Bureaucrats bungle implementation while health care costs skyrocket.
By David Catron
Texas Insider Report: WASHINGTON D.C. It seems that Joe Klein
a usually reliable Democrat hack is deeply unhappy with the slow and clumsy implementation of the Affordable Care Act." As a rule I avoid the weekly news magazines as they are filled
with bad fiction disguised as reporting". Nonetheless I recently stumbled across a post in
Times Swampland blog
titled Obamacare Incompetence" and succumbed to morbid curiosity.
Kleins
post focuses primarily on the implosion of Obamacares exchanges. Pointing out that the Presidents apparatchiks squandered three full years during which they should have been hard at work preparing for the advent of these insurance marketplaces" Klein laments their failure to do so with the following piece of Solomonic wisdom:
This is a really bad sign." Indeed it is. And Klein isnt the only advocate of Obamacare to finally notice that this hopelessly Byzantine health care reform" law is an implementation nightmare.
Even the Secretary of Health & Human Services (HHS) has
admitted as much. But whereas Klein correctly assigns responsibility to the President Commissar Sebelius places the blame on evil Republicans: It is very difficult when people live in a state where there is a daily declaration We will not participate in the law."
Other Democrats have been more candid. Senator Jay Rockefeller who played an important role in getting the law passed called Obamacare so complicated that if it isnt done right the first time it will just simply get worse."
And it most emphatically isnt getting done right the first time.
Not only has the go-live date for the insurance exchanges been pushed back a year a wide variety of the laws other key provisions have either been delayed or simply abandoned. The most conspicuous of the latter category was the
Community Living Assistance Services and Supports (CLASS) Act.
This program was so badly designed that Kathleen Sebelius admitted HHS couldnt pay for it and one of its own administrators speculated that it might collapse. It was
repealed in January.
Another moribund provision of Obamacare is the Basic Health Plan" included in the law to give states the flexibility to provide coverage for low-income residents unable to afford employer coverage or qualify for Medicaid. Democrat Senator Maria Cantwell is so frustrated with administration foot dragging on this provision that she has
announced her opposition to Obamas nominee to head the Centers for Medicare & Medicaid Services (CMS) Marilyn Tavenner: Ms. Tavenner definitely will not have my support."
Senator Cantwell was also among the thirty-three Democrats who voted with all of the Senate Republicans last month to repeal Obamacares job-killing 2.3 percent excise tax on manufacturers and importers of medical devices. This vote was toothless as a practical matter because as Daniel Horowitz
explains
They know that this is only an amendment to a massive budget bill that will never have the force of law.… If 33 Democrats really supported repeal they could force Harry Reid to bring it to the floor as a standalone bill."
Still the vote was not meaningless. These Democrat Senators know that Obamacare is still profoundly unpopular with the public. Indeed yet another poll was released in early April showing that only 41 percent of American voters approve of the law and that a mere 15 percent expect it to help them personally. Despite the
virtual blackout by the major
broadcast media of bad news concerning Obamacare including the medical device vote the implementation delays and even the survey just cited the public understands that the law is already failing.
Even the much-touted Obamacare provision that we were told would eliminate the pre-existing condition" scourge is proving to be a bust. According the Heritage Foundation the Obama Administration
estimated that 375000 people would enroll in the pre-existing conditions insurance plan (PCIP). But as of January 2013 over two-and-a-half years since the plan began only 107139 were enrolledless than 29 percent of original projections."
And yet the program is running out of money forcing the HHS bureaucrats to suspend enrollment.
It hardly needs saying that this failure like everything else associated with Obamacare is incredibly expensive: In a 2012 report the Administration conceded that claims costs had been 2.5 times greater than they had anticipated." This is of a piece with the Affordable Care Act" in general. When Obamacare was first shoved down our throats we were told that it would cost $898 billion.
Now the projected cost is $1.6 trillion. Meanwhile many of its taxes are now in effect and it is forcing health insurance premiums through the roof.
What we are left with then is a big-government vampire that will drain our personal and public coffers without delivering on its most important promises. Where will all this end? To quote Joe Klein again
One thing is clear: Obamacare will fail if President Obama doesnt start paying more attention to the details of implementation.…
And in a larger sense the notion of activist government will be in peril."
Heres hoping that the President continues to focus on
his golf game and delegates Obamacare implementation to his creatures.
David Catron is a health care revenue cycle expert who has spent 20 years working for and consulting with hospitals and medical practices. He has an MBA from the University of Georgia and blogs at Health Care BS.
