Skip to comments.Why the White House is Panicking About ObamaCare
Posted on 07/13/2013 12:27:33 PM PDT by Kaslin
Actors. Actresses. NFL football players. Baseball players. Librarians. Mayors. City councilmen. Members of AARP.
The Obama administration is looking far and wide, leaving no stone unturned in a relentless search for well for help.
Help with what? Help with getting people to enroll in health insurance plans this fall.
And why is that? Because the administration is facing the very real possibility that its signature piece of legislation may fall flat on its face.
Last week's announcement that the employer mandate will be delayed for a year and that income verification for people getting subsidies will also be delayed are the latest signs of trouble. The next shoe to drop may be the failure for people to obtain (ObamaCare) insurance even if it's free or highly subsidized.
· About one in every four individuals who are eligible for Medicaid in this country has not bothered to enroll.
· About one in five employees who are offered employer-provided health insurance turns it down; among workers under 30 years of age, the refusal rate is almost one in three.
Think about that for a moment. Millions of people are turning down (Medicaid) health insurance, even though it's free! Millions of others are turning down their employers' offers. Since employees pay about 27% of the cost of their health insurance, on the average, millions of workers are passing up the opportunity to buy health insurance for 27 cents on the dollar.
You almost never read statistics like these in the mainstream media. Why? Because they completely undermine health policy orthodoxy: the belief that health insurance (even Medicaid) is economically very valuable, that it improves health and saves lives, and that the main reason why people don't have it is that they can't afford it.
Welcome to the huge disconnect in health reform. On the one hand there are the people who are supposed to benefit from health reform. On the other hand there are the people who talk about it and write about it. I think it's fair to say these two groups almost never meet.
Study after study has purported to have found that health insurance improves health, saves lives, makes people happier, etc., etc. But these studies almost always ignore two cardinal facts:
· We have made it increasingly easy in this country for the uninsured to obtain health care after they get sick.
· We have also made it increasingly easy for people to get health insurance after they get sick.
Both developments reduce the incentive to spend time and money enrolling in a health plan.
I have described before the experience of emergency room care in Dallas:
At Parkland Memorial Hospital both uninsured and Medicaid patients enter the same emergency room door and see the same doctors. The hospital rooms are the same, the beds are the same and the care is the same. As a result, patients have no reason to fill out the lengthy forms and answer the intrusive questions that Medicaid enrollment so often requires. At Children's Medical Center, next door to Parkland, a similar exercise takes place. Medicaid, CHIP and uninsured children all enter the same emergency room door; they all see the same doctors and receive the same care.
Interestingly, at both institutions, paid staffers make a heroic effort to enroll people in public programs ? working patient by patient, family by family right there in the emergency room. Yet they apparently fail more than half the time! After patients are admitted, staffers go from room to room, continuing with this bureaucratic exercise. But even among those in hospital beds, the failure-to-enroll rate is significant.
Clearly, Medicaid enrollment is important to hospital administrators. It determines how they get paid. Enrollment may also be important to different sets of taxpayers. It means federal taxpayers pay more and Dallas County taxpayers pay less. But aside from the administrative, accounting and financial issues, is there any social reason we should care?
Economics teaches that people reveal these preferences through their actions. If people act as though they are indifferent between being uninsured and being on Medicaid, we may infer ? based on this behavior ? they are equally well off in both states of the world from their own point of view.
Against this conclusion, advocates of "behavioral economics" might argue that people don't know what's best for them. They have to be "nudged." Seeing a football star on TV encouraging young men to enroll in a health plan might do the trick. But for the Obama administration that doesn't solve the problem. People need more than an initial nudge. They have to be nudged every month.
Take Massachusetts. That state cut its uninsurance rate in half. But the main vehicle was Section 125 plans set up by employers. These accounts allow employees to pay their share of the premiums with pre-tax dollars and they are mandatory. Further, for lower-income employees the insurance is highly subsidized by the state. More to the point, under this arrangement, the employee's contribution is automatically deducted every pay period.
Under ObamaCare, similarly situated individuals are going to be expected to pay a monthly premium the way they pay their utility bills. But with this difference. When people don't pay their electricity bills, the utility cuts off their electricity. When they don't play their rent, the landlord throws them out in the street. But when they don't pay their health insurance premium, what happens then? Not much.
Why is it so important to the administration to have people enroll? If they don't enroll in Medicaid, I don't think it matters very much. But if they don't enroll in private plans sold in health insurance exchanges, it will matter a great deal. Remember, these will be artificial markets in which insurance will be underpriced to the sick and overpriced to the healthy. A lengthy, complicated enrollment process will further discourage those with no health problems.
But if the only people who enroll are those who are sick, the average premium will go through the roof. A death spiral will ensue as ever increasing premiums price more and more buyers out of the market, leaving only those whose expected medical expenses exceed those high premiums.
The bright side of all this is a possible teaching moment. The whole nation may be treated to one vast demonstration of why prices matter.
Sorry, no, on the final sentence of the article. Low information people do not learn; they blame.
Notice how they never mention the obvious?
Medicaid means that the government owns your body!
If it’s that good we should demand that every senator and congress person and thier families sign up and be subjected to the very bill they voted for!
Zerocare reminds me of Hillarycare, except they moved the ball much further than before, but with the same backlash.
When push comes to shove, most people don’t like to be pushed or shoved into something that effects them personally regardless of the “greater good”
Sad, that this POS law has been able to get this far.
Dead Before Delivery.
Let them blame that witch...and run her out of town on a broom. That photo of her and that gavel should be on billboards in every city, along every highway...along with you wanted it, you got it. Now, choke on it. Stupid sheep.
Kill the damn thing (ObamaCare) before it kills us. And drive a stake through its evil communist heart so it can never rise again!
He is the MOST VACATIONING pRESIDENT THAT WE HAVE EVER HAD !
Parkland in Dallas and the major public hospital in nearby Fort Worth were reporting that half or more of the babies born there had illegal immigrant mothers. While I’d believe that in Laredo and other places by the border, it seemed unlikely in a city only half Hispanic, with many Hispanics here multiple generations.
It turns out that if you claim to be illegal and thus have no legal paperwork, they roll out the bandwagon. They assume you cannot pay, so there is no bill. The baby gets freebies for the indigent, like a free car seat, bag of free formula and free cribs when they have them. A friend of mine was furious when her teenaged daughter had a baby; they were clearly going to be financially stressed, but they received a fraction of the freebies because the new mother was white. All those who could get away with it said “yo no Americano”, got the freebies and still received citizenship for the babies.
I don’t trust the medical profession. I’m a little less distrustful if I’m paying for services and I’m deciding what’s best for me.
The gubermint knows your income but they do not know your net worth and it is the latter that really drives Medicaid eligibility. So any stats about the number of people turning down "free" Medicaid are misleading because they are missing half the picture.
That really isn't true in many states. Two years ago we were evaluated by the State of Washington for Medicaid eligibility (totally unilaterally on their part -- we did not apply or even inquire). The house and assets and even IRA were no problems -- the other thing that prevented us from being enrolled was the withdrawals from the IRA I made that year (counts as income). I understand that Expanded Medicaid will be pretty much the same as the situation in my state -- pretty much open to all subject to income limits (no asset test).
Instead of “the other thing” should read “the only thing”.
I did that a few years ago. I already had Blue Cross, and since the 100% of the cost of the employer policy was born by the employee and the coverage stunk to boot, I could not see dropping it. I since changed employers. The new policy is much better and 95% covered, so I dropped BCBS. I liked having my own policy, though.
Nice to see the republicans taking advantage of this disastrous second term. I swear they are the absolute stupidest bunch of idiots in the history of creation.
IRS Scandal, NSA Scandal, Health Care DISASTER, ...don’t focus on any of that!!! lets piss off our base and pass immigration reform.
Freaking idiots beyond all reason and understanding
The GOP has as much interest in getting rid of Obamacare as the NAACP has in ridding the country of racism. It’s the gift that keeps on giving. I believe there are more elected democrats that would like to get rid of Obamacare than republicans. For the democrats it’s an albatross; for the GOP it’s a cash magnet and election issue.
Are people waking up to the fact that your friendly IRS agent will know all about all of your health issues, your income, and nearly every aspect of your life?
If the conservatives in Congress succeed in delaying the Individual Mandate as well it will be giving cover to the kenyan and the whole obamacare bill. Better the individual mandate stays in place as written and insufficient people sign up for it.