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Jul 10 2013

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The Desperation of Obamacare

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The Future of Health Care in America...
The Future of Health Care in America…

No recent statute has so readily lent itself to Hollywood analogy as Obamacare.

It was birthed in an unholy spasm of sordid kick-backs and extra-parliamentary maneuver (“The Omen“). The bill was slapped together with little thought to how the provisions would play out in real life, creating a wonderland of unintended consequences (“Frankenstein“). It was challenged in court and declared innocent when a key player in the trial was badly misled (“Jagged Edge“). And despite durable public opposition – dating from its original passage – and countless Republican attempts to kill it since, the law just won’t die (“Halloween,” “Friday the 13th“).

In the run up to launching the program, ill-considered theories ran headlong into reality (“A Bridge Too Far“), sparking more opposition and lawsuits. Now, in less than three months, this hissing, toxic creation, disfigured and wonting, will be unleashed on the American people with potentially large-scale and dire results (“Godzilla“).

Of course the Administration knows all of this, but failure is not an option, no matter the carnage (“Gallipoli”).  But as we come down to the home stretch, we do see evidence of the Administration grudgingly tipping its hat to reality, while at the same time making a desperate gamble to create and cement the public support that has never materialized for Obamacare, and which may be the only hope for the law and sagging Democratic political fortunes in 2014.

In a time-honored Washington tradition, the Administration announced a most consequential decision regarding an integral component of Obamacare – the employer mandate – issued through a lower-level official at the Treasury department (in a blog post no less) right before the 4th of July holiday, when no one is typically watching.

By way of reference, the employer mandate is an Obamcare requirement that companies with 50 or more “employee equivalents” must pay a $2,000 penalty for each full-time worker (anyone who works more than 30 hours per week) if they don’t provide government approved health insurance.

Mark Mazur, the Treasury official in question, announced that the employer mandates implementation would be delayed by a year – from January 2014 to January 2015.

Of course, it is only a trifling inconvenience that Obamacare the law makes no provision for the Executive branch to change the date of implementation. Section 1513 states in black letter law that “(d) Effective Date. – The amendments made by this section shall apply to months beginning after December 31, 2013.” As the Wall Street Journal pointed out, “the law does not say the Administration can impose the mandate whenever it feels it is politically convenient,” though that is exactly what they are doing.

While America’s 5.7 million businesses will no doubt be relieved – puzzled and flummoxed as they were by the emerging, byzantine paperwork requirements and rules necessary to comply with the mandate, it is only a reprieve. The sentence will eventually be carried out after the midterms, at least as of today, unless additional lawlessness could rear its head.

However, it is important to note that even before the most recent delay in the mandate; it’s already having an impact on the economy. In the world of unintended consequences consistently inhabited by the most well intentioned but cloistered officials that distain reality, the latest monthly jobs report bears out the completely predictable business reaction to the onerous mandate, where companies are cutting back on full time workers in favor of part-timers who work less than 30 hours.

Without a policy even written, Obamacare is already having a profound, tangible and negative impact on the struggling US economy.

This latest delay is only one of a growing string of embarrassing public fumbles as HHS and the Executive Branch have applied the best progressive creative thinking to capitalize on the truly breathtaking grants of discretionary authority that Congress provided to rulemaking bodies when Congress couldn’t – or wouldn’t – provide direction.

Those fumbles included the unworkable, abandoned and repealed CLASS act on long term care, last April’s decision to delay implementation of small business health exchanges (leaving those businesses without a marketplace), and the abject failure of high risk pools that are under-performing and running out of money well before the denizens at HHS thought possible.

Meanwhile a brew of legal objection, politics and logistical fumbles has put the state level exchanges – the core of Obamacare where Americans not otherwise insured must purchase healthcare – into different levels of collective dysfunction. Yet the priority of fixing the exchanges has not stopped the Administration from producing a needlessly provocative ruling that religiously affiliated organizations must provide birth control and abortion inducing drugs, free of charge; a sop to NARAL associated militants, but also a  blatant infringement on First Amendment religious liberty protections of those organizations, which has created a formidable array of otherwise avoidable litigation.

Far from the promised, smooth running program, where costs were reduced, care and coverage expanded, where everyone could keep their own insurance and the national deficit would be cut as expenses were contained, we have a wheezy, oozing, uncoordinated mess (“Men in Black“) whose sole goal is to inflict itself upon its host for its own self-serving reasons.

Which leads us to the Administration’s “Hail Mary” play to save the legitimacy of Obamacare – taken right from the pages of a Tammany Hall playbook.

Fast on the heels of the Administration’s punt on the employer mandate, came another, more deeply hidden change. According to Forbes, “On Friday, the Washington Post discovered that the Obama administration had buried in the Federal Register the announcement that the government won’t be able to verify whether or not applicants for Obamacare’s insurance exchange subsidies are actually qualified for the aid, in the 16 states that are setting up their own exchanges. Instead, until at least 2015, these states will be able to “accept the applicant’s attestation [regarding eligibility] without further verification.”

This new wrinkle was necessitated in part by the delay in implementing employer mandate. Under Obamacare, an individual isn’t eligible for subsidies if their employer has offered what the government considers “affordable” coverage. But due to the delay employers are not reporting whether or not they’ve offered “affordable” coverage, so how can the government verify whether or not workers are eligible for subsidies?

The answer is the “honor system.”

But the real goal is as noxious as it is plain. Without verification protocols on income, anyone can sign up for what will effectively be “free” healthcare; a not insignificant inducement to enter the system. Far from a burden, it will be a bonanza, with corresponding billions of taxpayer dollars that are misdirected and wasted.

But the politics here are crystal clear. What’s a few tens of billions among friends when a cherished policy goal is on the line? No entitlement program in American history has ever been repealed once Americans have begun receiving the benefits. All they have done after that point is grow, and the public debate has been on the rate of that growth exclusively.

By waiving the income verification procedures for Obamacare, the Administration effectively achieves two complementary objectives; the more rapid acceptance of Obamacare by the public through cynical manipulation, and a very potent tool to blunt GOP arguments against the law in 2014.

Suddenly, instead of debating the merits of a bad and deficient law, as Republicans hope, Democrats will state that the GOP only wants to “take away your health care.”

Anyone who has tried to have a sane debate on the financial condition of Social Security, Medicare or Medicaid knows that the future bankruptcy of these programs overall has almost no standing when the benefits to the individual are being questioned. It’s pure demagoguery, of course, but it is very effective politically.

Naturally, the true costs of the coverage will only become apparent after 2014 is safely in the rearview mirror, and those falsely suckled on early Obamacare largesse come face to face with the true financial implications of the law.

But by then it will be too late.

What happens to the quality and availability of our health care, the future of our economy and our competitiveness after that? Well, just watch “2012.”

 

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