The irony value of having the President’s home-town paper poking holes in the administration’s policies and performance has dimmed a bit recently, as the Chicago Tribune’s editorial board has become a vocal critic of the White House lately, especially on ObamaCare. Today, they warn their readers that this Christmas may not be very merry on the mandate front, in large part because of (a) the Obama administration’s incompetence, and (b) their dishonesty about (a):
You think the Obamacare run-up to Jan. 1 has been a train wreck? Now it gets worse.
You’ll soon be hearing more stories of people who thought they’d signed up for coverage, only to find that their paperwork was gobbled by computer gremlins. U.S. Department of Health and Human Services officials said they’ve whittled down the error rate in enrollment data sent to insurers from an astronomical 1 in 10 to “close to zero.”
But insurers say they are still finding errors and the government is overstating improvements to HealthCare.gov, The New York Times reported. In some cases, for instance, the home address for a new policy holder was outside the insurer’s service area. Or a child was listed as the main subscriber — the person on the hook for premiums — with parents listed as dependents. Or people were listed two or three times on an application, which could mean higher premium payments.
Looming question: How many people have gained coverage versus those who have lost it? No one knows — yet. HHS is fond of boasting of rising numbers of people who have signed up for coverage, but officials don’t keep track of how many have paid premiums to start coverage.
One thing is certain: Most states lag behind in their Obamacare sign-up goals. The National Review Online reported this week that 45 states haven’t yet hit 10 percent — 10! — of their enrollment goals. In Illinois, a paltry 7,043 people have signed up, hardly a dent in the state’s goal of 300,000 by the end of March.
Well, at least Chicago isn’t Guam — and that actually matters. The Washington Post reports today that the Affordable Care Act was written poorly (shocker!) and only parts of it apply to US territories such as Guam and the Northern Mariana Islands:
Because of a quirk in the Affordable Care Act’s drafting, the Northern Mariana Islands and the four other American territories are subject to some parts of the law but not others. This has messed up the individual market in the Northern Mariana Islands so badly that the one plan selling policies there told the territory’s top insurance commissioner it would not sell new plans for 2014.
In other words: Beginning Jan. 1, regulators expect it will be literally impossible for an individual to buy a new policy in the Northern Mariana Islands, and difficult in other territories. …
The problem, in its simplest form, is this: While the Affordable Care Act requires health insurers in the territories to accept all shoppers no matter how sick, it does not mandate that all territorial residents buy plans nor does it provide subsidies to make coverage more affordable–as it does in the 50 states and the District of Columbia.
This is, to put it mildly, a really bad way to run an insurance market. The whole idea of the subsidies and the mandate was to encourage enrollment among the healthier, younger people necessary to support an insurance market that also works for the sick. Without them, experts expect only sick people will enroll–and premiums will skyrocket. It’s like building a house with a roof but no walls.
Actually, the entire ObamaCare law is based on a flawed idea that top-down federal government control is the best way to “run an insurance market.” Every bad consequence that has developed flowed out of that assumption, when the supposedly central issue of the uninsured-by-circumstance was relatively narrow and could have been resolved with a much more modest approach without disrupting the rest of the market. In my column for The Fiscal Times, I explain that this is how we’ve gotten to shotgun weddings to avoid asset seizures, and begun tipping over Guam in a figurative sense:
That’s one of the problems of Obamacare itself – the perception that it’s a free lunch. Even those who do qualify for subsidies get that only through the collection of a myriad of taxes imposed by Obamacare. Those taxes apply to employers, insurers, and medical-device manufacturers, which drive up the costs for consumers and workers in indirect ways. It’s a shell game–not a reform that actually drives costs down. Instead Obamacare only masks price increases through dishonest opacity.
The problem here is the arrogance of the solution itself. Had the Obama administration focused on just those who could not get coverage because of income or pre-existing conditions, they could have expanded Medicaid in an intelligent manner while protecting existing assets, without disrupting the rest of the market.
That might still have been controversial and would not have been cost-free by any means, but it would not have fatally undermined a system that worked for 85 percent of Americans and misled many of the rest into risking their estates without any warning that government would strip their heirs of family homes.
Targeted and modest solutions minimize unintended consequences, and allow for more speed and efficiency when they do arise. Obamacare will serve for decades as the cautionary tale when arrogance rules over modesty and common sense.
Legislate in haste (and bulk), repent at leisure.
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