cur-mud-geon: anyone who hates hypocrisy and pretense and has the temerity to say so; anyone with the habit of pointing out unpleasant facts in an engaging and humorous manner
Wending our way to the implementation of the Affordable Care Act (ACA), ObamaCare for those who prefer, we are finding more issues that promise to develop when the switch is thrown to the “on” position.
Maybe one issue that will be most obvious is the uncertain nature of the actual workings of the exchanges or ‘marketplaces’ where one is to be able to go online, shop, and make informed decisions about health care coverage for 2014. There have long been questions about whether or not these online portals will be functional by October 1st when they are to be turned on.
Recent revelations that the security tests for these portals have been delayed until September 30th, the day prior to launch, is particularly disconcerting. Federal assurances seem not to have eliminated the concern. These sites will transfer very important personal information to many elements within the federal government and security is absolutely paramount.
Another concern, recently noted, is that the ‘navigators’ who are to assist you and me in making our choices are very concerned that they are not being properly trained so as to discharge their responsibilities properly. People who are licensed insurance agents and who have spent years working with clients who are most likely to be seeking service through exchanges report they do not feel adequately informed after sitting in on the training modules that are available. The state agencies charged with responsibility for delivering this training are reportedly overwhelmed with the enormity of their charge. We are about five weeks away from launch; this is not a good omen.
Yet another concern is that there will be limited choice in the Wisconsin federally facilitated exchange (FFE) which has nothing to do with the state relegating responsibility for the exchange to the federal government. The insurers and HMOs that have indicated they are going to participate have narrow networks since they are each local or regional in nature. The major insurers have chosen to sit out the opening day, the opening year in reality, in large part because they simply did not know how to price for the risk given the thought that many who had not had coverage didn’t have coverage because of pre-existing health problems.
Beyond the potential issues within the system, there are the recurring anecdotal announcements such as that of United Parcel Service (UPS) yesterday. That company has made it known that spouses, who have other coverage available through their own employers, will not be eligible for coverage under the various UPS health plans.
Anecdotal reports of more part-time employees due to employers reducing hours to get beneath the 30 hour benchmark for eligibility continue to be heard. The unemployment reports, unless the U6 version is used, do not adequately indicate this phenomenon. The people who are having their hours reduced continue to be employed so they do not impact unemployment numbers. But, they are under-employed which is the next worst thing to being unemployed. This has, and will continue to have, an impact on the overall economy. Even if it seems to be healthy, it could’ve been much healthier without the under-employment.
As if all this weren’t enough to cause us to have a bad feeling, there lurks the 800 lb. Gorilla of costs for all this. No one has a well-informed idea of what the real costs will be to our country, our employers, our health system and our citizens.
The ACA was ill-thought by Congress. The delays of some of the enforcement actions was likely the White House response to its own concerns about what all this is going to do to the election races in 2014. An aroused voting citizenry could decide that it wants to ‘clean House’ and ‘clean Senate’. President Obama does not relish the thought of closing out a feeble second term with Republicans controlling both sides of the Legislature.
His signature piece of legislation, the Affordable Care Act, could well go far down the road of determining how his eight years as President will be seen through the lens of history.
That, however, is a relatively small consideration when contrasted to what he and his Congress might have done to our system of health care financing and delivery.
But, to borrow the words of Alfred E. Neumann from the cover of the old Mad magazine: “What? Me Worry?”