Obamacare - Broken Promises

Obama promised change. Not so sure I like the change we got.

Obama promised to lower the cost of health insurance by $2500 per year.

So far, all we have is higher insurance premiums.

Obama promised to eliminate "discrimination" against children by health insurance carriers.

What we got was the elimination of child only health insurance plans.

Obama promised free preventive care and free contraceptives.

What we got was higher premiums to offset the cost of "free" care.

Obama promised not to raise taxes.

"Under my plan, no family making less than $250,000 a year will see any form of tax increase. Not your income tax, not your payroll tax, not your capital gains taxes, not any of your taxes.”

We already know how well this has played out here, here and here.

Now we hear about 7 new taxes imposed on those earning less than $250,000 per year.

Once in office, President Obama broke this pledge a mere 16 days into his administration when he signed a tobacco tax hike into law (industry statistics say that the average smoker earns less than $40,000 per year).

Then Obamacare hit the president’s desk. In signing that jobs-killing bill into law, he broke his promise to middle income families at least seven times.

The individual mandate has an excise tax for non-compliance of at least 2.5 percent of adjusted gross income. There is no exemption for families making less than $250,000 per year.

Oops! Probably just an oversight.

Apparently Chairman Obama pulls a Pelosi and does not read his speeches before he reads his speeches.

The medicine cabinet tax prevents families from using their health savings accounts (HSAs) or workplace flex-savings accounts (FSAs) to purchase non-prescription, over-the-counter medicines on a pre-tax basis. There is no exemption for families making less than $250,000 per year.

The “special needs kids” or “braces” tax puts a cap of $2,500 for the first time on FSAs. Prior to Obamacare’s passage, families with very high medical bills could put an IRS-unlimited amount in their FSAs to pay for things like special needs tuition or braces on a pre-tax basis. Obamacare changed all that. There is no exemption for families making less than $250,000 per year.

I believe those earning less than $250,000 would be classified as the 99% made infamous by Occupy (insert place here).

Finally, in 2018 Obamacare will levy a 40 percent excise tax on high-cost (“Cadillac”) health insurance plans — which will, of course, have to be built into the health insurance premium, making them even more expensive. As you might have guessed by now, there is no exemption for families making less than $250,000 per year.

Most folks with "Cadillac" plans are union members that have collectively bargained for . . . rich benefit health insurance plans.

Do you think anyone in the lame stream media will take him to task over these broken promises? Do you think the middle class, especially those that supported him in 2008, will take notice and vote for him again?

Let's hope they are much wiser this time or we are all sunk.

Contract Law vs ObamneyCare©

When I first posted on this late last month, I was skeptical that it would gain much traction.

As regards the (Evil) Individual Mandate that ostensibly free citizens must buy a product from a private vendor:

"[T]the age-old caveat that a contract entered into under duress is non-enforceable. Their stance is that, because insurance is, in fact, a contract, forcing one under penalty of law to sign on the dotted line renders it moot."

Now comes George Will, noting in the Washington Post that:

" [T]he elegant scholarship and logic with which it addresses an issue that has not been as central to the debate as it should be ... The individual mandate is incompatible with centuries of contract law. This is so because a compulsory contract is an oxymoron."

So maybe it is picking up steam.

Tax Break Jeopardy

D.C. is a sinking ship and they are looking for money from anywhere and everywhere. Based on this from Bloomberg, the biggest target is employer tax breaks.

With $1 trillion in tax breaks on the line, the biggest ones are in the employer market.

The Congressional Research Service report found the biggest tax break is likely to be valued at $164 billion annually in 2014 and is on employer-provided health insurance, while employer-provided pensions are the second-biggest exclusion at about $163 billion, the newspaper said.

The study said the most that might be gained in additional tax revenue from eliminating tax breaks was $150 billion, because of political opposition and technical hurdles, the newspaper said.

"I'll take employee benefits for $500, Alex".

Tax deductions and shelters for health insurance started during World War II as a result of union pressure on Congress. With wages frozen, union leaders lobbied Congress to grant special tax breaks so employers could increase wages (in the form of additional benefits) without taxation.

Will this 70+ year tradition of providing group health insurance on a tax favored basis come to an end?

Stay tuned.

Friday LinkFest

A veritable smorgasbord of interesting items:

■ First up, The Feds are starting to roll out new ObamneyCare© regulations in the hopes of answering lingering questions about implementation of this train-wreck.

Methinks they will generate more questions than answers.

■ FoIB Holly R sends us a pair of relevant stories. From The Atlantic, FoIB Avik Roy opines that ObamneyCare© proponents have it all wrong: the free market can provide the necessary answers to our health care financing and delivery woes.

■ She also tips us to the non-news that PresBo is still misrepresenting his own mother's health insurance "crisis;" apparently the man is incapable of differentiating between health insurance (which did, in fact, pay mom's health care bills) and disability insurance.

PresBo, lying? That's just crazy talk!

■ Bob D tips us to this little factoid:

"Computer Access to Patient Test Results Does Not Decrease Cost or Curtail Test Ordering"

So the digital age doesn't automatically cut costs? Hunh.

■ CareSource runs the Dayton (OH) Medicaid program; it's recently partnered up with Humana to "more effectively serve Medicare and Medicaid beneficiaries, particularly people who qualify for both programs." It's easy to see why Humana wants a piece of that action: they're a major player in the Cincinnati market, but not so much up the road here in Dayton.

■ And finally, loyal reader Patrick P points us to yet another Avik Roy piece, this one explaining the highly negative impact ObamneyCare© is already having on younger folks.

That's a wrap - Have a GREAT weekend!

Medicare Part D - What You Need to Know

Medicare Part D can be a snake pit if you don't understand how it works. Medicare Part D can be a blessing for some but a nightmare for others. Seniors age 65 and older are not required to buy a Medicare Part D plan, but if you don't and then later change your mind, you will be subject to a Late Enrollment Penalty (LEP) of 1% per month.

If you were eligible to buy a Medicare Part D plan when you turned 65 but waited 3 years to buy one, you would pay a LIFETIME PENALTY in 36% additional premiums.

Medicare Part D Traps and Penalties

In 2003, Congress enacted the Medicare Modernization Act that would forever change benefits, especially as it impacts the cost of prescription drugs. Did you know . . .

• Outpatient prescription drugs are not part of Medicare, but rather a private insurance product marketed and administered by health insurance carriers.


• Pharmacy Benefit Managers (PBM) negotiate pricing tiers for prescription drugs but the insurance carriers decide which drugs to include in their plan


• Insurance carriers also assign tiers and copays for the Prescription Drug Plan (PDP) as well as setting the premium you pay


• Medicare Part D is a voluntary plan but you will pay a penalty if you fail to enroll on a timely basis


• Once enrolled, you must remain in the plan until the next enrollment period BUT your plan can add or drop drugs during the year as they see fit


• Non-formulary drugs do not count toward your deductible or Rx out of pocket maximum

How do you enroll in Medicare Part D?

You should start by making a list of all your current medications by name. Include the dosage and how often you fill your prescription.

Next, use the Medicare Prescription Drug Formulary Plan Finder to determine which plan is best for you.

You can also call 1-800-MEDICARE and ask for assistance.

If you have a regular pharmacy, such as CVS or Walgreens, you can take your list of prescription drugs to your pharmacy and ask them for assistance in selecting a Medicare Part D plan.

Stupid Agent Tricks: Annuity and Jail

First, let me be clear that the (unfortunate) victim of this story, (former) insurance agent Glenn Neasham, is not stupid. From all accounts, his conduct was appropriate and aboveboard; he appears to be the victim of a vindictive and over-zealous prosecutor.

The "stupid" folks here are my fellow agents, who could give lemmings a run for their money (straight off a cliff). Stephen Forman, an agent himself, sums it up nicely:

"Should I not be optimistic that our fellow producers wish to band together and help Glenn Neasham? At first blush, you'd think so. But my experience in this industry leads me to believe the cavalry may not be coming ... I was only too happy to sign the pledge at America Needs Agents ... just over 1,100 have signed the pledge out of 228,000 health agents"

[ed: I just learned about the pledge and signed it; the current total is 1,136]

He goes on to list other, similar efforts, all doomed to failure because agents just can't be bothered to actually step up.

Now, you may be thinking: Henry, surely these are anomalies - agents care about their livelihoods, after all.

I wish.

Let me share my own experience in a similar situation. About 10 years ago, a major carrier decided to change their commission structure from a percentage of premiums to a flat per member fee. Fair enough. But they went a step further, making this change retroactive, in clear violation of the agent's agreement.

About two dozen of us met at a local restaurant to compare notes and plan strategy. One colleague brought along an attorney friend who specialized in arbitration. We agreed that we would proceed, in accordance with the agent's agreement.

One of the hats I wear is Continuing Education instructor, primarily for folks who work in the health side of the business. In that capacity, I had a fairly large contact list of agents all around the state, folks who would be directly impacted by this. I offered up my list, and we sent out a mass mailing to about 300 or so fellow agents, asking them to join us in our fight.

We got back maybe a handful of replies. In fact, by the time we eventually settled with the carrier, there were exactly 8 of us (out of the original 24 plus the additional 300 from the mailing) left standing.

Mind you, joining us would have required zero financial contribution, nor did we ask for any time or effort. Just some words of support.

Cue the sounds of crickets chirping.

So it comes as no surprise to me that Mr Neasham is left to twist alone in the wind, nor that out of hundreds of thousands of agents, less than one half of one percent can even be bothered to click a link and supply an email address.

So who's worse, the prosecutor or us?

Medicare Patients Have Trouble Finding Docs

Medicare patients are having trouble finding doctors willing to treat them. Every time the government cut's doctor reimbursements for Medicare patients, the doctor has to decide if they can afford to continue treating Medicare patients.

If you are on Medicare and need treatment you may run in to Dr. No . . .


If you just turned 65 you may be in for a surprise. Some doctors, including your family doctor, may not be taking any new Medicare patients . . . including you.

This Madison clinics decision to refuse new Medicare patients may be a trend.

Wertsch, a big guy with a droopy mustache who founded the clinic in 1977 with his wife and another graduate of the University of Wisconsin-Madison's family practice program, says he and the other 10 doctors who now manage and own the practice can no longer afford to provide that care to additional people on Medicare, who already make up a quarter of the clinic's caseload and up to 70 percent of the rosters of its older doctors, like him.

Medicare pays only a quarter to a third of every dollar the clinic charges, Wertsch says, often half of what private insurance carriers pay. When you figure that overhead for the clinic — which includes stuff like electricity, staff salaries, and a whopping $700,000 or so for the clinic's electronic records system — adds up to around 80 cents on the dollar, accepting Medicare is a losing proposition, he says. "I love taking care of Medicare patients," says Wertsch, 68. "But every time we treat them we have to dig into our wallets. What kind of business model is that?"

Read more: http://host.madison.com/ct/news/local/health_med_fit/madison-clinic-s-decision-to-stop-taking-new-medicare-patients/article_70520894-72c8-11e1-a7d0-0019bb2963f4.html#ixzz1pn2FyZ4y

We see and hear about this more often. Doctors lose money treating Medicare patients and have to make it up somewhere else.

That somewhere else is in the form of seeing fewer Medicare patients and more private insurance patients where the reimbursement for services rendered is considerably higher.

Most doctors accept Medicare asssignment but some are not taking on new Medicare patients. This can be even more challenging if you have a Medicare Advantage plan. Less than half the doctors in Georgia take ANY Medicare Assignment plan and even when you do find a doc willing to take Advantage plans they may not take yours.

Ask your doctor if they are taking new Medicare patients before making any decisions.