The speed at which Obamacare is now collapsing has exceeded the pace at which its advocates are able to produce plausible excuses. For evidence of this, one need look no further than the latest conspiracy theory concocted by Andrew Slavitt, the paragon of public service who runs the Centers for Medicare and Medicaid Services (CMS). Slavitt, best known to the public for lying to Congress about his agency’s efforts to recover taxpayer-funded PPACA start-up grants misappropriated by state officials, has instructed his minions to issue a public information request concerning the “inappropriate steering” of patients to Obamacare exchanges.
The ostensible impetus for the request involves “reports” allegedly received by CMS to the effect that numerous doctors and hospitals, “for the purpose of obtaining higher payment rates,” are steering uninsured patients toward the exchanges and discouraging them from applying for Medicare or Medicaid. For anyone familiar with how Obamacare plans actually pay, this will fail the laugh test. But Slavitt apparently expects us to take it seriously. In a press release, he made the following claim: “We are concerned about reports that some organizations may be engaging in enrollment activities that put their profit margins ahead of their patients’ needs.”
The real purpose of the information request is, of course, to create another set of villains to blame for Obamacare’s rapidly accelerating collapse. This is why neither the CMS information request nor Slavitt’s news release provides any information concerning how many reports the agency has received or from what source they emanated. The request does, however, provide a gruesome list of calamities that may result from this fictitious plot: “We believe this practice not only could raise overall health system costs, but could… result in higher out-of-pocket costs for enrollees, and have a negative impact on the individual market single risk pool.”
It is no coincidence that the risibly titled “Affordable Care Act” already suffers from all of the problems listed, and that they have recently been the subject of considerable public scrutiny. Now that the Obama administration is in its waning months, the media have been less reticent about reporting the truth about “reform’s” catalogue of failures. Even the most biased outlets have reported on the exodus of insurers from Obamacare’s exchanges. The New York Times, for example, provides an honest report on a study showing that “17 percent of Americans eligible for an Affordable Care Act plan may have only one insurer to choose next year.”
Even more amazing is a report from CNBC titled, “Aetna’s Obamacare pullout means the ‘insurance death spiral’ has arrived.” When a notorious purveyor of White House talking points runs such a story, written by a longtime Obamacare critic like Sally Pipes, it’s safe to say that the “it’s working” argument is a goner. More to the point, however, is this passage: “Obamacare’s critics have long predicted that exchange plans’ high premiums and deductibles would keep all but the sickest Americans from enrolling… insurers would lose money no matter how much they raised premiums. Eventually, insurers would have no choice but to pull out.”
What Pipes is speaking to is the individual market risk pool about which Slavitt and his CMS minions affect such concern. In reality, this problem is not the result of health care providers more concerned with profit margins than patients. Nor is it the fault of greedy insurers, another favorite scapegoat of the Obama administration. The lopsided risk pool and the insurance death spiral are the result of structural defects that were built into Obamacare from the beginning. They were set in motion by market realities that were flouted by the President and his congressional accomplices when the latter passed this boondoggle and the former signed it into law.
This is also true of the overall health system costs and out-of-pocket costs to which the information request refers. As to overall system costs, CMS itself produced a report showing that Obamacare reversed a longtime downward trend during its first year of full implementation: “In 2014, U.S. health care spending increased 5.3 percent following growth of 2.9 percent in 2013.” And, Obamacare’s effect on out-of-pocket expenses is justly notorious. As I recently wrote in this space, a Kaiser Family Foundation study shows that the increase in 2017 premiums paid by individuals buying coverage through the exchanges will double the 2016 increase.
All of this was utterly predictable, of course. In fact, it was predicted by yours truly and many others. Less predictable was the lengths to which the President and his creatures would go to convince the public that Obamacare’s inevitable failure is the fault of implausible conspiracies and unlikely villains. It’s one thing to point the finger at evil Republicans and greedy insurance executives. But when the head of CMS insinuates that the whole mess is the result of health care providers steering patients to exchanges that the Obama administration has been shamelessly pimping for years is just plain weird, even for an oily character like Andy Slavitt.