Thursday, July 4, 2013

The Health of American Democracy

And the man who killed it:

"Health mandate reprieve probable; 18-month delay set for employers" by Chelsea Conaboy and Tracy Jan |  Globe Staff, July 04, 2013

Massachusetts employers, which are required to pay a penalty if they fail to provide health insurance for their workers, are likely to get an 18-month reprieve from the mandate, a central piece of the state’s first-in-the nation health care law.

The state budget awaiting Governor Deval Patrick’s signature would repeal the penalty to clear the way for a similar provision in the federal Affordable Care Act that was set to take effect in January. But the Obama administration announced Tuesday that it would delay the employer penalties in the national law until 2015, citing the complexity of the program.

Patrick said Tuesday that he was still considering whether to take action to extend the state penalty but was likely to move ahead with the repeal.

“We’re going to look at that,” he said. “The point is we’re going to be ready when the federal government is ready.”

A spokesman later said in an e-mail that employers in Massachusetts, where there is near-universal coverage, already are more likely than those in other states to offer health insurance and the delay in the federal law’s penalties was unlikely to change that.

The wait may make little difference in the lives of most people. In Massachusetts, employers will have little incentive to drop coverage only to have to buy it again months later, business leaders said. And nationally, more Americans will have an opportunity to buy insurance from state exchanges this fall if their employer doesn’t provide coverage.

It's not an "opportunity," it's a mandate -- the very essence of the opposite of freedom.

But some advocates for the landmark federal law say they are concerned that political pressure is eroding the Affordable Care Act’s framework and that the employer penalty could face further challenges.

Rob Restuccia, director of Community Catalyst, a national consumer advocacy group for health reform based in Boston, said he was puzzled by the delay, announced during a holiday week when Congress is on recess.

I'm not puzzled at the release at that time (posted on a website no less!). It's a Slow Saturday Special only better!

“In Massachusetts we implemented something that’s relatively complicated, that’s not that different, and that was fairly effective, so why the administration did this is really not clear to me,” he said.

It is to me! As we were told yesterday, it is ALL POLITICS!

The Massachusetts mandate, referred to as the “fair share employer contribution,” was a key part of the 2006 law, meant to prevent businesses from dropping insurance plans and swelling the rolls of people receiving subsidized plans or charity care.

Then-governor Mitt Romney vetoed the provision but was overridden by a Democrat-dominated Legislature. Under the law, businesses with more than 10 employees that do not provide adequate coverage are fined $295 per employee.

Employer coverage has held about steady in the years since its passage. In 2011, about 62 percent of Massachusetts residents had insurance through their employer, according to a state survey released in January. The report attributed a small drop in that rate in 2010 and 2011 to the recession.

The absence of an employer penalty may do little to change that rate, said Richard Lord, president of Associated Industries of Massachusetts. Many businesses see health insurance as an important recruiting tool, he said.

Pffft!

Business groups had lobbied the Legislature last year to change the state penalty, seen by some as overly onerous. Ultimately, Lord said, his group worked with the Patrick administration to repeal the state penalty altogether because the federal one, affecting businesses with more than 50 employees at a cost of between $2,000 and $3,000 per full-time employee, was imminent.

“We didn’t want to have overlapping penalties,” he said.

Amy Whitcomb Slemmer, executive director of the Massachusetts consumer group Health Care for All, wrote a letter to Patrick Wednesday urging him to put the state provision into effect once more.

“We are very concerned that this delay in Washington could be extended,” she said in an interview. “We very much want to stick with the formula that has worked thus far in Massachusetts, where everyone is contributing something.”

Obama administration officials have characterized the federal delay as a simple effort to “cut red tape” in response to small businesses that complained about the complexity of the law and threatened to lay off workers or cut their hours so they would not be subject to the penalty.

That's a LIE! 

"Small businesses and ordinary Americans will be able to go to one place to learn about their coverage options and make side-by-side comparisons of each plan’s price and benefits "

Yeah, they responded to BIG BUSINESS!

The move also could benefit Democrats representing swing districts in the run-up to the 2014 midterm elections, by appeasing businesses. 

Oh, so the move WAS ALL POLITICAL!

The delay illustrates the administration’s “flexibility and thoughtfulness” in implementing the new law, said Representative Michael E. Capuano, a Massachusetts Democrat. “I’d rather have it done right than done quickly.”

Qualities they didn't use in hastily writing and passing the pos.

But Republican critics seized upon the delay to attack the law Wednesday. Tea Party groups saw it as evidence that the law is a “train wreck.”

It is a wreck!

Senator Lamar Alexander, a Tennessee Republican and ranking member of the Senate Health, Education, Labor and Pensions Committee, said the delay is a sign of “Obamacare unraveling.”

“Pushing the implementation of the employer mandate until after the 2014 election confirms the law was an historic mistake,” he said.

Yup.

The administration lately has encountered hurdles publicizing the law. Republicans, who have blocked funding for outreach and enrollment, recently pressured the National Football League and other major sports leagues to distance themselves from promoting the law’s benefits, like the Boston Red Sox did in Massachusetts. The team was instrumental in getting young uninsured fans to sign up for coverage under the 2006 law.

Then it is over for Obamacare.

Republican lawmakers and governors in more than a dozen states are considering laws to make it harder for so-called “navigators” to educate and enroll the uninsured. Other bumps include a one-year delay in requiring that insurers adhere to a $6,350 out-of-pocket limit for individuals, as well as a delay in providing small business workers a choice in health plans.

You know what? I'm sick of the Globe always blaming Republicans.

The administration has yet to issue regulations on the law’s requirement that prohibits employers from offering more robust health benefits to executives than to average workers.

Oh, they haven't written those either? WTF?

Nor has it implemented a provision requiring businesses with more than 200 workers to automatically enroll them in health insurance.

Postponing the employer mandate will cost the government an estimated $5 billion that businesses were expected to pay in penalties next year.

A small price for Democratic political prospects.

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Also seeBudget plan adds Medicaid funding

At least there is health debate in AmeriKa, 'eh?

"Postponing health rules emboldens Republicans; GOP leaders seek probe into reason for delay" by Jackie Calmes and Robert Pear |  New York Times, July 04, 2013

WASHINGTON — The Obama administration’s decision to delay enforcing a pillar of the health care law, the mandate that larger employers provide insurance benefits, raised new questions Wednesday about the government’s preparedness to carry out the landmark law and emboldened congressional Republicans to open an investigation into the postponement.

Republican leaders of the House Energy and Commerce Committee demanded documents and other information from the Treasury secretary and the secretary of health and human services about the decision announced Tuesday to put off for a year, until 2015, the law’s reporting requirements and penalties. Some Republicans charged that the White House was trying to help Democrats by postponing the changes until after the 2014 midterm elections, but others saw no advantage for Democrats either way.

Absolutely. Once American see the forms they will have to fill out they are going to revolt!

“Despite delays and missed deadlines, administration officials had repeatedly testified before Congress that they were still on schedule to implement the law,” said US Representative Fred Upton, a Michigan Republican who is chairman of the Energy and Commerce Committee.

What, this administration lied again (yawn)?

“It’s clear we have no idea the full scope of delays and disarray that may be coming,” he added. “The American public deserves answers.”

On so many things.

While business leaders and political analysts struggled to assess the practical consequences of the surprise decision, Democrats and some nonpartisan health policy experts were quick to emphasize that about 96 percent of employers with more than 50 workers, who are covered by the mandate, already provide insurance. They argued that the issue was simply about delaying requirements for businesses to report on their coverage policies, as well as penalties for any noncompliance. Industry groups — especially those representing restaurant owners and retailers — had complained that the provisions were too burdensome and uncertain....

Wow. And yet hospitals have to comply!

 Josh Earnest, the deputy White House press secretary, said....

Who cares?

After returning from Africa late Tuesday, and with Egypt in turmoil, President Obama did not address the latest development for his signature domestic policy achievement, nor did senior advisers brief reporters. Certainly the action confirmed Obama’s prediction last month, at an event in California lauding that state’s progress in carrying out the law, that “when you’re implementing a program this large, there will be some glitches.” 

Obama the prophet! Gimme a f***ing break!

However limited the postponement was technically, it was sure to ripple out as a matter of both policy and politics. The delay also raised questions about whether new federal and state insurance exchanges, or the computer systems crucial to their operation, would be ready on time.

The federal government is creating a data network to help verify the income and citizenship of individuals buying policies in the marketplaces, which are to start enrolling people Oct. 1, to determine if the buyers qualify for subsidies.

Oh, look, ANOTHER DATABASE!

Through the network, each state exchange is supposed to be able to swap data with the Internal Revenue Service, the Social Security Administration, and the departments of Homeland Security and Health and Human Services, among other agencies.

That is WHY WE DON'T WANT THIS MASSIVE ANAL PROBE, sorry!

People with knowledge of the administration’s work to put the law into full effect said the postponement was in part a result of delays by the IRS and the Treasury Department in finishing proposed rules and regulations for businesses.

Catherine E. Livingston, who was the health care counsel at the IRS until February, said the delay was “a recognition of practical realities.” Employers and insurers are supposed to inform the agency of the people they cover. But without the final rules, employers and insurers could not program their computers to comply, said Livingston, a lawyer at Jones Day, a Washington firm.

Lame and weak excuses!

That uncertainty, in turn, fueled a campaign by employers lobbying for a delay. Business groups Wednesday continued to praise the administration for the postponement, which mainly provided regulatory relief to businesses that already insure their employees. With the threat of penalties also delayed, larger businesses that do not cover their workers will be under no pressure to do so before 2015.

But you better find a crappy corporate plan or face a tax penalty.

“With this temporary reprieve from a complex compliance regime, US companies will have additional time to find workable solutions to these challenges while continuing to provide employees and their families with certainty and peace of mind about their employer-provided health insurance coverage,” said Gary W. Loveman, the chairman of Caesars Entertainment Corp. and the leader of a health committee of the Business Roundtable.

It was always a gamble, folks.

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NEXT DAY UPDATE:



Globe coverage flat-lined.