LOS ANGELES, September 16, 2013—The Oct. 1 Obamacare implementation date looms large, yet many Americans are still befuddled, confused, and insecure about this complicated piece of legislation that was meant to simplify healthcare and make it more accessible and affordable.
Others aren’t confused or insecure—they are just dead-set against it. According to polls by NBC/WSJ, USA Today/Pew, and Rasmussen, disapproval of the law is at 53 percent. The law continues to not live up to its press, and some of its staunchest supporters are now changing their tune. The AFL-CIO passed a resolution on Sept. 13 formally criticizing Obamacare, stating it would drive up the cost of health care plans rather than stabilize or lessen them. Among its complaints is the loss of coverage for its part-time members who are being cut loose from association healthcare plans and absorbed into the Obamacare exchanges. These are benefits unions fought long and hard for, and they will more than likely lose members because these sweetened benefits can no longer be used as an incentive for maintaining union representation.
Large employers like Trader Joe’s are also removing their part-time workers from the company’s health insurance in order to offload them onto the exchange. Think Progress considers this an indication that Obamacare is working as it should. Companies like Trader Joe’s, Costco, and Starbucks are just being “good corporate citizens” by offering health insurance to a sector of the workforce that generally does not receive it. “Now, employers like Trader Joe’s don’t have to offer health coverage to Americans at these income levels anymore. That’s because the employees will soon have a place to buy affordable insurance: Obamacare’s statewide marketplaces,” says Think Progress writer Sy Mukherjee.
Sarah Kliff over at Washington Post’s WonkBlog also spins optimism about Trader Joe’s move, and what it means for the workability of the overall plan:
“As for what Trader Joe’s decision means for the health-care law, that’s not totally clear either. On the one hand, it likely makes the health law more expensive: Trader Joe’s is essentially shifting the costs it used to pay for health insurance onto the federal government. On the other, bigger marketplaces are good for the health law. More subscribers make it more likely that insurers will want to sell and, if Trader Joes’ employees tend to be younger, they’ll likely help hold down the cost of premiums there.”
Both writers reach their conclusions on two premises: 1) The competitive environment of the exchanges will make insurance affordable enough for part-time/partially employed individuals, and 2) The amount of subscribers (particularly young subscribers) will keep costs down.
Both these premises are untested, and unclear. As reported by Entrepreneur magazine, the competitiveness of the exchanges has not yet manifested. In Washington State, there was not even enough interest from insurance carriers to launch a statewide small-business exchange for 2014. Other states are seeing major carriers take a “wait-and-see” approach, or removing themselves from the individual and small business marketplace altogether. United Health Care and Aetna did just that in California, leaving close to 60,000 policyholders out on a limb.
As for an influx of young subscribers helping to mitigate costs and bringing them down, this is not only unproven, but negligible. The Department of Health and Human Services (HHS) is relying on 2.5 million young, healthy people to enroll in the exchanges come Oct. 1. Since August, there has been a massive public relations push, social media campaigns, and a whole lot of reporting about the support of the 20-35 set for this law’s implementation. Theories always sound great and often get blanket agreement; the actual nuts and bolts of the costs of making that theory a reality, not so much.
Today’s Kaiser Health News reports that young people are mostly still in the dark about Obamacare. With the massive media blitz, being willfully uninformed is difficult—but apparently this is the result. The Atlantic decided to do a “scientific survey” with members of the company’s Fellows program; comprised of young people who fit the demographic HHS is trying to reach. HHS teamed up with an advocacy organization to hold a YouTube contest, giving away cash prizes to those who best made the case. The Atlantic used the entry of early bird winner Jason Girouard as a test gauge and came to this conclusion: “Thinking about it in the abstract, sure, sounds smart. But actually putting money on the line? Less enthusiasm. Not even a semi-amusing YouTube video does much to change their minds on that.”
The last thing on my mind in my 20s was health insurance. When it was supplied, it was useful. When it was lacking, didn’t blink an eyelash. As indicated by the Kaiser and the Atlantic Wire reports, not much has changed over a generation. So we are basing the success of an entire health system overhaul on convincing a tricky demographic that it is not only necessary for them, but for the well being of their fellow citizens and their country. Good luck with that.
These untried exchanges also create a new point of concern: Fraud. John Breyault, vice president of public policy for the National Consumer League said that the Federal Trade Commission has received more than 1,100 fraud and scam complaints since May. Apparently identity thieves are hard at work trying to compromise individual privacy where each person’s health information is concerned. The exchange will require that millions of Americans provide personal health and financial data; an abundant ground that is ripe for fraud, abuse, and malfeasance.
Despite reassurances from the Centers for Medicare & Medicaid Services (CMS) that the system will be safe and reliable, this entity that will be responsible for verifying, disseminating, and protecting your data has presented little detailed testing reports or documentation to prove this. As reported by ABC News, an Inspector General report stated that the chief information officer for CMS will not sign off on data security until Sept. 30—one day before the exchanges are scheduled to begin enrollment. We have yet to see whether this close shave between formation and implementation will turn out for good or for ill. From my years of information technology and program rollout experience, the potential leans toward the latter.
Last August, California said it would consider a soft launch of its Obamacare online health insurance exchange if tests of the new system were not ready for primetime. Its potential backup plan: Using “aided enrollment” where counselors help California residents sign up over the phone or in person. Once again, this opens the door for increased fraud and abuse, and California already has its share.
None of this is simple, and on that basis alone, the law has failed. The Unions, Republican House members, and a growing number of doctors may be right. Delay or repeal would be in the best interest of the country.
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