10/31/13 Your Health Care Plan Come January 1

What’s it gonna look like? Are you wondering? If so, then you have lots of company. I think we are all wondering, and I think there will be no one unaffected, except for those on Medicaid; the rest of us will feel some impact.

Our President said, during his 2012 re-election campaign, “If you like the health-care plan you have now, you’ll be able to keep it. Period.” He said it several times. There are a couple of videos floating around on YouTube that I’m sure he wishes were not there, since they show him saying it over and over again, in different venues, on different dates. Maybe he believed it. Maybe not. Maybe he believed what his own minions (read that as sycophants) that surround him were telling him.

I think it might have been more accurate had he said, “If you like the health-care plan you have now, you will be able to keep it. Asterisk.” While that may have been more accurate, it doesn’t yield much of a dividend for a political campaign, does it? There are so many caveats surrounding what one may be able to keep or not keep as their health care plan, the statement the president made was an outright prevarication, which is a kinder yet no less direct way of saying that he lied. Now his minions are turning to the law itself for clarification of what he really meant by saying what he said.

The Patient Protection and Affordable Care Act, as it is officially called, or the ACA for short, or Obamacare as it first became somewhat disrespectfully known, but is now being called that even by Valerie Jarrett, the President’s most senior adviser, which means that it is perfectly acceptable for me to call it that, too, has specific language that sets the minimum standards for a health insurance policy. Many existing catastrophic policies and “mini-med” policies do not meet those standards, so, by law, they can no longer exist. That means that even though one likes them, they cannot keep them. The administration is relying on the language of the law for this elimination of these classes of health insurance policies.

Yet, the administration has granted waivers to the law, choosing unilaterally to apply it some places and not in others, seemingly at will, including waivers of self-insured plans administered by unions. Millions of people’s insurances were waived so that they did not have to comply with the law. Those waivers were granted to unions and large employers who had some clout. A single person purchasing insurance for themselves and their families lack that clout, so they got no waivers.

The administration also chose to grant a one-year waiver of the employer mandate, having reasonably decided that imposing it now would result in some serious job eliminations to stay under the 50 employee threshold, or some substantial hour cut backs to keep employees under the full-time status of 30 hours per week or more. This was a great boon to business. Large employers have political clout. Again, a single person purchasing insurance for themselves and their families lack that clout, so they get no waivers.

The administration, at the pleading of congress, saving them the potential danger of doing it themselves by legislation bound to cost some of them their careers, waived the requirements of the Grassley Amendment that would place Members of Congress and congressional aides and staffers under the aegis of Obamacare, subjecting them to the same income/subsidy relationship as all other Americans who are required to obtain insurance on the exchanges will face. Thus, the law as it stands for Americans in general will not apply to Congress, who will get to keep their employer contributions even though the law specifically says that they cannot. This has infuriated many Americans. The reason given for this was that it would cause a brain-drain in Washington, as if more lucrative jobs awaited those aides and staffers outside Washington, who are the ones who actually wrote and the only ones who actually read the behemoth Obamacare bill, since government jobs nowadays pay more than their private counterparts. Some creatively diligent patent-medicine salesmanship has gone into the selling of this, but no one seems to be buying.

That’s a lot like the Obamacare Exchange Website. No one seems to be buying there, either. What idiot decided, apparently at the last minute, to force you to “enroll” before being able to look at plans and prices. The enrollment means nothing until the plan is bought and the first premium is paid. I wonder how many enrollees have not bought, or have actually enrolled and pressed the BUY button, but will never send in the first premium check. And if they send the first premium check, I wonder how many will send the second? Or how many will send December’s premium payment?

One can count on seriously ill people to make great sacrifices to pay their premiums. The healthy ones? They may just decide to skip December’s since there are many other things to spend their money on than insurance they don’t think they really need, since they are healthy enough not to need any health care, whatsoever. What they won’t realize, until it’s beyond repair, that it isn’t just a matter that they weren’t covered for December and they can pick back up in January, having skipped December…their policy will have lapsed, and it must be re-instated, or they must apply for a new policy during the open enrollment period. This will subject them to the penalty, not just $95 the first year, but $95 or one percent of their income, whichever is greater. Most of them will be making more than $9,500 per year.

I am covered under a waived union plan. Under the rules of the waiver, the plan must come in to compliance by January 1, 2014, without any excessive rate increases. Excessive here is being defined by HHS. I’d be willing to bet that the basis will be somewhat arbitrary based on the clout of the waivee, but I am speculating. My speculations, however, are not without some historical precedent. This has yet to be determined. What has been determined, though, is that if and when my plan comes in to full compliance, it will be considered a “Cadillac” plan, and I will be subject to taxes on the employer contribution.

Right now, insurance on the health care exchanges is based on actuarial tables prepared with the input of government. Someone made some calculations of who is likely to join and what the likely income and the likely payout is likely to be. That is a lot of likelies in one sentence, too many to make an insurance actuary comfortable. If you do not know what an insurance actuary is, he is the person who looks at statistics, preferably based on data collected over time, to determine the income/expense of an insurance product which is used to determine the premiums charged so that the insurer can stay solvent while still being able to pay claims. An insurance company that is nearing insolvency can find their license to sell insurance in a particular state revoked, and every state has an insurance commissioner, of an office of insurance that looks into the fiscal viability of those companies allowed to sell insurance products in their states. The Federal government does not regulate this….states do, and each one has their own requirements.

Once actual data is collected, we can expect the insurance premiums to rise. Under Obamacare, insurers have to justify rate increases, and they must pay out a certain portion of their income, with only a certain percentage allowed for overhead, expenses and, (GASP!) profit. Excess profits must be refunded to someone. I’m not sure if it is the policyholders or the government. I’d be willing to speculate that the government gets this money, but that is pure speculation since I don’t know. I admit of speculation. I am prone to it and am seldom lonesome for it, gleefully indulging myself with a sometimes reckless abandon.

“I speculate that if you like the health care plan you have now, you may, in special circumstances, be able to keep it. [Asterisk-deleted].” might have said the president much more accurately. But one cannot run a political campaign on that sort of statement.

“The health care plan me and Michelle have is better than yours,” might have said the President with no speculation involved, “And even though we mean-spiritedly closed the Grand Canyon and every other thing visible and painful to the American people during the nasty government shutdown perpetrated by unpatriotic, recalcitrant, obstreperous, and reprobate Republicans, we kept the golf course at Andrews Air Force Base open so I could have a little time away from the hectic duties of my office.” He might have said that, and if he had, he would have been telling the truth, but one cannot admit of such things. One must listen to one’s advisers who whisper of their greatness in their ears, ears longing to hear such whispers.

Valerie Jarrett actually said of Barack, as she referred to him in an interview, “…I think he has never been challenged intellectually…He’s just too talented to do what ordinary people do.” That leaves us with a couple of assumptions, one of which is undeniable…Ms. Jarrett thinks he is intellectually unchallenged and above the ordinary things other people are faced with. The other is that Barack Obama thinks this of himself. Perhaps this is why  he was not more personally involved with the roll out of the piece of legislation that bears his name. The nuts and bolts by which mechanisms are held together, the fasteners that keep them in place and stop them from flying apart when force is applied, the very force that they were designed to handle….well, those nuts and bolts were just too ordinary for such a talented person. Those mundane things are better left wholly in the hands of small minded people. The small minded person he left in charge was Kathleen Sebelius, who, apparently taking her cue from the President, felt that those nuts and bolts were far to mundane for a person of her talents, and who accurately but arrogantly reported to Congress that she works for the President and the President alone, while being unable or unwilling, or both, to answer any questions in a congressional hearing. She deferred to Marilyn Tavenner, the administrator of the Centers for Medicare and Medicaid Services (CMS), who admirably did her best at explaining why things were like they were and what rapid fixes we could expect for the obvious malfunctions, who very unadmirably failed to reveal any numbers on actual Obamacare enrollees, saying that those numbers would be available in mid-November. She either knew and would not say, which is bad, or she literally did not know, which is even worse.

The President, Sebelius, and Tavenner, or all three of them, or others (most likely others we will learn as they explain their actions from under the bus) hired the Canadian company, CGI International, as one of the contractors to design the website, which, with many cost overruns, cost about $600 million only to work as good as it does, which is hardly at all. Apparently the thing that CGI International is best at is lobbying for large, no-bid government contracts and the ability to satisfy bureaucrats with all the complex government contracting paperwork required by law to be a large, regulation compliant government contractor, both of which is far more important to a bloated government bureaucracy than actually delivering any useful work at the contract price.  No one bothered to check that the government of Canada had fired them, as well as the government of the province of New Brunswick. Having a good lobbyist helps you get through several past incompetencies when being vetted for such a huge government contract. And having Senior Vice-President Toni-Townes Whitley, a friend and Princeton University classmate of Michelle Obama, who are both members of the Association of Black Princeton Alumni doesn’t hurt either. While it certainly didn’t hurt, I wonder if it helped? I will wonder about that for a while.

Did I also mention that Whitley is an Obama campaign contributor and a contributor to his victory fund? I might get around to wondering if that helped a little bit, too, since her contributions as reported by the Federal Election Commission seem generous but not excessive for one whose friend’s husband is running for President of the United States of America, which is pretty impressive.

While I am wondering, let me wonder why Princeton allows a black alumni association? What is wrong with just being a member of Princeton’s regular old alumni association? I will speculate that many Princeton alumni may be asking themselves this same question right about now, perhaps wondering where their large, open-ended, no-bid government contract is. Maybe it’s in the same place as their winning Powerball ticket. I don’t think that even a good lobbyist can help you acquire a winning Powerball ticket beyond recommending that you try your best purchase one that has the winning number, but a no-bid government contract coming on top of a string of previous firings for failures to deliver services to other governments is a piece of cake.

I think I will call the Obamacare toll-free number (which has a terribly ironic numeric acronym associated with it) and ask to speak to the supervisor, either Ms. Tavenner or Ms. Sebelius and see if I can get them on the line, or at least to return my phone call. If I complained about not being able to speak to them, they’d likely say that they are far too important and busy to speak to an ordinary person about a personal problem. They’d most likely tell me about the law and how I have to comply with the law. I doubt I could get a waiver of any kind, since they would say that the law is the law, and I cannot be exempted from the law.

“Hmmmmm!” I might say to Ms. Sebelius, but not wanting to ruffle her feathers, just let that lay there for a moment.

“Is there anything else I could help you with, sir? I am extremely busy reporting to the President for whom I work directly.”

“Do you think you might be able to help me get one of those no-bid government contracts?” I might ask.

“To do what?” she might ask back.

“Oh, just about anything you want, I reckon,” I might say.

“Well, what qualifications do you have for offering any services to the government on a contract basis?” she might ask.

“I’ve never been fired by any other government for failing to perform, which, I think, is a pretty good qualification, besides, I have a Princeton tee-shirt, which seems to be as good a qualifer for performance as an actual Princeton education,” I might say, adding, “But it’s got an egg stain on it that just won’t wash out. I hope that doesn’t disqualify me.”

“CLICK,” the phone most likely might say.

That’s about the most accurate likely that is contained in this document, and I don’t even have to speculate about that.

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