Morning Jolt
. . . with Jim Geraghty December 27, 2013 Hope your Christmas or nondenominational day off was merry. Smile! The Worst Is Yet to Come Be of good cheer as 2014 ends, my friends. The dominant story for the past three months has been our political opposition's hell-bent determination to enact a legislative monstrosity which is generating and exacerbating a giant national mess with canceled plans, higher premiums, higher deductibles, headaches, stress, and a domino effect of new problems. Our friends on the left -- I can hear people screaming, "Why are you calling them that? They're not our friends!"-- have had to spend the past three months saying: 1.) "The problems aren't that bad." 2.) "They're fixing it." 3.) "The problems are only affecting a few million people." 4.) "They'll be better off in the long run, we're sure of it." 5.) "You're racist." Liberals greet 2014 in a cranky mood because they know, deep down, these are real problems and Obamacare is exacerbating all the problems they set out to solve. We on the right have reason to be similarly cranky, because we warned them, we opposed this, we were derided and mocked for our skepticism, and we are, for now, powerless to fix the problem. For now.
Meanwhile, enjoy the new taxes in the new year! Insurance companies aren't crazy about their share of the health law's taxes, but mostly they've complained to politicians and regulators. At least one health plan wants to bring consumers into the loop. "Affordable Care Act Fees and Taxes" is a separate line item on bills Blue Cross Blue Shield of Alabama is sending to individual customers. The tax amount is $23.14 a month, or $277.68 annually, on a statement one subscriber shared with Kaiser Health News. That's added to the "Current Amount Due for Benefits" of $322.26, for a total monthly premium of $345.40 for one person…. Alabama Blue Cross accounted for these ACA taxes in the amounts shown on individual subscriber bills, said spokeswoman Koko Mackin: A fee for the Patient Centered Outcomes Research Institute. Next year it's $2 per subscriber for the year. PCORI works to control health costs through research that attempts to distinguish wasteful spending from cost-effective procedures. A premium tax estimated to add about 2 percent to consumer costs. This is the one insurers really hate and have been trying to delay or get rid of. A user fee of 3.5 percent to sell through the online marketplace that the federal government operates for Alabama and 35 other states. Reinsurance and risk-adjustment fees to create backstops for insurers with big medical claims as they are required to accept people with pre-existing illness under new price regulations. Ted Cruz shares: 
Hey, look, at least the taxes are relatively clear, and aren't changing every five minutes: "If the launch had gone properly in October, we would not have been put between one rock and one gigantic hard place," says David Oscar, communications chair of the New Jersey Association of Health Underwriters. "All the rules that are coming out last-minute are unfair to both the consumer and the carrier." Insurance workers know that the past weeks have been a matter of "grin and bear it." Like the Obamacare administration, the industry wants to enroll as many people as possible to avoid the specter of skyrocketing premiums next year. But for providers that have had to cope with the White House's shifting enrollment guidelines and goal posts, recent days have been an unwelcome reminder of how much depends on them, and how little time they have to get it right. Nearly everyday, Mr. Oscar says, he's on the phone telling a client that what he told them earlier no longer applies. And it has gotten so frequent that his assistants and coworkers decided to make it a game. They printed a picture of a yellow school bus and taped in next to his desk. They also printed little miniature David Oscars. Now, whenever they hear him apologizing to a client, or explaining new rule changes, they run over and tape a picture of him underneath. "Health-care reform is throwing me and my industry under a bus," Oscar says. "We've been running for a deadline, and everybody wanted this coverage for Jan. 1, and then you sort of soft move it from Dec. 15 to Dec. 23," he says. "And then on the 23rd, you let it leak that day? You don't even give a heads-up announcement?" You know, insurance companies, if you're that upset about things, you could emulate Alabama Blue Cross and Blue Shield and let your customers know how much of their monthly premium reflects taxes and fees imposed by the (chuckle, snicker) "Affordable Care Act." Let every industry that's ever thought about getting in bed with this administration and Congress watch closely. Sure, it always seems like a sweet deal at the time. But when the government gets really nervous under a system of crony capitalism, they're more than willing to turn around and bite the cronies. Are You Ready for Those New Deductibles in 2014? But wait, there's more! Some folks are going to head into an emergency room in 2014, thinking they have insurance, only to find their 834 packet didn't transfer successfully from Healthcare.gov to the insurer. Or perhaps they'll find they do have insurance . . . but that the cost of that first visit to the emergency room hasn't reached their deductible yet. Surprise! You're on the hook for the entire $5,000 cost of the emergency-room visit. No, I'm not kidding: Sixty-four percent of bronze plans offered in Dallas, for example, require policyholders to meet the full deductible before insurance coverage kicks in, according to the eHealth/KHN analysis, which included all insurers except one, Molina Healthcare. The average deductible in those plans was $5,400, according to the data provided to eHealth by insurers. How many of the newly-insured will go to a doctor's office this winter? Better hope it's a mild flu season: All new plans must cover some defined preventive services with no copayment by the consumer and without having to meet the deductible first. Those include some vaccinations, mammograms and other cancer screenings, contraception, including birth control pills, and periodic physicals. But prevention services do not include treatment for an illness, such as the flu. Charges could also apply if, during a preventive care visit, the patient is also treated for a medical condition or a minor injury. How many of the newly-insured think that insurance is covering most of the costs, for everything starting from day one? How many think their premium means their insurance company covers all of the costs? David Nather, writing in Politico: The point of the Affordable Care Act is to cover people who haven't had health insurance before, and it may have already reached some of those people. But because they're new to health insurance, they may be in for a rude shock: It doesn't cover everything. There are deductibles, for example — the amount of money you have to spend out of pocket before coverage kicks in — which can be very high with "bronze" Obamacare plans, the cheapest kind. There are also co-payments for office visits, as well as co-insurance, the percentage of medical expenses you have to pay even if most are covered by your insurance. There's no way to know how big an issue this could be before January arrives — but if newly insured people think they're getting free health care, or just think the deductibles are too high, they could be disappointed with their first experiences with Obamacare. Back in June 2013, Megan McArdle shared a pastor/reader's portrait of the decision-making of some Americans who, for all of their other wonderful qualities, aren't so great at considering long-term consequences, deferred gratification, cost-benefit analysis, and other hard financial realities: I work with what I'd call median Americans. Incomes right around the median. Family structure and dysfunction right around the median. You get the picture. And to work on spiritual issues often requires dealing with financial ones at the same time. (Often they are the same problem.) Everything that I've seen about the ACA and its implementation seems completely divorced from how say 35%+ of these median Americans function on a daily basis. The ACA and every wonk assumes rational people who can make good financial decisions. Instead what you have is people with $100K of school debt because it compounded when they stopped paying it, who are leasing a new car, who have an interest only mortgage (or a HELOC to help them pay the original mortgage), who have at least 3 credit cards maxed, maintain a pay-day loan they got scammed into, and yet find cable with HBO and an iPhone 5 with all you can eat plan necessities. It is not that on a median salary it is not possible to live a good and prudent life; it just requires some restraint and a minimum amount of simple rules. (Rules like Dave Ramsey talks about, or Benjamin Franklin divorced from the Christian content). But this is what the ACA mandate and cost is going to mean to many of these people: do I keep HBO & Cable, my iPhone, or buy medical insurance? Which bill that I already have must be done without? They will refuse to even think about that. On top of that, if they recognize Obamacare at all what they think it means is "universal free health care" with emphasis on the free. When you try and say that it will cost them at least 4% of their income, they go directly into denial. What I'm saying is that for a large minority of people opting out of the ACA probably won't even be a conscious choice. It will just happen because of the complexity, the upfront sticker cost and the lack of ability to make good financial decisions. They will deal with it later when they file taxes which won't be until September, because when their tax guy tells them they won't get the refund they were expecting, they will file the automatic deferral to "put it off" for a little while. A Quick Glimpse at the Bloody Mess Overseas Meanwhile, over in Lebanon: A powerful car bomb tore through a business district in the center of the Lebanese capital Friday, killing a prominent pro-Western politician and at least five other people in an assassination certain to hike sectarian tensions already soaring because of the civil war in neighboring Syria. The blast, which wounded more than 70 others, set cars ablaze, shredded trees and shattered windows in a main street of the posh downtown Beirut area of five-star hotels, luxury high-rises and high-end boutiques. It sent a pall of thick black smoke above the nearby government headquarters and the seafront. The bomb targeted the car of Mohammed Chatah, a former finance minister and a senior aide to former Prime Minister Saad Hariri, security officials said. Chatah, his driver and four others were killed, the National News Agency said. Meanwhile, over in Iraq and Afghanistan: Two car bombs targeting Christians killed at least 38 people in southern Baghdad on Christmas. In Afghanistan, two rounds of "indirect fire" hit the U.S. Embassy compound in Kabul, but no one was hurt. Meanwhile, in South Sudan: South Sudanese President Salva Kiir on Wednesday called for an end to ethnically based attacks on civilians, even as fighting raged in a key oil-producing region and a fast-spreading humanitarian crisis worsened. Kiir's appeal comes amid widespread reports of extrajudicial killings, rapes, beatings and mass graves, according to victims, witnesses and U.N. human rights officials, raising fears of a civil war. . . . On Wednesday, the United Nations announced that the number of people who have sought shelter at U.N. peacekeeping bases nationwide had mushroomed to 58,000. More than 92,000 have fled their homes. Don't worry, South Sudanese! The civilized world is on the case! [Japan and South Korea] have about 300 troops deployed as peacekeepers in South Sudan, where internal conflict looks increasingly like the makings of a possible civil war. The South Korean troops needed more ammunition, which on Monday was supplied by the nearby Japanese force. But what should have been a rare opportunity for cooperation has quickly become the opposite. South Korea said it asked the United Nations for ammo, and the United Nations just happened to pass along Japanese-owned bullets. Japan put out the story that the Koreans had asked them directly for the ammo. South Korea took this as an insult, apparently believing that Tokyo was attempting to spin the story to make Japan look strong and South Korea look weak. It has devolved rapidly from there, with national media in both countries playing up the grievances and offense-taking. Meanwhile, in Syria: At least 25 people were killed in the northern Syrian city of Aleppo on Sunday, antigovernment activists reported, in the eighth straight day of intense government bombardment of rebel-held areas there, while a suicide car bombing that the state news media blamed on insurgents killed at least 10 people in the central province of Homs. . . . Violence in Syria appears, if anything, to have escalated in recent weeks. Rebel and government groups have each been accused of massacring civilians, and the government has stepped up air attacks on Aleppo with barrages of improvised "barrel bombs" packed with high explosives that activists say have killed more than 200 people. The war has killed more than 120,000 people, according to the Syrian Observatory for Human Rights, and the United Nations said that nearly nine million people, more than a third of the country's population, had been driven from their homes. President Obama, speaking at the United Nations in September: "The world is safer than it was five years ago." ADDENDUM: An important correction, from Haaretz, spotlighted by Hugh Hewitt: "An earlier version of this article erroneously stated that Bugs Bunny's most notorious enemy is Porky Pig. While the two are known to frequently squabble, often in the public eye, they are in fact good friends." That's all, folks.
To read more, visit www.nationalreview.com
| Why not forward this to a friend? Encourage them to sign up for NR's great free newsletters here. Save 75%... Subscribe to National Review magazine today and get 75% off the newsstand price. Click here for the print edition or here for the digital. National Review also makes a great gift! Click here to send a full-year of NR Digital or here to send the print edition to family, friends, and fellow conservatives.
| National Review, Inc.
Manage your National Review subscriptions. We respect your right to privacy. View our policy. This email was sent by:
National Review, Inc.
215 Lexington Avenue, 11th Floor
New York, NY 10016 | 
Comments
Post a Comment