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Obamacare Shoes Begin To Drop . . .

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Skull and Bones:
It was designed to fail so a single payer system could be ushered in.  Cost will be too high on this crap.

I am beginning to believe that S&B - at first I thought that idea was far fetched.  But then... well stuff happens and that which is far fetched becomes real - like this -


--- Quote from: dbucfan on August 11, 2013, 12:22:09 PM ---I am beginning to believe that S&B - at first I thought that idea was far fetched.  But then... well stuff happens and that which is far fetched becomes real - like this -

--- End quote ---

Not possible, there is no voter fraud. I know that because I read it here in The Cove

This isn't anything new, Obama himself admitted it before it was even voted on. 

Oh yea, I don't believe anyone who watched the HC mess move through a democratically controlled Congress and Executive thought for a second their actions were anything by the prelude for Government controlled HC. 

Even the NY Times is getting put off - I wonder if they will sniff the BS...

A Limit on Consumer Costs Is Delayed in Health Care Law
Published: August 12, 2013 730 Comments

WASHINGTON — In another setback for President Obama’s health care initiative, the administration has delayed until 2015 a significant consumer protection in the law that limits how much people may have to spend on their own health care.

The limit on out-of-pocket costs, including deductibles and co-payments, was not supposed to exceed $6,350 for an individual and $12,700 for a family. But under a little-noticed ruling, federal officials have granted a one-year grace period to some insurers, allowing them to set higher limits, or no limit at all on some costs, in 2014.

The grace period has been outlined on the Labor Department’s Web site since February, but was obscured in a maze of legal and bureaucratic language that went largely unnoticed. When asked in recent days about the language — which appeared as an answer to one of 137 “frequently asked questions about Affordable Care Act implementation” — department officials confirmed the policy.

The discovery is likely to fuel continuing Republican efforts this fall to discredit the president’s health care law.

Under the policy, many group health plans will be able to maintain separate out-of-pocket limits for benefits in 2014. As a result, a consumer may be required to pay $6,350 for doctors’ services and hospital care, and an additional $6,350 for prescription drugs under a plan administered by a pharmacy benefit manager.

Some consumers may have to pay even more, as some group health plans will not be required to impose any limit on a patient’s out-of-pocket costs for drugs next year. If a drug plan does not currently have a limit on out-of-pocket costs, it will not have to impose one for 2014, federal officials said Monday.

The health law, signed more than three years ago by Mr. Obama, clearly established a single overall limit on out-of-pocket costs for each individual or family. But federal officials said that many insurers and employers needed more time to comply because they used separate companies to help administer major medical coverage and drug benefits, with separate limits on out-of-pocket costs.

In many cases, the companies have separate computer systems that cannot communicate with one another.

A senior administration official, speaking on condition of anonymity to discuss internal deliberations, said: “We knew this was an important issue. We had to balance the interests of consumers with the concerns of health plan sponsors and carriers, which told us that their computer systems were not set up to aggregate all of a person’s out-of-pocket costs. They asked for more time to comply.”

Health plans are free to set out-of-pocket limits lower than the levels allowed by the administration. But many employers and health plans sought the grace period, saying they needed time to upgrade their computer systems. “Benefit managers using different computer systems often cannot keep track of all the out-of-pocket costs incurred by a particular individual,” said Kathryn Wilber, a lawyer at the American Benefits Council, which represents many Fortune 500 companies that provide coverage to employees.

Last month the White House announced a one-year delay in enforcement of another major provision of the law, which requires larger employers to offer health coverage to full-time employees. Valerie Jarrett, Mr. Obama’s senior adviser, said that the delay of the employer mandate showed “we are listening” to businesses, which had complained about the complexity of federal reporting requirements.

Although the two delays are unrelated, together they underscore the difficulties the Obama administration is facing as it rolls out the health care law.

Advocates for people with chronic illnesses said they were dismayed by the policy decision on out-of-pocket costs.

“The government’s unexpected interpretation of the law will disproportionately harm people with complex chronic conditions and disabilities,” said Myrl Weinberg, the chief executive of the National Health Council, which speaks for more than 50 groups representing patients.

For people with serious illnesses like cancer and multiple sclerosis, Ms. Weinberg said, out-of-pocket costs can total tens of thousands of dollars a year.

 Despite the delay, consumers in 2014 will still have many new protections. They cannot be denied health insurance or charged higher premiums because of pre-existing conditions, and many will qualify for subsidies intended to lower their costs.

In promoting his health care plan in 2009, Mr. Obama cited the limit on out-of-pocket costs as one of its chief virtues. “We will place a limit on how much you can be charged for out-of-pocket expenses, because in the United States of America, no one should go broke because they get sick,” Mr. Obama told a joint session of Congress in September 2009.

Advocates for patients said the promise of the law was being deferred. “We have wonderful new drugs, the biologics, to treat rheumatoid arthritis, but they are extremely expensive,” said Dr. Patience H. White, a vice president of the Arthritis Foundation. “In the past, patients had to live in constant pain, often became disabled and had to leave their jobs. The new drugs can make a huge difference, and we were hoping that the cap on out-of-pocket costs would make them affordable. But now many patients will have to wait another year.”

The American Cancer Society shares the concern and noted that some new cancer drugs cost $100,000 a year or more.

“If a prescription drug plan does not currently have a limit, then it will not have to have one in 2014,” said Molly Daniels, deputy president of the lobbying arm of the American Cancer Society. “Patients who require expensive drugs could continue to have enormous financial exposure, despite the clear intent of the law to limit a patient’s total out-of-pocket exposure.”

Federal officials said they were offering transition relief to certain health plans in 2014. But, they said, by 2015, health plans must comply with the law and must have an overall limit on out-of-pocket costs for medical, drug and other benefits combined.

Theodore M. Thompson, a vice president of the National Multiple Sclerosis Society, said: “The promise of out-of-pocket limits was one of the main reasons we supported health care reform. So we are disappointed that some plans will be allowed to have multiple out-of-pocket limits in 2014.”

The law also requires coverage of dental care for children, but these benefits can be offered in a separate health plan with its own limit on out-of-pocket costs.

Federal rules say that a free-standing dental plan must have “a reasonable annual limitation on cost-sharing.” In states where the new health insurance marketplace will be run by the federal government, the limit on out-of-pocket costs for pediatric dental benefits can be no more than $700 for coverage of one child and $1,400 for a plan covering two or more children in the same family.

How odd - Fox reports on what the Times has put out - seems there has been a sale on the river.

Latest Obamacare Carve Out a Boon to Big Insurance
By Chris Stirewalt
Power Play
Published August 13, 2013

“We can't have a system that works better for the insurance companies than it does for the American people…. And they will keep on doing this for as long as they can get away with it.”
-- President Obama in a March 8, 2010 speech at Arcadia University calling for passage of his health law.

The wealthy and well-connected seem to be having a much better go of getting exemptions from Obamacare.
When President Obama’s health legislation was teetering after the election of Sen. Scott Brown, the president and his administration went on the attack, ripping into the profits of Americas big insurance companies. He and his team said that those who oppose his law were putting “profits ahead of people.”
Today, as the law lurches into full implementation, we learn that the administration has imposed another delay in a key provision of the law, this time to help the profits of those same insurance companies he once attacked.
The inside joke in Washington back in 2010 was that while Obama was sharpening the tines on his pitchfork for his populist push to get to final passage of the bill, much of the legislation had been crafted in consultation with industry lobbyists. Obama co-opted many in the industry of the industry with promises of protection and predictable profits, just as he did with the biggest drug companies.

But as he campaigned ahead of the law, Obama went on the attack, looking to not only keep his industry partners in line but scare off any Democrats getting queasy about the big costs and disruptions associated with the beleaguered bill.
One of the key selling points in Obama’s populist push was that the bill would set annual caps on out-of-pocket expenses demanded by insurers. Starting in 2014, the law sets the limit at $6,350 for individual policies and $12,700 for family plans.
But through a regulatory re-write slipped into the rule book in February, but first publicized in today’s New York Times, the administration has given big insurance companies a one-year delay on the caps.
The reason cited is a technical problem in getting new and existing computer systems in synch. But the move will also help prevent more rate shocks. Insurance premiums are set to rise precipitously next year as insurers are required to begin accepting patients with pre-existing conditions.

If the insurers were also required to absorb the cost of very expensive treatments not covered under plans, like new prescriptions for cancer treatment that cost more than $100,000 per year, at the same time, premiums would climb even higher.
Obama has so far spared big business, big insurance and members of Congress from expensive provisions of the law.

With forecast rate hikes already causing agitation in the administration, these out-of-pocket caps would have to be seen as a liability. And for industry lobbyists, that would provide the perfect pressure point. Delay the cap and spare yourself more coverage of skyrocketing rates.
One of the upsides of having lobbyists present at the creation of the law and now having so many members of team Obama on the other side of the revolving door is that the lobbyists know just where to go to get what they want.
What about the 2009 and 2010 promises from Obama and his health law team, particularly Health Secretary Kathleen Sebelius, that they would smack down insurance companies who sought big rate hikes? Why didn’t they just tell insurance companies to pay for it out of their cushy profits?

Well, Sebelius has lately been in trouble for calling to raise money from the insurance industry to back her campaign to get more people to sign up for Obamacare. And Obama spent part of his evening last night at the Martha’s Vineyard home of Washington mega-lobbyist Broderick Johnson. Doubtful there was much pitchfork sharpening going on there.

Aside from the reverse co-opting of the president and his team, there’s this: The profits Obama demonized in 2010 aren’t big enough to pay for all the changes in the law. If Sebelius played hardball, other insurers would decide to get out of the business. Aside from disrupting coverage, it would mean less competition and… higher rates.

Obama has so far spared big business, big insurance and members of Congress from expensive provisions of the law. For regular folks, including the same union members who helped pass and protect the law, the exemptions don’t come so easily.
Instead of writing anguished letters, what those folks ought to be doing is hosting **CENSORED**tail parties on the Vineyard or writing checks to the Health secretary’s campaign. That’s how you get attention in Obamaland.

I don't recall other programs which did this?  Does anyone else - or has anyone read of such actions?

ObamaCare's 'navigator' program ripe for disaster
By Gov. Bobby Jindal
Published August 12, 2013

We already know ObamaCare is a poorly conceived law that is unworkable in the real world. We know the law is already driving health care premiums through the roof contrary to what President Obama promised. For instance, in my home state, our largest health insurance provider reported recently that health care premiums could go up by more than 200 percent on some customers, and the average increase could be almost 30 percent according to one study.

We also know that implementation of the law has been a disaster so far. The Obama administration made the decision last month to delay the penalty provisions in the bill on employers for another year. So the boss gets spared, but no such luck for the working stiff.
This action is an acknowledgement from the administration that the law is not ready for primetime. Worse, the delay is going to increase the cost of the already too expensive bill by $12 billion. And there are clearly political motivations behind the delay as moving the tax on employers beyond the 2014 elections removes a burden on Democrats running to defend this terrible piece of legislation.

ObamaCare is just not ready for primetime, and there is something more than a little odd about using taxpayer money for a marketing campaign aimed at taxpayers
The writing is already on the wall -- the entire ObamaCare law needs to be repealed.

But wait, as they say in the infomercials, there’s more! By August 15, the Obama administration is expected to spend $54 million of our tax dollars to hire community organizers to push this law on the American people. The president was once a self-professed community organizer, so perhaps this is his way of “giving back” as they say.

Here is how it is supposed to work.
Over the next few weeks, the Obama administration is set to dole out grants and begin to hire thousands of marketers to help sell ObamaCare. The Obama administration came up with a clever name for these marketers – ‘navigators’ – who are charged with helping to sign people up for ObamaCare.

‘Navigator’ is a crafty name, but in reality, there are very few restrictions on who they are, and what exactly they are supposed to be doing. ‘Navigators’ are supposed to be hired to help consumers understand the law and the insurance coverage provisions in the new health exchanges. Sounds like a job for a rocket scientist.

The ‘navigators’ are prohibited from having financial ties to an insurance company, but other than that there are few constraints. Union organizers and community activists are among the types that are allowed to be hired as ‘navigators’, and having prior experience working in the health care field doesn’t seem to necessarily be a pre-requisite for the job. I wonder what percentage of these ‘navigators’ will be partisan Democrats?

The ‘navigators’ will be required to take only 20 hours of online course training, which will apparently make them experts on the 1,000 page ObamaCare bill. An HHS official was even quoted this week saying, “We view training as an ongoing process.” Count me as skeptical.
To make matters worse, these ‘navigators’ are going to have access to all kinds of personal information that will make the whole program ripe for fraud.

When helping individuals sign up for ObamaCare, these community organizers will have access to sensitive personal information, including social security numbers and tax information.

Amazingly, HHS is not planning on requiring background checks on these individuals before putting them to work. Besides the obvious identity theft concerns, this is a frightening development in light of the political activities and invasion of privacy, which the IRS and others have engaged in during the Obama presidency.

But the biggest problem with the ‘navigator’ program is it appears the federal government still doesn’t have the complete means to verify if an individual is even eligible for exchange insurance subsidies.
Coupled with the delay of the employer mandate, there is little way to know if a person has access to affordable insurance through their employer, making them ineligible for subsidies. This makes the system open for fraud and abuse. ObamaCare is now on the honor system.
Beyond the serious implications for taxpayers that thousands could be signing up to receive taxpayer subsidies who are not eligible, this is problematic for consumers who could be forced to pay back money if they mistakenly sign up for ObamaCare, along with the potential for fines.
You could not make this stuff up. No one would believe it. I’m not sure I believe it.

In Louisiana, I signed a law to ensure that felons and ex-cons are not the ones who will be in charge of the ‘navigator’ program and have access to all this sensitive personal data. This is a step in the right direction and some other states have passed similar legislation, but running the ‘navigator’ program without a proven means to verify if a person is eligible for ObamaCare has the potential for disaster.

Like he did with the delay of the employer mandate, the president needs to halt these lucrative grants to the ‘navigator’ program immediately.

ObamaCare is just not ready for primetime, and there is something more than a little odd about using taxpayer money for a marketing campaign aimed at taxpayers. The troubling details of the navigator program provide just another example of the poor planning and implementation of ObamaCare and shows why the law must be repealed.
Republican Bobby Jindal is governor of Louisiana.

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Dolorous Jason:
What a joke this government is ...


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