Almost eight months in and the overhaul is as unpopular as ever. Polls show that 58 percent of voters still favor repeal. Voters also sent a resounding message to Democrats during the midterm elections this month, rebuking those who played a role in passing President Barack Obama’s health care plan.
Yet President Obama has no problem using the people’s resources to mount an all out propaganda campaign in support of the law. In September, he hosted a conference call, organized through his office for faith-based community partnerships, with selected religious leaders. He exhorted them to “Get out and spread the word.” Imagine if a Republican had done the same on any issue.
Meanwhile, HHS Secretary Kathleen Sebelius alternates between threatening letters to those companies struggling to comply with the 2,400-page bill and puff pieces designed to bamboozle young minds.
Incoming medical students across the country were treated to a pure propaganda piece signed by Secretary Sebelius and Dr. David Blumenthal, the National Coordinator for Health Information Technology. The piece pandered, pointing out how the Affordable Care Act solved the problem of 26-year-olds having to secure their own plans in the cold, post-college world. It painted a bright picture of the future, claiming “your patients’ lives will be better off as a result, and you will have a new level of clinical autonomy the preceding generations of physicians never enjoyed.” As with the religious leaders, the Obama administration seeks public relations help. The letter notes, “We especially need your help to get the message out.”
For all of its use of taxpayer dollars to expound the features of its plan, the Obama administration is downright authoritarian when it comes to private organizations communicating its consequences. By mandating expensive benefits and changes to plans–some of the very changes that went into effect on September 23 — the bill is sure to increase prices over the short and intermediate term. Just look to Massachusetts, the model for Obamacare, where small business premiums have skyrocketed 30 percent –even after the government attempted to use price controls to stem costs.
Earlier this month, some insurers sent letters to customers explaining impending increases and detailing the portion that was due to Obamacare. Sebelius sprang into action. “We will also keep track of insurers with a record of unjustified rate increases,” she wrote, after insisting that new mandates would not really increase premiums. “Those plans may be excluded from health insurance exchanges in 2014.”
Sometimes those letters blow up in her face. As originally written and passed, the health bill did not mandate guaranteed coverage for children and standard rates. Insurance companies did not have to offer coverage to people with pre-existing conditions until 2014. Until then, they just had to cover the conditions of their policyholders. Sebelius was set off when the New York Times reported that insurers understood this provision and planned to abide by it. She sent a letter to insurers that they would, in fact, have to offer insurance on a guaranteed issue (no discrimination based on medical history) basis and that she was promulgating regulations to that effect. That was March. In September, when the first benefits of Obamacare were delivered, so too was the first casualty. Most major insurers in several states offering the niche product of child-only coverage announced it would not offer any more new policies. HHS subsequently reversed its edict and said that insurers could write child-only policies based on actuarial rates.
Secretary Sebelius may soon have to send threatening letters to her former colleagues in state insurance bureaucracies. Unlike her current marketing position, they have the responsibility to actually ensure that residents of their states can purchase individual and small group insurance products. Regulations that put Washington in charge of micro-managing insurance company books, specifically the amount of premium they spend on what is officially deemed “patient care,” the Medical Loss Radio (MLR), threaten to wipe this market out in some states. The MLR, as it stands for this market, is 80 percent. Insurance commissioners in Iowa and Maine have already requested waivers, noting that the regulation, if enforced, will prompt firms to stop offering policies and will destabilize the market.
And on Sept. 28, Harvard Pilgrim, one of Massachusetts’ large insurers, announced that effective at the end of the year they will no longer offer Medicare Advantage plans to 22,000 seniors in Massachusetts, Maine, and New Hampshire. The reason: the feds are cutting reimbursement rates for Medicare Advantage coverage. This will inevitably spread to other states.
When this comes to a head, Sebelius, President Obama, and other big government pitchmen will no doubt fire up the word processors, take to the pulpit and expend millions more of the taxpayers’ money to bash the private sector for its inability to defy gravity while wearing the new, government-issued concrete boots. Word of advice to executives, medical students, and perhaps even patients: don’t object too strenuously, the federal government and perhaps even your priest, minister, or rabbi is keeping a “list.”