No Runny Eggs

So the Republican plan to “repeal” and “replace” PlaceboCare 2.0 is out. Those of us who dreaded what would result once the words “and replace” were appended to the 7-year-old slogan were right. Allow me to quote Philip Klein:

Barring radical changes, Republicans will not be passing a bill that ushers in a new era of market-based healthcare. In reality, the GOP will either be passing legislation that rests on the same philosophical premise as Obamacare, or will pass nothing at all, and thus keep Obamacare itself in place….

But at the same time, the GOP bill preserves much of the regulatory structure of Obamacare; leaves the bias in favor of employer healthcare largely intact, replaces Obamacare’s subsidies with a different subsidy scheme, and still supports higher spending for Medicaid relative to what was the case before Obamacare.

Ultimately, it doesn’t do much to foster the development of a free market system. Under GOPcare, individuals would not be able to take insurance with them from job to job, because tax credits would not be available to people who have an offer of job-based insurance. They would not be able to purchase whatever plan they want, because the federal government will still be dictating what has to be in insurance policies, making insurance more expensive then it needs to be. If this bill passes, everybody would have to get their insurance either through government, their employer via tax subsidy, or be left to purchase government-designed health policies using federal subsidies.

Those are not the only elements of PlaceboCare 2.0 that are planned to survive the transition into PlaceboCare 3.0-Platinum Edition. Sen. Rand Paul and Rep. Mark Meadows point to a few other very troubling items that survived the platinum coating (formatting errors in the original fixed):

2. Leadership wants to keep the ObamaCare Cadillac tax but rename it a tax on the top 10% of people who have the best insurance.

3. Leadership wants to keep the individual mandate but instead of mandating a tax penalty to the government they mandate a penalty to the insurance company. (Can it possibly be Constitutional to mandate a penalty to a private insurance company?)

4. Leadership wants to keep $100 billion of the insurance company subsidies from ObamaCare but call them “reinsurance”. (Why? Because insurance companies love guaranteed issue as long as the taxpayer finances it!)

Should we have expected anything else from the party that got elected as President a fan of single-payer health care? Should we have expected anything else from the party that ran, in the Presidential election immediately after the adoption of PlaceboCare 2.0, the guy who created PlaceboCare 1.0? Should we have expected anything else from the party that got the federal government into the senior-citizen drug insurance game 7 years prior to PlaceboCare 2.0?

No wonder why I’ve gone radio silent. I got tired of being played and betrayed.

I wonder whether this counts against the 80 million-100 million of those with existing group health insurance plans expected to lose said insurance by the end of 2014:

For 75 million Americans who get their insurance through large companies, the Affordable Care Act is a mixed bag. Experts tell NBC News the new healthcare law is only slightly increasing premiums next year, but causing some companies with the most generous plans to reduce their employees’ benefits.

Aaron Baker, 36, his wife Billie and their two young children are covered under a generous health insurance plan offered by the private Midwestern university where he’s worked for 10 years. When they opened their benefits notice this year, they were pleased to see their $385 premium is only up by four dollars next year. However, they were shocked to discover that instead of covering the first dollar they spend with no deductible, the Baker’s plan now includes a $1,000 deductible and a $2,500 out of pocket maximum. They also will still have small co-pays for services.

According to the enrollment notice, the changes are “to relieve future health plan trend pressure and to put the university in a position to avoid the excise tax that becomes effective in 2018.” The 40 percent excise tax—often called the “Cadillac tax”— is part of Obamacare and is levied on the most generous health plans. It’s designed to bring down overall health costs by making companies and workers more cost-conscious. The thinking is that if consumers have to pay more expenses themselves, through higher deductibles and out-of-pocket expenses, they’ll avoid unnecessary or overly costly procedures. And that is supposed to make care more affordable for everyone.

I have to quibble with NBC’s analysis of the PlaceboCare Cadillac plan tax – it’s designed not to drive down costs, but to ensure that, except for the favored nomenklatura, nobody gets high-quality care. I am frankly surprised that some entities, specifically the non-union shops that are the primary targets, are reacting 4 years early.

That will just make the eventual repeal at the behest of the unions, which by 2017 will be essentially the only places still offering group health insurance, that much more odious.

You heard the rumblings here last week about the Obama administration looking into administratively rewriting their signature law one more time to benefit those who can’t use their PlaceboCare exchange website by 2/15/2014. Yesterday, they made it official. From the AP:

The extension — granted for 2014 only — addresses confusion that was created when the administration set the first open enrollment period under the law from Oct. 1-March 31.

The problem was that health insurance coverage typically starts on the first day of a given month, and it takes up to 15 days to process applications. So somebody signing up March 16 — well within the open enrollment period — wouldn’t get coverage until April 1, thereby risking a penalty for being uninsured part of the year.

While there is a limited authority for HHS Secretary Kathleen Sebelius to grant individual waivers from the ta…er…penalty, the key word is “limited”. Specifically, that authority extends only to those who have “no affordable qualified health plan available through the Exchange, or the individual’s employer, covering the individual”, or to those covered by the other, specified exemptions from the individual mandate. Mere “glitches” and general failures of the exchange website do not qualify as a complete lack of available plans.

Unless you’ve been in a cave watching NBCCBSABCCNNPMSDNC or reading the NYTWaPoLATUSATodayYourLocalPaintcatcher, you know that we’ve entered the third week of EPIC FAIL of PlaceboCare’s exchange website. Not two weeks after they torpedoed the GOP’s “fallback” position of a 1-year delay in the individual mandate to buy PlaceboCare “coverage”, Democrats have started calling for a “delay” until the exchanges are actually up and running, a process that likely will take months.

The early response from Team SCOAMT:

BREAKING: NBC News has learned the WH intends to delay the deadline requiring every American to buy health insurance by as much as 6 weeks

— NBC Nightly News (@nbcnightlynews) October 23, 2013

Before I continue, I need to explain a couple things. Health insurance is sold by the month, with coverage beginning on the first day of a month. In order to get coverage for the following month, one must complete the application process 2 weeks prior to the month.

There is a ta…er…penalty for not having PlaceboCare “coverage” (the greater of $95 or 1% of one’s adjusted gross income for 2014, payable when one files one’s 2014 income tax return in winter/spring 2015), with a 2-consecutive-month grace period for non-“coverage”. That means, at least according to the state of law when the sun rose this morning, one had to complete their PlaceboCare exchange application by February 15 to get coverage for March and thus not pay at least 3 months’ worth of ta…er…penalty. Since PlaceboCare’s 2014 open-enrollment period ends on March 31, that is the last day one can avoid paying the full 2014 ta…er…penalty, but one would still be liable for 4 months’ worth of the ta…er…penalty because they wouldn’t have “coverage” until May 1.

Now, I can continue. There was some confusion on whether the “6-week delay” would be an extension of the PlaceboCare open-enrollment period until mid-May or an increase in the “grace” period described above. I’ll let Phillip Klein explain why administratively extending the administratively-set end of the open-enrollment period is illegal.

NBC News later clarified what Team SCOAMT was talking about:

As the law stands now, individuals are expected to begin the application process via HealthCare.gov by Feb. 15 to avoid a financial penalty. But under the prospective change, individuals will be expected to have started enrollment by March to avoid incurring the penalty.

It figures that they would go with the more-blatantly-illegal route. 26 USC § 5000A (e) (4) specifically proscribes the exemption from the ta…er…penalty for those with “short coverage gaps”:

(4) Months during short coverage gaps

(A) In general
Any month the last day of which occurred during a period in which the applicable individual was not covered by minimum essential coverage for a continuous period of less than 3 months.

(B) Special rules
For purposes of applying this paragraph—

(i)the length of a continuous period shall be determined without regard to the calendar years in which months in such period occur,

(ii)if a continuous period is greater than the period allowed under subparagraph (A), no exception shall be provided under this paragraph for any month in the period, and

(iii)if there is more than 1 continuous period described in subparagraph (A) covering months in a calendar year, the exception provided by this paragraph shall only apply to months in the first of such periods.
The Secretary shall prescribe rules for the collection of the penalty imposed by this section in cases where continuous periods include months in more than 1 taxable year.

In short, the United States Code, which prior to Teh SCOAMT’s ascension to the Oval Office, trumped administrative decisions, mandates that those without PlaceboCare “coverage” for more than 2 months must be ta…er…penalized. Of course, in the ObamiNation, Teh Royal Team SCOAMT decrees override any and all laws or provisions of the Constitution.

1-800-F1UCK YOU (or for those of you who can’t spell on a phone handset, 1-800-318-2596, with the 8-for-U not necessary).

What, were 1-800-382-5968 (FUCK-YOU), 1-800-358-5936 (FLUKE YOU, courtesy Myron Falwell in the comments section of Duane Patterson’s piece), and all the 888/877/866/855 variations of those two taken? Then again, Fluke does rhyme with fuck, so HHS might be counting on the low-information voters needing to L33T-spell phonetically.