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Where Is Obamacare’s Transparency?

Posted Jun 26 2013 10:58am
 Stanley Feld M.D., FACP,MACE

As we get closer to the implementation date of Obamacare it becomes more and more obvious that there are more and more things we do not know about the law.

Something we do know is that the law gives all the decision-making discretion to the head of the Department of Health and Human Services. This is an obvious defect in Obamacare as new regulations are produced by the Secretary of HHS daily.

The new rules are a huge black box secret. The steps being taken to implement Obamacare have also been a secret. None of what is going on with Obamacare is transparent. 

Health and Human Services has not provided coherent answers to congressional oversight committees that have requested answers to certain questions. Neither have comprehensive answers to questions been provided to the press.

The Government Accountability Office released the results of two investigations of Obamacare. The implementation of Obamacare has blown deadlines and has improvised on regulation. There has been general chaos at HHS.

The GAO said HHS isn't close to being ready to launch in October. The Obama administration has told congress and the press that it will be ready.

HHS has already announced it is throwing in the towel on small business health insurance exchanges. These exchanges were supposed to allow employees to choose from competing healthcare insurance plans.

These small business health insurance exchanges have been put off for at least one year. It is not clear whether these exchanges are the same as those that are supposed to launch on October 1,2014.

The employees must choose from their employer’s private plan options. However it is not clear if employers are going to stop offering healthcare coverage and pay the “tax” penalty Obamacare imposes.

Employees will have to buy healthcare insurance from the health insurance exchanges with after tax dollars. Prior to Obamacare employers bought healthcare insurance with pre-tax dollars.

This is another Obamacare hidden tax increase.

If everyone is driven into health insurance exchanges and the healthcare industry drops out of the health insurance exchange because of the tax it will have to pay for every policy sold, America will have a single party payer (the government) system by default.

This is President Obama’s goal.

The healthcare insurance industry will continue to make its money with a single party payer because it is the government’s administrative service provider. As administrator service providers the healthcare insurance industry still takes its 40% off the top.

Consumers will be the ones that get penalized through increased taxes.

HHS will be forced to run 34 of the 50 health insurance exchanges and pay for the cost overruns expected. These cost overruns are not in the healthcare budget. There are more than 100 “key activities” necessary to set up exchanges.

Sixteen states have opted to run their own exchange and take the money the federal government has offered. These states still have between 16-52% of the key activities undone in order to qualify as a health insurance exchange.

The complete set of regulations for these key activities has not been completely written by HHS.

Two states, Massachusetts and Utah, have had functioning   health insurance exchanges. These exchanges were developed pre Obamacare. These exchanges might have to be redone once all the rules and regulations are written and federal requirements are known.

“If HHS had any appreciation for basic accountability it would release the facts itself instead of going dark and running ObamaCare as a black-ops mission.

“HHS has insurance premium filings for the 34 federal exchanges but it decreed in a May memo that it would keep that information secret until September.”

“Could it be that the department doesn't want people to know about the coming "rate shock" like that in California?”

The traditional media have declared that there will be lower rates in the health insurance exchange in California. The facts are the opposite.

An interesting observation using the Covered California calculator is that a family earning  $38,000 a year would be entitled to a tax credit of $11,448 after they file their tax return for the previous year. The yearly outlay for the health insurance exchange silver plan for this family of four would be $13,164.

This family would have a theoretical cost of $1716 dollars per year for silver plan healthcare insurance plus deductibles which are significant.

This family making $38,000 a year pays no income tax. I tried to figure out how the government applies the tax credit if they pay no income tax.

Does the government write a check of $11,448 dollars for their tax credit after they file their income tax return the following year? This is not the definition of a tax credit.

This family earning $38,000 a year cannot afford to pay the $1,097 a month for the insurance the first year. It is thirty-three percent of their salary.

Second, the tax credit is worthless because they do not pay any tax to be credited.

I wonder if Kathleen Sibelius thought of this?

The health insurance exchanges developed so far are experiencing massive cost overruns.

The CBO originally estimated that setting up all the 50 exchanges would cost $5-10 billion dollars. California has spent $900 million dollars so far and they are not completely set up.

The Obama administration has been taking money out of other federal health budgets to find more money to help states develop the health insurance exchanges.

“In June Kaiser Family Foundation health tracking poll—which also found that public support for ObamaCare hit a new post-passage low of 35%—reports that nearly one of three Americans between the ages of 18 and 30 do not believe that insurance "is worth the money it costs."

 “ And persuading young, healthy people to sign up for coverage requires them to act against their own economic interest, since they can always enroll later when they need it as a result of ObamaCare's mandates.”

The health insurance plans are expensive and the exchanges will malfunction. Physicians won’t participate because the reimbursement fees have not been published. If someone files a claim wrong, they will not get paid. 

These are just a few of the issues that can and will come up that have not been explained.

The public must become aware of the facts and not buy into the Obama administration propaganda campaign that Obamacare is the greatest.

It is time for Americans to stop being passive. The protest must start now before implementation is a disaster and taxes and premiums escalate because of massive cost overruns.

The opinions expressed in the blog “Repairing The Healthcare System” are, mine and mine alone

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