First wave of Obamacare destroys single practice doctors

[Valin]

BUSY HANDS ARE HAPPY HANDS!

HHS releases 1,296 pages of regulations ahead of holiday weekend
Philip Klein
July 3, 2014

As Americans scrambled ahead of the July Fourth holiday weekend on Thursday afternoon, the Department of Health and Human Services released 1,296 pages of new regulations dealing with payment rates to doctors and hospitals.

The timing of the news release is part of a long pattern for President Obama's administration, which has often used holidays as an opportunity to dump dense regulatory changes when most reporters and Americans are focused on their holiday plans.

The release came at 4:15 p.m.

(Snip)


H/T Power Line

[clearvision]

 

BUSY HANDS ARE HAPPY HANDS!

HHS releases 1,296 pages of regulations ahead of holiday weekend

Philip Klein

July 3, 2014

 

As Americans scrambled ahead of the July Fourth holiday weekend on Thursday afternoon, the Department of Health and Human Services released 1,296 pages of new regulations dealing with payment rates to doctors and hospitals.

 

The timing of the news release is part of a long pattern for President Obama's administration, which has often used holidays as an opportunity to dump dense regulatory changes when most reporters and Americans are focused on their holiday plans.

 

The release came at 4:15 p.m.

 

 

 

That was a hard call to make..... GOV WILL RELEASE STUFF JULY 4TH WEEKEND

[Draggingtree]

Massive amounts of “inconsistent data” remain irreconcilable. ObamaCare: A ‘Signature Achievement’ of Unaccountable Bureaucracy

By Arnold Ahlert July 4, 2014

A little over a week ago, reports surfaced revealing that the so-called “back end” of the Healthcare.gov website remained months away from being completed. On Tuesday, the consequences of that ongoing fiasco were revealed. A pair of reports released by the Department of Health and Human Services’ (HHS) Office of Inspector General (OIG) reveal “internal” controls for evaluating healthcare applications are ineffective, and 85 percent of 2.9 million data “inconsistencies” on ObamaCare applications cannot beresolved, even after nine months of attempting to do so.

 

 

“The federal marketplace was generally incapable of resolving most inconsistencies,” one OIG report said. “Without the ability to resolve inconsistencies in an applicant’s eligibility data, the marketplace cannot ensure that an applicant meets each of the eligibility requirements for enrollment in a QHP [qualified health plan] and when applicable, eligibility for insurance affordability programs.”

 

For clarity sake it should be noted that 2.9 million inconsistencies does http://canadafreepress.com/index.php/article/64310

[Valin]

An Unfolding Fiscal Disaster

The calamitous finances of Obamacare.

CHARLES BLAHOUS

Jul 14, 2014, Vol. 19, No. 41

 

(Snip)

 

CBO currently estimates that the ACAs coverage provisions will cost the federal government $92 billion a year by FY2015. This is roughly 0.5 percent of projected U.S. economic output for 2015, well exceeding the relative costs of Social Security and Medicaid at similar points in their histories. (The amount falls just short of the proportion of GDP absorbed by all of early Medicare.) Worse, the federal fiscal position was far weaker when the ACA was passed than when Social Security, Medicare, and Medicaid were created.

 

Troubling though the ACAs startup costs are, they represent only the tip of the fiscal iceberg that will be the fully phased-in law. CBO projects that its annual costs will hit $200 billion by FY2020, or nearly 0.9 percent of GDP. Yet this assumes that lawmakers will be content to allow the ACAs health insurance subsidies to grow more slowly than low-income beneficiaries health care costs, as the law now stipulates. Thus there is every reason to believe that the ACAs eventual costs will far exceed initial estimates, as happened with Social Security, Medicare, and Medicaid.

 

No sooner was the ink dry on the ACA than the laws various pay-fors began to be tossed overboard, one after the other. The ACAs CLASS Act (Community Living Assistance Services and Supports, a long-term care program) was financially unsound from the beginning, had to be suspended a little over one year later, and was eventually repealed. The original CBO score had assumed that CLASS would provide $86 billion of net financing for the ACA over the first 10 years.

 

(Snip)

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[Valin]

HHS Audit Finds Security Weaknesses in New Mexicos Obamacare Exchange

An inspector generals audit found information-security weaknesses in the states system.

Jillian Kay Melchior

July 8 2014

 

 

A federal audit has found information-technology security weaknesses at New Mexicos health-insurance exchange, according to records obtained by National Review Online.

 

The final audit report was completed by June 17, 2014, but because it contains such specific information about vulnerabilities, it is not public, according to a letter sent from the Department of Health and Human Services Office of Inspector General (DHHS OIG) to the health exchange.

 

Mike Nuñez, the interim CEO of the New Mexico exchange, tells NRO, The audit identified some high and critical issues that need to be addressed with our vendor.

 

(Snip)

[Draggingtree]

Dr. Ben Carson’s alternative to Obamacare – Part Three

By: stridentconservative (Diary) | July 10th, 2014 at 01:04 PM

In the usual back and forth between the Democrats who want socialized medicine and the rest of the world who don’t, the Saul Alinsky-ites of the left often rail about the lack of an alternative from the Republicans. Besides the fact that this is total bovine fecal matter—Bobby Jindal’s proposal for example—there have been many alternatives offered to improve our previous system without nuking it and turning it into a system like the one that brought you the V.A. scandal.

 

As the new chairman of the Save Our Healthcare Project (a part of the American Legacy PAC), Dr. Carson is releasing a five-part series on how we can get rid of Obamacare and replace it with something that might actually work:

 

Part Three (see below for links to previous episodes) of the Save Our Healthcare “Remedy for a Free & Healthy America” is Access for Every American.

 

 

https://www.redstate.com/diary/stridentconservative/2014/07/10/dr-ben-carsons-alternative-obamacare-part-three/

I seen some Ben Carson’s articles before but never brought any interest to me.

[Valin]

Week ahead: Ruling looms in O-Care subsidy challenge

Elise Viebeck

07/14/14

 

This week promises a slew of healthcare news between the courts and Capitol Hill.

 

An ObamaCare court ruling could dominate the week if plaintiffs succeed in convincing a judge that the Affordable Care Act does not allow federally run insurance exchanges to distribute premium subsidies.

 

The case, Halbig v. Burwell, has the potential to blow a hole in the healthcare laws coverage scheme and deal a serious loss to the Obama administration, though few legal experts believe it will succeed.

 

The D.C. Circuit Court of Appeals could issue its ruling as early as Tuesday, and conservatives are hoping that an eventual win will prevent the law from becoming further entrenched.

 

(Snip)

[Geee]

Government Spending on Health Care Projected to Rapidly Increase

 

One of the biggest contributors to the nation’s spending crisis is federal spending on government health care programs, according to the Congressional Budget Office’s Long Term Budget and Economic Outlook projections released this week. And Obamacare only exacerbates that problem.

Here are the main takeaways:

Health spending is projected to surpass all other government programs.Federal spending on Medicare, Medicaid, the Children’s Health Insurance Program (CHIP), and exchange subsidies will grow from 4.8 percent of gross domestic product (GDP) in 2014 to 8 percent of GDP 25 years from now, exceeding all other categories of spending.

Obamacare’s new spending is the biggest factor contributing to federal health spending growth over the next decade.Obamacare’s exchange subsidies and Medicaid expansion are projected to account for 62 percent of the increase in health care spending through 2024. This means Obamacare’s spending accounts for more than even the aging population and excess health care cost growth. In addition, the CBO projects that about 20 percent of federal spending on major health care programs in 2024 would finance care for nonelderly able-bodied people.

http://dailysignal.com/2014/07/16/government-spending-healthcare-projected-rapidly-increase/

[Valin]

Liberal Analysis: 'Obamacare Implementation Went Great and People Love It'
Guy Benson
Jul 18, 2014

When Ezra Klein and friends launched Vox as an "explanatory journalism" site this spring, conservative catcalls and ridicule began promptly. The project's critics have been vindicated time and again. Though the site sometimes produces solid content, it's run by hard-left ideologues who lack the capacity to present "just the facts, ma'am"-style reporting. Over the last 24 hours or so, Vox has beclowned itself on four separate occasions. First, see Mollie Hemingway's brutal take-down of co-founder Matt Yglesias' stupefyingly ignorant attack on conservatives and religious liberty. His asshattery was so acute that even a junior Vox colleague publicly rejected Yglesias', er, "point." Confronted with facts, Yglesias retreated into the realm of non-sequiturs and snark. A separate Vox post suggested that even though Hamas is using human shields to protect their terrorist arsenal and leaders -- a point conceded by the author, and again confirmed by very recent events -- Israel "doesn't have to bomb them." This sharp take demands that Israel lie back and endure a terrorist bombardment, while rewarding its enemy's inhuman tactics with pointless, suicidal "restraint." On healthcare, Yglesias was back at it with a piece whose title I quoted in the headline. It's only partially tongue-in-cheek, a riff on one of his most infamous Obamacare tweets:

 

(Snip)

 

In yesterday's "anaylsis," Yglesias congratulates himself for having been "pretty much right." His evidence is Gallup's finding that the US uninsured rate has dropped under Obamacare, plus a poll showing that most people with subsidized coverage through Obamacare's exchanges are at least "somewhat satisfied" with their plans. Ahem. At the Weekly Standard, Jeffrey Anderson explains how the law "misses its original target by half," and we've run through the reasons why the enrollment numbers are artificially and significantly juiced. Beyond those details, though, reducing the uninsured rate by passing a hugely expensive law that requires people to buy health insurance, and uses taxpayer money to buy it for a lot of people, doesn't qualify as a grand success. By a double-digit margin, more Americans were hurt by the law than helped by it. The "satistfaction" chart Yglesias presents fails to mention that people who were booted off of their existing coverage (in violation of a core political promise) are much, much less likely to be pleased with their new deal. And his "people love it" happy talk entirely ignores widespread and enduring public disapproval of the law. Some people, a very specific subsection of the population, do love Obamacare. Most people do not, thanks in large part to the shattered promises and lies employed by people like Yglesias in the selling of the law. By no reasonable definition has the implementation of Obamacare been "great." Indeed, Reason's Peter Suderman reports that major portions of Healthcare.gov still aren't built, and won't be until sometime in 2015:

 

(Snip)

 

 

______________________________________________________________________________________________________________________________________

 

What Can I Say, Except.......

 

[Draggingtree]

7/18/2014

Blogger Must Come Up With Non-Halbig Post Yet Again

Filed under: General — Patterico @ 7:51 am

UPDATE x2: This is odd as well: Obama administration says territories not subject to ObamaCare. I don’t follow their logic, as the law actually provides that territories are treated the same as states. Still, this seems worth noting. Time to move to the Virgin Islands?

http://patterico.com/2014/07/18/blogger-must-come-up-with-non-halbig-post-yet-again/

[Geee]

KING BARACK REWRITES OBAMACARE… AGAIN

 

Obamacare’s supporters have long insisted that it is the “law of the land,” implicitly suggesting that it is immutable and permanent. Evidently, it hasn’t occurred to these people to mention that to their dear leader. His Majesty, Barack I, obviously thinks of the Patient Protection and Affordable Care Act as a collection of royal decrees, any one of which may be altered at his pleasure. Thus, in a proclamation issued last week through the Centers for Medicare and Medicaid Services, His Highness declared that all U.S. territories are now exempt from most of PPACA’s morass of rules and regulations.

 

Neither he nor any other official of the executive branch possesses the constitutional authority to issue such an exemption to the territories, which include Puerto Rico, the U.S. Virgin Islands, American Samoa, Guam, and the Northern Mariana Islands, without first consulting Congress. In fact, one of His Majesty’s courtiers made that clear in a letter written a year ago to Sixto Igosomar, Secretary of Commerce of the Mariana Islands. Igosomar, like many of his territorial counterparts, had requested relief from Obamacare’s most destructive provisions and was advised that HHS had no authority to provide it.

http://spectator.org/articles/60016/king-barack-rewrites-obamacare%E2%80%A6-again

[Geee]

Doctors: Health care monopoly driving them out of business

 

Single-payer advocates promise high-quality low-cost health care for all.

 

But physicians in Vermont say the state’s move towards a single-payer health care system is driving independent doctors out of business and eliminating patient choice.

 

“The health systems have caused it to be nearly impossible from a financial standpoint to stay in private practice. That’s not so in the rest of the country,” Dr. Paul Reiss, a Williston family practice physician, told Vermont Watchdog.

 

“We’ve gotten to a place here in Vermont where we have about 20 percent independents, yet in the rest of the country 50 to 60 percent are independent practice.”

 

According to Reiss, the dwindling number of independent doctors in Vermont is due in part to underpayment from government health care programs.

http://watchdog.org/160743/vermont-health-care-monopoly/

[Geee]

Obamacare Architect Argued Years Ago That States Without Exchanges Can’t Get Subsidies

 

One of Obamacare’s authors said in 2012 that states that don’t set up their own Obamacare exchanges can’t offer residents subsidies, throwing heavy weight behind the argument that the billions in subsidies to federally-run exchanges are illegal.

Earlier this week two appeals courts heard arguments that the Affordable Care Act’s language doesn’t allow for subsidies in federally-run exchanges but answered the question differently. While the D.C. District Court of Appeals first found that the subsidies are illegal for the 36 states that didn’t create their own exchanges, the Fourth Circuit Court of Appeals said otherwise. (RELATED: Second Federal Court Rushes To Save Obamacare From Devastating Ruling)

But Jonathan Gruber, an economics professor at MIT who worked closely with the Obama administration to create and draft the health-care law, said as far back as 2012 that states that didn’t step up to make their own exchanges wouldn’t be able to offer premium subsidies.

http://dailycaller.com/2014/07/25/obamacare-architect-argued-years-ago-that-states-without-exchanges-cant-get-subsidies/

[Valin]

[Valin]

Well this is...disconcerting....for Democrats


Obamacare Architect: If A State Doesn't Set Up An Exchange, Its 'Citizens Don’t Get Their Tax Credits'
JOHN MCCORMACK
Jul 25, 2014

(Snip)

Obamacare's supporters have argued that it's foolish to think Congress didn't intend for Americans to get subsidies in states that didn't set up their own exchanges: They ignore the plain text of the law and point out that no member of Congress publicly made that claim while the law was being drafted. On the other hand, there isn't a record of any member of Congress saying before the bill became law that people would get subsidies outside of state exchanges.

But a newly-released video shows MIT professor Jonathan Gruber, widely acknowledged to be the architect of Obamacare, saying in 2012 that "if you’re a state and you don’t set up an exchange, that means your citizens don’t get their tax credits—but your citizens still pay the taxes that support this bill."



(Snip)

 

During a January 18, 2012 speech, Jonathan Gruber, one of the architects of Obamacare, was asked about health insurance exchanges. He states:

"In the law it says if the states don't provide them then the federal backstop will. The federal government has been sort of slow in putting out its backstop I think partly because they want to sort of squeeze the states to do it. I think what's important to remember politically about this is if you're a state and you don't set up an exchange that means your citizens don't get their tax credits. But your citizens still pay the taxes that support this bill. So you're essentially saying to your citizens, you're going to pay all the taxes to help all the other states in the country. I hope that that's a blatant enough political reality that states will get their act together and realize there are billions of dollars at stake here in setting up these exchanges and that they'll do it, but you know once again the politics can get ugly around this."

 

Speaking January 10, 2012 at the Jewish Community Center of San Francisco, Obamacare architect Jonathan Gruber states that insurance subsidies are tied to state-based exchanges.

[clearvision]

So just how involved was Gruber? "Widely acknowledged as the architect of" is not a term that will work well in Court.

It is pretty clear his early understanding of the law.

[Geee]

Another Stunning Admission in Gruber's Speech: The Public Option Was Single Payer

 

As I was watching the video clip of Jonathan Gruber talking about state-based exchanges and subsidies last night I came across another admission which deserves some attention. A few minutes later in the Q&A following his January 18, 2012 speech, Gruber admits that the public option was an attempt to slip single-payer into the Affordable Care Act.

 

So I like the public option. The public option is actually the brainchild of another academic, a guy named Jacob Hacker who's at Yale. And the public option, basically it was a clever idea. He said look, the left wants single-payer, the right wants competition--how about we have competition where the option is single-payer. It's kind of a clever way to call both sides bluff. Basically, since it was such a good idea that's why both sides didn't like it. Okay, the right didn't like it because they were afraid that the left was right and the single-payer would work. The left didn't like it because they were afraid that the single-payer didn't have enough teeth to really work. And basically, the public option, to be honest, was never going to happen. The public option was really something that was in there. It was a good idea as a debating point but it just was too radical. Remember, the reason this reform passed, as barely as it did, is because it was not trying to rip up things and start over. It was trying to work incrementally off the existing system. The public option was viewed as too radical.

http://www.breitbart.com/InstaBlog/2014/07/25/Another-Stunning-Admission-in-Gruber-s-Speech-The-Public-Option-Was-Single-Payer

[Valin]

 

[Valin]

Another Stunning Admission in Gruber's Speech: The Public Option Was Single Payer

 

As I was watching the video clip of Jonathan Gruber talking about state-based exchanges and subsidies last night I came across another admission which deserves some attention. A few minutes later in the Q&A following his January 18, 2012 speech, Gruber admits that the public option was an attempt to slip single-payer into the Affordable Care Act.

 

 

 

 

Single Payer is what the Left wants, it is always been their goal.

[Geee]

OBAMACARE WAS DESIGNED TO PUNISH UNCOOPERATIVE STATES

 

It all comes down to four crucial words. In 2009, as the Affordable Care Act was being rammed through the Senate, those words made their way into the statutory behemoth. The law says that the federal government has the power to dole out premium-lowering subsidies through those insurance exchanges “established by the State.” Now that thirty-six states have declined to set up exchanges, the implication is that those who purchase insurance from the federal HealthCare.gov website are, under the text of the law, ineligible for the tax credits. Their premiums would be much higher.

 

No one knows for sure how these four words made their way into the statute—which is to be expected. The 3,000-page bill was drafted quickly behind closed doors. Almost no one in the Senate bothered to read it. The version of the bill that passed the Senate on a straight party-line vote on Christmas Eve 2009 was only a draft that was never intended to become law. However, once Democrats lost their filibuster-proof majority after the election of Senator Scott Brown in Massachusetts, they decided to foist this incomplete, rushed, and unfinished draft on the American people.

 

All that said, these four words, if followed, trigger a devastating chain reaction in the Rube Goldberg-esque machinery of Obamacare. Without the tax credits, the unsubsidized premiums would be unaffordable to many. Further, because Obamacare’s mandates are tied to the subsidies, removing the latter eliminates the former. Meaning millions of Americans in thirty-six states would suddenly be exempt from the individual mandate, which narrowly avoided invalidation by the Supreme Court in 2012. In addition, many businesses would no longer face penalties for failing to provide their employees with health insurance. Without these two essential mandates, Obamacare would unravel.

http://spectator.org/articles/60093/obamacare-was-designed-punish-uncooperative-states

[Draggingtree]

Posted

 

July 29, 2014 - 12:01am

 

EDITORIAL: Affordable Care Act’s own words should be its undoing

 

LAS VEGAS REVIEW-JOURNAL

The Democrats who forced the Affordable Care Act on the American public are predictably outraged that Obamacare appears headed back before the U.S. Supreme Court for another make-or-break appeal on a pillar of the legislation. But for the Obama administration to prevail once more, the justices will have to follow the president’s lead in ignoring the letter of the law.

The latest legal challenge to Obamacare addresses the health insurance subsidies that have propped up the country’s tepid pursuit of coverage mandated by the law.

http://www.reviewjournal.com/opinion/editorial-affordable-care-act-s-own-words-should-be-its-undoing

[Valin]

Medicare Actuary Throws Cold Water on ACA Cheerleaders
July 29, 2014

Health care wonks are very excited this week that Medicare is now expected to go bankrupt four years later than previously predicted. To the rest of us, a slightly later bankruptcy may not seem too encouraging, but those on the left have been quick to attribute Medicare’s somewhat-extended lease-on-life to structural reforms put in place by the ACA. There’s no consensus among the experts about what the main cause of this shift is. But even if you think it’s the ACA, there’s now a further problem complicating ACA cheerleading. Paul Spitalnic, the chief actuary for the Centers for Medicaid and Medicare Services, has come out claiming that the ACA’s Medicare changes aren’t sustainable.

He’s particularly critical of the cuts in Medicare reimbursement rates built into Obamacare. Providers simply won’t be able to afford those cuts as long as it remains as labor intensive to deliver care as it currently is. More, via The Washington Times:

(Snip)

 

Spitalnic is right to note that policies like tinkering with reimbursement rates won’t solve the health care crisis unless new technologies (like digital consultations) and approaches (like empowering nurse practitioners) revolutionize service delivery. That revolution will help our health care system the most, and policy makers should work to facilitate it.

[Geee]

OBAMACARE’S PROGNOSIS WORSENS

 

while back, I suggested in this space that Obamacare might go the way of McCain-Feingold. That campaign finance “reform” law was not, you will recall, killed by a single lawsuit or act of Congress. Indeed, the general consensus at the end of 2003 was that McCain-Feingold was in perfect health. Less than seven years later it was, for all intents and purposes, dead. It had succumbed to a long series of attacks by determined opponents who were convinced that it was unconstitutional. Much the same thing is obviously happening to PPACA.

 

This view runs contrary to the conventional wisdom, of course. Most pundits and politicians, including a number of libertarians and conservatives, believe that Obamacare enjoys a good long-term prognosis. That perspective is typified by Avik Roy, who assured his readers after last week’s Halbig v. Burwell ruling, “Obamacare is not on the verge of collapse.” Obviously, PPACA isn’t going to drop dead tomorrow. But Roy, like other subscribers to the wisdom of the crowd, ignores the cumulative ill effect of multiple surgeries by Congress and the courts.

 

Congress has already been compelled to repeal a number of Obamacare’s provisions. In April 2011, for example, it killed the notorious “1099 mandate.” This provision would have forced businesses to track and report to the IRS all purchases over $600. The law’s so-called “free choice vouchers” were also eliminated at that time. Another welcome repeal came in 2013 when the CLASS Act, ostensibly meant to provide long-term coverage for the elderly, was deep-sixed. And, in 2014, Congress got rid of Obamacare’s cap on deductibles for small group plans.

http://spectator.org/articles/60107/obamacares-prognosis-worsens

[Draggingtree]