Another reminder that when the economic realities of this boondoggle collide with Democrats’ political priorities, the economics ultimately must bow. The first hard lesson in that was the “if you like your plan, you can keep your plan” fiasco. It was never true that people could keep their old plans if they liked them under O-Care, as even Barney Frank admits. The whole point of the law was to cancel low-cost existing plans and steer healthy people to new plans with “comprehensive” benefits that many don’t really need. That’s how you justify squeezing them for the added revenue needed to cover medical treatments for people with preexisting conditions in the same new plan. But Obama had lied too many times on camera to escape political damage from the “if you like your plan” nonsense being exposed. So, to contain the political fallout, he created an economic “fix”: Insurers would be allowed, if they so chose, to bring back plans that had already been canceled. That’s nutty from a revenue perspective — the last thing you want is healthy people bailing out of the new risk pool and buying an old, cheaper plan instead — but it made jittery Democrats feel better and that’s what’s important.
Second verse, same as the first. The feds were expecting a certain amount of revenue from uninsured people opting to pay the individual mandate penalty instead of buying insurance. But the mandate is unpopular, and since the people who are most likely to end up paying it are core Democratic voters, i.e. young adults, it might be especially dangerous electorally for the White House to be sticklers about collecting the money. Politics versus economics once again.
Which do you suppose won this round?
Almost 90% of the nation’s 30 million uninsured won’t pay a penalty under the Affordable Care Act in 2016 because of a growing batch of exemptions to the health-coverage requirement…
The Obama administration has provided 14 ways people can avoid the fine based on hardships, including suffering domestic violence, experiencing substantial property damage from a fire or flood, and having a canceled insurance plan. Those come on top of exemptions carved out under the 2010 law for groups including illegal immigrants, members of Native American tribes and certain religious sects…
Patrick Getzen, vice president and chief actuary at Blue Cross and Blue Shield of North Carolina, said he saw more “older and sicker people” enrolled in 2014 than projected. He attributed some of that to the weakened mandate. “With a stronger penalty and less broad exemptions, that would be better for the risk pool.”…
Critics have assailed one exemption for people who “experienced another hardship obtaining health insurance” as too broad. That exemption asks for documentation if possible but doesn’t require it.
Two years ago, CBO estimated that six million uninsured people would fail to qualify for a hardship exemption and be forced to pay the penalty, producing $7 billion in revenue. Today we’re down to four million who fail to qualify and $4 billion in revenue. What happened in the interim? You already know: Late last year, HHS quietly added a “temporary” hardship exemption for anyone who’d had their old insurance plan canceled, even though canceling old plans was the whole point of ObamaCare. As Ezra Klein put it, the feds were now treating ObamaCare itself as a hardship worthy of an exemption. (That’d make a dynamite attack ad for the GOP if the law wasn’t too complicated to explain in 30 seconds.) Then, four months ago, HHS went a step further for good measure and added the catch-all hardship category described in the last paragraph of the excerpt above — with no requirement that the applicant provide proof that they were really suffering from a hardship. In other words, we’ve gone from Obama waging a legal war before the Supreme Court to protect the mandate to Obama handing out exemptions essentially as a matter of right, no questions asked, to anyone who wants one. It’s de facto repeal of the mandate, albeit on a case by case basis. (Not unlike his approach to immigration, in which he’s going to repeal parts of U.S. immigration law de facto in the guise of exercising “prosecutorial discretion” towards each individual illegal.) It’s also a $3 billion hit to the federal coffers, but so what? It makes jittery Democrats feel better before the midterms and that’s what’s important.
Incidentally, the rule extending these hyper-broad mandate exemptions is due to expire in … October 2016, one month before America chooses a new president. What do you suppose are the odds that it’ll be extended beyond that date before then?
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