ObamaCare Roundup: Fun with the IRS, the Auto-Renewal Trap, and Continued Relentless Creation of Second-Class Citizens

By Lambert Strether of Corrente.

Just let me repeat my basic perspective once again. From ObamaCare and Its Opportunity Costs:

The key point to remember in all discussions of ObamaCare is that neither it, nor indeed the entire private health insurance “industry,” should exist. They are rent-seeking parasites, economic tapeworms. One does not improve a tapeworm; one removes it.

Fun with The IRS

It looks as though dealing with ObamaCare’s tax consequences — remember when only people with money had “tax consequences”? — is going to be just as fun as dealing with healthcare.gov was. Since ObamaCare grants subsidies based on your estimated income, it then must recalculate your subsidies at tax time based on your actual income, and then either give you money back, or take money from you. And who doesn’t enjoy a big fat crapshoot at tax time? Especially when the recalculation demands a shit ton of complicated forms that have never been used before. 

Politico describes step one, sending out plan details:

The insurance exchanges and employers must send consumers details about their health plan and benefits or exemptions in time for them to file a tax return. If any of that information is delayed or wrong, tax refunds could be delayed. …

At this point, the new forms look “very daunting” for taxpayers, said Mark Ciaramitaro, vice president of health care services at H&R Block. “Overall, we expect the complexity level is just going to go up for a significant group of moderate- to low-income people, whether they got insurance through the marketplace or they didn’t.”

Just going into “fixed it for ya” mode here for an instant, by “said Mark Ciaramitaro” the writer surely must have meant something like “said Mark Ciaramitaro, extruding his feeding tube,” since tax preparers like H&R Block will be the parasitical rent-seeking siphonoptera profiting from ObamaCare’s complexity. But I digress.

Then step two, the new form 1095A:

Exchange enrollees won’t be able to file their taxes until it sends them a 1095-A form, and there are some concerns that the forms will be late, especially in states with struggling exchanges.

What could go wrong? And then there’s step three, the 1040 itself. Remember that, incredible as it may seem, that although there is a mandate to purchase health insurance under ObamaCare, and even a penalty, the IRS can’t put a lien or a levy on you for not paying it. So people who just skipped all the hassle could end up being better off than people who tried to comply, but got hung up in the complexity:

But if they completely ignore the question of having health coverage, now a new line on the standard 1040, it’s unclear how the IRS will respond, says George Brandes, vice president of health care programs at Jackson Hewitt. The result, he worries, could be that filers trying to comply with the law are penalized with delays while those ducking it aren’t.

You’re at much greater risk for having things gummed up if you’ve done what you’re supposed to do,” [another minefield!] Brandes said. “We’re not name calling here — it’s just sort of a recognition of the reality of how this is going to work.”

Tax Foundation economist Alan Cole agrees and, like many experts, doesn’t expect the IRS to vigorously enforce the law’s individual mandate in its first year, using this upcoming filing season more as a trial run.

So, once again, ObamaCare nudges you into a minefield without any signage.

(And just be sure to record everything if you can. It’s your only protection.)

But it’s an ill Rube Goldberg device that blows nobody good! From American Public Media’s Marketplace:

H&R Block is expected to report its earnings Wednesday afternoon, and analysts feel good about the tax-prep giant’s future. Actually, they feel pretty great about the industry as a whole.

The source of their optimism is the Affordable Care Act, thanks, says George Brandes with Jackson Hewitt, to the tax-prep business truism: “Complicated taxes equals more people needing help.”

The IRS says 140 million people file tax returns every year, with about 60 percent being done by professionals. Northcoast Research analyst Kartik Mehta expects that percentage to increase.

“We haven’t seen this type of a complication to the tax return in a long, long time,” he says.

Mehta says the real winners will be the brand-name preparers who can afford to blitz the airwaves come tax time.

With the H&R Block example, the rent-seeking from ObamaCare’s complexity is of crystalline clarity; it’s like when some entity decides to dump stuff (say, three dozen armored personnel carriers) into the ocean instead of a landfill, and then call it an artificial reef, and in fact you do end up with an ecosystem of sorts. Well, ObamaCare is the artificial reef, and H&R Block are artificial fish living in that reef. But so are they all, all artificial fish: The web developers, the navigators, the consultants, the trainers, the marketing weasels, the CEOs, etc., etc. None of them should exist in the first place. And never mind the toxicity as the APCs rust out, eh?

The Auto-Renewal Trap

From Kevin Drum, the setup:

[F]ederal subsidies are calculated based on a “benchmark” plan, and this means that low-income taxpayers can buy the benchmark plan at pretty low cost. However, since Obamacare encourages competition (yay!), your region might have a whole bunch of new, lower-cost plans [of equal quality? Drum doesn’t know, and neither do we] available next year. This means the benchmark will be recalculated, and if you want to keep your low payments you’ll need to switch to one of the newer plans.

National Journal gives the detail:

The White House has already set up an auto-renewal process, making it easier to stick with the status quo.

As cheaper plans come into the marketplace, millions of consumers will see the cost of keeping their plan rise. But they might not know it.

HealthCare.gov isn’t able to automatically recalculate the subsidies existing consumers are eligible for. [Who wrote the spec for this turkey?] So, while the dollar value of your financial assistance drops, you can only find out that’s happening by going back into the system and asking for a redetermination as part of the shopping process.

Consumers who auto-renew their policies will get the same dollar value of subsidies they got last year—even though changes in the marketplace all but guarantee that will no longer be the right subsidy amount for millions of people.

“That’s the totally crazy part,” Pearson said. “They’re basically going to send them what they know to be the wrong subsidy.”

The IRS will eventually [and, apparently, spontaneously] figure out how much financial assistance you should have received, and will reconcile the difference on your taxes [and pay you the interest on the money you paid that you didn’t have to. Not].

Remember Cass Sunstein, genius, and his “nudge theory”? Where “choice architectures” set default options so that they “nudge” people to more socially desirable outcomes? Well, Obama set the default for ObamaCare to autorenewal, right? Back to Drum, who describes the result:

Since you’re no longer buying the benchmark plan, your subsidies will go down and your annual premium will go up.

So, that’s the outcome that Obama regards as socially desirable. I keep saying ObamaCare is a minefield without any signage; auto renewal is a fine example of such a minefield. You auto-renewed, then? Blam!

Second-Class Citizens Wherever You Look

Two figures tell the tale. First, ObamaCare takes from the almost-poor and gives to the poor. From the Brookings Institute:

Figure 1

income_obamacare

It’s like reverse noblesse oblige, isn’t it? The more you make, the less you give! (Granted, in percentage terms. But ya know, redistribute a yacht cover or two and bale of Hermes scarves from the Top Tenth (first class) versus redistribute the kids’ college fund or repairing those shock absorbers or a few nights out at the Olive Garden (second class), all so some poor shrub doesn’t keel over and die for lack of care, and who wants that… Who feels it more, modulo the ol’ ego mego way up there at the top of Maslow’s hierarchy (“self actualization”)?

And then there’s this, the kind of inexcrementalist framing that makes my back teeth itch. Read the headline on the chart, which I’ve also helpfully annotated, in the spirit of clarity:

Figure 2

2014_ObamacareEnrollment

Again, it’s the topsy turvy world of ObamaCare advocacy. The headline: “Where Obamacare Has Made The Most Progress.” But that’s not what the map is really telling you, is it?

If you accept that lack of health insurance leads to excess deaths, then there are excess deaths in every state except the three top states: Vermont, California, and Rhode Island. (I’m being charitable; even those three have excess dates.) Why is this anything other than a miserable failure?

Single payer would save those lives. Everybody in the country would have equal access to health care, simply by virtue of being a citizen. Any other solution on the table — see “Neoliberalism Expressed as Simple Rules” for the policy parameters — means that people live and die at random, by accident, simply because of whatever state or city or county they ended up in. Those in first class (dark green arrows) go to Happyville. Those in second class (light grey arrows) go to Pain City. It’s a crap shoot, the luck of the draw. This is life and death! How is this in any way acceptable? It baffles me that “progressives” — do note the “progress” in the headline — don’t see the moral issue here.

* * *

TROLL PROPHYLACTIC It may be that you personally have benefited from ObamaCare. In a program of ObamaCare’s size, it’s only natural that some would benefit. My question for you is this: Do you think that all should benefit as you have, and if so, what are you doing about it? The same reasoning applies to those who say that ObamaCare has benefited X millions of people. Why should not all benefit as some do?

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About Lambert Strether

Readers, I have had a correspondent characterize my views as realistic cynical. Let me briefly explain them. I believe in universal programs that provide concrete material benefits, especially to the working class. Medicare for All is the prime example, but tuition-free college and a Post Office Bank also fall under this heading. So do a Jobs Guarantee and a Debt Jubilee. Clearly, neither liberal Democrats nor conservative Republicans can deliver on such programs, because the two are different flavors of neoliberalism (“Because markets”). I don’t much care about the “ism” that delivers the benefits, although whichever one does have to put common humanity first, as opposed to markets. Could be a second FDR saving capitalism, democratic socialism leashing and collaring it, or communism razing it. I don’t much care, as long as the benefits are delivered. To me, the key issue — and this is why Medicare for All is always first with me — is the tens of thousands of excess “deaths from despair,” as described by the Case-Deaton study, and other recent studies. That enormous body count makes Medicare for All, at the very least, a moral and strategic imperative. And that level of suffering and organic damage makes the concerns of identity politics — even the worthy fight to help the refugees Bush, Obama, and Clinton’s wars created — bright shiny objects by comparison. Hence my frustration with the news flow — currently in my view the swirling intersection of two, separate Shock Doctrine campaigns, one by the Administration, and the other by out-of-power liberals and their allies in the State and in the press — a news flow that constantly forces me to focus on matters that I regard as of secondary importance to the excess deaths. What kind of political economy is it that halts or even reverses the increases in life expectancy that civilized societies have achieved? I am also very hopeful that the continuing destruction of both party establishments will open the space for voices supporting programs similar to those I have listed; let’s call such voices “the left.” Volatility creates opportunity, especially if the Democrat establishment, which puts markets first and opposes all such programs, isn’t allowed to get back into the saddle. Eyes on the prize! I love the tactical level, and secretly love even the horse race, since I’ve been blogging about it daily for fourteen years, but everything I write has this perspective at the back of it.

92 comments

  1. sd

    I wish it were possible to organize Americans not to file their income tax returns for 2014 as a simple means of protest as money is the only thing Washington will listen to.

      1. diptherio

        On an unrelated note: for the last two days my comments have been taking about 20 min (I would guess) to actually show up. They’re not getting sent to the moderation queue–the page just reloads from the top when I hit “submit” and my comment is apparently nowhere…re-loading the page doesn’t make it appear–but then I check back after awhile and there it is. Curious.

        I’m guessing that the same issue is leading to the occasional “double-comment” and the ubiquitous “test” comments. I wonder if it’s just a matter of having too many comments to process (seems unlikely) or what. Never had this issue in the past, but now it seems continual. On the up side, I get more work done…we’ll see how this one works–time stamp should be 11:23

    1. Lambert Strether Post author

      Tax resistance is a conservative thing. They hate taxes. And although ObamaCare has fines if you don’t obey the mandate, the IRS can’t put a lien on you if you refuse to pay; the act seems tailored for tax resistance! And there’s a perfectly reasonable argument, acceptable to conservatives, that it’s wrong to force people to enter a market. And yet we hear nothing. If there’s one thing that convinced me all the hoopla about repeal was kayfabe, it’s that.

        1. OpenThePodBayDoorsHAL

          Were he not so feckless, corrupt, and overmatched, Obomba could have chosen to control the tapeworm rather than kill it or feed it. That’s what the Dutch did, kept the rent-seeking insurers in place but severely controlled the products they must offer and the prices they can charge. It made them compete on quality of service, what a concept. But no new private islands for a handful of insurance CEOs, so instead 320 million Americans must be made to suffer.

      1. bob goodwin

        I agree that the conservatives would rather just let obamacare continue and move onto to other issues. The problem is that there is a thriving populist movement that started with the bank bailouts and truly hates corporatism. So the republicans are stuck in an untenable track. There may be another trap coming, as the world is destabilizing, the hawks in both parties are going to go up against the same ‘extremists’ in both parties who both hate corporatism and military adventurism.

        Politicians are easy targets, especially in the presence of a populist movement.

        1. tusense96761

          We been played by all the republicans, they say they are against Obamacare and they strug us along with the March 31, 2014 deadline date. Obama had to have a certain amount of people signed up. Where is the debate on that, why hasn’t Obamacare been dismantled? Why does the NSA spying on all Americans continue. We need to vote every last one of these congress people and senators out except for Rand Paul. None of the others are representing their people or the people in this country. IRS continues to go after opponents of the democrats, voter fraud continues, unnecessary wars continue and escalates.

  2. bob goodwin

    Am I allowed to agree that Obama care means theft, but also disagree and say that single payer means death?
    I would much rather have an out of control market than a dangerous government. We agree that they should not be mixed.

    1. CB

      Here you have both, an out of control market and a dangerous government. Relieves you of the emotional stress of having to choose.

    2. lolcar

      “Single payer means death” Is this a metaphorical death, a death of the spirit – because there’s not a single first-world country with single payer which has a higher rate of avoidable death through inadequate healthcare than the US.

      1. NotTimothyGeithner

        To be fair, 21st century Americans would probably make a mess of single-payer even if they had Canadian advisers and could overcome the language barrier.

        1. lolcar

          I don’t know. I’ve always found Americans rather good at getting things done. Put them in a system that actually makes sense and they’d get it working as well or better than anyone.

          1. Banger

            In the past you would have been not completely inaccurate, but at this historical moment government is too corrupt to run anything well–we are well past the tipping point.

              1. Banger

                If you instituted civil service reform of some kind seriously limiting or regulating contractors then, and, almost as important, had a Congress interested in crafting a law that was based on what is good for the public then yes we could run a pretty good system because we have a lot of excellent professionals to draw on.

                But how likely is that? I have argued that the way the USG and elections are structured real reform that you and I and the majority of Americans would like is impossible. I see no path that anything could be done–do you? I mean what scenario can you imagine? Look at the upcoming election! I see no signs of hope.

                I do have hope and that is that the system will go through, at best, some creative destruction out of which something new could evolve.

                  1. NotTimothyGeithner

                    Not really. King was a prominent voice, but he didn’t deliver the 10 Commandments alone. The NAACP, SNCC*, the voter drives, the student led sit ins, and Rosa Parks’ own machinations (she was an active NAACP member; a single mother was forced to stand a few months prior by the same bus driver. Parks decided a senior citizen and respected member of the community would produce greater outrage, so she started riding that driver’s route. She was pretty smart) all happened without the work of MLK Jr. They didn’t wait around for him.

                    Where was King during the Pullman Porter’s strike? Preaching? Teaching? I don’t want to disparage the man, but he didn’t say, “racism is bad,” and have the non redneck whites just be impressed.

                    The focus on King has led the country to forget the collective effort and long term forces and fight that ended segregation. One of the Republicans active in the movement was moved when his district was redrawn to include a small black population and he heard personal stories.

                    *When King wasn’t active, he had been a mentor for SNCC’s founders.

    3. SaltyJustice

      To get this straight:
      It’s not okay to have a large collection of very powerful individuals who take money from you which they then spend in order to further their own interests against yours (the government).

      But it is okay to have a large collection of very powerful individuals who take money from you which they then spend in order to further their own interests against yours (a private health care industry).

      There’s something wrong there, but I can’t quite place it.

    4. Clive

      Erm, please look at this chart:

      http://theincidentaleconomist.com/wordpress/life-expectancy-and-health-care-spending/

      Can you spot the outlier ? Who is more likely to croak earlier, you there in ObamaCare’d America or me in terrible old Single Payer England (GBR). And who has paid more for the privilege ? While our Single Payer service is way, way less than perfect, I know where I’d much prefer to sit here knowing that if I had an embolism or coronary attack, an ambulance would come, I’d get taken to a hospital where I’d receive at least adequate care — and, here’s the stinger — it wouldn’t cost me a dime. No claims form, no crapified HMIs, no insurance scamming, no out of pocket. I’d merely have to concentrate on getting well again.

      There is a point to be made that poor US governance might sabotage any Single Payer scheme and leave you up the proverbial creek with out a paddle. But our governance standards here in England are way, way worse than yours in my opinion (yes, we’d win that particular ugly contest I think) and even we can’t mess up Single Payer. So it must be fairly bomb-proof as a system.

      1. Banger

        Again, any new government program in the US will be quickly infected with corruption–the more money involved the deeper and more virulent the corruption–I’ve seen it close up. There are govt programs that run well but they are older ones and they have also fallen prey to scams and various levels of corruption–even Social Security, mainly the part that deals with disability

          1. Banger

            First face reality. Once that is done everything changes dramatically and smarter people than me will come together with miracles. The example I use is the incredible synergy and humanness that breaks out like a smile when we have major storms or disasters and peopl have to rely on themselves and each other–I’ve seen amazing things happen. In contrast look at what happened with Katrina where the government descended on the people like a ton of bricks attempting to crush all compassion and humanness.

              1. Banger

                I believe like Confucius that human beings are naturally altruistic and modern western culture is profoundly perverse because it tends to disregard compassion or directly discourage it. Confucius called it Jen:

                Jen (pronounced “ren”) is translated into English as “humanity” or “humaneness.” It is the highest Confucian principle. People cultivated by it are humane individuals who exhibit benevolence and care toward others. They are motivated by a deep empathy for others – what might be called “human-heartedness.”

                According to Confucius, all people have the capacity to be people of jen or humaneness mainly because all people are intrinsically good. This is a fundamental assumption of the Confucian worldview – that all people are inherently good and, thus, capable of operating in a way that is empathetic, humane and full of care for others. When people are not educated or developed properly, this intrinsic quality breaks down – people become hateful, rash, uncaring, undisciplined – and chaos comes into life at every level. (from http://www.world-religions-professor.com/jen.html)

                When we forget our conceptual framework that we have to be selfish a-holes and we let down our hair during a disaster when we are required to be attentive and alert or, sometimes, when we get high or drink a lot in a bar and start talking to people we would never want to connect with we encounter Jen.

                1. Clive

                  And yet, you seem to be implying that a government (which in, say, theosophical belief systems to give one example, could be considered – like the body of humanity itself – to be a living thing) is incapable of this sort of, how can I put it, redemption ?.

    5. Oregoncharles

      Medicare (gov’t bureaucracy, partly privatized) is glitchy and a little unpredictable, but the coverage is ultimately decent.
      I’ll take it, but a truly universal plan would be more efficient (more able to regulate medical practices, for one thing.)

    6. Benedict@Large

      Would you feel better about single payer if the payer were a private entity (corporation) as opposed to the government?

      (And yes, that is possible. I know because I worked on spec’ing out just such a system for one of the major insurers.)

      And Lambert, you go too far when you say the insurer is simply a rent extractor. Like it or not, insurers are the only entity in the current system that restricts cost increases.

  3. gardener1

    It is impossible to imagine a health care system worse than this. I honestly can’t think of one. Maximum complexity and minimum return. Plus penalties.

    Speaking only for myself, our solution to this fiasco is to leave the country. We are near-retirement working class people with some small Social Security and tiny bits of pension. There is just no way we can afford to get old in America. We have made an expedition to the country we wish to retire to, examined the details carefully, and think it is a workable plan. We don’t have a plan B. We have to leave.

    After a lifetime of working and paying taxes X 2, we can no longer afford to live (or die) in our own country. No matter what the happy talk wishful thinking media and politicians burble on about recovery, *we* are screwed.

    I truly have no words anymore for what a clusterfuck America has become. It’s all just too late and too far gone.

    1. Jim Haygood

      Most countries in Latin America offer pensionado visas to US retirees. Perhaps anticipating beleaguered citizens’ attempts to flee the greatest country on earth, Fatca makes obtaining a non-US bank account somewhere between difficult and impossible, and then imposes savage fines if you don’t file your FBAR report.

      But it’s all worth it to live in a normal country, where political debate doesn’t consist of deciding whom ‘we’ should bomb this week.

    2. Banger

      The words are: the “Land of Larceny”; or maybe “Con Country” because everything has become a racket–we live in the world of Film Noir.

      1. Lambert Strether Post author

        My country ’tis of thee
        Sweet land of larceny
        Of thee I sing!

        Land of the bankster’s pride
        Land where the Preznit lied
        From [something something] Countrywide
        The big ka-ching!

  4. John

    Rent extraction from poor folks has been policy for a long time. ObamaScare is one of those long line policy manifestations of ripping people off. The staff authors made sure of it.

      1. Jim Haygood

        Last time I checked, it cost a million or so to buy your way into Quebec. The Canadian point system for immigration focuses on young, skilled workers. Older Americans wanting to freeload on the Canadian health system are not welcomed at all.

  5. deb schultz

    The same situation vis-a-vis automatic renewal applies to Medicare Part D policies. A study has shown that people tend to spend about $348 more per year on their drug policy than necessary for adequate coverage. Many people simply enroll in a plan and then never check out the available policies during the annual open enrollment season.

    1. Doug

      Every year the various Part D plans change around their lists of covered drugs and the tier level of coverage for various drugs. I feel bad for the elderly who have to navigate this labyrinth of an “artificial reef”.

  6. timbers

    I can’t wait for the “improvements” to Obamacare we we’re told would be coming AFTER it was passed, and so we should shut up and support it.

    Of course now that’s it’s law, at least one person said: Obamacare is here, it’s law, stop complaining or trying to change it (yes, leave that to the insurance and medical corporations to do the changing they know what to do).

  7. bh2

    A well stated summary of the disaster O-care really is, Lambert. However, I have to wonder at this rather strange, rhetorical question: “Who wrote the spec for this turkey?”

    Can there really be any doubt about who “wrote the spec”? It was the Democratic Party in both houses of the US Congress whose toady members passed a bill to satisfy the desire of an amateur President who wanted it as his flagship accomplishment while in office. That wish was fulfilled by majority control of both political branches of government. Unlike a summer rainstorm, it wasn’t an exogenous event.

    It was the (“progressive”?) Democratic Party leadership which laid on what amounted to a triple-line whip of members in both houses and thereby successfully committed the almost unbelievable rookie error of moving a major bill (which even some of its own members thought not ready for prime time) with zero support from the opposition party.

    By first arguing this law is not a tax (to get it through Congress) then later arguing to the contrary that it is a tax (to get it past the SCOTUS), Democrats collectively moved heaven and earth to own this monstrosity, lock, stock, and barrel. Mission accomplished.

    It therefore seems rather odd that you should wonder aloud about who is responsible when that is the only feature of this mess which has been perfectly clear to even the most casual observer. Mr. Obama said “elections have consequences”. He was right.

      1. bh2

        Congress has sole Constitutional authority to “author” bills forwarded to the President for signature. Most are drafted by political staff, either by their own effort or by tweaking work produced by lobbyists on behalf of beneficiaries of the legislation. Or some of both. But Congress owns the final bill approved — and the President, too, if he signs it.

        1. Oregoncharles

          As far as ultimate legal and moral responsibility, correct. If the industry wrote the bill, Congress let them.
          And the Democrats are still paying for it. Their share of Congress has collapsed since 2009, a clear indication of the voters’ judgment.

          1. McMike

            Arguably, We the People are the only ones to blame.

            We reelect the creeps again and again. We allow ourselves to be fooled and lied to over and over. And we refuse to water the tree of liberty with blood, as specified in the owner’s manual.

      2. NotTimothyGeithner

        Liz Fowler was a hack from Wellpoint, an HMO. The insurers received subsidies to buy them off from a system which was driving them to bankruptcy. The Hospital cartels wrote ACA with enough goodies to break up opposition to our cartel system.

        Insurers are the villains because they bill the patients (they aren’t saints and could demand a more equitable system for patients and their shareholders), and the HMOs employ the doctors and nurses and have volunteer opportunities for dedicated candy stripes. The HMO ceos aren’t the highest paid by industry for delivering care. In the end, they control pricing, kinds of treatment available, and what health professional one can see.

    1. Oregoncharles

      I think he meant the website. that actually came from an office of Medicare, but we don’t know who was personally responsible. At least, Lambert and I don’t.

  8. McMike

    I like the concept of economic artificial reefs.

    But I would note that nearly every sector seems to be an artificial reef these days (think War on Drugs). It’s just a matter of degrees.

    1. Jim Haygood

      ‘There are some concerns that the forms will be late, especially in states with struggling exchanges.’

      This line made me laff out loud. In Soviet times, it was the peasants who ‘struggled’ to meet grain production quotas. Now it is the state (so woefully underfunded!) which ‘struggles’ helplessly in the web of its own complexified paperwork. I weep with empathy!

  9. ScottW

    For all of the self-employed people claiming an ACA subsidy, the tax auditors are going to come a calling. Do I declare that extra $5,000 in earnings if it costs me my entire ACA subsidy? Hmmmmm.

  10. ambrit

    Who wants to bet that the rate of increase in the subsidies lags behind the actual increase in health care costs? (Chained CPI = Chained Consumers)

  11. NotTimothyGeithner

    I’m going to be first in line for the Obama library.

    Can we make predictions about the theme or displays yet?

    “A Bridge to Somewhere” -obviously playing on O’s Clinton fascination

    “A Bridge to Hope” -a slight variation demonstrating the Obots inability to detect irony.

    “How to improve your handicap?”

    “Turning partisanship into bipartisanship” -this exhibit would focus on t he VA scandals from Walter Reed to Shinseki

  12. Jim Haygood

    Could somebody explain how Massachusetts, which ran the Romneycare pilot project, ended up with one of the lowest sign-up rates?

    There has got to be a story there, which might be well suited for an MPA case study: how to simply cast aside a fairly well-tested system, start from scratch, and sh*t the bed on a epic scale. Yes we can!

    1. sd

      Seems obvious, most everyone in Massachusetts were already insured because of Romneycare. In other words, there just weren’t that many people left to sign up.

      1. Doris

        Seems obvious? Yes I thought it was obvious that I would continue in the Romney version of this extraction racket since the ACA is “based” on it. Thus I was stunned to be informed that my coverage would be cancelled and I would be frog walked into “shopping” for new coverage on the idiotically nonfunctional Massachusetts exchange, which is pleased to tell me how delighted I am to now pay over $100 more per month than I already was struggling to pay before. I know, I’m not a smart shopper, that must be it.

        The low sign up may be from Massachusetts having everyone who could be on Medicaid already on it before ACA changes, I don’t know. It may also be because people who had “Romneycare” shoved down their throats haven’t stopped puking long enough to pursue compliance with “Obamacare” yet.

        1. CB

          Confirms what I guessed: MA residents already have too much experience with mandatory medical rent extraction.

        2. sd

          Quality of product has nothing to do with whether or not you were already in the system, which, by your own admission, you were.

  13. ep3

    to me the “progress” map looks like a political card game. help california to get the latino vote. vermont should be excluded because they are getting single payer (until obama blocks it).

    1. Lambert Strether Post author

      Yes, it does, doesn’t it? Funny, that. Interesting, the California Democrats shielded Covered California contracts from the state open records law. I wonder why?

      1. jrs

        In the bag for what? Presidential electoral college votes? The house, some seats could be competitive, it’s not all blue, but it is pretty gerrymandered.

  14. beene

    Lambert, excellent article, thanks.

    Thou the article suggest that it had to benefit some. This I would disagree as unless you are in the .01 percent of the populist and have the funds to have your choice of coverage picked for you. Having private health insurance may not help you, if you are not able to pay the co-pays of the coverage you have chosen. For those who disagree I offer the following URL which give an excellent example of even how hare it is to chose when you think you know what to look for in a private health insurance plan.

    http://www.nakedcapitalism.com/2014/03/neo-liberalism-expressed-simple-rules.html

  15. Carla

    The only hope is at http://www.movetoamend.org: the Constitutional amendment stating that corporations are not people and money is not speech. Whatever issue is your main concern (the environment, poverty, education, healthcare, ETC), I suggest you make this at least your number two, because without it, we’ll never get anywhere.

    I worked on single payer for years — YEARS. When Obama barred single payer from that famous table (“Everyone will have a seat at the table” said he, lying as usual), I quit the single payer effort and started working on Democracy. Forget all those “repeal Citizens United” amendments that would return us to the perfect state of Democracy we enjoyed in early January 2010. Here’s the real deal, in its entirety:

    House Joint Resolution 29 introduced February 14, 2013

    Section 1. [Artificial Entities Such as Corporations Do Not Have Constitutional Rights]

    The rights protected by the Constitution of the United States are the rights of natural persons only.

    Artificial entities established by the laws of any State, the United States, or any foreign state shall have no rights under this Constitution and are subject to regulation by the People, through Federal, State, or local law.

    The privileges of artificial entities shall be determined by the People, through Federal, State, or local law, and shall not be construed to be inherent or inalienable.

    Section 2. [Money is Not Free Speech]

    Federal, State, and local government shall regulate, limit, or prohibit contributions and expenditures, including a candidate’s own contributions and expenditures, to ensure that all citizens, regardless of their economic status, have access to the political process, and that no person gains, as a result of their money, substantially more access or ability to influence in any way the election of any candidate for public office or any ballot measure.

    Federal, State, and local government shall require that any permissible contributions and expenditures be publicly disclosed.

    The judiciary shall not construe the spending of money to influence elections to be speech under the First Amendment.

    1. Park Nihrs

      Carla, thanks for your comments. I am just about to get active again in Physicians for a National Health Plan, as i am also leaving an increasingly corporatized non-profit that mainly serves low income people (making me a low-income doctor, but just fine overall!).

      So will I be wasting my efforts? I plan to keep the GATS scam front and center in discussions.
      I don’t have much hope for democracy until we see our fat and not quite unhappy-enough rabble in the streets. It takes several types of pressure. In Minnesota, voting may mean something, so for local and state I will vote. Even at the national level, we at least got a few dollars spent on solar by Mr. Obama, that would not have happened had the Koch Bros. faction of our oligarchy had a woman in the White House (Palin by now!)
      But I’m about to put the Don’t Vote sticker on my car.

      I will be interested in whatever you think might work (and I’ll check back in about 10 hours)

    2. beene

      Carla, you might also want to look into Friends of Democracy, an anti–super PAC super PAC that seeks to elect state and federal lawmakers who support public financing of elections.

  16. Randy

    What is up with all the typos in this article? The typos in conjunction with the made up words made this nearly unreadable. But I hate Obamacare so much I made my way through the whole thing. What a tremendous racket.

  17. dannyc

    No, I’m not saying King just spoke and the waters parted or that others didn’t make major contributions (and sacrifices.) I was replying to Banger’s pessimism for how cynicism is the governing force – the prevailing political ideology – of today. I’m not speaking for Banger either, that’s just what I get from his comments here and elsewhere.

    1. NotTimothyGeithner

      We (humans) made our luck. People didn’t wait on King. Guys like King emerge as consensus leaders or figure heads over time. I don’t even think he was active between ’57 and ’62. He taught, preached, and had a familyl Women’s suffrage in the U.S. was the work of forgotten extra Mormon wife’s, not Alice Paul and Lucy Burns (I had to go to wiki). Instead of waiting on King to come down from the mountain and take us to the promised land (King cast himself as Moses who died only seeing the Promised Land and not the Messiah to King; the Israelites had to muddle through on their own), you have to recognize there is no savior on the horizon.

      I knew Obama would be a disaster when I saw people use the “don’t worry. Obama has got this, ” routine because they saw him as a savior and would reward him for any behavior. We (I wasn’t born) weren’t lucky to have King or anyone like him because people understood you have to be the change. They didn’t look for saviors.

  18. Don Levit

    Regarding subsidies, they certainly are needed.
    Group insurance for a family of four is around $15,000 a year.
    That would be equivalent to some mortgages.
    But what effect will subsidies have on the premiums?
    i believe that which you subsidize, people will buy and utilize.
    If correct, premiums should go up faster with the subsidies than without.
    There is one catch, though.
    Subsidies are based on the second lowest cost silver plan in each state.
    If 2 insurers could consistently be the 2 lowest premiums by a significant margin, they will not only corner the market.
    They will also reduce subsidies over time, saving the government millions of dollars!
    Those insurers could even be not-for-profit , earning their status through “lessening the burdens of government.”
    National Prosperity Life and Health will make a significant difference starting Jan. 1 for self-funded employers of 250 or more, with our patented Health Matching insurance.
    Once we go on the exchanges (estimated some time in 2017), we will partner with another insurer to eventually be the 2 lowest cost silver plans, by a huge margin.
    Maybe even carve out a portion for a non-profit insurer through “lessening the burdens of government.”
    Don Levit

  19. frosty zoom

    here’s the form i fill out in on-tair-eye-oh:

    http://www.cra-arc.gc.ca/E/pbg/tf/5006-c/5006-c-13e.pdf

    scroll down to page 3 to see what we do.

    (holy cow, the top rate (over $200,600) is $900).

    unformatted it looks like this:

    Ontario Health Premium Enter your taxable income from line 31. 1
    Go to the line that corresponds to your taxable income. • If there is an Ontario health premium amount on that line, enter that amount on line 65 above. • Otherwise, enter your taxable income in the first box, complete the calculation, and enter the result on line 65 above.
    Taxable income
    Ontario health premium
    not more than $20,000 = $0
    more than $20,000, but not more than $25,000 – $20,000 = × 6% =
    more than $25,000, but not more than $36,000 $300
    more than $36,000, but not more than $38,500 – $36,000 = × 6% = + $300 =
    more than $38,500, but not more than $48,000 = $450
    more than $48,000, but not more than $48,600 – $48,000 = × 25% = + $450 =
    more than $48,600, but not more than $72,000 = $600
    more than $72,000, but not more than $72,600 – $72,000 = × 25% = + $600 =
    more than $72,600, but not more than $200,000 = $750
    more than $200,000, but not more than $200,600 – $200,000 = × 25% = + $750 =
    more than $200,600 = $900

  20. dannyc

    ‘you have to recognize there is no savior on the horizon.”
    “Savior,” ” Messiah” -Those are your words, not mine. All I said was that MLK was special and rare. In that category I’d also put John Maynard Keynes, Abraham Lincoln, Daniel O’connell…??????????
    WTF is Daniel O’connell? ( You may say.)
    Daniel O’connell was a lawyer. A NON-Violent lawyer – how rare is that – who lead demonstrations against the British Empire, where as many as 800,000 people showed up. These peaceful demonstrations (called Monster Meetings) followed only thirty/forty years after the American and French Revolutions and Napoleon’s bloody wars; so, they got Britain’s attention. O’connell had a huge influence on another specially and rare non-violent lawyer who struggled against empire: Gandhi. (Personally, my favorite thing about O’connell. is that he called George Washington a hypocrite for being a freedom fighter who owned human beings.)
    http://en.wikipedia.org/wiki/Daniel_O'Connell

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