Author Topic: Right-wing nuts nab new way to sabotage Obamacare  (Read 605 times)

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Offline sinkspur

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Right-wing nuts nab new way to sabotage Obamacare
« on: October 17, 2013, 11:07:41 AM »
http://www.salon.com/2013/10/17/right_wing_nuts_nab_diabolical_new_way_to_sabotage_obamacare/singleton/

Right-wing nuts nab new way to sabotage Obamacare
Remember how the shutdown deal only gave the GOP "small" concessions? One low-profile component could prove costly
By David Dayen


The final deal to avert a breach of the debt limit and end the government shutdown included what has been described as a “small concession” to Republicans: tightening the income verification measures for customers on the Obamacare insurance exchanges to qualify for subsidies. But considering the hurdles associated with this step – and the enormous IT problems we’ve already seen with the exchanges – the concession may not be small at all.

As one prominent health care expert tells Salon, the impact could contribute to an attempted sabotage of the law by those who want to see it repealed. Rather than letting the health care law survive “unscathed,” the income verification piece could trigger a new round of headaches for Obamacare, and this time, Republicans – and the country – will be paying attention.

Conservatives have been grumbling for months that Obamacare invites fraud, by using an “honor system” to verify the income levels that determine subsidy amounts on the exchanges. Just last month, House Republicans passed the No Subsidies Without Verification Act 235-191, with all of their members voting in favor. The bill prohibits any subsidies from being distributed until the Inspector General of the Department of Health and Human Services (HHS) certifies that a system of income verification is operational.

HHS did say back in July that they would rely on “self-attestation” to determine the initial subsidy level, with sample audits to verify information. But later, HHS announced the sample size would equal 100% of the population, and that they would test self-reporting against sources like past tax filings and Social Security data. While they haven’t officially changed the regulation, income verification tests are included in the exchange’s data hubs. So you can say that the Republican measure just forces compliance with spelling out the regulations for a full verification regime.


However, there’s another part to this, the simplest and easiest way to ensure that everyone receives the proper subsidy level. It’s called the Internal Revenue Service. Every American sends in a tax return annually showing their exact income level, subject to routine verification by a large government agency. Under Obamacare, the IRS can claw back excess subsidies after the fact, something frequent conservative critic Avik Roy acknowledged in July. He added that “the IRS’ record of impartiality is, shall we say, contested,” and that people in poverty who don’t file tax returns “would probably not be subject” to clawbacks (weasel word alert!). Roy is relying on the discredited IRS scandal here to suggest that the agency wouldn’t do their job when Obamacare recipients (read: Democrats) are involved. But he also takes a very curious stance for a conservative: that the IRS, far from being a group of jack-booted thugs who will stop at nothing to take your money at the barrel of a gun, is simply too lazy to do its job!

“You have to wonder, why isn’t clawback enough,” Paul Starr, Princeton professor and author of Remedy and Reaction, about the legislative fight over Obamacare, told Salon. “This seems to me another form of sabotage.”

Starr’s perspective is borne by the early experience of the exchanges. The federal exchange, which is the Obamacare portal for customers in 34 states, has performed very badly in the opening weeks. Even supporters of the law like the Washington Post’s Ezra Klein has called the rollout a disaster. Not only have potential customers been unable to register for the program after 20 or 30 attempts, those few who have been successful aren’t having their data transferred to insurance companies properly.

“Things are worse behind the curtain than in front of it,” according to health care writer Bob Laszlewski, describing how the system is enrolling and unenrolling customers seemingly at random. If HHS can’t approve subsidies until the Inspector General decides income verification is operational, that would definitely delay subsidies – nothing is operational about the federal exchanges right now. (Subsequent reports about the deal suggest that Health and Human Services Secretary Kathleen Sebelius, and not the Inspector General, would do the certification. But it’s not clear what would have to be tweaked in the process.)

And you have to question whether income verification would ever be operational, and if that’s contributing to the major delays on the exchange website. Accurate, real-time income verification has been a cherished goal for members of the financial services industry for many years; they use this data to determine eligibility for loans of all types. Needless to say, big banks and financial services firms have massive resources relative to the federal government. And they haven’t been able to nail electronic income verification yet; they mostly ask people to mail or fax in forms proving income, rather than submit them through the Web (which leads to losing forms and multiple queries for data and all the rest).

Most of the information you can scrape from payroll or Social Security data would be 6-18 months out of date, especially for the types of part-time workers, freelancers, “unbanked” individuals and self-employed persons who comprise the primary group signing up for Obamacare. Demanding real-time income verification would require technology that doesn’t even exist for the financial sector, and to get it right would add significantly to the already burdensome delays in acquiring insurance coverage on the exchanges. It would also expand costs for IT development exponentially, achieving the neat trick of making Obamacare more costly and more ineffective at the same time.

As noted before, there’s an already existing method of income verification, through the IRS, that stands ready to handle any potential misreporting through clawbacks. In fact, the IRS will have to verify income anyway; people simply don’t have perfect information about their future income, especially part-timers and freelancers and the self-employed. This is how many means-tested programs like Medicare and Medicaid work, and despite the cries of conservatives, fraud in those programs mostly come from health care providers bilking the government rather than individual subscribers.

Instead of using a time-tested process that works (and would work better if Republicans weren’t so dedicated to defunding the IRS), the GOP wants to add this kludgey extra step to an already strained online exchange. The clear goal here is to make it harder to enroll or collapse the insurance exchanges entirely, along with creating the impression that Obamacare customers are automatically freeloaders and cheats, which aligns with conservative demonization of other government programs.

So far, the woes of the insurance exchanges have played in the background of the news, far behind the government shutdown and possible debt limit breach. By embarking on a white-whale quest to defund Obamacare, Tea Party Republicans have ignored the huge PR value of the exchange disaster. Indeed, many people logically assume that the problems with the exchanges are due to the shutdown (they aren’t). The Administration has basically gotten a lifeline on the bad rollout, thanks to the GOP focusing attention elsewhere. That could change with this deal, and the added hurdle of income verification.

Obviously, verifying the income of applicants to determine their proper level of subsidy is critical to Obamacare running smoothly. But there are plenty of ways to do this, particularly through the agency best equipped to verify income. Asking the federal government to perform an impossible technical feat through a shaky online portal is a recipe for further disaster. Senate Democrats made this concession to Republicans in their fiscal deal; House conservatives are well-positioned to exploit it.
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Offline rb224315

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Re: Right-wing nuts nab new way to sabotage Obamacare
« Reply #1 on: October 17, 2013, 11:39:35 AM »
Not sure why you're on a GOP/conservative message board carrying water for Salon & the libs, but I chose just a couple of Salon's points for comment.


“the IRS’ record of impartiality is, shall we say, contested,” and that people in poverty who don’t file tax returns “would probably not be subject” to clawbacks (weasel word alert!). Roy is relying on the discredited IRS scandal here to suggest that the agency wouldn’t do their job when Obamacare recipients (read: Democrats) are involved. But he also takes a very curious stance for a conservative: that the IRS, far from being a group of jack-booted thugs who will stop

Not discredited, and you & Salon know it, sinkspur.  I suppose if the media did its job, more than just a few people would know that Lois Lerner resigned last month after being informed she was to be fired.  People in the federal government don't get forced out for a "discredited scandal".


So far, the woes of the insurance exchanges have played in the background of the news

True, but they've been in the foreground of people's lives and will only continue to be in the foreground.  People don't need the media to tell them that their premiums and/or deductibles are going up significantly in exchange for less coverage.  A very small percentage of people will end up paying less out of pocket for premiums and deductibles, and the rest of the cost of their coverage is just extracted without them having seen it first.
« Last Edit: October 17, 2013, 11:42:40 AM by rb224315 »
rb224315:  just another "Creepy-ass Cracka".

Offline sinkspur

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Re: Right-wing nuts nab new way to sabotage Obamacare
« Reply #2 on: October 17, 2013, 11:46:00 AM »
Not sure why you're on a GOP/conservative message board carrying water for Salon & the libs, but I chose just a couple of Salon's points for comment.


Not discredited, and you & Salon know it, sinkspur.  I suppose if the media did its job, more than just a few people would know that Lois Lerner resigned last month after being informed she was to be fired.  People in the federal government don't get forced out for a "discredited scandal".


True, but they've been in the foreground of people's lives and will only continue to be in the foreground.  People don't need the media to tell them that their premiums and/or deductibles are going up significantly in exchange for less coverage.  A very small percentage of people will end up paying less out of pocket for premiums and deductibles, and the rest of the cost of their coverage is just extracted without them having seen it first.

Did you even read the article?

Salon is bitching that the income verification requirement agreed to by the Democrats will bring the exchanges to their knees in a way that will make the current plodding performance look like the speed of light.
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Offline rb224315

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Re: Right-wing nuts nab new way to sabotage Obamacare
« Reply #3 on: October 17, 2013, 12:04:59 PM »
Did you even read the article?

Salon is bitching that the income verification requirement agreed to by the Democrats will bring the exchanges to their knees in a way that will make the current plodding performance look like the speed of light.


Yes, and I commented on things in the article.  If you're particularly sensitive about comments on the other stuff you should have left it out.

Since you seem sensitive about someone not commenting on what a piece of excrement that 0bamacare is, I'll oblige you, but with 2 quotes from 0bama's hometown newspaper: 

"Last spring, President Barack Obama said "there will still be, you know, glitches and bumps" in the rollout of the new system. But what we're seeing now is no glitch or bump. There is a growing mountain of evidence that Obamacare has fundamental problems in design and implementation." 

What are those fundamental problems?  Are they limited to the computer system used to sign people up?  Apparently not:

"The deeper problems of cost and coverage in Obamacare are going to require an admission by the administration that this government management of the health care market is extraordinarily complicated and will be very costly for many people. The law has to change." 
http://articles.chicagotribune.com/2013-10-15/opinion/ct-obamacare-edit-1016-20131016_1_obamacare-health-insurance-insurance-premiums/2

It's not the Republicans' fault that 0bama and the Dems rammed through such a monstrosity without bipartisan support.  The Dems are foolish to expect anything but resistance from their opposition, especially when all of the problems--the basis of their opposition--were foretold by the GOP and have come to pass.
« Last Edit: October 17, 2013, 12:11:06 PM by rb224315 »
rb224315:  just another "Creepy-ass Cracka".

Online andy58-in-nh

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Re: Right-wing nuts nab new way to sabotage Obamacare
« Reply #4 on: October 17, 2013, 12:23:13 PM »

It's not the Republicans' fault that 0bama and the Dems rammed through such a monstrosity without bipartisan support.  The Dems are foolish to expect anything but resistance from their opposition, especially when all of the problems foretold by the opposition have come to pass.

Exactly so. But Salon and other redoubts of Progressive polemicism will call you a "right-wing nut" or worse, for suggesting that ObamaCare is anything but "settled law", and further, will insist that any Republican effort to address its manifold problems amounts to "sabotage".

The ideological rigidity of the Progressives flows from their Manichean world view (black/white; good/evil) and from their historical determinism (progress only marches in one direction - toward socialism specifically, and collectivism in general; any attempt to alter that course is deemed "reactionary").   

Conservatives cannot truly negotiate or compromise in the political sphere with people who adhere to such views, because the meaning of compromise has an entirely different purpose for Progressives than for conservatives. Those on our side use the process as a means by which to correct, amend or improve legislation or governance. Their side uses compromise as a tactic by which to further their agenda, regardless of the practical effect (often, failure) of their policies.
Liberalism isn't really about making the world a better place. It's about reassuring the elites that they are good people for wanting to rule over it.


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