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Today in the White House Rose Garden before a crowd of the compelled and the unwilling to hold a pep rally and spike the football for the ACA (Obamacare). 

Giving what are presumably cooked figures, which count anyone who ever went to the Health care website, Barack now claims he met the 7 million enrollments goal. Balderdash. If any one ever audits this it will undoubtedly be significantly lower and false. 

Further those who have signed up are primarily those who already had Insurance, had it cancelled due to the ACA and had no choice but to enroll or not replace coverage.

Others have a number of thoughts on this in some older and recent comments. Consider the following:

WASHINGTON – Rod Coons and Florence Peace, a healthy couple in Indianapolis, spend only $500 every year on medical care and say their current health plan works well for them – but Obamacare will soon strip them of that contentment, forcing them to pay soaring rates and accept inferior care because their existing plan isn’t “government approved.”
And they aren’t alone.
Many Americans don’t realize their health plans won’t meet Obamacare standards next year, experts warn.

Abbey Bruce, a nursing assistant who works a second job cleaning, learned she will now pay a sharply higher deductible, because of Obamacare’s so-called Cadillac tax, which penalizes companies that offer high-end health care plans to employees.
The problems don’t end there. Now that America is finding out what’s in President Obama’s signature legislation, dozens upon dozens of severe problems, failures and unworkable plans are coming to light. And now, polls show most Americans are beginning to suffer both sticker shock and buyer’s remorse.
The controversial, 10,000-page law is now literally falling apart on dozens of different fronts, as a comprehensive WND review has revealed.

Obama promised his health plan would improve coverage, lower premiums by $2,500 per family and allow Americans to keep their doctors and health plans, but a crushing mountain of evidence is indicating otherwise. Given the more than 50 major problems WND has documented, all of President Obama’s promises appear either highly in question or unlikely to happen, more than three years after his Affordable Care Act was signed into law March 23, 2010.

The most recent glitch is a significant one: The administration’s decision to delay the caps on out-of-pocket expenses is a large part of what is supposed to make the Affordable Care Act affordable. No caps on out-of-pocket expenses means insurance customers will have to pay more for co-payments and deductibles and insurance companies will be required to pay less. This setback to Obamacare is merely the latest in what has become a long and staggering list of failures or impending failures – including the most important promises affecting cost and coverage. Some of the most striking Obamacare problems are:

  • no guarantee Americans will keep their doctors,
  • Americans may lose their health plans,
  • worsening health care,
  • higher premiums,
  • higher taxes,
  • budget deficit increase,
  • hiring freezes,
  • slashed workers’ hours,
  • killing existing jobs,
  • killing new jobs,
  • jobs already killed,
  • 1,200 business waivers,
  • higher Medicare costs,
  • seniors may lose Medicare,
  • most Americans don’t want it.
The list of Obamacare failures, problems and setbacks is growing at a faster pace as Obamacare approaches its implementation deadline of Jan. 1, 2014:
1) Americans may lose their doctors: The president promised, “No matter what you’ve heard, if you like your doctor or health care plan, you can keep them.” However, that promise is not necessarily true, according to his own Department of Human Health and Services. HHS recently posted the answer to this question on “Depending on the plan you choose in the Marketplace, you may be able to keep your current doctor.”
The government explains, “Most Health Insurance plans offered in the Marketplace have networks of hospitals, doctors, specialists, pharmacies, and other health care providers. Networks include health care providers that the plan contracts with to take care of the plan’s members. Depending on the type of policy you buy, care may be covered only when you get it from a network provider.”

2) Americans may lose their health plans: Obama promised “you can keep your health plan,” but customers with high deductibles are now discovering their insurance plans do not qualify as “government approved” under Obamacare, so they will be required to change plans. A fact-check review by even the left-leaning found Obama’s promise only “half true” and difficult to predict, due to continuing uncertainties in the implementation of Obamacare.

3) Worsening health care: The New York Times reports as many as 75 percent of health plans will be affected by the so-called “Cadillac tax” on what the administration labels high-end plans. A health-care expert warned consumers should expect their plan is going to be more expensive and they will have fewer benefits. The Times predicts those patients can expect to visit clinics instead of doctors for prescriptions or blood-pressure checks; programs, rather than doctors, to manage such chronic conditions as diabetes; and a health screening to determine one’s odds of developing a costly health condition.

4) Higher premiums: Although Obama claimed his program “would save the average family $2,500 on their premiums,” a Wall Street Journal study revealed premiums for healthy people could actually double, or even triple.

5) Higher taxes: The Heritage Foundation found 20 new or increased taxes in Obamacare, including taxes on investment income, Medicare payroll, the individual and employer mandates, insurance companies, insurance plans, innovator drug companies, medical device manufacturers, medical bills, flexible spending accounts for special-needs children, over-the-counter medicines, parts of Medicare D, Blue Cross/Blue Shield deductions and charitable hospitals.

6) Budget deficit increase: The GAO reports Obamacare will increase the long-term federal deficit by $6.2 trillion.

7) Hiring freezes: A Gallup poll found more than 40 percent of small businesses have frozen hiring because of Obamacare.

8) Slashed workers’ hours: A survey by the U.S. Chamber of Commerce found half of small businesses affected by Obamacare plan to either replace their current full-time workers with part-timers or cut their workers’ hours because of the law’s requirements.

9) Killing existing jobs: The same survey found 24 percent of small businesses plan to cut staff to less than 50 to avoid paying penalties for not providing health insurance.

10) Killing new jobs: One-third of employers cited the uncertainty of Obamacare’s costs and regulations as the biggest obstacle to hiring more workers. New taxes could kill tens of thousands of jobs, possibly causing more layoffs. The employer mandate, once implemented, will be a disincentive for businesses to hire more than 49 full-time workers if the businesses can’t pay for health insurance.

11) Jobs already killed: Layoffs at a south-side Chicago hospital, a Wisconsin health care company, a Pennsylvania community college and cities in Ohio and Pennsylvania have already been attributed to Obamacare.
12) More than 1,200 business waivers: HHS acknowledged issuing businesses more than 1,200 waivers from parts of Obamacare by January 2012. After that, the department stopped updating the total number of waivers because of monthly ridicule from the GOP. Instead, HHS stopped accepting applications for one-year waivers and simply granted or denied waivers through the end of the year.
13) Higher Medicare costs: A Heritage Foundation analysis found Obamacare will force seniors to suffer higher out-of-pocket expenses over the next five years. Payments will be reduced to hospitals, skilled nursing facilities and home health-care agencies.

14) Seniors may lose Medicare: Another Heritage Foundation study determined, “Many seniors will experience a reduction in their Medicare Advantage benefits or even a loss of their existing plan.”

15) Americans reject Obamacare: A CBS News poll found 54 percent of Americans disapprove of the health-care law. More Americans than ever, 39 percent, want it repealed.

16) Fewer insurance companies: Businesses providing health insurance dropped from 59 percent to 52 percent from 2000 to 2011.

17) Fewer insurance choices: Two major health care providers, United Healthcare and Aetna, stopped providing coverage in California because of Obamacare’s requirements.

18) Basic health plan delayed: The administration postponed until after the 2014 election the health program for low-to-moderate income people who don’t qualify for expanded Medicaid.

19) Early retiree program broke: A plan intended to insure early retirees between ages 55 and 65, and their dependents, until government-run exchanges are in place quickly ran out of money. HHS stopped accepting new applications in May 2011. By December 2011, the program had spent its $5 billion budget and stopped paying any claims  two years before it was supposed to end.

20) High-risk pools failing: The administration cut payments to doctors and hospitals before it ran out of money to fund the pre-existing condition insurance plan for people with cancer, heart disease and other serious conditions. HHS Secretary Kathleen Sebelius simply announced “health care facilities and providers will get paid less” for providing the same services.

21) Insurance co-ops failing: The Inspector General for HHS reported most of the 24 health care cop-ops created under Obamacare are in danger of running out of money before they even provide health insurance.

22) Uninsured children: Major health insurance companies, including Anthem Blue Cross and Aetna, decided to stop selling new policies for children rather than comply with the law now forbidding them from rejecting children with pre-existing medical conditions. Insurers say the law could create large and unexpected costs.

23) Union opposition: The leaders of three major U.S. unions (including the Teamsters), which strongly supported Obamacare, now warn Democratic leaders that unless the health-care law undergoes major changes, it will “destroy the very health and well-being of our members along with millions of other hardworking Americans.” It will also “destroy the foundation of the 40-hour work week that is the backbone of the American middle class.”

24) Patients expect worsening care: A Rasmussen poll finds 61 percent of Americans expect health care to get worse under Obamacare over the next two years.

25) Doctors expect worsening care: Many doctors fear they will be unable to continue 
private practice because of low reimbursement rates from Medicaid and Medicare and will end up working for a corporation hospital where the profits are distributed to shareholders. Doctors fear they will be punished in that system if they spend too much time with a patient or provide too much treatment.

26) Small business plan delayed: The administration delayed implementation of a program designed to provide affordable health insurance to small businesses, a program the New York Times called “a major selling point for the health-care legislation.”

27) Losing the mainstream media: NBC has discovered Obamacare will cause some people to lose income, others to lose their jobs and some to lose their insurance. Reporter Lisa Myers said they “spoke to almost 20 small businesses and other entities around the country. Almost all said because of the new law, they’d be cutting back hours for some employees” below 30 each week because they can’t afford to offer the health insurance mandated by Obamacare.

28) Death panels confirmed: Physician and former DNC Chairman Howard Dean wrote an editorial in July essentially confirming Sarah Palin’s contention that Obamcare will have a “death panel.” Palin was excoriated for her assertion by the administration and the mainstream media. even dubbed it 2009′s “Lie of the Year.” But Dean confirmed the Independent Payment Advisory Board, or IPAB, “is essentially a health-care rationing body” that will “be able to stop certain treatments its members do not favor by simply setting rates to levels where no doctor or hospital will perform them.” The rationing board will decide whether or not some patients get potentially life-saving treatments, which is basically how Palin described “death panel” in her 2009 Facebook post.

29) Growing Democratic Party opposition: Along with Howard Dean, 22 elected Democrats at the federal level now back the repeal of the Independent Payment Advisory Board. (The American Medical Association, the American Hospital Association and the pharmaceutical lobby also support repeal of the IPAB.) Four House Democrats were scolded by their own party after voting with Republicans to delay the individual and employer mandates.

30) Medicare cuts delayed: The administration is spending billions to postpone cuts to Medicare until after the 2014 election.

31) States resist Medicaid expansion: Following the Supreme Court’s ruling allowing states to opt out of Medicaid expansion, 24 states are moving toward expanding the program and 21 states are not.

32) Insurance exchanges unwanted: Most states have declined to create their own insurance exchanges and are letting Washington create a federally run exchange for them. A full 27 states are opting for the federal exchange while only 17 states are creating their own exchanges.

33) Bypassing Congress to change law: The Obama administration used the IRS to unilaterally rewrite the health-care law to fix a problem it did not anticipate, withoutconsulting Congress. The administration had expected all states to create health-insurance exchanges, but so far only 17 have done so and 27 states have defaulted to the federal exchange. The problem is, Obamacare authorized tax credits and subsidies for the purchase of qualifying health insurance plans in state-run exchanges (Section 1311) but not federal ones (Section 1321). So, in May 2012, the administration simply had the IRS issue a rule to authorize tax credits and subsidies in federal exchanges.

34) Congress investigates key rule: The chairmen of the House Ways and Means Committee and the House Oversight and Government Reform Committee announced in January they would investigate and hold hearings on the IRS rule allowing federal exchanges under Obamacare to issue tax credits and subsidies. Federal exchanges were not allowed to do so under the Affordable Care Act passed by Congress and signed into law by the president. But the administration directed the IRS to unilaterally change the law without involving Congress in May 2012.

35) Judge OKs suit against HHS: A federal judge rejected the federal government’s motion to dismiss Oklahoma v. Sebelius. Oklahoma is challenging the legality of the IRS regulation giving tax credits to federal exchanges under Obamacare. The Affordable Care Act passed by Congress and signed into law by the president allows those tax credits only to state exchanges, but only 17 states have established such exchanges. So the administration simply had the IRS issue a rule in May of 2012 to authorize tax credits and subsidies in federal exchanges.

36) Critical deadlines missed: A GAO report says critical deadlines to create a federal exchange have been missed, suggesting “a potential for challenges going forward.”

37) Doctors fleeing and opting out: The Wall Street Journal found Obamacare is causing fewer doctors to treat Medicare and Medicaid patients. The number of doctors opting out of Medicare has nearly tripled from three years earlier. Even fewer are accepting new Medicaid patients. A survey found six in 10 physicians say it is likely many doctors will retire earlier than planned in the next one to three years. The same percentage say the practice of medicine is in jeopardy as medical experts lose control of their clinics and compensation because of Obamacare.

38) Fewer doctor and hospital choices: The New York times found health insurance companies are cutting costs by selecting health-care plans that reduce the number of doctors and hospitals available to customers.

39) HHS mandate challenged: The highly controversial HHS mandate, opposed by many (including the Catholic Church) on religious grounds because it would force employers to provide contraceptives and abortion-inducing drugs, is tied-up in the courts and may go to the Supreme Court.

40) Employer mandate delayed: The mandate requiring employers with 50 or more employees to provide health coverage has been postponed until after the 2014 election. Unions complain it is most unfair to require employees  but not employers  to adhere to Obamacare. Other prominent critics have echoed the accusation of Rep. Steve King, R-Iowa, that it is unconstitutional for the president to unilaterally order this change after Obamacare had become law.

41) IRS “honor” system open to fraud, abuse:  Because the employer mandate is delayed but not the individual mandate, the government has no way to determine whether employees of businesses with 50 or more workers are eligible for subsidies. So, individuals will be on the “honor system” to report their insurance status to the IRS and whether they are eligible for subsidies. That leaves the door open for potential widespread fraud and improper subsidy payments. It also makes taxpayers liable to repay any subsidies and/or tax credits erroneously granted while the honor system is in effect.

42) Fewer child-only plans: According to a senate committee report, “As a result of the new regulations, children who are not eligible for Medicaid, the State Children’s Health Insurance Program (SCHIP), or high risk pools have fewer plans to choose from, and in many states are no longer able to obtain insurance coverage under child-only plans.”

43) Schools can’t afford insurance: Schools have already begun cutting hours to avoid paying insurance for substitute teachers and support staff such as classroom aides, cafeteria workers and bus drivers. Obamacare requires employers to offer health coverage to all employees who work an average of 30 or more hours per week each month, or else pay a fine.

44) Young people expected to opt out: Obamacare needs enough healthy people ages 18-34 to join health insurance exchanges to “cross-subsidize” people who are older and not as healthy. But a study shows the younger people will have a financial incentive to instead pay the individual mandate penalty of $95 or one percent of income. Approximately 3.7 million of those ages 18-34 will be at least $500 better off if they forgo insurance and pay the penalty. More than 3 million will be $1,000 better off if they go the same route. The study finds that is a big enough problem to doom the insurance exchanges.

45) Identity theft risks: The California insurance commissioner warns that poor screening of those helping people sign up for Obamacare could lead to identity theft and fraud.

46) Obamacare con artists: CNBC reports Obamacare is “a dream come true for rip-off artists.” Scam artists are setting up fake health-care exchanges on the Internet, enticing victims to enter their personal financial information. Other scam artists are calling, faxing and emailing people claiming to be with Medicare or Obamacare, asking for a bank account or Social Security number to “verify” personal information and to “make sure you get the proper benefits.” Others have tried to sell fake insurance cards and have even threatened people with jail if they don’t purchase one. Con artists have also tried to pass themselves off as Obamacare “navigators” who can help Americans apply for coverage through an exchange, then ask for money or personal information.

47) Public option failure: The public option would have provided a government-run insurance agency to compete with private insurers. The Department of Health and Human Services admitted in 2011 it would not work; then Congress repealed the program.

48) Employee free choice repealed: The plan would have allowed 300,000 employees to choose their own insurance coverage, using employer-financed vouchers.

49) Obama exempts Congress and staff: President Obama personally negotiated an exemption from the health-care law for members of Congress and their staff. They reportedly will have 75 percent of their health insurance costs paid by the government. That circumvents an amendment by Sen. Chuck Grassley, R-Iowa, put into law, and expressly designed, to ensure Congress lives under Obamacare, just as the rest of the nation must.

50) Federal workers don’t want Obamacare: According to a survey of 2,500 federal employees and retirees, 92.3 percent do not want to be forced into Obamacare. Only 2.9 percent want to make the change.

51) Involuntary home inspections: Critics say these are actually forced home inspections targeting a wide variety of Americans. They point to a provision in Obamacare providing hundreds of millions of dollars to make “evidence-based” inspections of “high-risk populations,” defined as families in which any of these conditions apply: the mother is under 21; someone is a tobacco user; children have low student achievement, developmental delays or disabilities; individuals who are serving or formerly served in the armed forces. Critics say even homeschoolers may be subject to “intervention” in “school readiness,” and farm families could face intervention to “prevent child injuries.” Gun owners may be required to comply with safety inspections.

52) Charitable hospitals threatened: Charitable hospitals that treat the uninsured could face hefty fines and even lose their nonprofit status. Hospitals that devote a minimum amount of their expenses to treat uninsured poor could face penalties because of a new provision in Section 501 of the Internal Revenue Code taking effect under Obamacare. Charitable hospitals will face considerable paperwork and scrutiny from bureaucrats particularly interested in how and why hospitals will be providing discounted or free care to poor patients.

More recently Forbes reports:

Many Affordable Care Act Problems Are From Design, Not Implementation

The laudable goal of the Affordable Care Act is to make health insurance more available by establishing insurance exchanges and eliminating bias based on preexisting conditions.  But insurance may still be unaffordable to many lower and middle income workers – even in states that agree to expand Medicaid. The problem has nothing to do with implementation.  It is the way the law was designed, to keep budgetary costs under control.  Here are some examples that illustrate the problems.
For a firm whose workers all make over $40,000 the typical cost of the least expensive “affordable” policy for each worker might be approximately $5,000.  Of that amount, the workers themselves could be required to pay up to $3,800 which is 9.5 percent of their wages.  This 9.5% of wages is the amount the law allows the employer to pass on to the employee and still be considered to have offered that employee “affordable” care. That leaves the employer paying only $1,200, a fully deductible expense.  That is why most employers who consult their tax advisors will prefer to provide the minimum required insurance subsidies rather than paying a nondeductible $2,000 tax penalty for failure to provide affordable healthcare coverage.
The workers may be surprised to learn that no employer subsidies are required for the worker’s children or spouse.  As a result, even if the spouse is also making $40,000 and receives a similar $1,200 subsidy from her employer, the total family cost for premiums could be over $10,000.  That is $3,800 for each spouse, plus around $4,000 to cover their children.  As a result, many families may decide not to purchase insurance, or delay the purchase until someone becomes ill.  This is the free-rider problem the law was supposed to fix.
Some workers – including some unionized workers — would like to get the more generous tax credit subsidies that have been widely advertised. But those tax credits are available only if neither spouse is offered an employer-subsidized policy like the ones described here. Even if the employer’s offer is declined neither that employee or their family is eligible for subsidized insurance from an Exchange.  This is the least understood provision of the law.  Generous tax credits are available to lower and middle income families, but only if neither spouse is offered a much less generous employer subsidy – like the $1,200 described above.  Since most employers will provide that subsidy to avoid a more costly tax penalty (see above) most workers will be ineligible for any tax credits, even if they meet the advertised income limits.  Again, this is part of the law’s fundamental design, not an implementation issue.
Some employers with substantial number of low-wage workers would like to increase the hours their part-time employees work – say, from 29 to 39 — and still obtain exemption from the employer mandate.  That would be very helpful for their businesses and for the labor markets, but it would also shift more costs to the Federal government by expanding the number of workers eligible to receive tax subsidies at the exchanges instead of their employer.

As these examples illustrate, the actual costs of health insurance may still be quite high – even after all available subsidies are taken into account.  Thus, success in expanding coverage may rest on the individual mandate penalty.  But as many supporters of the law have acknowledged, those penalties may simply be too low.  The penalties start a under $100 and grow to approximately $700 per person or $2,100 per family once they are fully phased in.  But a family facing cash cost of $10,000 for the least expensive family coverage – or a potential $2,100 penalty for remaining uninsured – may choose the latter.
These are obviously not implementation problems – or even problems educating the public about the new law.  They are issues presented by fundamental design decisions that Congress made to keep the budgetary cost of the law under control.  Changing them could be very costly and very difficult.
The litany of problems with the ACA goes on and on. The pep rally that the President held in the Rose Garden today was simply singing to a forced attendance choir from the administration, offering anecdotal praises, but addressing nothing of the real structural and implementation problems of the ACA.
These articles are not partisan, they are fair descriptions of SOME of the problems of the program.
Its a train wreck, it should be repealed and intelligent and meaningful reforms of medical insurance should be instituted without the gestapo bureaucracy of the ACA.

This post first appeared on Mr Smith Thinks - Musings From The Mainstream, please read the originial post: here

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