The WasteWatcher: The Staff Blog of Citizens Against Government Waste

Obamacare Has Taken a Lickin...And It Still Isn't Tickin

The WasteWatcher is the staff blog of Citizens Against Government Waste (CAGW) and the Council for Citizens Against Government Waste (CCAGW). For questions, contact blog@cagw.org.


Well, now that January 1 has come and gone many of us get to experience the joys of government-controlled health insurance, better known as Obamacare or the Affordable Care Act.  (Yes they ARE the same thing.  There have been polls, which indicate people believe they are two different laws.)

Three interesting stories popped up within the last 24 hours that I want to share with you.  Two stories demonstrate the on-going problems with the Healthcare.gov website. The third gets into one of the many policy problems with Obamacare.

Let’s start with the policy problem – Medicaid expansion.  For three years we have been told by the president and many members of Congress that Medicaid expansion will assist low-income people in obtaining a primary care doctor and thus avoid going to the hospital emergency room for routine health services, a very expensive way to get healthcare.  We were told Medicaid expansion would free up hospital emergency rooms for those that needed urgent care and save money.

Not so fast. A MIT study published yesterday in Science shows “adults that are covered by Medicaid use emergency rooms 40 percent more than those in similar circumstances who do not have health insurance.”

This is not good news for the patients who utilize Medicaid, a terrible health insurance program, and it certainly isn’t good news for the taxpayers.

The researchers took “advantage of Oregon’s recent use of a lottery to assign access to Medicaid, the government-backed health-care plan for low-income Americans, to certain uninsured adults.  The research examines emergency room records for roughly 25,000 people over 18 months.”  And the result?  Amy Finkelstein, the principal investigator said that when you provide the uninsured with Medicaid, emergency room use increases by a large magnitude.

The researchers discovered that Medicaid increases visits to the emergency room consistently across demographic group, type of visit, or health condition.  The researchers were unable to find any subgroup – either population or type of condition – which caused a large decrease in emergency room use.

So what can we expect based on this study?  Thanks to Obamacare expanding Medicaid, we can expect emergency room use to grow exponentially.  The exact opposite of what was promised by the president and the members of Congress that wrote the law.

Now for the two website-related problems:

We learned today if a couple has a baby, it is going to be difficult to get the child formally added to their health policy via the Healthcare.gov website.  In addition to being unable to accept a new baby, the Heathcare.gov website cannot handle a whole host of personal changes such as marriage, divorce, a death in the family, moving, a new job, or a change income.   Certainly these changes would affect any health insurance policy but now because of Obamacare,  they also affect how much financial assistance (subsidies) an individual or family can be obtained from taxpayers.

With regular private insurance, one just needed to notify the insurance company of a change.  But if you get your insurance through the exchange, now you have to let the government know too.

Robert Laszewski, a health insurance industry consultant, stated this recent glitch is just “another example of ‘we’ll fix it later.’  This needed to be done well before January.  It’s sort of a fly-by-night approach.”

The lackadaisical approach for how the Obama administration has approached the construction and design of the Healthcare.gov website; its willy-nilly changing of law when it comes to Obamacare implementation dates and procedures, and ordering insurance companies to cover-up for their incompetence should send shivers up Americans’ spines.  It’s bad enough the government was unable to have the website working properly by October 1 even though it had three years to do so.  Now it is the overseer of one of our most personal assets: our health.

Finally, the Mail-on-Line, the e-version of the British paper Daily Mail provided what certainly is the beginning of a series of stories that highlight the problems people face who think they have insurance coverage but do not.  The reporter, David Martosko, interviewed several individuals trying to utilize their new insurance policy.  They went to a hospital in Northern Virginia and discovered since they had no proof of insurance coverage, they would have to pay full price for whatever procedure they wanted.

Here are some of the problems patients faced:

  • One woman, who had a bad cough, went to the hospital for a chest x-ray.  The hospital had no idea if she had health insurance or not.  (No surprise here.)  The only way the woman could get the x-ray is if she paid for it with her personal funds, approximately $500.  She decided to leave without obtaining the x-ray.
  • Another woman went to the hospital because she had chest pains.  The hospital was going to admit her but when it was discovered she hadn’t heard yet whether she had insurance, the hospital officials told her that she would be responsible for the bill  and that it could be as high as $3,000 for a day's stay.  The doctor told her the decision was hers to make.  She decided to return home even though she thought she should be admitted.

It is also likely the patients may not really understand the policy they supposedly have purchased.  According to Martosko, the woman looking for the x-ray had a Bronze plan with a $5,500 deductible.  She would have had to pay out-of-pocket for her x-ray anyway.

The back-end of the website, the part that consumers do not interact with but insurance companies do, is still in the process of being built.  Many insurers are not getting correct information about a patient and CMS, the government agency overseeing Obamacare, has not transferred the premium payments.  Many experts have said in numerous reports that it could take up to a year to fix this part of the website.

As time goes on, many more patients will realize they do not have an insurance policy when they visit their doctor or enter a hospital even though they enrolled on the website.  Many news outlets have been reporting that these problems were likely to occur as the website’s poor functionality has been discussed in several Congressional hearings.  Even Health and Human Services Secretary Kathleen Sebelius advised consumers to call their insurance company to make sure they were covered.  However, it is clear many people have not been following the daily machinations concerning the Obamacare roll-out.

One of the patients interviewed by the paper put it pretty succinctly.  She said, “Why is this so complicated?  I had my own private insurance last year, but they cancelled me in November.  I'm not sure which end is up.”  No doubt many Americans are asking this question.

Here is the answer…the government is in charge of your health decisions now.

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