Mimsy Were the Borogoves

Editorials: Where I rant to the wall about politics. And sometimes the wall rants back.

Firewall affordable care act failures

Jerry Stratton, November 2, 2013

Car crashed into tree

“Hello, State Farm? I’d like some cheap insurance, please.”

The “Affordable” Care Act is two thousand pages1 of math-challenged disasters waiting to happen, such as the latest discovery of massive hikes to individual insurance on January 1 when people start moving to the exchanges.

If you purchased a rider to your car insurance to cover all of your gas, you would expect the rider to cost a bit more than your monthly gas costs—it has to pay for your gas, and it has to pay for the secretaries, computer programmers, and so forth to implement the new gas payments. If your car insurance was mandated to cover everyone’s gas costs without regard for how much anyone uses, you would expect car insurance to go up by the same amount, plus, if you’re an efficient gas user, the difference between your usage and the average.

It’s just math. The money has to come from somewhere, and it’s going to come from you. Government-run exchanges like this are going to increase costs.

Hopefully, America will reject the Democrats’ government-run health insurance exchanges in November 2014 just as California rejected the Democrats’ government-run power exchanges back when they caused price escalations in San Diego in 2003.

You’d think at some point Democrats would realize that government-run exchanges are a guaranteed cost disaster. But they haven’t realized it yet, or they just don’t care; they are not going to let the ACA get repealed and replaced with something that works. What they will allow, however, is a piecemeal fixing of its failures as they become obvious. We already repealed the crazy 1099 reporting requirement which required “that companies track and submit to the IRS all business-to-business transactions over $600 annually”. It would have meant price increases at all levels of our economy, because at that low threshold you never know if some mediocre ten dollar or twenty dollar transaction every once in a while will add up, over a year, to $600. At first, the White House fought the repeal but they eventually acquiesced.

Today, we need legislation to let people and companies opt out of the exchanges: individuals need to be able to buy any insurance, even insurance that doesn’t meet ACA regulations, so that they can in fact afford to buy insurance.

And whenever the ACA has another crisis—which it will, because it is so poorly in tune with reality-based math—we must be prepared to firewall the failure a bit further until we have whittled down the failure to the point where we can start discussing real reform. It’s very important, when we fix these failures, to firewall the success from the remaining failures. Otherwise, what little success we can squeeze out of the Democrats will be engulfed in the huge 1,990-page disaster. Every attempt should be made to take Obamacare out of areas where it clearly isn’t working.

And for god’s sake, the GOP should be storing these crazy attempts by the Obama administration and other Democrats to tell people not to believe their own lyin’ eyes. In November 2014 they need to be saying, “We saved your insurance. We overcame a Senate dominated by Democrats to keep your insurance costs down. Think what we could do if we didn’t have to overcome the Democratic Party’s disdain for your choices.”

The Democrats will try to lay blame for Obamacare’s failures on the Republicans—but we just went through a high-profile fight where Republicans tried very hard, at great risk to their own reputations, to block this very problem, to simply delay the whole thing a year because it was clearly going to be a failure. Democrats refused to even negotiate.

For four years, Republicans and conservatives have been saying, this thing is a mess. It is going to fail. For four years, Democrats in power have ridiculed them as grandstanding chicken littles. Some of them still are trying to do this in the face of people losing their insurance.

Back in 2010, Republicans tried to head off all of these policy cancelations, warning it was going to be a failure. Democrats in the Senate voted, 100%, to kill the Republican resolution. They tried to say that Republicans were just grandstanding, and that there was no failure.

Well, now it’s obviously a failure. Just delaying it isn’t enough. Perpetuating the status quo isn’t enough. The failure needs to be firewalled. Letting people keep their December 2013 insurance through 2014 is the absolute minimum they should agree to. The real minimum is:

  • anyone can opt out and buy insurance outside of the exchange;
  • they can do this pre-tax, such as in an HSA;
  • pre-existing conditions, at least outside of the exchanges, need to be moved to some program other than insurance;
  • off-exchange customers must not pay for on-exchange customers.

“Delay the individual mandate” is now where Senate Democrats can start negotiations. The end result has to be something better for everyone who buys health insurance.

This is a personal fight for me. I have health insurance through my job, but I also pay for my girlfriend’s health insurance. I don’t even know how to buy her a plan on the exchanges—there doesn’t seem to be any way to buy insurance for someone else. It’s either fall into Medicaid or lie about her income, forego a subsidy, and watch our monthly premium go from $132 to, at minimum, $205.00. And this is for, as everyone’s been reporting, higher deductibles—$6,350 vs. the old $5,0002. And this is after a 40% increase in premium during 2013 as the ACA’s mandates have gone into effect.

Why move pre-existing conditions?

We cannot have pre-existing conditions in health insurance, by definition. If we want to handle pre-existing conditions (which we do), they need to be handled somewhere other than insurance or we will not have insurance.

You cannot buy fire insurance after your house has burned down, or accident insurance after your car has been totaled, or health insurance after you are already sick for the same reason you can’t place a bet with the dealer after you have already rolled the dice. The event has already occurred and the results are visible. If you are somehow able to finagle money out of the dealer after both of you have seen the results it is not a bet.

Perhaps we need emergency health loans, or even emergency health copayments on a sliding scale. Or (more likely) we need a solution I am currently unfamiliar with. But it cannot be insurance without destroying the purpose of insurance and what keeps it affordable.

In response to Why we must not ration health care: Rationing health care means fewer cures.

  1. I’m counting the law itself; there are of course thousands of pages of regulations in addition to the law that must also be followed.

  2. I can’t believe that the ACA categorizes our crappy catastrophic policy as a bronze plan, and creates an even crappier policy to replace it.

  1. <- Walking into quicksand
  2. Fixes, fast and furious ->