Private Exchanges: Getting Ready For Individual Health Insurance To Be The Standard | The Beacon

December 31, 2013

So, what is emerging is large employers contributing fixed dollars to employees for them to buy state-regulated insurance from a portfolio in an exchange organized by a benefits consultant. To clarify: ACME, Inc., for example, as employees all over the country. Those employees are covered by a national, self-insured, ERISA plan, likely administered under a national contract with a benefits consultant. The benefits consultant has assembled a national network of providers by renting a large number of local provider networks. All the medical claims flow through the consultant to ACME for payment.

In the new world, the consultant organizes an exchange and solicits insurers in states where ACME has offices to join it. Employees now have a choice of state-regulated plans. ACME gives each employee a fixed contribution to pay premiums.

If private exchanges continue to grow as anticipated, it is easy to see how they could ease the transition into a future of individual health insurance, post-Obamacare.

via Private Exchanges: Getting Ready For Individual Health Insurance To Be The Standard | The Beacon.

What “Surge”? ObamaCare Enrollments Remain Dangerously Below 60 Percent Of Target – Forbes

December 30, 2013

Back in September — when some Obama administration health officials were hoping the ObamaCare website would crash during demonstrations so that somebody would have the good sense to delay its rollout — the administration’s more deluded officials were projecting ObamaCare’s Exchanges would enroll 3.3 million paying customers by tomorrow, December 31. Yesterday, the administration released figures suggesting that total enrollments are now just shy of 2 million, or 60 percent of the administration’s target.  When I was in school, 60 percent was an “F.” The Washington Post reports, “Still, officials celebrated the end-of-year results.” Of course.

via What “Surge”? ObamaCare Enrollments Remain Dangerously Below 60 Percent Of Target – Forbes.

If 2013 Was Hard on Obamacare, Just Wait for 2014 – Bloomberg

December 30, 2013

As bad as 2013 has been for Obamacare, the year ahead doesn’t look much better. In fact, 2014 has the potential to be even worse — for the law, the Obama administration and congressional Democrats.The drafters of Obamacare recognized that many elements of the law would be unpopular, while other provisions — allowing people up to the age of 25 to remain on their parents’ plans, ending co-payments for preventive care or closing the “doughnut hole” in Medicare prescription drug coverage — would be immensely popular with the voting public. These provisions all took effect shortly after the law was signed in 2010.So, what was left for 2013 and beyond, after Obama had been re-elected president, were a series of provisions that Democrats knew would cause more political and policy trouble. Millions of Americans in the individual market being dropped from their existing plans is directly related to Obamacare’s essential health benefits requirement, which mandates coverage across 10 categories and goes into effect in 2014. And the one-year delay in the effective date of the employer mandate, which now starts in 2015, was an attempt to delay some of the law’s negative labor market effects — cuts in wages, hours and employment — until after the midterm elections in November 2014.

via If 2013 Was Hard on Obamacare, Just Wait for 2014 – Bloomberg.

Report: Health Care Law Fraud Likely Without IRS Changes

December 30, 2013

Since the credit is refundable, it can benefit taxpayers who have little or no tax liability which makes it potentially more vulnerable to abuse, according to the audit. Republican Senator Orrin Hatch called the system, which effectively pays taxpayers first and verifies income later, a “fraudster’s dream come true”.

In outlining the audit findings Inspector General J. Russell George said, “The IRS’ existing fraud detection system may not be capable of identifying (Affordable Care Act) refund fraud or schemes prior to the issuance of tax return refunds.” Specifically, the audit noted that critical elements of IRS security controls failed when subjected to testing and that anti-fraud programs were still in development.

The report went on to say that, “Without adequate fraud mitigation controls, the IRS may be unable to identify ACA refund fraud or schemes prior to the issuance of erroneous refunds.” Auditors also said that the IRS had acknowledged limitations with its existing fraud detection system, including an inability to keep up with rising a levels of fraud.

via Report: Health Care Law Fraud Likely Without IRS Changes.

Biotech Visionary G. Steven Burrill Offers Predictions for 2014 – 12/19/2013 – The Burrill Report

December 30, 2013

As the year comes to a close, biotech visionary G. Steven Burrill issued his annual predictions for the life sciences in the new year. Burrill, CEO of Burrill & Company, a global financial services firm focused exclusively on the life sciences, says that though biotech’s upward momentum in the capital markets is likely to slow after its strong performance in 2013, the pace of innovation, the move toward precision medicine, and continued spending pressures will accelerate the transformation of healthcare.

“By any measure, 2013 was a banner year for the life sciences industry with surging stock prices, a record year for biotech IPOs, and the approval of important new products to help patients,” says Burrill. “We expect 2014 to be another strong year of performance for the sector. But companies will be challenged by continued demands to prove the value of their products and growing pricing pressures on innovative drugs from payers.”

via Biotech Visionary G. Steven Burrill Offers Predictions for 2014 – 12/19/2013 – The Burrill Report.

President Obama’s Top 10 Constitutional Violations Of 2013 – Forbes

December 30, 2013

Unfortunately, the president fomented this upswing in civic interest not by talking up the constitutional aspects of his policy agenda, but by blatantly violating the strictures of our founding document. And he’s been most frustrated with the separation of powers, which doesn’t allow him to “fundamentally transform” the country without congressional acquiescence.

But that hasn’t stopped him. In its first term, the Administration launched a “We Can’t Wait” initiative, with senior aide Dan Pfeiffer explaining that “when Congress won’t act, this president will.” And earlier this year, President Obama said in announcing his new economic plans that “I will not allow gridlock, or inaction, or willful indifference to get in our way.”

via President Obama’s Top 10 Constitutional Violations Of 2013 – Forbes.

Editor’s note: half of the top 10 violations relate to Obamacare.

2103: The Year The Progressive Narrative Collided With Reality – Forbes

December 30, 2013

2013 may prove to be the year the progressive spell was finally broken. The crash of Obama’s signature health care legislation, the Detroit bankruptcy, a hapless foreign policy as ill-defined as the Syrian red line, the meteoric growth of Food Stamp Nation, millions of long-term unemployed leaving the workforce, college graduates begging for jobs while struggling under $1 trillion in loans, the collapse of the global warming juggernaut, the debasement of the dollar with nothing to show for it but a stock market bubble—there are just too many progressive fingerprints on an unbroken string of failures for a good-intentions hall pass to carry much weight this time.

via 2103: The Year The Progressive Narrative Collided With Reality – Forbes.

How Many Healthy People Are Signing Up For Obamacare? The White House Won’t Say – Forbes

December 30, 2013

On Sunday, the Obama administration announced that a total of 1.1 million Americans have signed up for health insurance coverage on Obamacare’s federally-run exchange at While that number falls well short of the administration’s previous expectations of 3.3 million, it is a big step up; as of the end of November, only 137,204 individuals had “selected a marketplace plan.” But the Centers for Medicare and Medicaid Services continue to conceal critical data regarding actual enrollment in the exchanges—data that will tell us whether or not Obamacare’s insurance marketplaces will ever end up functioning as they were intended.

via How Many Healthy People Are Signing Up For Obamacare? The White House Won’t Say – Forbes.

A Large New Tax on Small Business –

December 29, 2013

ObamaCare includes so many taxes that it\’s hard to keep track, but one of the worst takes effect on Jan. 1. This beaut is a levy on health insurance premiums that targets the small business and individual markets.

At $8 billion in 2014 and $101 billion over the next decade, the insurance tax is larger than ObamaCare\’s taxes on medical devices and prescription drugs combined. The Internal Revenue Service classifies the tax as a \”fee\” but it functions like an excise tax on premiums. The IRS collects an annual flat amount specified by the Affordable Care Act to be allocated among the insurers according to market share.

via A Large New Tax on Small Business –

Fixing Obamacare: The Virtues of Choice, Competition and Deregulation by Richard A. Epstein, David A. Hyman :: SSRN

December 29, 2013

After a tumultuous and extended legislative process, President Obama signed the Patient Protection and Affordable Care Act (“PPACA”) on March 23, 2010. PPACA was “sold” to the public with an explicit promise that it would not interfere with existing coverage arrangements. President Obama repeatedly claimed “If you like your health plan, you can keep it,” and “if you already have health insurance, the only thing that will change for you under [my] plan is the amount of money you will spend on premiums. That will be less.”

It is now more than three years since PPACA was enacted — what lessons should we take from the first three years of PPACA? How likely is it that the government’s ponderous bureaucracy can keep the promises of President Obama? And, if government falters, as we think likely, what should the nation do instead? We sketch out our responses to each of these questions in this essay.

To summarize, PPACA is extraordinarily unlikely to lower health care costs, but it has significant potential to destabilize existing coverage markets. Our prediction is that neither of the two Obama promises will or could be kept, even were PPACA implemented more or less as written (which with each passing day seems increasingly unlikely). In our view, the problems that have already materialized in the first three years post-PPACA are merely precursors to greater difficulties to come – difficulties that virtually insure that PPACA will turn out to be an expensive and misguided failure, assuming that it survives at all.

PPACA’s fundamental design defect was to superimpose additional layers of regulation and subsidies on a system that was already top-heavy with both. These preexisting regulations and subsidies have already misaligned the incentives within the health care system. The next generation of rules will only compound the errors. In our view the right approach to these problems is to promptly initiate a program of systematic deregulation that will introduce the choice and competition that PPACA gives at best lip service to. The right sequencing of reform is critical. It is far cheaper to remove regulations and subsidies than to add them. Each of these maneuvers should work, as no regulatory scheme could do, to reduce cost and increase both access to care, and quality of health care. Then, and only then, is it prudent to consider further steps, such as additional regulations (to constrain costs) and subsidies (to increase access).

via Fixing Obamacare: The Virtues of Choice, Competition and Deregulation by Richard A. Epstein, David A. Hyman :: SSRN.