Thursday, November 14, 2013

Cruising the Web

Have some fun with the satirical Twitter feed of HealthDotGov.
“Get coverage for everything except your daddy issues.” #YouthCampaign

The Landrieu proposal to force insurers to continue to offer their plans to those who lost their insurance plans due to Obamacare is the typical liberal approach. She wants to mandate businesses to offer products even if offering those plans would be economically damaging to their businesses. That is the same mentality that underlay the individual mandate - that the government has the authority to compel private actions. Even John Roberts would find this a violation of the Constitution. As Jeffrey H. Anderson writes,
As for Landrieu’s bill, if Republicans can’t successfully argue that Congress has no constitutional power to compel commerce (the basic point of the successful — in that vein — challenge to Obamacare under the Commerce Clause), if they can’t argue that Congress has no power to compel anyone to sell an insurance plan, or, by extension, to compel a doctor to see a patient, etc., then we’re in sad shape.
Both the Upton plan in the House and Landrieu's plan would undermine Obamacare since people could keep their previous plans instead of buying on the exchanges.
Finally, Landrieu’s bill would undermine the Obamacare exchanges at least as much as Upton’s bill would. So the Democrats certainly don’t love it, and it’s highly unlikely they would ever pass it. But if they did, and if the House and Senate ended up reconciling Upton and Landrieu in conference, the clear loser would be Obamacare — whose exchange population would just have gotten older, sicker, and costlier.

And then around October 2014, all of those notices about losing your health plan because of Obamacare would start being mailed out again, just in time to help voters make an informed choice on November 4.
As Ezra Klein warns liberals, even Landrieu's bill would be very damaging to the overall bill.
4. The bill Landrieu is offering could really harm the law. It would mean millions of people who would've left the individual insurance market and gone to the exchanges will stay right where they are. Assuming those people skew younger, healthier, and richer -- and they do -- Obamacare's premiums will rise. Meanwhile, many people who could've gotten better insurance on the exchanges will stay in bad plans that will leave them bankrupt when they get sick.

"I think it would be a real substantive mistake to do the Landrieu bill," says MIT health economist Jon Gruber, a supporter of the Affordable Care Act.

5. Put simply, the Landrieu bill solves one of Obamacare's political problems at the cost of worsening its most serious policy problem: Adverse selection. Right now, the difficulty of signing up is deterring all but the most grimly determined enrollees. The most determined enrollees are, by and large, sicker and older. So the Web site's problems are leading to a sicker, older risk pool. Landrieu's bill will lead to a sicker, older risk pool. Obamacare has provisions meant to stop an out-of-control death spiral, but higher premiums are a real danger.
James Capretta explains how the Upton bill will be another shot to the heart of Obamacare.
At the same, the Upton legislation is not a panacea. It provides no guarantees, and it certainly doesn’t try to force insurers to reopen cancelled plans like the bill sponsored by Democratic Senator Mary Landrieu. No matter what House Republicans do at this point, there will be some casualties from the Obamacare train wreck. But strong support for the Upton bill would show voters that Republicans are doing whatever they can to minimize the casualties.

The defenders of Obamacare know full well that the Upton legislation represents a serious threat to the viability of the law. It would provide a lifeline for a viable insurance market outside of Obamacare’s rules and suffocating structure. Millions of Americans would flock to a revitalized insurance marketplace that offered lower premium products with better coverage. The end result would be one more step toward fully reversing the catastrophic mistake of Obamacare.
So either the Upton or the Landrieu bill may so damage Obamacare that it will be even more doomed. And I don't see how voting for the Landrieu proposal is going to help Red State Democratic senators up next year since opponents will have all their other votes in favor of Obamacare to throw in their faces. And their proposal is unconstitutional so insurance companies could probably get an injunction against its provisions until we get a ruling on its clearly unconstitutional provisions. And that's not even talking about the fact that regulating insurance policies has long been a state, not a federal responsibility. I figure that such elements of federalism have already been thrown out by this administration. But, when contemplating the creek that Democrats are paddling in without anything except an unconstitutional Hail Mary bill, remember that we just have to wait until next year as the great majority of people who get their insurance through their employer start to lose their policies. This is why things keep getting more and more dismal for Obamacare proponents. They have well earned their fates.

The administration's attempts to spin the news on Obamacare is getting more and more lame. Now they are releasing these numbers to include people who have an insurance policy in their shopping care, but haven't actually bought the policy. Raise your hand if, right at this moment, you have something sitting in a shopping cart on any website anywhere on the web. I'd have to visit all my regular sites just to find out what is in all my various shopping carts. That's the way people shop these days on the internet. As the WSJ writes,
But don't make too much of the numbers because they're deliberately inflated through junk accounting. A technical footnote in the HHS release explains that the agency is only reporting people who "selected a plan." That means they may or not have paid for it as required and the company that may or may not be their new insurer may or may not recognize it has a new customer. In other words, selecting a plan doesn't mean they've enrolled in a plan, which HHS euphemizes as "pre-effectuated enrollment." By that standard, ObamaCare is a roaring pre-effectuated success.
And even with this junk accounting, they still couldn't massage the numbers to get more than 26,794 people who have enrolled at

This is what happens when a bill is hurriedly written and passed without congressmen reading what they voted for.
From innocuous typos to substantive misstatements of policy, the Obama administration has had to correct more than 100 errors in the regulations used to implement its signature health care law.

One regulation said certain delays were “reasonable,” when it meant “unreasonable.” Another implied that health care “navigators” would have to be licensed insurance agents, when in fact agents are prohibited from becoming navigators. Employers were switched with employees, and mandates were presented as options.

Mistakes are inevitable in the regulatory process, and the vast majority of errors in Obamacare regulations are garden-variety technicalities—references to the wrong section of a law, typos, or minor clarifications.

But overall, the health care law is racking up more regulatory corrections than other large, complex measures. According to an analysis from the American Action Forum, a conservative think tank, regulators have issued 33 sets of corrections for the 104 published Obamacare regulations. All told, agencies have had to fix 254 errors, according to AAF.

Megan McArdle predicts a future of more bad news for Obamacare and everyone forced to buy policies under it.
Meanwhile, sometime between March and June, the other shoe drops: People who bought exchange policies realize that the restricted networks insurers created to keep the premium costs low cut out the best hospitals and doctors. A newly insured child with cancer cannot get into a top pediatric hospital because her insurance has zero coverage for out-of-network emergency care. Tearful Mom goes on the evening news and says that she thought when they went on Obamacare, that meant they were safe, and why can’t I take my baby to Philadelphia Children’s Hospital, Mr. President? That particular story will be fixed, through some combination of private charity, insurer PR sensitivity and government intervention. But there will be more of these cases that don’t make the papers. The folks who had no insurance and are now on Medicaid may be quite glad of their insurance, but those people don’t vote in large numbers. The middle-class voters who thought they were getting much more out of this law are disenchanted, maybe angry.
By June, insurers are filing their rate increases for next year. But there are already lawsuits being filed over the limited networks and rumblings about legal remedies in the legislature. They are paying out much more in claims for each customer than they expected when they set rates, and while the “risk corridor” reinsurance provisions mitigate some of their losses, they do not turn losses into profits. And public anger over all the downsides of the law -- the policy cancellations, the malfunctioning exchanges, the extremely narrow provider networks -- makes it look very likely that Democrats are going to lose the Senate in 2014. The law now seems to be in danger -- not in danger of outright repeal, but in danger of death from a thousand cuts, as legislators roll back anything that’s unpopular -- like, say, the individual mandate.
In a more auspicious political climate, insurers might well say, “Hey, we had a rough start, but we want to get market share, and we certainly don’t want to face the wrath of insurance commissioners and the Department of Health and Human Services, so let’s eat the losses of last year and come in with some modest rate increases for 2015.” But with the law looking shaky, they are no longer so sure that they want to take that risk. When they start filing rate increases, they are huge -- well into the double digits. Regulators and HHS fight back as hard as they can, but they cannot just order insurers to sell at a loss. Democrats lose the Senate in 2014, and even fewer people buy insurance for 2015.
And what can the administration do to fix all this? Well, it seems that all they have going for them is pre-packaged spin.

So what can they do about drip-drip of bad news about how few people have signed up already. Blue Cross and Blue Shield has an idea: stop reporting their own dismal numbers of how few people have enrolled. Yeah, that should fix it.

Jim Geraghty wonders if the President's problem is that he simply believes his own BS. He doesn't seem to have anyone around him who has the cahones to tell him about all the problems that his big deal of a law were going to cause. So conservatives who read blogs and websites of conservative think tanks are actually much better informed about what is going on than the President seems to be about his own policy. Is there any indication that Obama had any understanding of the consequences predicted by conservative analysts of his policies? Geraghty notes all the times that Obama seems to have been surprised by how his decisions have turned out.
As a result of that, Obama gets blindsided on a regular basis. George Will summarized the highest-profile examples…
“He seems to think that his job as chief executive is not to be the executive but to be angry at his own administration when it doesn’t perform well,” said the syndicated columnist and Fox News contributor. “Fast and Furious, the IRS, Benghazi, NSA, investigation of our Mr. Rosen, there’s just a list of things that surprise him.”
But there are plenty of other times Obama’s been surprised by the result of his own policies. He seemed to think that reaching out to the Iranians would lead to a change in the regime’s behavior and attitudes. Then he thought they would appreciate him not calling them out on their atrocities; he later regretted his “muted” stance during the regime’s bloody crackdown in 2009.

He was surprised to learn that shovel-ready projects were not, in fact, shovel-ready.

He was surprised to learn that large-scale investment in infrastructure and clean-energy projects wouldn’t create enormous numbers of new jobs.

He was surprised that his past housing policies hadn’t helped struggling homeowners as he had promised.

The “recession turned out to be a lot deeper than any of us realized.”

When a woman says her semiconductor-engineer husband can’t find a job, Obama said he was surprised to hear it, because “he often hears business leaders in that field talk of a scarcity of skilled workers.”

As I wrote in a previous Jolt, some cynics might look at this pattern and conclude that Obama isn’t as smart as he thinks he is — or as his fans think he is. But it’s probably more accurate to offer some variation of the Reagan line, that the problem with Obama isn’t that he’s ignorant; it’s just that he knows so much that isn’t so. (Links in the original)
Presidents would do well to have some professional nay-sayers on staff to give them the other side of an argument. Then they can make up their own minds. They could emulate the model of George Washington who could have Alexander Hamilton and Thomas Jefferson debate policy questions such as establishing the Bank of the United States in front of him and then make up his mind.

Matt Lewis wonders if young people have any idea of how they're being screwed over under liberal policies.
It's not just that young people will have to pay more — it's that they are doing so to make up for the excesses of the baby boomers. As a Wall Street Journal column recently noted, "While today's 65-year-olds will receive on average net lifetime benefits of $327,400, children born now will suffer net lifetime losses of $420,600 as they struggle to pay the bills of aging Americans."

What we are witnessing today is a historic inter-generational transfer of wealth. Past generations could expect a better life, but today's youth are picking up the tab for the baby boomers. What's more, it is the policies of the man they held up as a hero that are inflaming the problem.

Young people are easy marks. They don't have big lobbies like the AARP. And despite being helpful to Obama, they are still generally taken for granted by politicians. Even worse, the assumption is that they are a wholly-owned subsidiary of the Democratic Party — a designation that means young people can be taken for granted (by Democrats) or written off (by Republicans).

Maybe young people still haven't noticed, or don't really care — at least not enough to change their voting habits. Maybe they are too interested in political issues like immigration reform or gay marriage to worry about their economic future. Or maybe as long as there's bread and circuses (beer and pizza, as my college professor used to say), they'll be fine. But I suspect some day in their 30s when they are trying to get ahead and raise a family, many of them will have buyer's remorse.
Ramesh Ponnuru and Yuval Levin offer up a market-based proposal for Republicans to substitute for Obamacare.

Oh, dear. Hitler has found out that his policy was cancelled by Obamacare.