IRS: More ObamaBux©

Although we often mock HHS Secretary Shecantbeserious (and justifiably so), it's important to remember that the really big guns behind ObamneyCare© belong to the IRS, and the revenuers don't work cheap:

"The Internal Revenue Service is expected to use $881 million of taxpayers’ money to implement the first four years of Obamacare, including about $500 million that [HHS Secretary Shecantbeserious] diverted to the agency"

Remember, though, that this train-wreck reform package is going to save us buckets of cash.

Rubbing salt in the wound, we also need to be aware of this little "glitch:"

"[T]he Centers for Medicare & Medicaid Services (CMS) are predicting that health care spending will increase about 4% for the next couple of years."

Meh, that's not so bad.

Wait, what?

"Spending could then jump about 7% in 2014, when coverage expansion programs created by [ObamneyCare©] are supposed to start, the CMS analysts said"

Oh, well, it's only money, right?

Need Mo Money

The state needs more money to continue their Georgia Medicaid program. A LOT of money. Something on the order of $300 million.

The state Department of Community Health plans to ask the state legislature for roughly $308.2 million to make up the gap for fiscal 2013, Vince Harris, the agency’s chief financial officer, told board members.The looming deficit comes at a time when the state health agency is also facing the addition of another 600,000-plus Georgians to its Medicaid rolls starting in 2014, as part of the program’s expansion under the health care law.

Yes, that's right.

We can't pay for current care and Obamacare will force another 600,000 people on to Georgia Medicaid in 2014.

This is on top of the 1.7 million currently on Georgia Medicaid and chewing up $21 million every day in taxpayer funded benefits.

The health care program is also looking at a $90 million deficit for the current fiscal year. That accumulated in large part because the state legislature did not allocate funds for the final month of payments to three for-profit companies that manage care for primarily low-income kids and moms in Medicaid.

The state expects contract help to work for free?

Well, that is one solution.

As long as the contractors don't have a problem with it.

But how about the projected $600 million annual Georgia Medicaid deficit forecast for 2015? Wonder what those single payer fans will say then about how well the system works when the government runs health care?

MassCare Uh-oh

It will come as no surprise to regular readers of IB, but MassCare (famous for killing health insurance competition and increasing premiums in the Bay State) seems to be a gold-mine for folks gaming the system:

"Illegal aliens, out-of-staters and others who failed to produce proof of Massachusetts residency drained $118 million from the pool of cash the state uses to reimburse hospitals and clinics that care for the poor"

Ooopsies.

As we noted last Fall, Bay Staters were already on the hook to the tune of $93 billion for illegals' health care. As State Rep James Lyons points out:

"If you open a business in the commonwealth, you’ve got to provide documentation of where you live and what the business is ... If we’re providing benefits, all I’m suggesting we do is level the playing field. Don’t just give benefits out if we’re not requiring documentation.”

Yeah, rotsa ruck with that.

Maggie explains why we are all worse-informed

In her propagandizing for ACA (hope they pay her for all the hard work she does), Maggie Mahar had this to say in regards to State's not setting up exchanges;

"Tea Partiers celebrate such reports as a sign that health care reform is toast. Better-informed conservatives understand that even if states don’t create exchanges, the federal government will come in and do it for them. The law is very clear on this point."

If you're the governor of any State but ND, WI or AK you probably have a budget deficit, one that is getting worse, not better. You can spend tens of millions up front, or more, to create an exchange that will then have to be staffed and maintained at the cost of tens of millions of tax dollars. Or you can do nothing and someone will do it for free....that second option doesn't sound so bad.

The real question is why is government spending even a penny on this. There have been numerous exchanges done in the past by private industry (Cal Choice for example). These have been paid for by private capital and maintained by private capital. Private industry also has a much better track record - see my post from a few days ago - with getting such programs to actually work.

There is no shortage of private companies that would be more then willing to create these at no cost to the taxpayer, and do a much better job at it. NAHU would be a great sponsor of exchanges, for example. It is also important that we have competition amongst multiple exchanges, something that tends not to happen when competing against the government.

Obamacare, SCOTUS and Medicare Part D

Obamacare may be scrapped in part or completely if SCOTUS (Supreme Court of the U.S.) rules against the law as a violation of the Constitution. If that happens, there is speculation that the cost of medication for Medicare Part D  beneficiaries might increase.  

Obamacare provides "the necessary legal framework" for drug companies to slash brand-name drug prices by half for seniors and people with disabilities when they enter a coverage gap in their Medicare drug plans, said Matthew Bennett, a spokesman for the Pharmaceutical Research and Manufacturers of America.  Eventually the discounts grow so that the gap, known as the doughnut hole, is closed by 2020.  But if (Obamacare) goes, the discounts may go, too.

Part of Obamacare requires pharmaceutical manufacturers to provide a 50% discount on brand-name prescriptions filled in the Medicare Part D coverage gap beginning in 2011 and begins phasing-in federal subsidies for generic prescriptions filled in the Medicare Part D coverage gap.

If Obamacare is struck down the drug companies are no longer required by law to discount their medication.

If it isn't obvious, the pharmaceutical companies are not reducing the price of the drugs out of the goodness of their heart under Obamacare. All Obamacare did was to create a cost shift to others not in Medicare that will pay a higher price than they would have without Obamacare. Another offshoot of the mandated discount is increasing the price of some medications which puts them in a higher tier under a drug formulary.

In other words, they mark the drugs up so they can mark them down.

Voluntary drug coverage was added to Medicare in 2006, but consumers and advocates have been eager to get rid of the coverage gap. Insurance coverage stops when the beneficiary and the insurer together have spent $2,930 for prescription drugs, excluding monthly premiums. Under Obamacare, beneficiaries then get a 50 percent discount on brand-name drugs and 14 percent on generics drugs. When the beneficiary alone has spent a total of $4,700, coverage restarts. At that point the drug plan picks up 95 percent of the cost.

How is Medicare Part D voluntary if the government assesses a late enrollment penalty (LEP) if you do not buy a Part D when first eligible?

So while the discounts, and closing the donut hole may go away if Obamacare is overruled, the truth is the discounts were more smoke and mirrors than anything . . . kind of like political promises.

Drug companies could try to offer the discounts on their own but that effort could run afoul of federal antitrust laws that generally prohibit businesses from agreeing together to set prices for their products.  An individual drug company could offer Part D members coverage gap discounts, but it would have to steer clear of anti-fraud laws that ban a company from giving something of value to persuade beneficiaries to use its products.

Isn't it nice when the government interferes with free trade?

For all the political promises, lies and distortions, Obamacare is not a good law and Medicare Part D is more illusion than actual insurance.

Stupid Carrier Terminology

[Warning: inside baseball-type rant ahead]

Renewals happen. Specifically, health insurance rates are generally fixed for a year at a time. At the end of the year, rates go up (yes, theoretically they could stay the same or go down, but how often does that happen?), and one is usually given the option to make plan changes that mitigate the increase. These are typically along the lines of increasing deductibles or co-insurance percentages, or dropping optional prescription benefits and the like.

Not exactly rocket surgery.

These options are often included with the renewal letter; sometimes one must request them from the carrier. Regardless of how they're obtained, they'll require no additional underwriting (since one is actually reducing the carrier's exposure).

So far, so good.

Here's my beef: Anthem calls these options "downgrades."

How stupid is that?!

For better or worse, Anthem gets a major share of my individual medical business (and truthfully, aside from this particular aggravation, they're actually a decent enough carrier). It just ticks me off to no end to begin conversations with clients by telling them they can "downgrade" their plan.

Who the heck wants to downgrade anything?

This is not a new phenomenon with Anthem, it's just hit a boiling point for me: why would you risk alienating your own customers by implying substandard coverage?

It's not like there aren't perfectly good alternatives: plan adjustment, design change, anything neutral or (heaven forfend!) positive. But telling clients that they're being "downgraded" hurts Anthem's own image, while adding nothing of value to the process.

Sheesh!

TravelMed Apps

So you're taking that long-awaited cruise. Or flying to Italy for a week in the Tuscan sun. Or perhaps you're finally taking that ride on the Orient Express. Problem is, you have a few pills you take every morning, maybe a couple others at bedtime.

Or perhaps you have a more extensive health history, and worry about needing your medical records at a moment's notice.

Yeah, there's an app for that:

"Travelers can tap into technology before the trip begins, by storing information that can help ensure the right care is delivered if health issues crop up."

Everything from your most recent chest x-rays to pill and injection reminders can be loaded (or accessed) on your smartphone. For those tech-averse among us, there are also paper-based forms (even laminated cards with your info) that you can download, print-out and carry with you.

And for those who fret that their portable medical apparatus might be a problem, what with stricter luggage allowances, the TSA has a helpful site that explains how items like CPAP machines are exempt.

There's even an emergency care provider locator app available for folks who find themelves in unfamiliar surroundings while sporting a broken limb or major chest pains.

Pretty cool New World, indeed.

[Hat Tip: FoIB Holly R]