A (Timely) Blast from the Past

I had completely forgotten this post from co-blogger Mike, but it is incredibly relevant today. For one thing, it echoes a longstanding principle here that health insurance ≠ health care. And it presciently touches on the (Evil) Individual Mandate and the Death Panel that have been ObamaCare hallmarks. Finally, it seems to be an early, distant warning about what lies in store for us if (when?) Medicare4All is actually implemented.

Oh, what's it called?

"Why isn't health care compulsory?"

Here's a taste:

"I’m not talking about health insurance. I’m talking about health care. Health insurance is not the same as health care. Who calls their insurance agent when sick or injured? Who calls an actuary? Don’t real people call their doctor or go to the emergency room?"

Indeed.

And there's this:

"First, all health care professionals become employees of the Federal Government, paid a living wage from public funds. Second, hospitals, clinics, labs and other facilities are nationalized and their staffs also become employees of the Federal Government ... it is illegal to seek or receive health care from anyone except a Federal health care professional."

Yes, yes it is rather scary.

And that's the point.

Read the whole thing here.

Monday Round-Up

■ We noted last month that surprise medical bills, primarily from out-of-network providers, continue to be a plague and a menace. As a result, there's at least one legislative effort to curtail them, but will the cure be worse than the disease?

Our friends at Health Agents for America tipped us to this article that offers a clue:

"Legislation limiting a provider’s ability to negotiate prices could ultimately result in reduced access to care for consumers"

One step forward....

■ Short Term Medical plans continue to be a popular ObamaPlan alternative, offering lower premiums and greater flexibility. But so-called Blue States seem to have a problem with choice. Our friends at Inside Health Policy pointed out this handy info:

"A federal judge in DC on Tuesday (Oct. 2) scheduled a hearing for Oct. 26 on stakeholders' motion to immediately suspend the administration's short-term health plan rule."

Will be interesting to see the outcome.

■ Regular readers know about the zeroing-out of the (Evil) Mandate/Tax for the 2019 plan year (assuming there's no drastic change due to next month's mid-term's). But what most of us likely didn't know was just what burden that tax levied on those least able to afford it:

“The silver lining of the zeroing out of the individual mandate in the Tax Cuts and Jobs Act, though, is that a $43 billion tax -- essentially a poverty tax -- has been thrown into the dustbin of history.” https://t.co/uGiDJTIxFT

— Kris Held,MD (@kksheld) October 4, 2018

■ Finally, a bonus. Via email from the folks at All Health PR:

"Sperm Counts Drop Across U.S. - Except New York"

According to new research, the sperm counts of male residents of six major US cities went down over the past ten years, except for those in New York City.

Yeah, I don't believe that, either.

Dodging the Mandate Bullet

As we noted earlier this year, the recent tax law essentially neutered the (evil) Mandate:

"Quite simply put, the mandate still exists. It's still in the law. What has changed is the penalty for not purchasing health insurance has been zeroed out"

Note well, however, that:

1) This applies to plan year 2019 and after; the tax/penalty/fine remains in place for 2018, and

b) It's a certainty that the tax/penalty/fine will be reinstated should the Congress change hands in November.

That being said, there is some other good news out of DC:

"The Centers for Medicare & Medicaid Services announced on Wednesday a new opportunity for those who failed to comply with the individual mandate in 2018 to avoid the corresponding tax penalty.

The new policy allows hardship exemptions to be claimed without "the documentary evidence or written explanation generally required."

That is, "because I say so" becomes a legit deferral mechanism. And since this is an implementation under the Executive branch, it seems pretty Congress-proof to moi.

Sweet.

[Hat Tip: FoIB Steve Downey]

Words. Fail. Mandate. Lives.

While we've never been fans of the (Evil) Individual Mandate, we've recognized that it's limited in how draconian its enforcement is allowed to be. Worst case scenario, a big check to Uncle Sam (and even that's difficult to actually enforce).

But as terrible as the (Evil) ObamaCare Mandate is, it pales in comparison to the new iteration recently passed by the Rocket Surgeons in the District of Columbia:

"DC Passes Law Requiring People To Buy Health Insurance Or Have Their Property Seized"

So, "nice house you've got there, be a shame if something happened to it because you passed on buying health insurance."

Worse yet, it doesn't appear that there's a carve-out for Direct Primary Care or Health Care Sharing Ministries (as there is in the ACA).

Yikes, indeed.

On Severability

We first noted this issue way back in 2010:

"[A] federal judge in Virginia has ruled the (Evil) Individual Mandate unconstitutional ... Since the judge has ruled that the precept of "severability" does not attach"

Um, Henry, what's your point?

Well, it actually involves The Lone Star State (and 19 of its closest buds), The Constitution, and the law. Severability simply means that if one part of a particular law is deemed unenforceable, the rest of it could still be fine. But its absence would mean that if one part is tossed, then the rest is, too  (baby, bathwater, you understand). Most legislation includes a "severability clause" that essentially says "hey, even if Part 2 is deemed non-enforceable, the rest of this law still stands." It's pretty standard wording.

Unless you're the Party in Power©, in which case you ram through a hastily written revampling of our entire healthcare financing and delivery system, and decide one's not necessary [ed: we would also accept "You're the Party in Power© and are too stupid to catch its absence"]. And here's where it gets .... interesting:

The theory behind the suit is that, since Justice Roberts (et al) deemed the Mandate 'kosher' as a funding mechanism, and since  the  Tax Cuts and Jobs Act of 2017 explicitly set that funding at $0, the entire platform on which ObamaCare was built is null-and-void.

Whoa there, Henry, went a little fast there, didn't you?

Okay, remember that "severability clause:" we discussed? Well:

"Once the heart of the ACA — the individual mandate — is declared unconstitutional, the remainder of the ACA must also fall."

Of course, the Supremes will do what the Supremes will do, but this seems like at least a viable argument.

Snowy Wednesday Linkfest

■ As we've long noted (most recently here), 404Care.gov security is actually an exercise in kabuki theater. Need more proof?

Well:

"Judicial Watch today released over 1,000 pages of new documents that show federal health care officials knew that the Obamacare website, when it launched in 2013, did not have the required “authorization to operate” (ATO) from agency information security officials."

So they knew from the git-go that the site was vulnerable, a metaphorical cesspool of data virii, and yet they forced citizens who wished to avail themselves of subsidies to expose themselves to it.

Nice.

■ Likewise, we've been advising readers of the stupidity that is the (Evil) Individual Mandate: a toothless, nominal fee as opposed to an outrageous premium and massive out-of-pocket exposure.

At last, someone in the MSM 'gets it:'

"You spend thousands of dollars a year on insurance ...and you can't afford to go to the doctor."

No kidding.

But hey, free birth control convenience items.

■ Finally, the Rocket Surgeons in DC© have figured out that perhaps the "30 special enrollment” categories may be creating some perverse incentives, and are threatening to crack down on miscreants who actually take advantage of the system's own inherent flaws. According to the official CMS blog:

"One of the areas we have been reviewing closely is the special enrollment periods we offer ... elimination of several unnecessary special enrollment periods, clarifies the definitions of other special enrollment periods, and provides stronger enforcement so that special enrollment periods"

Hahahaha!

Sure they are. Fact is, virtually no one has even heard of most of them, including "tax season open enrollment" and a bunch of other esoteric, obscure circumstances.

But I'm sure the roughly 8 or so people who get their wrists slapped for this are the primary cause of carrier woes.

DPC Insurance? Maybe, maybe not [UPDATED]

[Scroll down for Update]

One of the "hot new(ish) things" is something called Direct Primary Care (DPC); the "ish" is because we actually blogged on this a few years ago in our interview with Dr Rob Lamberts. But it's gaining increasing traction of late, primarily due to a new (and as-yet unavailable) insurance product that would seem to answer some major objections. More on that in a moment.

First, let's define what DPC is (and isn't):

DPC is often conflated with "concierge" medicine; the major difference between the two models is that concierge is essentially a pre-paid subscription service that promises enhanced access to one's provider. These fees can range from a few hundred to tens of thousands of dollars (a month!). Some concierge providers also accept insurance.

DPC providers also charge a fee (although it is usually much lower than their concierge cousins'), but don't accept insurance; in fact, one of the model's primary goals is to service the uninsured.

One of the immediate problems that one encounters with either model is that, since insurance is not a pre-condition of membership, there seems to be a problem with the ACA tax penalty fine. That is, if one can eschew insurance and still gain provider access, then one is by definition skirting the (Evil) individual mandate.

Or is one?

According to Dave Chase, writing at Forbes, the model is unequivocally empowered by the ACA itself (Section 1301 (a)(3):

(3) TREATMENT OF QUALIFIED DIRECT PRIMARY CARE MEDICALHOME PLANS.—The Secretary of Health and Human Servicesshall permit a qualified health plan to provide coveragethrough a qualified direct primary care medical home plan thatmeets criteria established by the Secretary, so long as thequalified health plan meets all requirements that are otherwiseapplicable and the services covered by the medical homeplan are coordinated with the entity offering the qualifiedhealth plan.

So, seems legit, and an interesting, perhaps even viable alternative to an expensive ObamaPlan, which satisfies the mandate. What's not to love?

Well, the problem with the DPC and concierge models is that they provide for only one provider's care. They don't have any mechanism to pay for one's oncologist or nephrologist, or the ER doc, for that matter. Neither do they pay for the surgeon or anesthesiologist, or the hospital charges themselves. Nor, of course, one's insulin or Lipitor. What to do?

Well, up until now, perhaps, not much: the ObamaTax has effectively killed off the mini-med market, and if one chooses the DPC route then no HSA for you. One could, of course, still purchase an ObamaPlan, but this defeats the purpose of DPC, no? After all, the ObamaPlan already includes first-dollar preventive care, and its own (typically hefty) price tag and additional out-of-pocket exposure. Not to mention, a DPC plan would be subsidy-ineligible. Oops.

Enter Pan-American Life, which recently announced a partnership with MedLion (a sort of DPC co-operative, which seems to have a price transparency problem of its own). Pan-Am has announced a new "wrap around" product that seems to promise an answer to the conundrum named above,  namely: what about non-preventive care?

According to the company's press release:

"Pan-American Life’s U.S. Benefits division will administer a supplemental “wrap” insurance program exclusively for MedLion Direct Primary Care clients."

And that's it. Not exactly long on details, is it?

So, we reached out to Pan-Am, but they were unwilling to share any information about the plan itself. Which is, of course, their call to make, but leaves us a bit doubtful about the product. Plus, such an arrangement means two expenses: the DPC fee plus the "wrap-around" plan (and any additional out-of-pocket exposure that such a plan may also entail).

And there's this: the kind of policy that would be needed to supplement the DPC plan is likely illegal. Which may be why Pan-American is reluctant to share details.

'Tis a bummer. [SEE UPDATE BELOW]

Which is not to say that the idea lacks merit: we're all for any product (or products) that offers a viable ObamaPlan alternative.

I just don't see this one accomplishing that.

Yet.

Look, I like the DPC model. It's just very obvious that this is an experiment that should have been tried pre- (or, wishcastingly, post-) ACA. And let's be frank, it was never going to have the kind of impact that its proponents claim: at most, 20% (and more likely less than 10%) of total health care expenditures are PC-related. So reducing PC costs by even substantial amounts (quite uncertain) wasn't going to impact overall expenditures all that much.

UPDATE/CORRECTION: Just spent a very fruitful half hour with Pan-American VP Carlo Mulvenna, who brought me up to speed on how the wrap plan works, and why.

I'll put up a full separate, complete post on the program shortly; suffice it to say, it does what the press release says it will do.

I'd add that it also doesn't do what I mentioned that it wouldn't. Stay tuned.

[Special IB Thanks! to Jason S, David W and co-blogger Patrick]

More March (Open Enrollment) Madness

As we noted a few weeks ago, Our Betters in DC© have (illegally) extended Open Enrollment season for those who flaunted the (evil) Individual Mandate last year:

"The Centers for Medicare & Medicaid Services (CMS) announced today a special enrollment period (SEP) for individuals and families who did not have health coverage in 2014 and are subject to the fee or “shared responsibility payment”

Aetna has emailed a helpful "message for the brokers" to let us know that "[t]his Special Enrollment Period is for on-exchange business only and all applications must go through the Marketplace." That's actually a helpful bit of info: it means that one can only satisfy the requirement this way by going to the buggy, security-challenged Exchange.

The carrier also "expects premiums to be paid prior to the member’s specified due date. Exchange rules require a payment grace period. Although this is not a new term, the grace period for Exchange premium payments will differ between non-subsidized and subsidized members."

Which is a rather long-winded way of saying that some insureds are more equal than others. You'll also note that they don't specify exactly how some are more equal, presumably to avoid giving folks any ideas about gaming the system (heh). The bottom line is that, if you're eligible for and take a subsidy, your grace period is 3 times greater than the rest of us proles.

Isn't that special.

Oh, and ICYMI, only those who meet these criteria are eligible at all:

• Are not already enrolled in a 2015 plan.
• Were unaware or did not understand the implications of the fee for not enrolling for 2014 until after the end of open enrollment (February 15, 2015).
• Owe a fee for not having coverage in 2014

"I forgot"

It's hard to beat this Steve Martin excuse:

"You.. can be a millionaire.. and never pay taxes! You can be a millionaire.. and never pay taxes! You say.. "Steve.. how can I be a millionaire.. and never pay taxes?" First.. get a million dollars. Now.. you say, "Steve.. what do I say to the tax man when he comes to my door and says, 'You.. have never paid taxes'?" Two simple words. Two simple words in the English language: "I forgot!"

Funny, but what does this have to do with insurance?

Glad you asked.

The folks at LifeHealthPro have complied a list of the 5 best excuses one might use to duck the (Evil) Individual Mandate. Here's a sampling:

"I don't earn enough to even file a return."

"Missed it [the cut-off date] by that much!"

And this gem:

"I get my care from Drs Tonto and Geronimo."

Jake must be jealous.

Stupid Government Tricks [UPDATED & BUMPED]

[Please scroll down for update]

From the Now-They're-Just-Making-(Stuff)-Up Department:

So yesterday, with 4 days to go until "The Deadline" (until they change it again, natch), the folks in Capital City have declared that those sub-par plans are okay, after all, at least when they're bought through the Exchange:

"The Obama administration said Thursday it would allow some of the millions of Americans whose insurance policies had been canceled to purchase bare-bones plans next year"

Now, in and of itself, a truly catastrophic plan isn't a bad idea. In fact, it's what a health insurance policy should be: coverage for large, unexpected claims, not every sniffle or paper cut (or birth control pills convenience items). While the mandate is evil, it would at least have been more palatable if it required folks to have at least this level of coverage. And if it were deemed Health Savings Account (HSA) compatible well, then, Bob's your uncle.

Alas, that's not to be.

But there are a few problems with how this is being handled, not the least of which is that it is blatantly, spectacularly illegal.

Here's the relevant section from the ObamaTax itself (emphasis added):

 (e) CATASTROPHIC PLAN.—
(1) IN GENERAL.—A health plan not providing a bronze, silver, gold, or platinum level of coverage shall be treated as meeting the requirements of subsection (d) with respect to any plan year if—

(i) except as provided in clause (ii), the essential health benefits determined under subsection (b), except that the plan provides no benefits for any plan year until the individual has incurred cost-sharing expenses in an amount equal to the annual limitation in effect
under subsection (c)(1) for the plan year (except as provided for in section 2713);
(2) INDIVIDUALS ELIGIBLE FOR ENROLLMENT.—An individual is described in this paragraph for any plan year if the individual—
(A) has not attained the age of 30 before the beginning of the plan year; or
(B) has a certification in effect for any plan year under this title that the individual is exempt from the requirement under section 5000A of the Internal Revenue Code of 1986 by reason of—
(i) section 5000A(e)(1) of such Code (relating to individuals without affordable coverage); or
(ii) section 5000A(e)(5) of such Code (relating to individuals with hardships).

Seems pretty clear-cut to me.

But in case it's not, the helpful folks who provided training to become certified to sell on the Exchange confirm:

Eligibility for catastrophic plans is limited to:
• Individuals under age 30
• Individuals who otherwise do not have an affordable coverage option, or who otherwise qualify for a hardship exemption to the minimum essential coverage rule

So again, we just throw the actual reg's out the window because they're, well, "inconvenient."

But that's not the only problem. With roughly 84 hours left on the clock - and a weekend taking up most of that - carriers are supposed to price these plans for people aged, oh, 35 or 45 or 55. This, despite the fact that rates have already been reviewed and approved (or not) by the 58 different states' departments of insurance, which will now also have to review and approve (or not), these new rates.

Rostsa ruck with that.

It gets better, though, if by "better" we mean "worse:" what if you've already bought an ACA-compliant policy (hey, it could happen!) but would prefer the less expensive catastrophic plan? The good news is that it appears that you can make this change (or pretty much any other) during the Open Enrollment season. Of course, you'd still be stuck with the old plan for a month, and good luck getting through to 404care.gov, but at least it's an option.

Probably.

UPDATE: It's also worth noting that - as the ObamaTax legislation is written (not that this continues to have any significance) - Catastrophic plans are not eligible for premium subsidies. So folks who opt for this choice may be in for a rude surprise. And as Bob would remind us, this is another great reason to shop (and buy!) OFF the Public Exchange.

Substandard?

Although the original Evil Mandate meme was predicated on the (long discredited) comparison to mandatory auto insurance, perhaps the latter may serve as a useful tool for comparison to the latest drivel from Our Betters in Government©.

The latest to weigh in on the matter is California Governor Mr Linda Ronstadt Jerry Brown:

"It’s not really a cancellation,” Brown said during the station’s Sunday Morning Q & A segment ... “these are Marylanders who are getting notices ... that you can renew your policy today and into 2014 but in 2014 you won’t be able to renew your current plan because it’s a substandard plan"

Interesting definition of "renewal" there, Guv.

But let's think about this for a minute.

What is "substandard" about existing plans? Well, most individual plans (and these are the ones being cancelled alternately-renewed right now, but don't assume that your group plan will be long immune) exclude normal childbirth, and birth control convenience items, for that matter.

Does this make them substandard, as compared with the new ObamaTax-compliant plans which mandate these coverages?

[ed: and BTW, why no prostate or testicular cancer screening bennies for us XY'ers?]

Let's take a look at a typical auto policy, shall we?

They (almost all) start with liability coverage; that is, to protect those whom you harm when you run into them in the intersection. This coverage will pay their medical bills, and fix their cars. But what about your car?

If you have a late model vehicle, odds are you have comprehensive and collision coverage to pay for those repairs. But say your ride is a dozen years old. Do you still carry comp and collision on it? Odds are, the answer's no, because it generally doesn't make financial sense. If it's worth only a few thousand dollars, and the comp/collision coverage is hundreds of dollars a year, then you're probably better off self-insuring. So you take a pass on the "extras," and cover the important, hard to self-insure portion (who has $250,000 sitting in the bank to pay off an injured stranger?).

Does this make your policy "substandard?"

I would argue "no," it makes your policy "appropriate to your needs." So why would maternity or pediatric dental, or any of the other EHB's be any different? If you're a 55 year old guy - or gal, for that matter - why would you want to pay for either of those?

Or is that too obvious?

It's Alive! (Oy)

Long time readers may recall The Great Quigley Kerfluffle of Aught Six; Bob's cogent, explicit and thorough take-down of the misuses of Section 105 plans still gets hits. Briefly (although I really suggest you check out Bob's original post on this), Section 105 plans are/were a way to run certain health insurance, and health care, dollars through a tax-advantaged vehicle.

They were touted by a certain "benefits advisor" as a way to delete group plans (and remember, this is 2006, when the ObamaTax was merely a gleam in a certain State Senator's eyes) and insure employees on individual plans. In and of itself, this is not a bad nor evil (or even fattening) idea; the problem arose when it became the de facto "flavor of the month," leaving the most ill employees and their dependents without coverage.

But that was then, and this is now, so why bring up such a painful episode from almost 7 years ago?

Let me tell you a (brief) story:

Yesterday, a former client called, telling me that she and her husband may need to purchase an individual major medical plan. Great timing! They're currently on a COBRA plan from his previous employer; his new employer, whom he joined a few months ago, promised a generous employment package, including a raise and, of course, first class health insurance. Last week, the employer announced that he was canning the group insurance, a few weeks before my erstwhile client (we'll call him Max) would have become eligible to sign up. And with what was his new employer going to replace the group plan?

You guessed it: individual, underwritten plans. The catch? Max and his wife were declined for coverage (although his co-worker, who had been treated for colon cancer just a few years ago, claims that he was accepted. Color me skeptical). Max called me for help and advice.

As I listened to his tale of woe, something struck me as "off" about the process he described. The more I heard, and the more questions I asked, the greater my discomfort grew. I finally asked him if he knew the name of the outfit his employer was using for this terrific new plan, and when I Googled its name, well, let's just say I was more grimly satisfied than surprised.

Turns out, our old "friend," about whose exploits Bob originally penned his 2006 post, is up to his old tricks. The employer is also playing with fire (he seems to have at least 50 employees, spread over several different companies in a sloppily transparent attempt to avoid the Evil Mandate), but that's his and his "advisor's" problem, not mine.

My challenge is to help Max and his family navigate [ed: Heh!] the minefield which has been set before him thanks to his new employer and his "advisor."

Oh, you may be wondering why I keep using the term "advisor." Turns out, in the years since our own encounters, the "gentleman" in question has decided to suspend his own insurance sales activities. Whether or not that was by choice remains unclear, but his official company bio simply says that he's "an advocate for the business owner [whose] main focus is on saving employer's money." A noble enough proclamation, if perhaps a bit self-serving.

And of course, it does nothing to ensure the financial health of that employer's victim employee. My client told me that his employer and the "advisor" assured him that they'd find him coverage, or at least work out some kind of reimbursement "arrangement;" as you've probably guessed, I urged him not to agree to or sign any such agreement before I've had a  chance to review it with him. I do, however, find it oddly amusing that this all took place yesterday.

A disturbing ObamaTax thought...

"House Republicans received a boost from Democrats on Wednesday during votes to delay ObamaCare’s individual and employer mandates ... Twenty-two Democrats joined Republicans in a vote to delay the individual mandate"

This in response to the Obamastration's unilateral suspension of the (Evil) Employer Mandate a few weeks ago. The premise seems to be "if employers are off the hook, why shouldn't individuals be off it, as well?"

Which may well be "fair," but it raises a disturbing point: having looked high and low, I can find no evidence that either side is also proposing a moratorium on the Guaranteed Issue provisions of the ObamaTax.

Now you may be wondering, why is this a big deal, Henry?

Here's why: as of January 1, insurers will no longer be able to decline coverage to unhealthy people. In fact, they must write anyone and everyone who applies, regardless of health status. But if no one is required to "buy in," it seems likely that only the least healthy among us will do so. After all, absent the (evil) individual mandate, healthy folks have no real incentive (other than personal responsibility) to sign up. But "sick" people have ample motivation, and will likely do so in droves, further driving up rates for those already insured, and presumably causing some (many? most?) to drop their increasingly unaffordable coverage.

ObamaTax supporters, of course, consider this a feature, not a bug.

Fees, Glorious Fees

So you think many of us dodged a bullet when the (Evil) Employer Mandate got pushed off a year?

Not so fast there, pardner.

Assurant's sent out an interesting FAQ (fact-sheet) about just what fees are due next year, exclusive of the employer reporting requirement. Lets take a look at some of the wonderful new expenses that will cause your insurance premiums to decrease 3000% next year:

1 - Annual Fee on Health Insurance Providers

Well first, let's make clear that this is a misnomer: insurers don't pay any fees, their insureds do. What's funny (ironic, not comedic) about this is that this fee is "to help fund the cost of PPACA." So it's a fee to pay for collecting itself.

Very meta, that.

2 - PPACA Transitional Reinsurance Fee

This one "is an annual per capita fee that funds a temporary reinsurance program" that lasts for 2 years ('14 to '16). It's essentially a pay-off to carriers involved in the now-defunct high risk pool program [Correction: this fee is designed to subsidize carriers as they take on higher risk individuals, and to "stabilize insurance premiums in the individual market" Thanks to Bob H in the comments for pointing this out!]

3 - Patient-Center Outcome Research Institute Fee (PCORI)

We've discussed this one before. Basically, it's a slush-fund for the benefit of a "not-for-profit corporation created by PPACA to give patients a better understanding of prevention, treatment and care options available."

You know, WebMD.

All of these fees go into your next renewal regardless of your company's size (or even if you've got an individual plan - remember, carriers don't pay these fees, you do).

[Hat Tip: Assurant's Jeremy F]

What the...? (Breaking)

So The ObamaTax Man has unilaterally decided to put the metaphoric brakes, at least temporarily, on the (Evil) Employer mandate:

"Businesses won’t be penalized next year if they fail to provide workers health insurance after the Obama administration decided to delay a key requirement under its signature 2010 health-care law."

So a couple of questions off the top of my head:

This was legislation he wanted passed, in fact rammed through, and which he signed, and he's only just now figuring out that it's a stink bomb?

Not the brightest light in the harbor, is he?

More to the point, it is the law, how can he just unilaterally suspend it?

Sheesh.

UPDATE: Mike has more:

"Keep in mind this is not the first time HHS was forced to interrupt the planned progress of ACA implementation. Just one example: new enrollment in the individual high-risk pools was stopped because HHS ran out of money (even though only a fraction of the expected population actually enrolled)"

Click through to read the whole thing.

Something else to ponder...

Although we've had an unofficial moratorium on predicting tomorrow's SCOTUS decision re: ObamneyCare©, it's worth noting that the [Evil] Individual Mandate and the Exchanges aren't the only issues to be decided:

" [T]here are some major health-insurance regulations besides community rating and guaranteed issue ... Medicaid expansion"

Although the CornHusker "dodge" was withdrawn, the very real financial (and legal) issues that accrue to the expansion (at state cost!) to Medicaid are very real.

Money is money.

More Stupidity from Ezra [UPDATED]

Alleged health blogger Ezra Klein, noted rocket surgeon extraordinaire, continues to double down on the stupid. Today he opines that even the Father of Our Country liked him some mandates. As reported on Twitter:

"In 1798, Congress mandated that sailors buy health insurance. John Adams signed it into law."

The twit (tweet?) directs the unwitting to Ezra's latest contrivance, wherein he demonstrates profound difficulty discerning the difference between forcing all citizens to purchase a product as a condition of citizenship and specifying that certain individuals must buy a product in order to serve in the military.

Seems pretty clear to me.

In order to show that he really doesn't get it, Ezzie doubles down by citing a 1790 Congressional mandate that "ship owners buy medical insurance for their seamen." Perhaps noticing that there's a pretty glaring logical fallacy here [ed: is there any other kind with this guy?], he observes that "in 1798, Congress ... enacted a federal law requiring the seamen to buy hospital insurance for themselves."

Again, one can choose whether or not to be a sailor. But the [Evil] Individual Mandate applies to all citizens (well, almost all). How come you don't talk about those exceptions, Ezra?

[Hat Tip: FoIB Holly R]

UPDATE/IRONY ALERT: I can't believe I missed this before posting. Ezra Klein relies on legislation from the 18th Century to make his "point?" Is this the same Ezra Klein that pooh-poohs the Constitution because it's "not a clear document. Written 100 years ago, when America had thirteen states and very different problems, it rarely speaks directly to the questions we ask it?"

Why yes, yes it is.

The stupid burns strong in that one.

ObamneyCare© Mecca

We've noted before that certain religious groups have been granted ObamaWaivers© as regards the (Evil) Individual Mandate. Exactly how that's legal has been unclear, though.

Until now:

"[ObamneyCare©] uses the Social Security language of the Internal Revenue Code to determine who is eligible for “religious conscience” objection to the insurance mandate."

That is, since Moslems consider insurance as "haraam" (forbidden), they're not going to be required to buy health insurance. Other religions, including the Amish and Christian Scientists, are also being given free passes on the Mandate.

I find this fascinating: after all, mandate is defined as "[a]n authoritative command or instruction." I googled around, and couldn't find it defined as "[a]n authoritative command or instruction. Unless it's inconvenient or offensive."

Funny, that.

Contract Law vs ObamneyCare©

When I first posted on this late last month, I was skeptical that it would gain much traction.

As regards the (Evil) Individual Mandate that ostensibly free citizens must buy a product from a private vendor:

"[T]the age-old caveat that a contract entered into under duress is non-enforceable. Their stance is that, because insurance is, in fact, a contract, forcing one under penalty of law to sign on the dotted line renders it moot."

Now comes George Will, noting in the Washington Post that:

" [T]he elegant scholarship and logic with which it addresses an issue that has not been as central to the debate as it should be ... The individual mandate is incompatible with centuries of contract law. This is so because a compulsory contract is an oxymoron."

So maybe it is picking up steam.

Inside Baseball and ObamneyCare©: Is it a tax?

We've been pretty silent on the Constitutional fate of ObamneyCare© as it wends its way to the SCOTUS. For one thing, we've already made it perfectly clear how we feel about the (Evil) Individual Mandate, and the other myriad of problems inherent in the bill we had to pass to learn what's in it.

But today, the folks behind ObamneyCare© let slip the mask, and perhaps tipped their hand:

"In a hearing of the House Budget Committee ... pressed [Acting Budget Director Jeffrey] Zients on whether the penalty that the health care law imposes on individuals who do not purchase health insurance constitutes a tax. Eventually, Zients said it did not." [emphasis added]

Of course, characterizing the fine as a tax is what gets them under the Commerce Clause umbrella, and hence (potential) legitimacy. One wonders if Mr Z was inspired by Tom Brady.