At two-year mark, health law’s legacy is confusion – Washington Times

At two-year mark, health law’s legacy is confusion – Washington Times.

States and employers wait for guidance

By Paige Winfield Cunningham – The Washington Times

Two years after congressional Democrats squeezed out enough votes to pass President Obama’s health care overhaul, confusion still reigns among the states, insurers and average Americans struggling to comply with the hundreds of pages in the law.

Some states say they can’t move forward until the government issues more rules to clarify exactly what kinds of services need to be covered, while other states dispute that, saying enough information is available to plow ahead.

Insurance companies are biting their nails over how the requirements will affect their bottom lines.

Business owners say they can’t begin to comply with the law because it is too baffling. “Most of ‘em don’t have a clue what’s fixin’ to happen,” said Grady Payne, owner of a business based in Fort Worth, Texas.

Analysts, however, say many questions have been answered and that businesses should invest the time to find the answers.

Add to that the legal uncertainty. The Supreme Court is slated to hear oral arguments over the law next week, Republican presidential candidates are vowing to repeal or waive the law, and some policymakers are asking for a pause.

“I think it would make an awful lot of sense to say, ‘Let’s wait a minute, let’s take a breath,’” said Bill Hazel, the secretary of health and human resources in Virginia. “Let’s get through this Supreme Court decision, let’s get through the elections and then reconsider this.”

The legislation passed by a 219-212 vote in the House and a 60-39 vote in the Senate, with just a single Republican in favor of it. The bill cleared Congress on March 21, 2010, and Mr. Obama signed it into law two days later in a ceremony at the White House.

“I’m confident that you will like what you see: a common-sense approach that maintains the private insurance system but makes it work for everybody, makes it work not just for the insurance companies, but makes it work for you,” Mr. Obama said at the time.

Ever since — and especially this week — the Obama administration and congressional Democrats have touted the immediate benefits: mandated coverage for employees’ children up to age 26, a ban on limiting lifetime benefits and drug discounts for seniors.

But two years after the president signed the Affordable Care Act, the law remains contentious. An ABC/Washington Post poll released Monday found that Americans oppose the law by 52 percent to 41 percent.

Waiting on the administration

“There are still a lot of outstanding questions because we’re still waiting for a lot of the regulations,” said Robert Zirkelbach, a spokesman for America’s Health Insurance Plans, the insurance industry’s trade association.

The association hasn’t seen the final rules on whether the administration will consider costs when deciding what kinds of services insurers will be required to cover as essential benefits.

The bewilderment is readily apparent among business owners, who recite long lists of worries.

It’s all the more confusing when large and small businesses are governed by different sets of rules.

Take Mr. Payne, the Fort Worth-based business owner who runs a chain of plants that produce wooden packaging and crating parts.

Since the 1990s, Mr. Grady has offered full-coverage policies to about 140 administrative staffers, but not to 300 or so factory workers, mainly young and male, who he said aren’t willing to help foot the bill. Now that he will be required under the law to either provide coverage to all of his employees or pay a $2,000 fine for each, he said, he worries that he won’t be able to afford the plans or persuade workers to pay their share.

Able to recite cost estimates off the top of his head, Mr. Grady has spent a lot of time poring over the figures. To cover factory workers, he said, he would have to double what he spends on insurance to $1.5 million a year, which would eat up all his profits.

“It’s really discouraging to go to work every day and think all I’m doing is working to pay medical insurance,” he said.

His chief fear is how he will cover the benefits Texas may end up deeming “essential.”

Analysts said Mr. Grady’s fear may be unfounded. The essential benefits mandate applies directly to small companies, while Mr. Grady’s business, with more than 50 employees, is considered large.

Dragging their feet

Such confusion is widespread, said Stacey Pogue, senior policy analyst for the Texas-based Center for Public Policy Priorities, which supports the law. She said the problem is especially evident in Texas and other states where officials are challenging the law before the Supreme Court and dragging their feet on implementing it.

“I think public education is one of the biggest challenges we’re facing with implementing the Affordable Care Act — without a doubt,” Ms. Pogue said. “A lot of people are misinformed about what’s in the law, and I think certainly that needs to be the focus of the federal government.”

Others blame the uncertainty on the Obama administration, saying it has been slow in providing guidance.

Last week, the administration released more than 600 pages of long-awaited rules on state-run insurance exchanges through which millions of Americans are expected to obtain base-line coverage.

But health care players are still waiting for rules about the minimum coverage that plans in the exchanges must offer.

The administration has told states only the first steps toward setting up exchanges. It has told them to identify an insurance plan that will serve as their minimum level of coverage.

The federal government is expected at some point to give more specific guidance, and some states wonder why they should write their own rules only to find out later that they don’t meet federal standards.

“It would have helped to have the essential benefits package worked out some time ago,” said Mr. Hazel, the Virginia official. “That’s the basic thing — how can you price it and figure out what your rules will be?”

The Obama administration says its approach gives states flexibility, and some officials said they appreciate that.

Kansas Insurance Commissioner Sandy Praeger, a Republican, said she is frustrated with states that blame their own inaction on the administration. A dozen states have passed bills to set up exchanges, but 17 have yet to take any legislative steps forward.

“This is the hallmark of the president’s first term in office, and I think it’s being fought by conservative Republican states, and I think a lot of it is political,” Ms. Praeger said.

She plans to issue recommendations for how her state should proceed, but fears her state’s Republican-led Legislature and Gov. Sam Brownback, also a Republican, won’t take action.

More questions than answers

No matter how they felt about the administration’s approach, states, employers and insurers are left with a laundry list of questions, including how they should go about approving a benchmark plan, how close a plan must come to meet the law’s requirements to be considered acceptable and how to define categories less commonly covered, such as habilitative services.

Acknowledging that there is no widely accepted definition of what qualifies as “habilitative,” the administration has offered an example of a service it could include: speech therapy for a child who is not talking at the expected age. Businesses say the example isn’t enough and that they need to see final rules.

At the core of the arguments are concerns about the ultimate costs of the plans. If states select a benefit-rich plan as their benchmark, insurers will charge more in premiums for all of their plans, and that could raise costs for businesses.

“If you were to require all auto manufacturers to make cars with sunroofs and leather seats, cars are going to be more expensive,” said Katie Maloney, a health care policy specialist at the U.S. Chamber of Commerce. “What if someone wants to buy a beater?”

While large businesses are allowed to purchase plans outside the exchanges that may not offer the same minimum coverage, they can’t impose any lifetime limits on any essential benefits they do offer. Uncertain of the costs, some large businesses are reconsidering whether to cover any essential benefits at all, Ms. Maloney said.

As they try to figure it out, the clock keeps ticking toward January 2014, when many of the law’s key provisions take effect.

“I think there are more questions than there are answers,” Ms. Maloney said. “We’re urging agencies to issue rules that are clear and simple. We’re looking at a very shortened crunch time.”

Insurers are also preoccupied with the question of whether thousands of new provisions will combine to lower costs or make plans more expensive.

Uncertainty over health care reform began unnerving some business owners even before Congress enacted the legislation.

Rose Corona, owner of a farm and feed store in Temecula, Calif., decided to hold off offering coverage to her 34 employees when Mr. Obama started talking about reforming health care because she feared his plan could end up making plans more expensive.

“You have to have some certainty about the costs of your business, and I think that’s what this comes down to,” Ms. Corona said. “I have to keep this business running, and we have to control our overhead costs.”

Land Of Opportunity – Tea Party Nation

Land Of Opportunity – Tea Party Nation.

Posted by Tim Nerenz

This is a story about two nations with two very different ideas about equality. One nation is named Opportunity, and the other is called Outcome.

When they run a 100-yard dash in Opportunity, everyone starts at the same time and place and runs the same distance – they call that equality in the land of Opportunity. No two people finish exactly the same because some people run faster than others; that’s how God made them.

When they run the 100-yard dash in Outcome, however, everyone finishes exactly the same. The only way to do this is to make the rules unequal, to let some people run a shorter distance and add burdens onto others to slow them down. Each runs according to his ability and starts according to his need – that’s what they call equality in the land of Outcome.

In Opportunity, the winner of each 100-yard dash gets $100. Everyone else gets a dollar for each yard they have completed when the race is won. Some get $99, some get $80, and some only get $50. The slower runners who want to earn more train harder, run faster, and earn more. The faster runners who don’t want to lose income also train harder, run faster, and earn more. So in the land of Opportunity, everyone runs faster and faster, earning more and more.

Some of the slowest runners in Opportunity decide they can’t make very much money running, but think they could win the $200 singing contest. And some of the bad singers see that they can make a lot more money running than singing. So people find the work that is best suited for them, train hard, and compete against each other for rewards. Before long, Opportunity is a nation of very fast runners and exquisite singers and they are all earning more and more for their efforts.

In Outcome, however, everyone gets a sticker and a hug for trying, and keeping track of time is discouraged as it is believed to damage self-esteem. The fast runners see that they don’t earn any more for all that hard work they put into to training, so they stop working so hard. The slow runners don’t want to run faster because then they would be forced to run longer or start later. In Outcome, everyone runs slower and slower.

The people of Outcome think it isn’t fair that the singers make more than the runners, so everyone gets the same income whether they sing or run, and whether they do either one well or poorly. Nobody in Outcome trains to get better at anything, and no one bothers to learn a new skill. Outcome quickly becomes a nation of slow runners and bad singers; they believe they are entitled to run or entitled to sing, no matter how badly they do it.

Meanwhile back in Opportunity, the fast races and beautiful singing make the contests very popular; people are willing to pay more to watch excellence, so the rewards paid to runners and singers increase. The runners and singers of Opportunity get rich, and everyone else works hard to afford the expensive tickets; there is abundance from all that hard work that everyone does in Opportunity.

In Outcome, however, no one is willing to pay their own money to watch slow running and bad singing. The only way for runners and singers to earn more money is to demand it from the government. The government in Outcome taxes everyone else to give money to the people who now feel entitled to high pay and lavish benefits for running slowly and singing poorly. Anyone who questions those high taxes is called greedy.

The fastest runners and best singers in Outcome begin to leave; they come to Opportunity where they are free to run or sing or do anything else they please. In Opportunity, they make more money and they keep more of what they make – no one covets the earnings of another. They are happy; that is the gift of liberty.

The leaders of Outcome assure their people that everything is fine; to prove it, they have their central banker print a bunch of fiat money so it looks to their grumbling singers and runners as if they are making more money, too. The whole world rejects Outcome’s paper money as reserve currency and starts to buy gold instead.

The people of Outcome are angry that they are slow runners and bad singers with worthless currency. Their leaders blame Opportunity for all of their problems.

And then one day, there is an international competition; the slow runners and bad singers of Outcome must race the swift runners and face the glorious singers of Opportunity. Opportunity demolishes Outcome and wins all the prize money. It is clear to everyone in the world that the quality of Opportunity beats the quality of Outcome.

Everyone, that is, except the dull and unthinking people of Outcome. They were brainwashed in their government schools to believe Outcome is better than Opportunity, so they assume that Opportunity must have cheated in order to have won so much prize money. Some of them occupy spaces and poop on things. The President of Outcome cheers them on when he is not golfing or fundraising.

The slow runners and bad singers of Outcome send their union muscle and government agents to Opportunity to take away Opportunity’s winnings by force. The fast runners and exquisite singers of Opportunity are not intimidated; they smile and calmly pull back their jackets to show their concealed-carry weapons. Outcome’s thugs go lay by their dish, and the patriots of Opportunity live happily ever after.

Here is the moral of the story: don’t mess with patriots in the land of Opportunity; we run faster, we sing better, and we are packing.

The End.

Moment Of Clarity” is a weekly commentary by Libertarian writer and speaker Tim Nerenz, Ph.D. Visit Tim’s website to find your moment.

Home Depot Co-Founder Bernie Marcus Blasts Obama Economy |

The Home Depot in Knightdale, North Carolina.

Image via Wikipedia

Home Depot Co-Founder Bernie Marcus Blasts Obama Economy |

First it was Steve Wynn, head of the famed Wynn resort empire, speaking out against Obama. Now its Bernie Marcus, co-founder of The Home Depot.

In an interview with Investor’s Business Daily (IBD), Marcus blasted Obama and his policies, saying “even brain-dead economists understand that when you raise taxes, you cost jobs.”

That’s some tough talk. But really, it’s only the beginning:

IBD: President Obama has promised to streamline and eliminate regulations. What’s your take?

Marcus: His speeches are wonderful. His output is absolutely, incredibly bad. As he speaks about cutting out regulations, they are now producing thousands of pages of new ones. With just ObamaCare by itself, you have a 2,000 page bill that’s probably going end up being 150,000 pages of regulations.

It gets even more direct:

IBD: If you could sit down with Obama and talk to him about job creation, what would you say?

Marcus: I‘m not sure Obama would understand anything that I’d say, because he’s never really worked a day outside the political or legal area. He doesn’t know how to make a payroll, he doesn’t understand the problems businesses face. I would try to explain that the plight of the businessman is very reactive to Washington. As Washington piles on regulations and mandates, the impact is tremendous. I don‘t think he’s a bad guy. I just think he has no knowledge of this.

Those are some harsh words. And as we get further into this administration, it’s becoming all too common. However, Marcus‘s biggest revelation may not be about Obama’s policies, but more about his administration’s alleged thuggery. According to him, CEOs are scared to speak out for fear of retaliation:

IBD: Why don’t more businesses speak out?

Marcus: They are frightened to death — frightened that they will have the IRS or SEC on them. In my 50 years in business, I have never seen executives of major companies who were more intimidated by an administration.

“Out of the mouths of babes,” the Bible says. Nowadays, it’s out of the mouths of business leaders.