the exchange blueprints of six states this week, though it has yet to release any formal objective standards for conditional approval. Some 24 states are refusing to participate, so the agency will be running a federal fallback exchange that it won’t reveal how it will operate.

A federal exchange is a vast undertaking. The clearinghouses will be open to the uninsured but also to small businesses and people who already buy plans on the individual market. On average about a quarter of a state’s population are expected to at least browse the exchange options, and the share will be far higher in states with large numbers of uninsured people under 65, like New Mexico (24%), Georgia (22%) and Texas (27%).

If 20% of Americans use exchanges, that’s 62 million people. At a House Energy and Commerce hearing on Thursday, ObamaCare point man Gary Cohen all but took the Fifth on how he’ll deal with this and other challenges.

The exchange naysayers now notably include Chris Christie of New Jersey and Bill Haslam of Tennessee. Sure, they’re Republicans, but both Governors flirted with the idea and wanted to participate if it would result in a saner and more rational marketplace. The costs and risks were too high.

HHS also declared this week that states can decide either to expand Medicaid (after the Supreme Court decision made it optional), or not. But states are not allowed to make the partial expansion that many states would have considered. This all-or-nothing political gambit is meant to put the Governors in a bad political spot at home if they don’t expand, but the irony is that many of them would participate if HHS gave them more flexibility to manage their own programs and control costs.

Yet HHS has made it almost impossible to qualify for Medicaid waivers. States aren’t even allowed to “go green” by using digital instead of paper applications. These “maintenance of effort” rules weren’t carved in stone tablets by LBJ. HHS formalized them in a regulation this February.

***

In other implementation hilarity, no fewer than 18 Democratic Senators and Senators-elect came out last week against ObamaCare’s $28 billion tax on medical device sales—and not just the usual penitents from Massachusetts and Minnesota. The list includes Chuck Schumer, Dick Durbin and Patty Murray.

“With this year quickly drawing to a close, the medical device industry has receive little guidance about how to comply with the tax—causing significant uncertainty and confusion for businesses,” they write about the tax most of them voted for.

The last entitlement to get off the ground was President Bush’s Medicare prescription drug benefit. Those rules were tied up with a bow by January 2005, giving business and government nearly a year to prepare—and that was far simpler than re-engineering 17% of the economy. No one knows where the current magical mystery tour is headed, especially not HHS.

 

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Stellar Phoenix Review

This website is steller! You definitely know how to keep a reader amused. Between your wit and your awesome content, I was almost moved to start my own blog (well, almost..lol.) Excellent job. I really enjoyed what you had to say, and more than that, how you presented it. Too cool! Stellar Phoenix Review

Earl Fuller

Everyone should read the tenth amendment and give it some time to sink in. Then contact your state leaders and push them to use nullification. The federal government does not have the power that it wants you to think it has. Its we the people that have the power. check out Sheriff Richard Mack who sued the Feds back when Clinton was president and won. It was over the Brady Bill. The feds will take advantage over people only when the people allow it to happen. Wake up America. Obama care can be defeated.

PEGGY FROM INDIANA

I AM A PROUD AMERICAN AND VERY DISTURBED THE WAY OUR COUNTRY IS HEADED. FIRST WE HAVE BEEN TAKEN BY A VERY SHREWD PRESIDENT. HE WANTS TO BE A DICTATOR. LOOK BACK AT HISTORY. HITLER DID THE VERY SAME THINGS. NOW WATCH HIM TAKE OUR GUNS AWAY. THE GOVERNMENT HAS GROWN INTO A GIGANTIC MESS. WITH ALL HIS CRONIES. THIS OBAMACARE ACT IS GOING TO GIVE US LESS CARE AND COST MORE. MY FAMILY DOCTOR HAS OPTED OUT OF MEDICARE. STATING HE CAN NOT SURVIVE ON THE PAYMENTS FROM MEDICARE UNLESS HE SEE MORE PATIENTS PER HOUR. AND HE REFUSES TO GIVE LESS ATTENTION WHEN NEEDED. HE REDUCED HIS OFFICE CALL AMT. AND I MUST PAY EACH TIME DIRECTLY TO HIM. I WILL DO THAT AS HE IS A EXCELLENT DR. ANOTHER FRIEND WAS TOLD THAT A DR. SHE WANTED TO GO TO IS NOT TAKING MEDICARE PATIENTS ANYMORE. AND… Read more »

Jim Connolly

This is just another gross example of the colossal incompetence of Obama, HHS, & company. And to think the uninformed voters elected this pathetic amateur and loser who doesn’t know what he is doing to a second term. The country is reaping this awful mess because it sowed it in 2008 and again 2012. I certainly did not. God help us!

E.D.

Unfortunately our country has put itself in great danger re-electing a man with socialistic and Marxist ties who knew how to attract the kind of people who followed the “carrot” to keep all their free benefits while the rest of us who worked all our lives are being further assaulted (after all he was a community organizer, right?). Money elected the man and money has protected the man and his past (remember the birth certificate question, the ?false SS number, etc.?) Since when is Medicare an “entitlement program?” Why are my benefits threatened? What will happen if there is a mass exodus of MD’s when Obamacare hits full force? This is a scary time. I agree that congressional terms should be limited but we are stuck. The best anyone can do is start and continue to vote the incumbents OUT and try to get some new blood in Congress. It… Read more »

Jean C.

It seems to me, that the right hand doesn’t know what the left hand is doing in Washington. All they know what to do is take a seat, vote for more spending and collect their pay and then retire at an astronomical pension. They only worry about what they are going to get, not what they can do for the people. It’s getting to be a joke.

Kristine Hondo

My husband and I are farmers in Idaho and we have worked all our lives for ourself. We are in business with our adult sons and have planned to work for ourselves as long as we are healthy. I feel that too many Americans have lost sight of supporting themselves and are too anxious to allow the govt. to decide everything about our lives. We love being in control of our destiny and don’t look forward to the gov’t. telling us how to think and when to do. We are both very healthy and love a days work and the satisifaction we feel…why are our contempories so anxious to let a bunch of idiots in gov’t. get away with the way they act and treat the great American people? Lets start a movement of seniors that don,t need the gov’t. to push us around and lets get involved letting our… Read more »

William Larrabee

The ONLY reason this lack of government is continuing to go by way of the prophesies is because GOD has been taken out of everything. And if you don’t believe it just go back into history and read about the development of our Constitution. Our forefathers appealed to a higher power in every way to make it right. Now, because we DON’T appeal to GOD we are fighting for our existence. I make reference to our standing in the world, our financial status with China alone and a Congress that can’t govern. I suggest everyone read the book, “The 5ooo Year Leap,” and the “The Economic Earthquake,” to understand why we are in the shape were in. And while your reading, try the Bible. It too will open your eyes.

Terri

Term limits would be wonderful Mildred, but we will NEVER be able to get them to vote term limits on themselves, unfortunately. They’re too addicted to the money and the power. They are not in it to “serve the people.” They are in it to serve themselves.

Phil in Washington state

12-31-12
If this Obama Care bill passed through the Senate three Christmas eves ago before dawn (as the article says), doesn’t that tell you that something is wrong? This is the way they passed the Federal Reserve Act with something like only six Senators there) . Why do we put up with this nonsense?

David

Why do so many complain about a, “do nothing” congress? The best this government could ever do for our country is nothing! Unfortunately, these bozos know they cannot get elected by promising to do nothing, so they continuously scramble to make it look like they are doing something for their constituents, while actually 100% focused on amassing as much power and wealth as possible. How about modifying baseline budgeting so it assumes modest annual revenue reduction – such as the 2 1/2 % that is now the Fed’s de facto inflation target? Finally, we need term limits (or merit reviews) for career bureaucrats far more than we need them for congress. These or the folks that currently have the greatest vested interest in growing government. They should be subject to reduction in pay by 2 1/2% annually if they fail to show they have reduced cost by at least that… Read more »

Mildred

It seems to me a bunch of monkeys could run the country better than our elected officials. They could probably come up with a budget which the senate has not been able to do in over 3 years and not nearly as much squabbling as we have now. Everyone that runs a household knows you have to have some idea of where your money is coming from and how it is being spent. Also, I agree with a previous writer about term limits, some of these people get reelected over and over again and do not really accomplish anything except occupy a seat and collect a paycheck. Pray for our country.

Horacio V.

I am surprised that only one person hit it right; in order to unwind the madness already created in our country, we need to start with the media; ABC, NBC, CBS, CNN, etc. Boycott their filthy programs and don’t buy from companies they advertise. People don”t realize that we pay high prices for essential goods, such as milk, sugar, butter, flower, gas, etc because the media charges exorbitant fees for advertising so they can pay exorbitant amounts of money to what they call celebrities and they are the filth of society and they get free time on television to promote their filth. So start now, pick one of them at list (I picked NBC) and pass the word around. “This will cut funds to the liberal’s big megaphones”

Fran D

Paul E is absolutely right. Obamacare is designed to crash the American healthcare system and have people begging for the government to just handle it all on a single payer basis. We are such saps. Or as Lenin called those who followed him- “useful idiots”.

Tom Muldoon

Was it John Adams who declared “Our Constitution was written for a moral and religious people? It is hardly fit for any other?” How true.

The Heritage Foundation and some other Conservative organizations miss that self-control is necessary for liberty. They need to see the roots of freedom in the Holy Scriptures and, more recently, the Protestant Reformation rather than in the deism of Thomas Jefferson or Benjamin Franklin.

If people finally figure out they have used the U. S. government to screw up their healthcare, the only good thing that might occur is that those same people might seriously turn to the Bible for answers. But by that time there may be a dictator in power, because even dictatorship is preferable to anarchy and mass confusion.

Betty

Well, there isn’t much to be happy about, but it does my heart good to read all this and realize that the entire population has not been hypnotized by our dictator. Unfortunately, the majority has, because they have kept him office unless as I sometimes suspect, it was a crooked election. I put nothing past him. How long will it take before there are enough of us to have him impeached?

Bob Mc

My fellow citizens, we must demand a national referendum for term limits on all elected officials. Two six year terms for Senators and 2, two year terms for Congress. No more pensions, 401k or 403b, HMO health care while they’re employed by us. Pay raises only when approved by 66% of the nation.Our government is broken and those we elected haven’t been able to initiate repair. Let’s attempt to make our nationally elected officials a collection of our best and brightest.

arlen Casteel

when people in this country get to where we can vote our selves a raise, the republic is no more. I could have retired 10 years ago but i choose to work until I can no longer function {dead} . working keeps me healthy at age 75 I am the oldest man in the company I.. work for and am appreciated by my coworkers.there two people I know of that said they were voting for obozo because he is gonna give me a raise. SEE what I mean, voting themselves a raise. I ask who do you think is paying for that.. the answer, the government. Ignorance is some times impossible to overcome. Good luck america.. and learn to pray.

Carol B

Maybe we could start with boycotting the three major TV networks and some cable networks who helped elect this pure evil. Do not watch and do not buy the products of the sponsors. Do not buy the liberal newspapers. I don’t understand why the press wants this man in place. It seems to me that they are putting their jobs on the line, who needs all of the news readers who just recite the garbage that the administration wants them to distribute. Also, don’t they have family members who work outside of the media? If we truly boycott, maybe the networks won’t be able to afford them and at least it could be a signal to the powers that be. It could be a start, and all of us can do this.

Carolyn

When are we leaving for Washington DC?