Monday, March 28, 2011

Why the Health Reform Law is in Trouble – A Chronology

March 2010

Health law passes on March 23 after a series of questionable political acts – the Louisiana Purchase, the Cornhusker Kickback, the Connecticut Con, financial sleights of hand and last minute parliamentary maneuvers against unanimous Republican opposition, fueling resentment and a taste for revenge.

April 2010

• News from Massachusetts indicates costs and waiting times continue to rise. Insurance commissioners reject 235 of 274 insurers’ requests for rate increases, threatening to drive them out of business.
• Richard Foster, Medicare chief actuary, releases report showing health plan will increase not decrease health costs.
• White House announces it will nominate Dr. Donald Berwick, an admirer of the British single payer system, as CMS administrator, raising howls of protests from conservatives.
• White House says coverage of those with pre-existing illness, children, young adults under their parents’ policies; removal of caps for medical expenses, small business tax credits, and ending the “donut hole” for seniors will benefit millions of Americans. Polls indicate 59% of Americans not impressed and remain against reform plan.

May 2100

• Obama administration caps percentage of insurer premiums to be used for administration and marketing by establishing a “medical loss ratio.”
• Insurers pull out of children, small group, and individual markets, leaving millions without insurance and calling into question repeated Obama promise “If you like your health care plan, you will be able to keep your health plan. Period. No one can take it away.”

June 2010

• CBO Director Douglas Elmendorf declares “In the CBO’s judgment, the health legislation does not substantially diminish the rising cost of health care.”
• New York Times article doubts White House claims government can end $700 billion of wasteful spending by micromanaging doctors.

July 2010

• White House rubs salt in Republican wounds by announcing recess appointment of Dr. Berwick, thereby depriving Republicans of chance to question and perhaps embarrass Dr. Berwick in open hearings.
• The Massachusetts health plan, the paradigm for Obamacare, continues to unravel with still higher costs and ever longer waiting times. To bring down costs, Mass legislators talk of bundled bills and licensing only those doctors who accept government patients.

August 2010

• U.S, District Judge Henry Hudson says of individual mandate, “Never before has the Commerce Clause and Necessary and Proper Clause been extended this far.”
• CBO estimates Health Reform Law will end 780,000 jobs.
• CMS actuary says new law will ultimately have physician reimbursement rates below those of Medicaid, forcing hospitals and doctors out of Medicare and leaving seniors without access to care.

September 2010

Washington Post says elimination of “donut hole” may “steeply increase” costs of drugs.
• Democratic governor of New York says “Medicaid is the largest single driver of State’s growing expenditures.” and governors of other states fret about their ability to carry burden of Medicaid under health reform.
• Harvard Pilgrim, Massachusetts 2nd largest plan, pulls out of state program.
• Maine and Iowa ask for waivers from medical-loss ratio rates.
• McDonalds asks for waivers saying they will be forced to drop coverage for 28,500 employees.
• Market for child only coverage disappears.
• Republicans release Pledge to American, promising to repeal health reform law and replace it with incremental plan.

October 2010

.Kiplinger itemizes ten tax increases secondary to health reform plan.

November 2010

• Republicans gain more seats (63) in Congress than any time since 1938, more than 600 seats in state legislatures, and more governorships (31).
• Governors, wary of massive Medicaid increases, consider dropping of Medicaid programs.

December 2010

• Bipartisan fiscal commission says CLASS, new entitlement program for long-term care is “financially unsound “and will require large tax transfers or will collapse.
• Federal judge Henry Hudson rules individual mandate unconstitutional.

January 2011

• House Republicans vote to repeal law, bill dies in Senate.
• New research by CBO health law will explode deficit by employers and dump employees into government-subsidized exchanges.
• 40% of waivers given to unions.
• Blue Shield of California, former Obama supporter, seeks rate increases of up to 59%.
• Judge Roger Vinson, voids health reform law in its entirety, says individual mandate is unconstitutional.

February 2011

• President Obama supports giving states more “flexibility,” as long as they toe the federal standard line.
• Number of waivers tops 1000 for health plans covering more than 2.6 million people.

March 2011

• Judge Vinson tells White House to stop stalling and to file an expedited appeal to his ruling.
• Survey indicates Romney care has not decreased medical bankruptcies in Massachusetts.
• Congress repeals 1099 provision.
• Kathleen Sibelius admits reform law “double-counts” Medicare cuts to close its deficit and to contribute to image Medicare solvency.
• Clash warfare between GOP and Dems intensifies with 1st birthday of health reform law with conflicting claims of impact.
• 48% of Americans believe health reform law already repealed.
• CBO predicts premiums will go up $2100 in 5 years despite Obama administration claims they will go down up to $2500.
• Premiums grew 12% in 2010 along with increased copays and deductibles.
• HHS says 51% of businesses will change insurers, and up to 80% of small businesses will lose current coverage.

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