by Katherine Restrepo
Director of Health Care Policy, John Locke Foundation
The president fails to recognize that his health reform law’s unpopularity continues to grow. Only 17% of the public supports the individual mandate. Unions, once major advocates for the federal health law, are livid. Democrat fissures are widening in Congress on delay of the employer and individual mandates. And until recently, Members of Congress were flipping about the law’s requirement that they enroll in the health insurance marketplaces, thereby stripping them of their generous benefits on the FEHB (Federal Employees Health Benefits) Program, while leaving them ineligible to receive premium assistance subsidies because their incomes are too high.
Furthermore, Insurance companies are backing out of the law’s individual marketplaces. In North Carolina, only three insurers have signed up to offer heavily regulated health plans on the state’s federal exchange. And Blue Cross and Blue Shield is the only insurer offering plans in all of the state’s 100 counties. Because of this, the limited marketplace will not generate sufficient competition, and rates will rise for the young and healthy.
Step Back From the Forest
President Obama envisions providing universal health care for all citizens through expanding the welfare state and increasing the number of government programs. His ultimate goal is to make everyone dependent upon government assistance. Here are just a few provisions that keep many citizens, including the most vulnerable, well, vulnerable.
Stuck In the Trees
Medicaid Expansion — The final ruling in NFIB vs. Sebelius concludes that states cannot be forced to expand their Medicaid eligibility to childless adults living under 138% of the Federal Poverty Level (FPL). The Supreme Court voted 7-2, granting states the option to expand their entitlement program. North Carolina said no. But, Obamacare expands Medicaid in other ways.
For example, the law requires that Medicaid must cover all children ages 6-18 living in households earning up to 138% FPL. North Carolina is one of 18 states where original Medicaid eligibility levels fall below this percentage of the FPL. Prior to this mandate, children living in families earning up to 100% FPL were eligible for the state’s program. Last week’s newsletter discussed how this eligibility increase shifts more children from NC Health Choice onto Medicaid, which in turn creates more open slots for children to receive government assistance on NC Health Choice — a program established by the Social Security Act that provides health benefits and services to children in families living between 100-200% FPL.
Exchanges — Now called Marketplaces, these regulatory bodies determine whether applicants qualify for federal subsidies that offset their health insurance premium costs. Consumers who qualify for such taxpayer assistance earn an annual household income of 100-400% FPL. These exchanges further dependency on our nation’s welfare state, for families earning over $90,000 can qualify for premium assistance. In addition, if an applicant does not make enough income to purchase subsidized private coverage, the verification system assesses whether the applicant qualifies for Medicaid. This information is then sent to the Department of Health and Human Services, the entity that must determine whether the applicant qualifies for medical assistance. The Marketplace verification system not only determines whether people qualify for private premium assistance, but also directs applicants to Medicaid.
The Marketplace verification operation forces North Carolina to appropriate $160 million for adding potentially eligible citizens onto Medicaid — yet another indirect way of expanding the welfare state.
Don’t forget that the delay of the information reporting requirements under the employer mandate will most likely generate taxpayer fraud. Chris Conover’s explanation in the Weekly Standard is an excellent article worth reading.
Basic Health Plan (BHP) — The Basic Health Plan is scheduled for implementation in 2015 for eligible citizens living with a household income of 133-200% FPL. Again, the state’s Marketplace, will direct the applicant to enroll in the BHP if he/she does not qualify for private coverage premium assistance.
The Forest is Burning
All of these programs contribute to higher health care costs. President Obama’s landmark legislation forces federal taxpayers to cover health care costs for those most vulnerable to families making a combined income of over $90,000 a year.
More government only increases government dependence, while prohibiting personal responsibility, individual choice, and financial stability.