Health reform: going forwards or going backwards?

Ron Bachman Contributor
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Republicans talk about repealing and replacing ObamaCare.  The president counters that we should go forward with policies that are beginning to work.  Democrats say we should not return to the failed policies of the past.

All are arguing their case to the American people in hopes of winning elections in November.  But, all are missing the message a majority of Americans are sending:

“It is not about going forward or going back. It’s about standing up to big government or bowing down to it.”

Americans want smaller government, freedom to choose, recognition of personal responsibility, and promotion of self-reliance.  They want regulations that protect them, not handcuff them.  They want a government that works, not more paper work.  They want protection and a safety net, not risk elimination.  They are told that there is a method to the madness when they only see a madness to the method.

They don’t want hyper-partisan laws passed ignoring their voices.  They don’t want politicians to make shady deals to pass bills.  They don’t want to be called un-American, mobsters, and racists when they raise questions.  They don’t want policies that redistribute wealth; they want policies that create wealth.

Decision-making power has been moved from elected officials to government bureaucrats.  ObamaCare includes 159 new offices, agencies, and programs. The word “secretary” shows up in the ObamaCare legislation 3,267 times.  “Fees” and “Penalty” or “Penalties” show up 450 times.  Contrast that with the consumer-oriented terms “Health Savings Account” and “Health Reimbursement Arrangement,” which each show up only once.

ObamaCare limits plan choices in the small-group market.  The mandated plan deductible cannot exceed $2,000 for an individual or $4,000 for families.  These high premium plans are mandated.  It will be illegal to purchase a higher deductible plan and use health savings accounts to cover lower costs of medical needs.

Under ObamaCare, all individuals or groups not in grandfathered health plans must be put into a single risk pool.  Plans with cost-lowering features that emphasize personal responsibility must be lumped together with all other plans.  It will be illegal to recognize plan designs with better claims experience.  All plans are mandated to have the same percentage premium increases, regardless of plans’ designs.

The 2,700-page ObamaCare legislation will likely generate over 30,000 pages of regulations and guidelines.  More than 700 new regulators have been hired to write the new rules.  Over 17,000 new IRS agents will enforce new purchasing mandates, administrative mandates, income limits, fees, and penalties.  Each new agency will write rules and guidelines to define and restrict choice, limit access, lower quality, and increase costs.

There are many simple examples of ObamaCare’s madness.  For example, under ObamaCare, employers will have to file any payment greater than $600 with the IRS.  The filing must be in a manner similar to the way in which businesses file W-2 forms to report employees’ wages.  Employees are concerned that, effective January 1, 2010, employers are mandated to report the value of an employee’s health benefits on the employee’s W-2.  They are concerned that this initial information reporting will quickly lead to the government taxing health benefits.

New ObamaCare mandates restrict the use of FSA/HRA/HSA debit card purchases for over-the-counter medications, but include 43 separate categories of mandated preventive care services.  There is wide discretion for outside entities and government agencies (e.g. USPSTF, CDC, and HRSA) to mandate additional coverages.  Special interests will lobby the bureaucrats for inclusion of their services, products, screenings, testing, medication, etc., in a nationally mandated benefit.  Advisory commissions will control what plans pay for and what the government mandates as covered.  Non-compliance will generate penalties.

Effective January 1, 2014, ObamaCare mandates that all U.S. citizens and legal residents have qualifying health coverage.  Non-compliance will have a penalty equal to the greater of $695 per year up to a maximum of three times that amount ($2,085) per family or 2.5% of household income. The penalty will be phased-in through 2016.  After 2016, the penalty will be increased annually by a cost-of-living adjustment.

Effective January 1, 2014, ObamaCare mandates that employers with 50 or more employees offer government approved health insurance.  Non-compliant employers with at least one full-time employee who receives a premium tax credit are subject to a penalty of $2,000 per full-time employee, though the first 30 employees would be excluded from the penalty.

Employers with more than 50 employees that offer coverage but have at least one full-time employee receiving a premium tax credit will pay the lesser of $3,000 for each employee receiving a premium credit or $2,000 for each full-time employee, with the first 30 employees excluded from the assessment.

Mandates, requirements, penalties, fees, limited choices, added paperwork, reporting, filing, and healthcare controlled by government bureaucrats are not part of our DNA.  We are Americans.  We don’t want or need the opiate of government control.  We don’t like unaccountable faceless bureaucrats.  We want an opportunity society not a dependency society.  We will stand up, not bow down to big government.  In this country, elected officials work for us, not the other way around.

Ronald E. Bachman FSA, MAAA, is a Senior Fellow at the Center for Health Transformation, an organization founded by former U.S. House Speaker Newt Gingrich. Nothing written here is to be construed as necessarily reflecting the views of the Foundation or the Center for Health Transformation or as an attempt to aid or hinder regulations or the passage of any bill before the U.S. Congress.