Core Essays

30 November 2013

Government Continues to Lower Expectations for Pre-paid Health Care Exchanges

The federal government pre-paid medical care exchanges are supposed to be working better today.  They are supposed to handle up to 50,000 people on-line at one time now.  Since the federal exchanges are claiming you can sign-up for plans beginning on 1 January 2014 until 23 December, this means that counting today, there are 23 days to sign-up.  So far in two months, it is thought that about 150,000 have chosen plans.  At 50,000 sign-ups per day henceforth a grand upper limit total of another 1,150,000 sign-ups may occur before time has run out.  Some people will not sign-up for anything until they have been on-line over the course of several days examining the offerings and then looking into the provider networks elsewhere.  The enthusiastically socialist state of Maryland, which operates its own exchange, has a much earlier sign-up deadline of 10 December and a very confusing website.

It is not at all clear that even if one signs up by 23 December on the federally operated exchanges, that one will have an actual plan by 1 January 2014.  This is because you do not have a plan until you have paid the company offering the mandated ObamaCare pre-paid medical care plans.  The federal exchanges do not yet have a means to enable such payments.  Given their track record to-date and the methods they are using to manage the exchanges still, it seems unlikely they will have a working mechanism for making payments to the plan providers before Christmas.  So, it seems very certain that fewer than 1,300,000 plans will actually exist on 1 January 2015.

Recall that ObamaCare was passed so that 47 million Americans without health insurance would have pre-paid medical care once it was implemented.  Nothing was said about many millions of people who had insurance losing that insurance.  As it happens, to-date more than 5.55 million insurance plans have been cancelled and the federal government wants to declare success for ObamaCare if 1.3 million new plans are issued under it.  But, this is a net loss of 4.25 million insurance plans, while the supposed 47 million Americans uninsured before will all remain uninsured.  Yes, of course some of them will get ObamaCare insurance and more than 4.25 million of the newly cancelled plans will have no replacement.  The few state-run exchanges which work better than the federal government exchanges will manage to sign-up a few more of the 4.25 million lost plans, but will not sign up most of them either.

Meanwhile, throughout 2015, tens of millions more health insurance plans offered by small businesses and big businesses will be cancelled or replaced by more expensive plans with much increased employee contributions.

On 1 January 2014, many more Americans will have no health insurance and no pre-paid ObamaCare medical care than the original 47 million claimed uninsured who were the very justification for the wrenching changes to our medical care system including the loss of our doctors and hospitals, especially the better ones, the cost of much increased premiums for most of us, the increase in deductibles for most of us, the need to travel much greater distances to the health care providers for many of us, long waits to see doctors or nurse and pharmacist substitutes, a decrease in medical innovation, a decrease in covered medical procedures, more trips to medical facilities to get through a given medical procedure, decreased medical and financial privacy and security, and the many aggravations of having to choose and learn new health networks and how to do their increased paperwork.

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