An editorial in the Bangor Daily News on March 12 chastised Republicans for not taking swift enough action implementing the Affordable Care Act or Obamacare ( “Republicans in Legislature—get on board with health insurance help”).
Obamacare mandates that states have until Jan. 1, 2014, to create health insurance exchanges. The editorial described exchanges as a panacea where consumers will find insurance coverage both understandable and affordable thanks to new government subsidies. The editorial specifically states that “insurers will become more competitive on price and coverage because they will be on a level playing field throughout the country.”
In reality, Obamacare will drive insurance rates up. We should applaud any effort to prevent this catastrophe from ever becoming a reality in Maine.
Let’s start with the concept of Obamacare putting insurers on a level playing field throughout the country. The provision of the ACA that would have started to accomplish this is the “essential health benefits package.”
Under the law, states must ensure the essential health benefits package covers several categories of care, including preventive care, emergency services, maternity care, hospital and physician services and prescription drugs. The idea was that the federal government would establish a base level of coverage necessary in all plans nationally as part of the mandate that we all purchase coverage. The floor would be the same regardless of state, rather than the state-by-state discrepancies associated with individual state mandates.
Guidance released this past December, however, simply pushed the responsibility to each independent state, essentially locking Maine in its current mandate and cost structure. Yes, that would be the structure currently producing some of the highest health care costs in the country.
Add to that the fact that health plans have to meet certain actuarial values under the ACA. That is a formula that determines the minimum portion of an individual’s health care expenses a policy must cover. The result will be many individuals and small businesses in Maine having to trade in their current policies for more expensive coverage.
We also seem to be putting a lot of faith in the government to make insurance understandable. The BDN editorial states that “the idea behind the exchanges is to make it easy for consumers to understand their options for health insurance and to shop with confidence.” The ACA also requires insurance companies to provide a standardized four-page benefit summary intended to make it easy for consumers to understand their coverage.
Any guesses on how many pages of regulations the feds have produced to offer guidance to insurers in creating these new benefit summaries? To date, over 250. Yet we are supposed to simply accept that, just because the government says so, insurance contracts will suddenly read like a kindergarten book.
The simple truth is that health care is complicated. There are thousands of illnesses and courses of treatment that one might encounter. Much of health care is still art over science, and quality of care is still a subjective measure. Developing insurance policies to pay for health care are complex by nature and will be until health care is no longer complex.
The BDN editorial points to affordable coverage for Maine families. But let’s not forget that the ACA first increases the cost of health insurance by requiring plans to cover more out of the gate. Many individuals and small businesses that buy higher-deductible policies will be told their plans are not good enough, even if they work well for them now.
The only hope for coverage being “affordable” is with massive federal subsidies. These subsidies will burden all taxpayers, especially our small businesses.
Speaking of Maine businesses, let’s not forget the employer mandates that potentially subject an employer to new fines every time one of their employees purchases one of these subsidized plans in the exchange.
The simple reality is that Obamacare is a very poorly written law with vast consequences for all Maine residents. Exchanges will ultimately increase insurance rates, tax Maine employers and threaten the viability of our private insurance market. It will also create a massive new entitlement that we cannot afford.
Of course we should wait for the Supreme Court to rule before investing our time and resources to implement Obamacare. We must minimize the negative impacts of this law on Maine residents and businesses to the extent possible. Not only is this the responsible approach, but we should be thanking the Republicans for protecting Maine’s interests by pushing back against this misguided law.
Joel Allumbaugh is director of the Center for Health Reform Initiatives at the Maine Heritage Policy Center. He also is CEO of National Worksite Benefit Group, Inc., an employee benefits insurance agency specializing in consumer-driven health plan strategies. He serves on the board for the Maine Association of Health Underwriters.
Thank you for this timely article. I just read an AP article by Ricardo Alonso-Zaldivar stating that this exchange ruling is out just 2 weeks prior to a Supreme Court ruling on the legitimacy of the entire Obamacare plan per the lawsuit by states. He states that it is a 660 page ruling giving states until January 1, 2014 to have exchanges in place, and if they do not, then the feds will step in to run them. Obama’s administration has asked for $8oo,000,000. to run the Federal exchanges. Republican governors have ‘panned’ it, he says–meaning to severly criticize it, I presume.
MHPC talking points rehashed. Nothing new here.
Hopefully the Supreme Court will rule according
to law and not because of their ideology and prevent
this from going too far.
We need a plan that everybody pays something instead those who are lucky enough to have insurance aren’t the only one’s paying. A system with more equity, yet more affordable.
Canada – run by Conservatives – Universal Health Care
Britain – run by Conservatives – Universal Health Care
France – run by Conservatives – Universal Health Care
Germany – run by Conservatives – Universal Health Care
Here’s a statement from the British Conservative Party website:
“We are committed to an NHS that is free at the point of use and available to everyone based on need, not the ability to pay.”
http://www.conservatives.com/Policy/Where_we_stand/Health.aspx
Universal Health Care isn’t Socialist or even Liberal, it’s just civilized.
I’d like to hear what you have to say about it – if it remains law – in a few years. I would be willing to bet you will be very unhappy with our dear leader.
MHPC– wrong as usual
how can anyone believe the HPC?
Heritage Predicted That Under The Bush Tax Cuts, “The National Debt Would Effectively Be Paid Off By FY 2010.” A 2001 report by the Heritage Foundation made the following assessment of what the Bush tax cuts would mean for the economy and federal budget: Under President Bush’s plan, an average family of four’s inflation-adjusted disposable income would increase by $4,544 in fiscal year (FY) 2011, and the national debt would effectively be paid off by FY 2010.
The net tax revenue reduction, after accounting for the larger tax base that would result from higher employment and faster economic growth under the Bush plan, is $1.1 trillion from FY 2002 to FY 2011, 33.4 percent less than conventional static estimates.
The plan would save the entire Social Security surplus and increase personal savings while the federal government accumulated $1.8 trillion in uncommitted funds from FY 2008 to FY 2011, revenue that could be used to reform the Social Security and Medicare systems and reduce the payroll tax. [Heritage Foundation, 4/27/01]
Pre-9/11 projections not applicable to a post-9/11 world. Who knew.
{The simple reality is that Obamacare is a very poorly written law with vast consequences for all Maine residents}
The simple reality is that there is no such thing as { Obamacare }!
Amen!
Please don’t force me into this broken monoculture.
There are so many “issues” in this Opinion, but just for starters:
Many individuals and small businesses that buy higher-deductible policies will be told their plans are not good enough, even if they work well for them now.
Seriously???? These “catastrophic coverage” policies work well for them???? Has it ever occurred to you the people that can even afford this so called “coverage” can’t afford anything else, and that’s not counting the many that can’t even afford “higher deductible”.
The second of many issues is to consider the source of this Opinion……..
The following is an excerpt from Bloomberg News article:http://www.bloomberg.com/news/… Cato is, well, “the foremost advocate for small-government principles in American life.” It advocates those principles when Democrats are in power, and when Republicans are in power. When I read Cato’s take on a policy question, I can trust that it is informed by more than partisan convenience. The same can’t be said for other think tanks in town.The Heritage Foundation, for instance, is a conservative think tank that professes to pursue goals similar to Cato’s. Where Cato’s motto is “individual liberty, free markets, and peace,” Heritage’s mission is the advancement of “conservative public policies based on the principles of free enterprise, limited government, individual freedom, traditional American values, and a strong national defense.”In practice, however, whatever the Republican Party wants, so does Heritage. In 1989, Heritage helped develop the idea of universal health care delivered by the private sector through an individual mandate. In the early 1990s, it helped Senate Republicans build that concept into a legislative alternative to President Bill Clinton’s proposed reforms.
In the early 2000s, Heritage worked with then-Governor Mitt Romney to implement the plan in Massachusetts. Then, when Obama won office and Democrats adopted Heritage’s idea, Heritage promptly fell into step with the Republican Party and turned ferociously against it.
Cato may not be independent for long if the Koch brothers have their way. They are suing the other living partner to take control of the deceased partner’s shares. I think if you just google “Cato Institute” you should be able to find more detail.
Joel Allumbaugh is director of the Center for Health Reform Initiatives at the Maine Heritage Policy Center. Impressive title isn’t it? It kind of conjures up thoughts of fancy big buildings like The Lincoln Center, The Rockerfeller Center, maybe the Staple’s Center in LA where the Lakers play or even The Collins Center at the University of Maine doesn’t it?
Fancy offices with mahogany paneling, well dressed people holding meetings, all kinds of employees busy at computers, answering phones . With the amount of power that the Maine Heritage Policy Center has within current State Government you would be right in expecting these things. Except for one itsy bitsy problem. There is no building, no fancy offices, no people well dressed or otherwise, no computers nope none at all. What there is is a post office box in Portland. That’s right, the one group that has more power then perhaps any other in The State of Maine doesn’t even have an office. What you have is The Grand Wizard and his clan of highly paid political operatives and a lot of really swell titles. They are great with titles everyone is a director of something or other. In addition to his duties in the post office box Joel
is CEO of National Worksite Benefit Group, Inc., an employee benefits insurance agency specializing in consumer-driven health plan strategies. Another impressive title. What Joel really does is sell insurance. Selling insurance is an honorable profession. Of course if “Obamacare” isn’t shot down by the U. S. Supreme Court then I wonder what Joel will be selling?
They really don’t want Obama care because they will be forced to insure all Americans. They don’t want to insure everyone, especially those who might cost them money. The insurance industry loves the current system where they can cherry pick their clients.
If I were an insurance salesman I’d rejoice in the government telling everyone in the country they must buy insurance. Glad this mandate dosen’t say every desert dweller must buy a bridge or every eskimo must buy a freezer! In reality there are some problems with this mandate ! Can you say ” free market ” ?
It’s not the policy of the insurance salesman. It is the policy of their employers who tell their salesman to not sell policies to those with prior medical conditions. The so called “free market” is rife with collusion among the marketeers.
So why not just change insurance laws to reflect that. There’s more to it than that !
I believe that is what Obamacare is trying to address.
Medicaid is broke now. What do you think is going to happen when millions more people are put into this program? Obamacare should have only been for those people WITHOUT insurance, not for the entire country. It is far from an affordable care act.
I personally think we need a national health care system. Wether it mirrors Canada’s or one of the EU nations or a combination of parts of all of them.
There is NO such thing as FREE health care. Someone somewhere along the line pays for it.
As it stands now 90% (guess on my part) of the people who have health insurance, have it through their employee benefits packages. If they were to lose their job, most of them couldn’t even maintain their coverage. Even with a COBRA plan. Millions of people can’t even get insurance unless they pay rediculously high premiums with huge co-pays if they have a pre-existing condition.
Will Obamacare fix all the problems? Probably not. It may address a lot of them. Some of them allowed my granddaughter to have an operation on her fathers insuarnce.
Thanks very much for your post.
Why would a title conjure up that type of imagery unless you had prejudices
He will probably be there when we all discover just what is in this ‘marvelous’ package, as Ms. Pelosi said. Be very afraid.
The MHPC is a bunch of greedy corrupt corporate toadies more interested in helping insurance company CEO’s have more mansions and limos than in helping people have healthcare. Same old same old corporatist propaganda, the American middle class be damned. Well, they are going to help make sure the Maine GOP gets crushed in November. Make no mistake of that.
Liberals are people whose only goal is to remove rights and perpetuate poverty. Without the ability to use tax dollars to buy votes; the Democratic party would cease to exist. Talk about greed, ask where all the trillions went fighting the war on poverty. Into the pockets of the Democratic Party.
How can the federal government force anyone to purchase anything? If you don’t purchase, you get fined. Same difference,,,,,,,unless you don’t work.
Actually that isn’t true at all. You can work, but make less than 70k a year. Also, if you make over 70k a year, you don’t have to buy insurance then, you can pay a small fine to cover the cost of your burden on society. Also, one other fact, our Founding Fathers required all sailors to purchase health insurance, so they believed the federal government could force people to buy things.
1. The 1789 Act only applies to a limited group of people, not everyone in the United States.
2. The Act set up a government-run healthcare system for sailors. It did not require them to purchase health insurance from private companies.
3. It was never a controversy in court, so it’s hard to analogize what it means, if anything, for the personal mandate in modern courts.
Source: Harvard Law and Policy Review – Marshall Thompson
And if you do not pay the fine you eventually end up going to jail.
Liberals claim that because the ACA never directly says anything about going to jail that saying you will go to jail is a lie. It doesn’t have to mention it for that to be the end result to an individual who fails to comply with the law.
Our government was designed as “of the people, by the people, for the people…” Why are you against the people? So the people ARE the problem, is that it?
Of course, the government is no longer “of the people, by the people, for the people…” but is “of the corporation, by the corporation, for the corporation…” something folks on the right seem to think is just peachy… I guess that proves it, the people are the problem…
“of the people, by the people, for the people” is a quote from Lincoln’s Gettysburg Address. It is first attributed to abolitionist preacher Theodore Parker. It appears nowhere in either the Declaration of Independence or the US Constitution.
And, so, that justifies your premise?
My “premise”, as YOU call it is that government is telling everyone that they must purchase a particular product as defined and specified by said government. The government has stated that failure to comply with this requirement will result in punishment in the form of a fine. Anyone who refuses to pay a fine will eventually have an arrest warrant issued and WILL end up before a judge. And if they still refuse to pay that fine they will go to jail.
This is all established law and considered legal due process. I would say my “premise”, as YOU call it, is actually FACT.
And by what convoluted logic does “of the people, by the people, for the people” have to do with any of this?
Darn, I do have to remember. Progressives do not do well with logic, facts, history, etc. Feelings, ideology, and good intensions are to substitute for said logic, facts, etc….
Whatever, dude.
Just more obfuscation from the health insurance sector. For a different perspective read T.R. Reid and get an unbiased insight into the US health-care fiasco: http://www.washingtonpost.com/wp-dyn/content/article/2009/08/21/AR2009082101778.html
A national health-care policy need not be complicated and can be built upon a simple private market approach. Take the employers out of the equation so insurers can no longer discriminate between members of pre-selected groups and individuals who must procure individual or single family policies.
Why use the private market? In Health care they have been shown to be much more costly and less effective than the government. In fact the administrative costs in the private market hovers around 30% and the government around 5%.
Again, read T.R. Reid’s book. The reason for the private market is that it would eliminate the GOP’s hang-up over government involvement. Switzerland, Japan and The Netherlands demonstrate that universal health insurance can be effectively provided by the private sector. The government’s role remains limited to regulation and subsidies for children and the indigent.
Just read your link. And actually I agree with most of what you said. Especially with getting employers out of the equation. Many of our present complaints about the health system are related to the employer based model. A model that was created because of government interference in the economy in the first place. I really want to know HOW the Japanese keep their costs down.
Mr Reid wrote a good article but I picked up one major incorrect fact in just this short piece. He said that the foreign health insurance plans exist only to pay people’s medical bills, not to make a profit. That is not strictly true because they are allowed to make a profit, especially on supplemental plans that cover more. Then he said “The United States is the only developed country that lets insurance companies profit from basic health coverage.” I would be careful with accepting his blanket statement but from my own limited research it appears to be true in many countries. (No one source is 100% right and more study needs to be done.)
I take exception with his minimizing the effects and extent of long waiting times for non-emergency care in many of these countries. And using elective medical care as an example of how they are as good as we are really isn’t pertinent. , Elective care is usually not covered by insurance in any country and is paid for out of pocket and is therefore subject to free market influences. The same can be said of plastic surgery and lasic surgery in this country.
One problem with the AFC is that it really does not draw from the good examples of how this is done in other countries. In many countries the mandatory plan is a basic health care plan. If you want more or better care you need to purchase a supplemental private insurance plan. The ACA appears to try and cover everything. One size fits all and this is a recipe for uncontrolled costs.
Another problem that drives people like me nuts is the outright lies and pandering used to justify and sell this law. The politicians are afraid that if they tell the truth that people may say no or even kick them out of office. Tell us the truth and we can have an honest discussion as a society about health care. Society as a whole may well decide this is how we want to do it. But STOP LYING.
And lets be honest. The legal profession sees medical lawsuits as a giant cash cow. Attorneys are standing in the way of real medical care reform and cost control as much as the insurance companies. If not more.
Thanks for taking the time. Reid’s book on the subject goes into much greater detail.
We are largely in agreement. I am fairly familiar with some of the overseas arrangements and, yes, insurance companies are usually allowed to make a profit on supplemental policies. Those policies do lead to differentiated services for wealthier clientele but that will always be the case, even for the UK.
Like you, I have been tearing my hair out over the obstinate refusal by Congress to try and learn something from those countries that have functioning lower cost systems in place, that could likely be modified to accommodate US concerns or conditions. Finally, one of my pet peeves is that may local medical facilities around the US charge patients, and reward administrators as though they function in major urban US environments. In reality many administrative positions are occupied by local talent that could easily be recruited atl salaries more commensurate with local industry.
For the sake of the argument, what is the political difference between a corporate monopoly and a government monopoly?
Oh, nevermind…let’s just let Obama and all his political operatives fix this so we can live happily everafter.
Fall to our knees!
Having one’s head firmly planted in one’s nether region does not an argument make. Analysis of the ACA by responsible, non-partisan, non-idealogical, fact-based organizations, the Congressional Budget Office for one, is correct to point out that the long term effects of implementation of the ACA will be DEFICIT REDUCING and help control Medicare costs, the single largest driver of long term deficit increases.
Of course, the option the VAST majority of the common folks in this country want, those people no longer represented in Congress having been pushed down and stepped on by the corporate lobby that dominates Congress’s lawmaking, the option these people want is single-payer health care like most every other CIVILIZED country has in one form or another. The for-profit health care system the corporatist Congress bows obsequiously to, with its de-facto death panels, called Cost Containment departments to make them sound reasonable and business-like, is killing people when it is not fleecing them, offering one more way for the middle class to face a financial crisis and fall through the cracks into ruin and homelessness.
The German system is not single payer.
The Swiss system is not single payer.
Italy’s system is so bad that most people take out private insurance.
Most French people take out private insurance as well.
I could go on.
And each one of them does better than our system. Ours is the most expensive, by far, with worse outcomes than all of those….
I too could go on…
Whatever
yep.
I guess you have not heard that the Congressional budget office just revised it’s estimates of the cost of the ACA. They just doubled the expected cost and it has not even been implemented yet. Get ready for continued revisions to the cost estimate.
Come on! The Maine Heritage Policy Center got us into the situation we’re in. Repubs are against anything that would be compasionate for PEOPLE! They’re still fighting Social Security! Their only solution to anything is cut help to the majority and give MORE to the rich! Typical trash from those quarters!
Grow up!
I would thank Republicans if they stepped down and turned themselves in for stealing from the American people for so many years…
If you call living on a small social security disability check stealing then this republican says ” guilty ” !
What are you talking about? That is so stupid. Go drink more kool-aid.
Single payer, please.
How can you blame Obamacare for our state’s current absurdly high insurance costs??
Sounds like more of the same from the MHPC……. the non-truth……
Where and when did this country become derailed from the premise that people provided for themselves, and families looked out for family members. Instead, everyone is lined up at the feeding trough waiting for their piece of the pie. Government being the provider. It’s so much fun seeing over half of my income get burned off, and now they just want more because it’s my civic duty. Time for people in this country to accept personal responsibility in their life, make healthy choices, try and succeed financially, and have a road map instead of relying on government. Go ahead and flame me. Doesn’t matter to me. Certain posters here just don’t get it. I suppose they would if they lived in Europe. Great system over there.
Finally… an article which makes sense. This will make the libs skin crawl. We must prevent the government from controlling health care, I believe they want the money to flow through their hands, and guess what… they will want some of it.
ha ha ha ha ha ha ha ha ha ha ha ha ha ha ha
ha
Obamacare will drive up rates……really, are they not going up now? Fifteen years of double digit increases now!
It goes too far in defining what comprehensive coverage is. Do we like the way the insurance companies have been making these decisions? They have continuously scaled back what is covered and instituted lifetime maximums and other ways of not paying claims. We should trust them instead?
This is a law that was written by the Heritage Foundation. It is almost identical to the Bob Dole plan to counter Hilarycare in the 90s. This is not a radical plan. It is not socialized medicine. It is not government run healthcare. It is not death panels. These are all lies.
The echo chamber of lies has been dedicated to fighting this basic contract of justice and responsibility. If you pay for coverage, you should get coverage. Nobody should not have access to care. If you want to be in the insurance business you have to cover sick people too, not just well people.
The reason this is being fought so hard is simple. It will work. Once in place, nobody will be able to imagine life without it. It is not a handout. It is insurance run by for-profit companies.
There was a recent economic analysis that showed that if the US spent per capita what the second most expensive country spends on health care, we would run no deficit. If you care about deficits, this is how you make a big impact in them. You cannot cut enough from this program or that to get to a balanced budget. This is the single most powerful tool to reduce this scourge on our future.
Yes rates are going up now because some parts of Obamacare are already in play.
Okay but….rates have been increasing since Obama was an undergrad….most years by 10+ %. You can choose to blame him for the last quarter century of runaway costs. It would be ridiculous to do so but the haters have blamed him for crazier things than that.
I know a lot of folks might not want to let a few facts get in the way of their pre-conceptions about the ACA controlling cost, but:
http://www.nejm.org/doi/full/10.1056/NEJMp1201853?query=featured_home