Tag Archives: IfYouLikeYourPlan

Obamacare’s Biggest Legacy? More Welfare Beneficiaries.


Once upon a time, in the darkest, most putrid bowels of the White House, the diabolical creators of the worst piece of health legislation in American history connived to completely uproot one-sixth of the economy by convincing the populace this was first, necessary, and second, a boon to the country.

The Obamacare architects knew that there weren’t that many Americans truly locked out of health insurance, and certainly not in the numbers that would justify such a massive overhaul. Yet they, with the help of the lapdog media, touted completely bogus numbers of 45 MILLION!, 47 MILLION!, and 50 MILLION! (depending on the source) to get your attention.

It worked, didn’t it? And we all felt bad to learn this, didn’t we? Half of the country was covered by company plans and we thought it was unconscionable that people hoping to purchase their own health insurance couldn’t afford to.

We were told in 2010, by Jonathan Gruber’s CBO, that the Obamacare insurance exchanges would cover 22 million more Americans by this year (which is, you’ll note, less than half of the purported 50 million uninsured. Some “universal coverage” plan!).

We were also told that insuring these long-suffering individuals would actually save us money!

“$2500 per family per year!”

Employers “would see premiums fall by as much as three-thousand percent, which means they could give you a raise!

Eureka, Big Daddy Government will deliver us from ever-increasing health care costs!!! We’re on board!

Now, of course, we realize that the middle-class is taking this law directly on the chin. Workers with health insurance benefits are seeing their out-of-pocket costs skyrocket — while many in the individual market have decided to take their chances as they abandon expensive Obamacare policies with unreachable deductibles. 

Meanwhile, as the Congressional Budget Office churns its new Obamacare numbers, we find that the 2009-2010 CBO — Jonathan Gruber’s CBO — was remarkably off-base in its projections. In short, this year’s CBO report shows that the enrollment numbers are roughly half the 21-22 million 2016 exchange customers CBO had consistently forecast in years past, even as recently as March 2015. 

 

Get this: For all the sacrifice
the American people are making,
only 10 million people
are expected to be enrolled
in the exchanges by year’s end.

 

So what happened? 

Well, what happened was that an unexpectedly large number of Americans were folded into Medicaid, the worst coverage in the entire country, instead of signing up for Obamacare plans.

As the Weekly Standard’s Jeffrey Anderson points out, “In 2013, the CBO projected that, in the absence of Obamacare … 34 million people would have been on Medicaid or CHIP” in 2016.

What are the Medicaid/CHIP numbers now? 

Sixty-eight million. 

That’s right. Sixty-eight million American human beings are now on (lousy) Medicaid. Let that sink in.

Even better news for Progressives: CBO also believes that slower wage growth in the future will qualify even more Americans for the welfare programs.

What’s ironic for Obamacare proponents is that increased Medicaid enrollment also poses an existential threat to the exchanges. Take it from CBO itself, which projects that “as more people become eligible for Medicaid coverage, enrollment in coverage through the marketplaces will decline.”

Dentons, a global legal firm, maintains that this is already happening:

“Medicaid and the Children’s Health Insurance Program (CHIP) cover 17 million more people in 2016 than projected, while private insurance through the non-group market, including exchanges … covers 10 million fewer people. Millions of young, healthy people are enrolled in Medicaid and CHIP, rather than in private insurance offered through the exchanges.”

Before a 2012 Supreme Court ruling made Medicaid expansion optional for the states, CBO assumed all Americans with incomes at or below 138 percent of the federal poverty level (FPL) would receive Medicaid. Nineteen states are currently opting not to expand, so a smaller pool of Americans are Medicaid-eligible.

Still, as Dentons notes, “in the past six years Medicaid and CHIP enrollment has nearly doubled from the 2010 baseline.

We’ve repeatedly been told that state legislatures opting not to expand their Medicaid programs are “greedy, selfish and uncaring.” Yet it is in Medicaid expansion states that Obamacare enrollment and risk pools suffer the most.

In non-expansion states, low-income, young, able-bodied Americans can purchase highly-subsidized exchange policies and help to balance out the costs of older, sicker enrollees. In expansion states, those same young, able-bodied Americans at or below 138 percent FPL are FORCED into Medicaid — as in:

“Sorry, you can’t have a real insurance policy.
You’re too poor.”

In the nation as a whole, insurers need about 40 percent of Obamacare enrollees to be 18- to 34-year-olds. Meanwhile, over at healthcare.gov, only “26 percent of the individuals who selected, or were automatically reenrolled in, a 2016 Marketplace plan are ages 18 to 34.” 

Where’d they go?
Medicaid, anyone??

The Wall Street Journal reports the reason the young and healthy are needed in the exchanges: to “hold down premium rates by balancing out the greater medical spending of older enrollees.” Insurers are already dismayed over the greater-than-expected costs of their current Obamacare populations and are threatening to raise 2017 premiums by double digits. As a result, reports of adverse risk selection and death spirals are proliferating.

It wasn’t enough that Progressives like Harry Reid, Chuck Schumer, and Nancy Pelosi put the exchanges at risk by insisting on a Cadillac Tax delay — which thus postpones the incentive for employers to dump workers in the Obamacare “exchanges, whether they like it or not.

Now we see that their failed Medicaid policies have doubled down on the damage.

The Obamacare exchanges are doomed,
and Progressives have only themselves to blame.

Obamacare’s “Wage Growth” Hoax

Families across the country are facing escalating out-of-pocket health care costs and, as a result, less disposable income, thanks to Obamacare’s Cadillac Tax. A major funding mechanism for the law, the 40 percent excise tax forces employers to cut back on health benefits, leaving workers increasingly subject to higher deductibles and copayments.

(Note: See here, here, and here for more details on the Cadillac Tax.)

The drive-by media originally maintained the Cadillac Tax was merely a justified penalty on unusually expensive gold-plated plans — such as those owned by Goldman-Sachs executives — that theoretically encourage over-utilization of medical care. 

However, we now know that the tax was designed to eventually target every employer-sponsored insurance (ESI) plan. We’re talking about 158 million Americans.

Since employers have already begun reducing the generosity of their plans to prepare for the tax’s 2018 implementation, even the drive-by media has had to pay attention to a flurry of reports — from sources like Forbes, The Los Angeles Times, Bloomberg, the Institute for Policy Innovation, The Wall Street Journal, and more — on soaring employee cost-sharing.

Completely blindsided by these revelations, Progressives are now referring to copayment and deductible victims as “underinsured” and calling for action, including government requirements that insurers lower deductibles. Some are even demanding a repeal of the Cadillac Tax.

This situation shouldn’t have been a surprise to anyone. This is, as they say, a feature, not a bug, of the law; the Cadillac Tax was always intended to discourage patients from consuming health care. This is Obamacare’s promised “cost control.”

Law professor (and big-time Cadillac Tax fan) Edward Zelinsky explains:

 “Those who drafted the Cadillac Tax presumed that this tax…would be passed on to the employer and that the employer, in turn, would transfer this additional cost to its employees. In this indirect fashion, the Cadillac Tax should sensitize employees to the high costs of their health care coverage.”

Steve Wojcik of the National Business Group on Health described the policy’s intention:

“If employees have more cost sharing…then they’re more mindful when they access health care to choose a more efficient provider or say, ‘You know, I don’t need to go to the doctor every time I have a cough.’” 

America, you were conned from the very start. Not only did politicians lie — including Obama, dozens of times — in maintaining we could keep our plans, period, but so did Progressive reporters, who insisted that job-based coverage would be untouched.

Young Jonathan Cohn explained that for most of those with employer-sponsored insurance, Medicare, or Medicaid, 

“Very little about their health plans are changing because of the law,
at least outwardly.”
 

America’s alleged wunderkind and intellectual giant Ezra Klein told us

“For most companies, the Affordable Care Act won’t bring much change at all.” 

And Ryan Lizza  assured readers that:

“About eighty percent of Americans are more or less left alone by the health-care act—largely people who have health insurance through their employers.” 

To prove that most people wouldn’t be affected by Obamacare, the liberals even paraded a pie chart, because apparently, in their view, “stupid” Americans understand colorful pictures more clearly than words. 

Even now, in the midst of this massive shift to higher employee cost-sharing, at least one of the law’s engineers is still perpetrating the fable that Obamacare isn’t affecting company plans.

Why did Obamacare’s designers aim to abuse American workers this way? Why was it necessary that Americans lose their policies to make Obamacare work?

To rake in more federal money, of course. The tax was devised to undercut the IRS provision that allows workers to receive tax-free company benefits. Policy experts estimate the government is robbed of $250 billion per year through this arrangement. 

And Progressive lawmakers rationalized that as employers scaled back or eliminated tax-free plans, they’d offset the loss with pay raises — in other words, taxable wages.

Here’s then-Senate Finance Committee chair Max Baucus explaining your raise.

Progressive politicians — backed by the Congressional Budget Office (CBO) — predicted that the excise tax itself would raise relatively little, since companies would have no choice but to bring plan costs below the tax’s threshold. Obamacare crafter Jonathan Gruber is quoted to say, “I would be surprised if [the IRS] even collect[s].’” 

Most of the $201.4 billion revenue over 2013-2019 was predicted to result from payroll and income taxation of, yes, your raises.

Are you following? America’s gonna get a raise, any day now.  There’s even an econo-wonk term for this phenomenon — the “Wage Growth” effect.

So what about this “Wage Growth?” And who was the genius predicting with absolute certainty how companies would react to any savings on benefit costs?

Let’s flip the calendar back to 1993-94, when Hillary Clinton and Friends were busily at work trying to accomplish a very similar government takeover of America’s health care sector. 

“Wage Growth” was a major assumption in the Clinton bill: employers were expected to “shift to wages” any savings or costs they experienced due to the employer mandate to offer insurance. Those offering ESI for the first time were predicted to offset costs by reducing wages; companies that had previously offered ESI would receive government subsidies and were expected to pass along those savings to employees. 

The proponent of the Wage Growth hypothesis was 28-year-old Jonathan Gruber — yes, that Jonathan Gruber — who explained it to a health reform group in December 1993, and in testimony before a House committee five days later. When testifying before a Senate committee in July 1994, he again maintained the legitimacy of his unproven assumption.

Gruber was successful in persuading the 1994 CBO to accept the same premise: “employers facing an increase in their premiums would probably shift most of the added cost to their workers by reducing cash wages” and “employees of firms that would pay less would receive higher wages.” CBO’s evidence? Two research papers (one of which was still “forthcoming”) written by Jonathan Gruber.

Fifteen years later, in the midst of the Obamacare battle, Gruber was again peddling Wage Growth, offering professional papers and articles attempting to prove that Wage Growth would materialize with Obama’s reform package as well. Gruber, then more heavily involved with the CBO, influenced the body to repeatedly make the same Wage Growth assumption with Obamacare. (That’s for a subsequent post.)

For now, remember that it was critical that CBO find that Obamacare would pay for itself, as Obama promised and demanded a reform package that didn’t increase the deficit by a dime. Also remember that CBO analysis killed HillaryCare when it found the proposal increased the deficit by $74 billion

Obama and his Progressive Senate buddies couldn’t endure such an outcome. And government control of one-sixth of the economy couldn’t wait. 

So Jonathan Gruber rode in to save Obama by convincing just about everyone who mattered that the plan was deficit-friendly. Gruber then effectively went “on tour” to sell his claim to the American people, citing the support of the “independent CBO” — that’s right, the CBO that relied upon his Wage Growth hypothesis. 

Why is this important now, six years later? Because a wage increase has not occurred, despite ever-increasing benefit cuts, and was known to be improbable before Obamacare was passed. In a December 2009 Mercer employer survey, only 16 percent of respondents said they’d convert any cost savings into pay raises. In Towers Perrin’s September 2009 survey, a paltry nine percent said they’d increase wages.

It’s less than clear that even Jonathan Gruber believed in the Wage Growth hypothesis, since he appears to have solely relied on his analysis of wage and health insurance trends in the late-90s. And he doesn’t appear entirely convinced he hadn’t overlooked some confounding variables.

Gruber told The New York Times in January 2010, “‘There are many academic studies showing that when health costs rise, wages fall,’ he said. ‘In the mid- and late-1990s, when we got health costs under control, wages rose nicely.’ But he added that other factors could have also lifted wages during that period.” (More on that later, too.)

Additionally, liberal economist Lawrence Mishel, a critic of Gruber’s Wage Growth hypothesis, wrote on January 12, 2010, that ”Gruber clearly overreached with the argument about health care driving wage trends and has acknowledged that to me privately (yesterday).

Given this, one must wonder: would Obamacare have passed if not for the false narrative of deficit reduction? Even in Gruber’s 2011 comic book, he admits this about the law:

“There are risks.  But we have the benefit of
the independent projections of the CBO
…to suggest that this should work out.”
 

Now we’re discovering that those CBO projections were not very “independent” and instead were biased by Gruber’s assumptions.

Stay tuned. A subsequent post will explain how Jonathan Gruber manipulated economic research to advance his Wage Growth hoax.

Reprehensible Republicans Ruin Medicare

Do you remember reading this from the Associated Press in mid-April? 

Suddenly, bipartisanship has broken out on Capitol Hill.

We were supposed to feel so proud of our Congress! They worked together, reached across the aisle, and enacted a permanent repeal of Medicare’s reviled SGR Fix (or Doc Fix)! 

Well, the Drive-By Media didn’t tell the rest of the story. What happened is this:

212 House Republicans and 46 Senate Republicans
joined the Democrats in radically changing the way
Medicare providers are paid
— and controlled —
by the federal government.

That’s right. The same GOP leaders vowing to repeal Obamacare just grafted it Big Time onto Medicare.

We expect this from the progressive members of Congress. But weren’t we supposed to expect a Republican Congress to lessen the size and scope of government? Didn’t last November’s election results reflect “a mandate to pass sensible legislation?”

And they wonder why we don’t take them seriously.

So who’s gonna pay for this knucklehead move? Eventually, you. 

Thanks to Congress, it’ll soon be very difficult to find a health care professional who’ll accept your Medicare card, since MACRA (Medicare Access and CHIP Reauthorization Act) applies Obamacare’s experiments to the whole program.

It wasn’t as if Medicare was untouched before MACRA, despite what HuffPo’s Jeffrey Young thinks. Thanks to Obamacare, pay-for-performance schemes like Accountable Care Organizations (ACOs) began in Medicare in 2012, and they’ve produced less than impressive results thus far. That didn’t stop our 2015 Republican “leaders” from expanding them.

What are ACOs? Think of the Health Maintenance Organizations (HMOs) of the 1990s, an idea that proved so wildly unpopular that patients revolted in near-universal protests about limited provider networks and rationed care. 

Still, the Obamacare Congress thought it was wise to apply HMO 2.0 to Medicare patients, but with an additional feature: patient satisfaction scores. That means ACO providers are financially rewarded for limiting care and procedures, but also have to make the patient feel happy about it!

(Never mind that payment for satisfaction is associated with higher health care expenses and a greater likelihood of hospitalization and death. The Obamacare Congress knows best.)

MACRA essentially forces all Medicare providers into Obamacare’s experimental ACOs. This spells the end to private independent healthcare practices, as providers must align themselves with a huge health system to survive.

Well, to be fair, doctors do have a choice. They can continue in traditional fee-for-service care, but anti-Obamacare warrior and ophthalmologist Kris Held explains the dangers of this route:

Government bureaucrats and committees will call the shots for Medicare patients. The law actually creates Alternative Payment Models (APMs) and a Merit-based Incentive Payment System (MIPS) which require physicians to follow a government rubric on which we will be graded in grade school fashion. Physicians, now defined as “eligible providers,” will get grades from 0-100 as determined by the Secretary of Health and Human Services. The grade for doing what the Secretary prescribes is called the Composite Performance Score. The score is publicly posted on the Physician Compare Internet Website of CMS, and the Secretary of HHS assigns each physician a payment adjustment factor based on this score. The payment adjustment factor will be positive, 0, or negative. Based on how well a doctor “performs” for the Secretary, the pay could be adjusted 9% up or 9% down, meaning the Secretary’s most compliant doctors will be paid 18% more than those who don’t perfectly make her wishes our commands. What will doctors put up with, and what will we do or not do for patients in order to be paid 18% more than those government deems “less quality” doctors and to avoid public humiliation on the government website? This is indeed chronic and continued abuse taken to a higher, institutionalized level.

That’s right. In either scenario, doctors will be scrutinized by federal bureaucrats aiming to reduce Medicare expenses by dictating care according to one-size-fits-all treatment protocols.

Since the passage of MACRA, many doctors are considering resignation from Medicare. “Opt out providers” will still treat you, but you’re gonna have to pay privately, outside Medicare’s supervision and reimbursement mechanisms.

This has one obvious disadvantage for the typical Medicare patient, since, depending upon the arrangement negotiated, costs may be higher to see these opt-out doctors. 

But it also means Creepy Uncle Sam won’t be in the exam room, and you’ll have care that is tailored to the individual, not forced onto you by Washington DC bean counters.

And it’s likely to be far more affordable than you may think, since health care professionals who opt out of arrangements with government and private insurance have reduced overhead costs. These doctors can charge less than their hand-cuffed peers, who can’t reduce fees for cash patients without violating government and insurance contracts.

As the Association of American Physicians and Surgeons pointed out when MACRA was passed, “opted-out physicians are able to charge a mutually agreeable fee (sometimes lower than the Medicare copayment), drastically reduce administrative overhead, give their patients the time that they need, keep records confidential, and prescribe according to their best judgment rather than a government-approved protocol.”

It’s reasonable to expect that, due to the “rising misery index” and increasing retirement rates among physicians, there will be far fewer of them in coming years. Among those that remain, a growing number will opt out of The System.

And you’ll know who to blame. This time, Republicans are the ones who apparently didn’t bother to read the bill.

Medicare providers wishing to learn how to opt out can visit here.

Americans wishing to do business with liberty-minded physicians can find them here.

Citizen Journalist v. Citizen Cohn: Obamacare Is All About Redistribution

This morning Huffington Post’s Jonathan Cohn let the cat out of the bag, admitting that Obamacare was a redistribution scheme.

Touché, Mr. Weinstein.

Do you remember anyone — journalist or politician — divulging that information before the law was passed? How about when Obama was running for reelection? Of course not. The policy would have been as unpopular as the Cadillac Tax is now becoming.

It’s unclear when Jonathan Cohn learned Obamacare was a redistribution tool, but he admits he was pretty cozy with the Obamacare architects during the law’s creation, especially with Jonathan Gruber.

And remember when Jonathan Gruber told his guests that Obamacare was written in a “tortured way” so as to deceive voters, especially as regards its redistributive mechanisms? 

In terms of risk-rated subsidies, if you had a law which said that healthy people are going to pay in — you made explicit that healthy people pay in and sick people get money? — it would not have passed. Lack of transparency is a huge political advantage.

Where was the American press on this nugget? Oh, that’s right. They weren’t interested in doing any investigative journalism on the law. That discovery was left to a financial advisor in Philly, an ordinary American who tried for well over a year to get the incurious press’ attention.

But Obamacare doesn’t only redistribute wealth. It also redistributes health.

In his January, 2015, Forbes piece titled “Is Obamacare Squeezing The Middle Class?” John Goodman explains:

Poor, long-uninsured patients are getting Medicaid through Obamacare and finally going to the doctor’s office for care. But middle-class patients are increasingly staying away…Gallup polling shows what has been happening over time: Even though more people are insured today than in quite some time, more people are putting off medical treatment because of cost than has been the case in the past eight years.”

Even The Los Angeles Times had to agree:

[T]he law hasn’t provided much relief to American workers either, according to a new study of employer-provided health benefits. Workers continue to be squeezed by rising insurance costs, eroding benefits and stagnant wages, the report from the nonprofit Commonwealth Fund found…”Workers are paying more but getting less protective benefits,” the report’s authors noted. 

Last December, The New York Timessurvey showed the impact of health care expenses on Americans, concluding that:

Affording medical care is more of a hardship.
Out-of-pocket expenses have gone up.

It’s an axiom of economics (and common sense): when you increase the costs of a commodity, in this case health care, you reduce demand for it. And so middle-class Americans, hammered by rising expenses, are avoiding care, even if that doesn’t bode well for their long-term physical and emotional health.

This will be a story that plays out over coming years.

But the concepts of health and wealth redistribution should have been put before the American public, by lawmakers and journalists like Jonathan Cohn, before the law was passed — and then cemented by Obama’s reelection.

It’s likely, however, that they thought we were too stupid to understand how amazingly awesome Obamacare would be for us. Progressive elitists always think they know what’s best for the unwashed masses, and if they have to lie to get their policies through, they will. To Obama and his ilk, the ends always justify the means.

How Obama Learned To Stop Worrying And Love The Obamacare Bomb

Last fall Duke University research scholar Chris Conover wrote a powerful piece titled “Obamacare’s Three-Legged Stool of Deception,” in which he explained the covert way Obamacare crafters aimed to eliminate job-based health insurance through the Cadillac Tax.

  • The first leg is that the Cadillac tax is paid by insurance companies, when in reality it is paid by employees. 
  • The second leg is that the Cadillac tax is aimed at “lavish” high cost plans, when in reality it is designed to eventually hit virtually every employer health plan (even those with lower-than-average costs). 
  • The third leg is that the Cadillac tax is functionally equivalent to a reform long championed by conservatives: a cap on the tax exclusion for employer-sponsored health insurance. 

Dr. Conover hit a home run in detailing the duplicitousness of the law’s architects, and his piece is probably the best exposé of the Cadillac Tax you’ll find.

But who designed the Cadillac Tax, and how did Obama come to love it?

In his first presidential campaign, Obama repeatedly maintained that he was dead-set against taxation of health insurance benefits. He even chastened his opponent, Senator McCain, for proposing that Americans receive tax credits instead of tax-free insurance benefits.

“This is your plan, John: for the first time in history,
you will be taxing people’s health care benefits.”

Ezekiel Emanuel, special advisor for health policy during the law’s creation, gives us important insights into how, in the summer of 2009, Obama decided campaign promises weren’t as important as was more money in the federal coffers.

Zeke describes a “hot Friday July afternoon” in the White House when he says the “core health team” was working on Obamacare. After about an hour, he recalls, the president walked in, “in his shirt sleeves with his cuffs rolled up. He was there to give us a sort of uplift.” After pleasantries were exchanged,

“I raised with the President one of the issues that had been burning up the staff — the issue of something called the Tax Exclusion.”

In both videos linked above, Zeke describes the issues he and others had with tax-free employee benefits: 

“The big argument we were having was, people on what was called the economic part of the health team…we wanted to do something about the tax exclusion because it’s inflationary, it’s regressive, it’s a lot of money.”

One obstacle? Obama wasn’t clear on his stance: 

“We got into some weeds, and he would say, ‘What did we say about that? What was my position on that? ‘Cos the people should know I stand by my position.’” 

And since David Axelrod, his senior advisor, pointed out that he’d spent $100 million running ads against McCain’s position, the Campaigner-in-Chief stalled, worried that he’d be contradicting his promises.

“David Axelrod, as part of this debate internally, created a montage of all the ads that President Obama had run against John McCain attacking McCain’s proposal — which was basically to get rid of the tax exclusion and give people a tax credit instead to buy health insurance.”

Eventually the economic team won Obama’s heart by showing him how much power and money ($250 billion per year) the Cadillac Tax would grant him.

“I said, you know, Mr. President, as President, you can control a lot related to the public provision of health care insurance — Medicare, Medicaid, CHIP, veterans health benefits — but you don’t have a lot of power over the private side. And that, after all, is the bigger side. It’s most of the money, covers half the American population.” 

That “hot Friday” was July 17, 2009, when the Washington, D.C., temperature soared to 90.9º.

“(O)ver the course of the next few days, this was Friday, then Monday and Tuesday we had meetings around this, the idea began to hold that we should do something about it, we shouldn’t roll it back, but we should modify it.”

The following Monday and Tuesday were July 20 and July 21, 2009. White House visitor logs show an “Economics Team” indeed met the morning of the 20th. (White House visitor logs also indicate that the beloved Jonathan Gruber was in attendance!)

So why did THIS happen, on Thursday, July 23, 2009, in Shaker Heights, Ohio?

“First of all, in terms of taxing benefits, I said I oppose the taxing of health care benefits that people are already receiving, so that’s not a proposal that I’m supportive of…But what I said and I’ve taken off the table would be the idea that you just described, which would be that you would actually provide — you would eliminate the tax deduction that employers get for providing you with health insurance, because, frankly, a lot of employers then would stop providing health care, and we’d probably see more people lose their health insurance than currently have it.”

Dear President Obama, wasn’t that exactly the goal? That we lose our plans and have to join your lousy exchanges?

It’s very odd that Obama repeatedly characterizes his views using terms like “what I’ve said is,” rather than “what I believe is.” 

But it’s more than disappointing to learn that Obama lied to his Shaker Heights audience — and America — mere days after he fell in love with the bomb that will blow up job-based insurance.

H/T Citizen researcher Kathy in Alabama

April Fools’ Bracket: Who Wins? The Cannon or The Gruber?

Financial services company Sun Life is again hosting its Wake Up Summit. Its last webinar explored the effect of Obamacare on the nation, and Jonathan Gruber, MIT economist and Obamacare architect, was a speaker in the keynote address and a contributor to one panel discussion (registration required to view). 

The conference could have been described as boringly collegial.

This year’s webinar occurs on April Fools’ Day and may prove more provocative. Wake Up Summit 2015 will again feature Jonathan Gruber, but this time alongside Michael Cannon, the Cato Institute’s director of health policy studies and, with legal scholar Jonathan Adler, one of the masterminds of the so-called Obamacare “subsidies cases.” The informed reader will recall King v. Burwell as the case most recently heard at the Supreme Court.

If you’re free at 2:00 p.m. on Wednesday, you can register to watch it live here. Click the RSVP button on the right side of the page.

You can also make the event more lively. Sun Life is inviting questions before the event. 

You may have a variety of questions of your own for Mr. Gruber. But you could also pose questions like these, for either participant:

1. Everyone’s heard that “if you like your plan, you can keep your plan.” Would you please explain how the ACA affects those who receive health insurance from their employers?”
2. When Senator Obama ran for office he promised not to eliminate the tax exclusion for job-based insurance. But doesn’t the Cadillac Tax achieve the same goal over an extended time frame?

3. Don’t you think the Cadillac Tax is mislabeled since it appears to eventually impact most if not all job-based plans?
4. Why does the Cadillac Tax cap grow at CPI or CPI +1? Won’t that assure that most if not all plans become Cadillac Tax plans?
5. What do you think of S&P Capitals’ recent prediction that by 2020 90% of those with job-based coverage will be shifted to the ACA exchanges?
6. Do you agree with Medicare chief actuary Richard Foster’s prediction that “essentially all Americans” will over time get their private coverage through ACA exchanges?
7. Exactly how does the ACA cause “wage growth” for workers?
8. The CBO scores the ACA as improving the deficit more in the out years than in the first ten years. Why is that?
9. Do you think the ACA is more like Romneycare or Hillarycare?
10. If states do not establish their own exchanges, what role do states really have with regard to the ACA?
11. Is a “single payer“ health system more likely if the ACA fails or if the ACA succeeds?

Of course, you’re also free to ask not-so-serious questions of either Mr. Gruber or Mr. Cannon, questions like these:

1. Why aren’t you, Mr. Gruber, still hiding under a rock?
2. Are you, Mr. Gruber, capable of feeling shame?

3. Mr. Gruber, would you like to clarify your “falling off a building” prediction for workers losing job-based insurance?
4. Mr. Gruber, why were your Obamacare models so wrong?
5. Have you, Mr. Gruber, apologized to your family for publicly humiliating them?
6. Has MIT placed any sanctions on you, Mr. Gruber, given your damaging effects on its reputation?
7. Mr. Gruber, when will you turn over your “research assistants’” records?
8. Mr. Cannon, how did you become so flipping awesome?

Feel free to offer your questions in the comments section below. But it’s far more important that you send them to Sun Life.

Of course, as Mr. Cannon points out, Mr. Gruber may not show up at all. 

John Kerry Is No More Trustworthy Than The Disgraced Jonathan Gruber

In summer of 2009, as Obamacare crafters were assembling their plan to destroy the U.S. health care industry, they faced several problems, and most of them involved financing.

Over twenty years ago, Mrs. Clinton’s health reform plan died when the Congressional Budget Office (CBO) determined it would cost too much. 

Learning from her failure, White House officials knew they had to create a plan the CBO could score as budget-neutral. But where, oh, where, would they find the money to not only subsidize insurance purchases but also fund an “unknowable” number of new agencies, boards, commissions, and task forces? 

It was at that point in late-July that Obama’s economic team advocated that the plan eliminate the tax exemption for job-based insurance. What was later dubbed the Cadillac Tax would result in an estimated federal tax grab of $250 billion per year. 

But, as Jonathan Gruber told a Boston audience, any plan that ended the tax exclusion would have been a political hot potato. “Economists have called for 40 years to get rid of the regressive, inefficient and expensive tax subsidy provided for employer provider health insurance…It turns out politically it’s really hard to get rid of.”

That’s where then-Senator John Kerry became Gruber’s “Massachusetts hero” by introducing a scheme to trick Americans. “No, no,” Gruber quotes Kerry, “we’re not going to tax your health insurance. We’re going to tax those evil insurance companies!” 

 When we all know it’s a tax on people who hold those insurance plans.

An ordinary person responsible for such duplicity might have experienced regret, even shame. But not Kerry, who, like Gruber, aimed to exploit Americans’ “lack of basic economic understanding.”

Less than six months later, Kerry doubled down on his deceit, penning a January 2010 Huffington Post piece explaining his support for the Cadillac Tax.

It will help control future health care costs without — I repeat without — directly taxing employees.

Notice the word “directly?” By this he means the tax on insurance companies will be borne by the worker, but certainly not clearly or directly. It was intended that Americans blame insurance companies and employers for jacking up premiums, deductibles, and copayments. (In fact, Harvard faculty members are already blaming the university for out-of-pocket cost increases.) Later, they hope, we will curse our bosses for eliminating job-based insurance altogether.

The excise tax included in the Senate-passed health care bill will affect only a small portion of the very highest cost health plans.

Not according to the American Health Policy Institute, who projects the tax will “hit 17 percent of all American businesses, and 38 percent of large employers” in 2018. And as Gruber explained, the method establishing the yearly tax threshold means that eventually all plans will be subject to the Cadillac Tax. 

For the small sub-set of plans that are affected, the likely impact will be to increase workers’ wages. MIT economist Jon Gruber recently found that the excise tax included in the Senate bill would lead employers to raise wages by $223 billion between 2010 and 2019. In 2019, wages for those affected by the provision will be higher by about $660 per household. I repeat — raise wages.

Did anyone think to ask Kerry how a tax on insurance companies naturally produces higher pay for America’s workers? That’s a curious connection, isn’t it?

Well, you see, Secretary Kerry conveniently omitted the “Employers-Kill-Your-Health-Plan” factor in his analysis. What he failed to mention is his apparent belief that, as employers shrink insurance benefits or dump employees in Obamacare exchanges, they’ll compensate them with higher wages. 

(By the way, this is an assumption based on Gruber modeling, the same model predicting that our health insurance premiums would fall under Obamacare.) 

Finally,

After spending years and years hearing from workers tired of seeing their unions forced to spend all of their energy at the bargaining table just to hold on to health care instead of negotiating for better wages, we now have a way to help increase wages and improve health care simultaneously.

If Kerry believed union workers would gleefully skip off to the Obamacare exchanges, he was wildly uninformed.

Let’s not forget: this is the same John Kerry currently negotiating a nuclear agreement with Iran. 

More than likely, Iran’s mullahs will fare better than Americans have with Obamacare. 

But they may have to sign the deal to find out what’s in the deal.