Disturbing Obamacare Inequities
By Stephen Lendman
A previous article said March 23, 2010 will live in infamy. With strokes from 22 pens, Obama enacted the Patient Protection and Affordable Care Act (ACA).
It's a monstrosity. Rules and regulations run thousands of pages. Providing healthcare should be simple.
ACA complicates it enormously. It's rife with inequities. Households can't possibly understand its provisions. They have no say. They're forced to comply.
ACA is a scam. It's a ripoff. It's a healthcare rationing scheme. It's a boon to providers. They wrote the law. It lets them game the system for profits.
It makes a dysfunctional system worse. US healthcare is outrageously expensive. It's double the cost of other developed nations.
It's woefully inadequate. Obamacare leaves millions uninsured. It leaves millions more way underinsured. It makes US healthcare more than ever unaffordable.
It requires buying insurance or be penalized. In 2014, it's $95 per person up to 1% of family income, whichever is greater.
Fines increase sevenfold over the next two years. In 2016, it's $695 per person up to 2.5% of income, whichever is greater.
Exemptions apply for individuals and families meeting these requirements:
uninsured less than three months a year;
members of recognized Native American tribes;
income officially deemed too low;
lowest-cost coverage exceeding 8% of household income;
belonging to a recognized religious sect rejecting health insurance coverage; and/or
belonging to a recognized health-sharing ministry.
Obama granted 1,231 companies, organizations and Congress exemptions. They're for one year. Perhaps they'll be extended. Maybe they'll become permanent. They provide special benefits denied ordinary Americans.
Congressional members and staffs get healthcare through Federal Employees Health Benefits Plan (FEHBP) coverage. It affords dozens of options. It lets them choose what's best for them.
It subsidizes 70% of premiums. It does so tax free. For an additional fee, congressional members (excluding family members) can get special on-site Washington area military hospital Attending Physician treatment.
Obamacare's Section 1312 says the following:
"(T)he only health plans that the Federal Government may make available to Members of Congress and congressional staff with respect to their service as a Member of Congress or congressional staff shall be health plans that are, (1) created under (ACA); or (2) offered through an exchange established under this act."
At the same time, congressional members, their families and staffs qualify for tax-exempt subsidies. They're afforded special benefits denied ordinary Americans.
An August Office of Personnel Management (OPM) proposed rule was finalized in September. It maintains congressional subsidies.
It does so for lawmakers and staffs enrolling in a Small Business Health Options Program (SHOP). It's available in Washington. It's for businesses with less than 50 employees.
On October 22, the Washington Post headlined "Health co-ops, created to foster competition and lower insurance costs, are in danger."
Ostensibly they were created for increased competition. Doing so helps lower costs. They failed the test. They're troubled.
One coop closed. Another is struggling. Federal audits show nine more have financial problems.
"Their failure would leave taxpayers potentially on the hook for nearly $1 billion in defaulted loans and rob the marketplace of the kind of competition they were supposed to create," said WaPo.
"And if they become insolvent, policyholders in at least half the states where the co-ops operate could be stuck with medical bills."
Pressure from insurance industry lobbyists created what's not working. "(O)nerous restrictions" doom many coops to fail.
"Federal grants were converted to loans with tight repayment schedules."
Coops "were barred from using federal money for crucial marketing."
"(T)hey were severely limited from selling insurance to large employers. " They're the most lucrative customers.
Obama officials approved limited coop funding. It was "cut to a small fraction of what experts told Congress" was needed to assure their viability.
Coops initially were meant to be nationwide. Only two dozen began operating. They differ from traditional insurers. They're nonprofit.
Onerous rules hamstring them. They're troubled. They're scrambling to survive against long odds.
According to Johns Hopkins School of Public Health Professor Karen Davis:
"One provision after another got stuck in there to limit their probability of success."
"It's a little ironic to say you are for competition in the free market and then you don't make it easy for new entrants."
A system ostensibly created to help ordinary Americans was designed to fail.
Earlier US coop experiments were "littered with failures," Davis added. Insurance giant lobbying assured it. This time appears no different.
Former Baltimore health commissioner Peter Beilenson is Evergreen Health Co-op CEO. He calls obstacles he faces "by far the most challenging (ones) (he's) been involved with in (his) 21-year career."
Evergreen is financially troubled. It's heavily debt burdened. Its solvency is in doubt. The entire coop experiment looks headed for failure. Obamacare rules bear full responsibility.
They mandate fining nonprofit hospitals for providing free healthcare. They're covered under ACA's Section 501c3. They're required to meet four specific requirements to maintain tax exempt status:
Conduct periodic community health needs assessments (CHNA).
Provide written financial assistance and emergency care policies.
Establish charge limitations for emergency or medically necessary care; and
Set policies and procedures related to billings and collections.
America has nearly 5,000 community hospitals. Around 2,900 are nonprofit. Complying with Section 501 isn't easy. Doing so involves considerable time and expense.
Obamacare imposed enormous burdens. Penalties for noncompliance are $50,000 annually. Multiple hospital organizations face larger fines.
Most serious is potential loss of nonprofit status. Losing exemption makes them subject to numerous federal, state and local taxes.
They'll no longer be able to issue tax-free bonds. Charitable fundraising will be denied.
Obamacare requires everyone other than above listed exemptions buy health insurance. It's no longer an option. It's to enrich insurers. It's to discourage charity.
Nonprofit hospitals are endangered. Henceforth, they must prove their service is needed. They must satisfy Obamacare mandated rules. They're overseen by IRS bureaucrats.
Failure to comply risks losing tax exempt status. Eliminating nonprofits affords insurance giants greater profit opportunities. They wrote Obamacare rules to assure them.
They're complicated and disturbing. Healthcare experts believe it's hard to impossible for charitable hospitals to properly comply.
Lewis and Roca law partner D. Douglas Metcalf questions whether they'll survive, saying:
They "should be advised that the new (ACA) requirements will play a significant role in how they operate and report, specifically when it comes to billing and collections for services provided to the uninsured."
"The new law leaves many gray areas, and hospitals themselves will have to establish eligibility criteria for financial assistance."
"Following the new procedures as best they can will ensure the best chance of maintaining their tax exempt status."
Doing so won't be easy. Many may fail the test. Obamacare perhaps planned it that way.
Less competition lets insurance giants game the system advantageously. Doing so means higher premiums. Imposing them assures greater profits. Coverage becomes less affordable.
Millions of Americans will be shut out. They'll be without vital healthcare when most needed. For many it's pay or die. Obama bears full responsibility.
Stephen Lendman lives in Chicago. He can be reached at firstname.lastname@example.org.
His new book is titled "Banker Occupation: Waging Financial War on Humanity."
Visit his blog site at sjlendman.blogspot.com.
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