Obamacare

Five Things Obamacare Won't Do

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WhiteHouse.gov

When Obamacare was being sold to the public, the president and his supporters made big promises about the law. But three years later, it looks a lot more limited. Indeed, it sometimes seems as if we're hearing more about what Obamacare won't do as what it will. Here are five things we probably shouldn't count on Obamacare to do:

It won't control health costs. A few months after the health care law passed, former White House advisers touted the law's cost controls: The law, they wrote in the New England Journal of Medicine, "puts into place virtually every cost-control reform proposed by physicians, economists, and health policy experts." Apparently it wasn't enough, even for the law's backers. A group of prominent liberal supporters of Obamacare recently launched a new effort to control health spending. The Washington Post reported that "While all support the Affordable Care Act, they tend to agree that additional legislation will be necessary to control health-care costs."

It won't lower premiums for everyone. During his first presidential campaign, Obama pitched his health care overhaul as a way to "lower premiums by up to $2,500 for a typical family per year." But average family premiums have continued to rise since Obamacare passed, insurers and actuaries are warning that they'll rise even higher as the law kicks in, and even Health and Human Services Secretary Kathleen Sebelius now says that some premiums will rise under the law. Sen. Chuck Schumer (D-NY) also seems to think the law could cause premiums to spike. 

It won't reduce emergency room usage amongst the poor. One of the arguments for the law was that it would reduce emergency room utilization by giving low-income individuals Medicaid coverage that would allow them to see a doctor instead. But according to a study published this week, a randomized controlled trial found that giving individuals Medicaid does not reduce emergency room usage. 

It may not make low-income Medicaid beneficiaries healthier or happier. That same study found "no significant effect of Medicaid coverage" on any of the objective physical health markers it looked at. The study looked at a very poor, very sick population, and examined health markers that should have been some of the easiest to treat. The study's authors also reported that they "did not detect a significant difference in the quality of life related to physical health or in self-reported levels of pain or happiness." Roughly half of the law's coverage expansion is projected to come via Medicaid.

It won't get rid of "uncompensated care." This is a little bit technical—but it's important. Related to the argument about emergency room usage, Obamacare supporters said the expense of the law could be justified in part by the way it would reduce uncompensated care—the "free" care hospitals give to those without insurance. The federal government was already paying hospitals for that care, the argument went, so why not just use that money to pay for insurance instead? President Obama claimed that the cost of uncompensated care was raising insurance prices nby an average of $1,000. Now it looks like the Obama administration believes that uncompensated care costs won't go down any time soon. The president implicitly admitted this when he proposed adding $360 million to a fund that pays hospitals for uncompensated care, a bump that would effectively get rid of the cuts the health law was supposed to enable. 

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132 responses to “Five Things Obamacare Won't Do

  1. I have my doubts it’ll end up with more insured people besides. So what was this going to fix?

    1. It will fix those pesky insurance companies that were making profits.

      1. It will fix those pesky insurance companies that were making not enough profits.

        FTFY

    2. So what was this going to fix?

      That 2012 presidential election thingy!

  2. I’m SO glad they passed it so we could finally find out what’s in it.

  3. But average family premiums have continued to rise since Obamacare passed

    C’mon. Start counting Jan 1, 2014 when the new law is in force. No one claimed it would cut premiums retroactively.

    1. Shorter Shriek: derp

    2. I’ve worked for my current company for seven years. My insurance rates were steady over the first six. This year we switched to a new insurance carrier and all rates went up. Plus we got narrowed down to a choice of two plans. How’s that?

      1. It is irrelevant until 2014. The new MLR calculations will change the payment balance.

        And one of the cost control measures is being delayed by the GOP – the IPAB (death panel).

        1. In 2014 I won’t be working at my current company anymore because they’re closing in July.

          1. 🙁 Bummer. Got anything lined up or are you looking now?

            good luck!

            1. I’m probably gonna take a contract job for a while. Got an email about a nice looking second shift contract job that pays more than I’m making now and would give me time to finish the last bit of classes I need for my degree.

        2. Palin’s Buttplug| 5.3.13 @ 1:05PM |#
          “It is irrelevant until 2014.”

          See? There are truly ignorant people who claim they know something about finance.

    3. Companies never plan ahead. Not even the mighty Popeye’s Chicken.

      1. Funny you should mention Popeye’s Chicken. I was about to cite that example as a low-wage fast food company unaffected by Obamacare. I will file that example for future use.

        1. You better, dipshit. Assuming it’s true, it’ll be the only one.

          1. Now we’re back to the onus of the mandate. Different subject.

            1. Palin’s Buttplug:

              Funny you should mention Popeye’s Chicken. I was about to cite that example as a low-wage fast food company unaffected by Obamacare.

              I think you brought it up.

            2. Palin’s Buttplug| 5.3.13 @ 1:38PM |#
              “Now we’re back to the onus of the mandate. Different subject.”

              Damn! Hypersonic goalposts!
              No, dipshit, that IS the subject.

              1. No, idiot. The subject is premium hikes and their causes.

                The individual mandate is a different subject. The mandate actually LOWERS premiums via group pricing.

                1. Palin’s Buttplug| 5.3.13 @ 1:52PM |#
                  “No, idiot. The subject is premium hikes and their causes.”

                  No,lying sack of shit; here’s your statement:
                  “Funny you should mention Popeye’s Chicken. I was about to cite that example as a low-wage fast food company unaffected by Obamacare.”
                  Can you read that? YOU posted it.

                2. The mandate actually LOWERS premiums via group pricing.

                  But that we can know before 2014!

          2. man?date /?man?d?t/: An official order or commission to do something: “a federal mandate”.

            Which part of Obamacare is not accurately described as a mandate, do you think?

            1. Well, there are several mandates in it. Again, mandates don’t cause premiums to rise.

              A tax is a mandate and can rise or fall independent of its existence.

              1. Palin:

                Well, there are several mandates in it. Again, mandates don’t cause premiums to rise.

                You must have a different idea of causality that I do. Mandating that people buy things = increase demand = price increases. It’s the basic law of supply and demand.

                If the government is going to regulate something as complex as health care, it’s going to effect prices. Believing anything else is a pretty strange idea of causality. Does Obamacare only get credit for causing good things? Mandates don’t make people healthier, either, based on your interpretation, it seems.

                1. Brian| 5.3.13 @ 2:02PM |#
                  “You must have a different idea of causality that I do.”

                  Possibly. More likely, he’s trying every bit of sophistry he can to avoid admitting he’s a lying sack of shit.

                2. Not to mention the fact that this law also limits the premiums the elderly can pay, which is guaranteed to force up premiums on the young in order to smooth out the curve.

                  That’s not even considering that people with health insurance go to the doctor more often, due to the fact that it costs them less, and forcing everyone onto health insurance will therefore increase the number of doctor visits. This means that insurance companies will have to pay out more, driving up premiums.

              2. Again, mandates don’t cause premiums to rise.

                Welcome to bizarro world, where mandating that an insurance policy cover more costs does not cause it to increase in price.

                1. The individual mandate was required to spread cost over a larger number of participants. You should know that.

                  The individual mandate is the crux of the law and the most offensive part of it.

                  1. Once again, I’ll quote what you said:

                    Again, mandates don’t cause premiums to rise.

                    The individual mandate is not the only mandate in the law. There are coverage mandates as well.

                    Regardless, the law subsidizes demand and constrains supply for healthcare – the usual government solution. Even a Progressive like you should be able to figure out what that means.

                  2. Palin’s Buttplug:

                    The individual mandate was required to spread cost over a larger number of participants. You should know that.

                    Mandating everyone buy insurance != only spreading costs to everyone. People are buying a product, and that does a lot more than just spread price around.

                    Also, You filed Popeyes away as an example of business not effected, where are people paying the tax and avoiding the insurance. Now mandates are spreading costs around by increasing participation in insurance? Which is it?

              3. Again, mandates don’t cause premiums to rise.

                Just look at car insurance. Rates plummeted after states started mandating liability insurance. Right?

    4. You claim to have some knowledge of finance and you post this pathetic excuse for apsin?
      “C’mon. Start counting Jan 1, 2014 when the new law is in force. No one claimed it would cut premiums retroactively.”

      Of course, no business raises prices in advance of higher costs, do they, dipshit?

    5. Remind me again how you’re a libertarian and not a fucking Demfag?

    6. It’s posts like this that get you tagged as an Obama fellator.

      1. It is only logical. I am all for metrics. They should by any measure begin when the law goes into full effect.

        1. Palin’s Buttplug| 5.3.13 @ 1:40PM |#
          “It is only logical. I am all for metrics. They should by any measure begin when the law goes into full effect.”

          You bet! Why that water over the dam doesn’t matter. Just wait till it fails!
          What a screaming idiot.

        2. The law was passed 3 years ago, and many provisions have already gone into effect, driving up costs.

          Are you saying that you expect IPAB (which is unconstitutional) to not only hold costs down, but reverse the gains that have occurred in the interim?

          Are saying that the penaltax is going to prevent the adverse selection that is going to occur amongst the population once community rating and guaranteed issue go into effect?

          I’m really curious as to how you see premiums going down.

          1. I haven’t claimed that premiums will go down.

            I do note there are cost-cutting parts of the law but the net effect won’t be known until it is all implemented.

            1. Palin’s Buttplug| 5.3.13 @ 1:58PM |#
              “I do note there are cost-cutting parts of the law but the net effect won’t be known until it is all implemented.”

              No, you lying sack of shit, there are none.

          2. In theory, the mandate will draw more participants in and drag down premiums but more benefits will be paid out.

            Net effect on premiums = unknown.

            1. You want to know whose premiums are guaranteed to increase? Young people. Considering that they aren’t as well off as older people, that seems incredibly unfair.

              1. Agreed.

                Again, I hate Medicare and the same can be said for it 100x over. I’ve paid Medicare premiums since I was 16 and am fucking sick of it.

              2. This premium increase means that they are simply going to opt out and pay the penaltax.

                Why would you pay thousands and thousands of dollars in premiums every month when you could buy insurance when you are sick, and pay a small tax penalty instead?

            2. There is no way a small penaltax on not carrying insurance is going to drive enough people to buy coverage to offset the new costs of guaranteed issue, community rating and new coverage mandates.

  4. It is so hilarious to watch this shitstorm unfold.

    Yes, Nancy you passed it, we found out what’s in it. It sucks.

    1. The funniest part is watching Shrike spin like a top.

      1. Dude, it’s a fucking sockpuppet. For you to treat it like it’s a real person and not a character played by someone who wants to get you to respond to it is beneath you. You’re a smart kid. Don’t play its game. Same with Tony. They are incredibly obvious sockpuppets. The only proper response is to ignore them.

        1. Don’t call me kid, buddy.

          1. Don’t call me buddy, guy!

            1. Alright, Gaylord.

  5. What five things will ObamaCarousel do, then?

    1. 1) Drive up the cost of health care.
      2) Drive up the cost of health insurance.
      3) Reduce availability of health care.
      4) Blame at the market.
      5) Demand single payer.

      1. Oh, yeah – MARKUT FAILYOOR!

        1. don’t forget “Republican obstructionism!!”

          1. Corporations! Profits! Deregulation! The Kochtopus must have something to do with it, too.

    2. http://www.youtube.com/watch?v=xSnLU9nyFSA
      1. Kill (relatively) Old People.
      2. Improve light effects
      3. Lower beer prices at the concession stand
      4. Hire more Sandmen (IRS agents)
      5. Audience Participation!

  6. You know five OTHER things Obamacare won’t do….

    1. 1) Change the tires on my Jeep
      2) Restain my deck
      3) Trim my dogs’ hair and nails
      4) Make me a sammich
      5) Boil the ocean

    2. 6) Give ‘ol sarcy a reach-around.

    3. Bring back Lucy?

      1. Too…..t…too…..SOON….

        *chokes back tears – wipes eyes*

      2. DON’T TALK ABOUT LUCY

        1. LUCY LUCY LUCY

      3. *blinks watery eyes, get up and looks for whisky flask*

    4. 7) Revive my confidence in my fellow man

    5. Win elections for Democrats in contested races.

    6. 1) Kick ass
      2) Chew bubblegum
      3) Put on the fucking glasses
      4) Eat a trash can
      5) Follow the rules

      1. We’re all out of gum

        1. And that still leaves us a sizable menu of options, and no, kicking ass, is not one of them.

          1. minus a comma…

            EDIT BUTTON GODDAMNIT!!!!

    7. 1) See attack ships off the shoulder of Orion
      2) Watch C-beams glitter in the dark near the Tannhauser gate
      3) Jump a shuttle off-world, killing the crew and passengers
      4) Be subject to a Voight-Kampff test
      5) Describe in single words only the good things that come into its mind about itsmother.

  7. This thing was designed from the start to cripple any existing healthcare system, to make as many people as possible hate what we have, so they would settle for what the political class really wants. One would be remiss not to point out that despite the stories the pols have told us when it comes to any kind of healthcare regulation in ght elast 3 or more decades, the goal has always been to destory the private healthcare system so people would have no choice but to accept the single payer system the nanny staters salivate about.

    Obamacare is all about setting the stage for a single player system. Keep that in mind and everything you hear makes perfect sense.

    1. That is some pretty good Conspiracy Theory there. I don’t remember that being pumped when Bush nationalized prescription drugs.

      1. Shreek again wades in to Tony-Straw Man territory.

        And it’s not a “conspiracy” when the left openly admits that this is what they want to have happen.

        http://online.wsj.com/article/…..hirdBucket

        1. All ObamaCare does is alter the way some health care is paid for and little else.

          Your link confirms my view that five years from now the collective assessment of Obamacare will be a big “So what?”

          Now if that is a jumping off point for single payer you have some more CT to cook up. Progressives will use any excuse to lobby for single payer.

          1. “Your link confirms my view that five years from now the collective assessment of Obamacare will be a big “So what?””

            Don’t you get dizzy now and then?

            1. So we paid a trillion bucks for a healthcare system that at best will result in “so what?”

              BIG DEAL!!!!

              1. No, we didn’t pay a trillion dollars for this boondoggle. That was the estimated cost the CBO came up with, based on an artificial 10 year window that allowed Leviathan to collect taxes for 4 or 5 years, and then, implement a light version of their plan for the remaining 6 years. That along with some seriously criminal accounting tricks and double counted savings (Medicare) allowed them to pretend this monstrosity would save money.

                The fact is that the price tag now stands at $2.6 trillion by some more accurate estimates that see the real costs Pelosi told us could only be divulged once Obamacare was the law of the land. And that cost is for the first 10 years, and likely double that after those 10 years are done. This thing will end up breaking the bank in record time. But that’s not either an unforeseen consequence or problem: it’s the main feature of this monstrosity.

                Shriek can keep pretending this thing is not bad, but it is a disaster we are just starting to get our heads wrapped around.

                1. “Shriek can keep pretending this thing is not bad,”

                  And *that* constitutes his best argument.
                  Hey, it’s only costing $2-1/2Tn, isn’t doing a single thing it was claimed to do, but ‘it’s better than a poke in the eye with a sharp stick!’

          2. All ObamaCare does is alter the way some health care is paid for and little else.

            Your link confirms my view that five years from now the collective assessment of Obamacare will be a big “So what?”

            When the way it alters the way some health care is paid for is by pushing it onto companies, that will have a major impact.

            I understand why a libertarian like you would be so high on health care regulation. Because that’s totally something a libertarian would do.

          3. Fuck you.

            “Jeffrey S. Flier, the dean of the Harvard Medical School, in “Health ‘Debate’ Deserves a Failing Grade” (op-ed, Nov. 18, 2009) made the point that “this can only be the first step of a multiyear process to more drastically change the organization and funding of health care in America. I have met many people for whom this strategy is conscious and explicit.”

            1. And shreek’s *BEST* response is that we’ll get used to it.

          4. “What difference, at this point, does it make?”

      2. Medicare Part D = Buying seniors’ votes

        Obamacare = Who the fuck knows? “We have to pass it to find out what’s in it.” The same statement applies to my (substantial) bowel movements.

        1. I think you’ve used the (substantial) bowel movements line before. It’s disturbing.

          1. There’s nothing wrong with him being very proud of his epic shit.

        2. You have to remember Obamacare was written by people who knew nothing about healthcare. It wasn’t designed to destroy the private healthcare system. To say that it was is to assume these people knew enough to design a system to do that. It was written by morons like Max Bachus who had no idea what they were doing. But once they started they had to get it passed no matter how awful it obviously was and no matter if they didn’t have any idea what it would do or actually said because passing it was essential to save Obama’s sorry ass in 2012.

          That is really all there is to it. Whatever Obamacare actually is or is not is the result of almost chance, because there was no thought given to the drafting of it other than the need to pay off cronies and pass something.

          1. You mean Mitt Romney’s team. Go ahead and say it.

            1. Yes. Mitt Romney is a fool too. Are you over it yet?

            2. Yeah dipshit, they let Mitt Romney draft the bill and then just passed it.

          2. Exactly. It’s the legislative equivalent of a million monkeys with typewriters.

      3. That’s because you have the memory and attention span of a fruit fly.

  8. During his first presidential campaign, Obama pitched his health care overhaul as a way to “lower premiums by up to $2,500 for a typical family per year.”

    the CFPB reforms of the Good Faith Estimate in the mortgage industry was predicted by the CFPB to lower closing costs by an average of $700. a study a year later found that it had increased closing costs by just over $700 on average. so other than getting the direction wrong, they were close.

    1. Highly unlikely. The CFPB just recently streamlined mortgage applications. As in late last year.

      1. The CFPB just recently streamlined mortgage applications

        and they said so themselves so it must be true. they probably even said it on the internet so doubleplustrue.

        1. I would certainly read a link from a reputable source on the $700 hike.

          No Breitbart, CNS, or liar site please.

          1. I like that Breitbart can be right about Pigford after being called a liar by Media Matters, a site you claim to be reputable, and yet Media Matters remains reputable in your eyes and Breitbart remains a liar site.

            You are the dumbest person to ever live.

            1. Tulpa seems to be gunning for that spot.

              1. Gunning? More like completely owning.

                1. That is like the Super Bowl of stupid. I wouldn’t give up on Shreek that easy Episiarch.

                  1. Shriek is a sockpuppet, which means he is specifically designed to be retarded and push your buttons. I think Tulpa might actually be for real, which is sort of scary, because it means there is a weapons grade moron out there, threatening teh children. And he’s running on pure dorkosterone.

                    1. Stop telling us not to argue with Shrike. I enjoy arguing with Shrike. It makes me feel smarter than I probably am, sort of like how a chubby girl looks okay when she’s standing next to a REALLY fat girl.

                      Why can’t you just let me be happy?

                    2. 1) Because I’m an asshole.

                      2) Because you encourage it and feed it. The worst thing you can do to it is ignore it.

                      3) Because otherwise Warty will rape you. Is that what you want?

                    3. 3) Because otherwise Warty will rape you. Is that what you want?

                      More than anything. His roaming tentacles make life worth living.

                    4. Why can’t you just let me be happy?

                      Dare I ask why you come to H&R for happiness?

                    5. Epi,
                      You gotta stop finding socks under your bed.
                      Now maybe shreek is a sock, but there’s a chance he isn’t. There are people that dumb and delusional.

                    6. I think Tulpa might actually be for real, which is sort of scary, because it means there is a weapons grade moron out there, threatening teh children.

                      At least he doesn’t have any children.

                    7. I am the last person to throw stones about being bullheaded and contrary. But I do at least pick my spots. Tulpa is that way on every single subject. I can’t think of a single subject he has a straight Libertarian opinion on. On every thread he is on there for the specific purpose to explain why there is a reasonable position that is not the “libertarian one.” I think he is either to insecure to ever actually agree with people and thus give up having a unique perspective or he is just a concern troll here to screw up the threads.

                    8. he is just a concern troll here to screw up the threads

                      Ding, ding, ding! We have a winner.

                      And as for Shrieking Dipshit, the fact that his screen name links to soros.org is all the proof I need that he’s a fucking sockpuppet likewise here solely to troll. They both have one goal: to metaphorically shit all over the carpet, wipe their asses on the drapes, and piss in the sinks. That’s all they ever do.

                    9. Here is what I think is going on with Tulpa.

                      He just can’t abide by agreeing with a group on anything. So for example, if the thread is about cops shooting dogs and kicking people in the head, anyone with any sense sings with the choir and agrees it is horrible. But Tulpa can’t do that. He is so insecure he must always prove to everyone he is smarter than they are. And how can he do that if he agrees with them? So he intentionally picks some idiotic position just so he can feel different and superior to the group. That is why the more obvious the position, the more annoying and stupid Tulpa is; an obvious position means Tulpa has to defend the indefensible and say stupid shit to be different.

                    10. Essentially his whole political philosophy is playing devil’s advocate, without saying so.

          2. No Breitbart, CNS, or liar site please.

            liar site = any site that doesn’t confirm my preconcieved biases. /shrieking moron

            1. That’s a given, Loki. I once posted a link from breitbart in a discussion on FB. I immediately got the “how about a link from a non-crazy site” and then they went on to refute my link with a link from Daily Kos…

        2. Only approved shreeky links for cites please. And don’t expect him to ever provide one himself.

          (And don’t expect him to admit when he’s wrong when you use the actual fucking facts from the company themselves to prove your point because he’s a sockpuppet demfag.)

  9. The uncompensated care piece is where I see future trouble.

    In the state of MA, the latest expansion/change of RomneyCare – Act 224 – takes the uncompensated care pool and turns it over to the state.

    In other words, if a hospital has bad debts, they put those bad debts into a pool. The state pays them the amount of the debt, and takes it over.

    Up until now, the hospitals just wrote bad debts off. But now, they can turn them over to the state. And the state is now going to start pursuing them.

    But the thing about debts to the state is that they aren’t dischargeable in bankruptcy.

    And since the fee / penalty you pay if you don’t buy mandated insurance is already a tax, if you don’t pay the mandate penalty that’s already a nondischargeable debt.

    I just foresee on the horizon – and not a very distant horizon – a time when all medical debt is made nondischargeable because it has been taken off by a state or federal body, and isn’t private debt any more.

    That just so happens to be a plurality of bankruptcies.

    Between student debt and medical debt, you get a convergence of factors where state and federal governments are going to box people in with nondischargeable debt.

    There are also rumblings out there about using some existing provisions of Medicare law to make heirs responsible for the Medicare debts of dead seniors.

    Now, I don’t know about you, but to me nondischargeability and heritability of debt = feudalism.

    1. That is some sinister shit. And remember Obamacare was sold in no small part as a way to save people from being bankrupted by medical costs. It would not surprise me in the least if the actual result of Obamacare was to send people into perpetual die to poverty non-dischargable medical debts owed to the government.

      1. What pissed me off about the BK scare stories was that it was all based on Senator Lieawatha’s horrible “Medical Bankruptcies” paper that McCardle destroyed in multiple articles.

        And yet the press lapped up the BK scare stories without saying anything.

        1. It is a total myth. And even if it wasn’t, so what? That is why we have bankruptcy. Anyone who went into bankruptcy got to walk out the other side without the debts. Sure, they may have had to sell some assets. But that is part of having debts. You do have to pay for them you know.

          1. But that is part of having debts. You do have to pay for them you know.

            There you go, hating the children again.

            1. You could have sold the laptop and the big screen – but you went with selling the children instead.

              1. Well you’re going to start with the items with the biggest return.

              2. Nathan Arizona Sr.: You want that $25,000 reward, you go ahead and claim it. What’s there to talk about?

                Leonard Smalls: Price. A fair price. That’s not what you say it is, and it’s not what I say it is… It’s what the market will bear. Now there’s people – and I know ’em – who’ll pay a lot more than $25,000 for a healthy baby. Why, I myself fetched $30,000 on the black market. And that was in 1954 dollars.

    2. Those are good points and iirc the precedent had been set a few years back when elderly Medicaid patients were prevented from signing over all assets to heirs to qualify for nursing homes.

      1. Eggs and omelette, in other words? And we’re doubling down on bad policies engendering perverse incentives with even worse policies?

    3. Hmmm that’s some good serfdom.

    4. Debtor’s prisons, FTW.

  10. OT sorry if already noted: Jezebel via HuffPo – stop having sex on the red couch at the sorority house!!!1111!

    SFW

    http://www.huffingtonpost.com/…..lp00000003

    1. I live in Williamsburg so I find this very intriguing.

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