Stanley Feld M.D., FACP,MACE
Health Insurance Exchanges are supposed to be state-regulated and standardized health care plans in the United States, from which individuals may purchase health insurance eligible for federal subsidies.
It is not going to happen on time. However the 20 hidden taxes in Obamacare are happening right now.
Their formation is failing.
President Obama will then have a clear path to a Public Option and a single party payer healthcare system.
Unfortunately, the single party payer system will fail because it will be unaffordable for Americans and the federal government.
The states and the healthcare insurance industry will do everything they can to undermine its success.
Federal officials never thought they would end up running the Health Insurance Exchanges. Their plan was to dump this formidable and complex task on the states. Half the states refused to participate.
“Obama administration officials are getting ready to set up and operate new health insurance markets in about half the states, where local officials appear unwilling or unable to do so.”
“So far, Governors of 13 states with nearly one-third of the United States population have sent letters to the Obama administration saying they intend to set up exchanges. Complete applications are due on Nov. 16, 2013.”
Stated another way, 37 states have not signed up yet. Once those 13 states that have signed up calculate the cost to setting up and running the health insurance exchanges I suspect they will withdraw.
The Secretary of Health and Human Services, Kathleen Sibelius’,plan was to create regulations for the states to develop the health insurance exchanges by January 1,2014. She has emphasized that states must meet her standards of transparency and accountability.
The federal government requires state exchanges to develop budgets and project operating costs, revenues and expenditures.
There are a great many regulations attached to qualify as a state exchange.
States must explain how the revenue will be generated and how the exchange will address any financial deficits.
The federal government wants to set up the rules that require the states to execute these rules at the states expense after the federal government funds the exchange for two years.
The health exchange program will be delayed because the government pledged to set up the health exchanges in the states that opted out of the program.
Creation of Health Insurance Exchanges is a complex and expensive task. States have to operate under a balanced budget. States cannot afford this undertaking.
My guess is it will be closer to 35 states. Federal officials are preparing to do the job but it will be a difficult political task.
The public fears a federal takeover of the healthcare system. This takeover is one more step by the government to increase its control over the healthcare system.
The Obama administration does not want to encourge that fear with its takeover of Health Insurance Exchanges.
The Obama administration does not want to alienate state officials whose help they need in the execution of the federally run healthcare exchanges.
The federal government does not have the manpower to run all these exchanges. It is outsourcing the work to private contractors.
We have seen the disastrous abuse to physicians by outsourcing fraud and abuse investigations to private contractors.
“The Obama administration has invited advertising agencies to devise an elaborate “outreach and education campaign” to publicize the federal exchanges and their potential benefits for consumers.”
The Federal officials are hiring private contractors to provide “in-person assistance” to consumers and to operate call centers.
President Obama’s administration has attacked Mitt Romney and Bain Capital for outsourcing of jobs.
President Obama is now outsourcing these jobs to a foreign company, while America desperately needs jobs here.
Federal officials have turned to the American subsidiary of a Canadian company, the CGI Group, to provide information technology services to the federal exchanges under a contract that could be worth $93.7 million over five years.
Kathleen Sibelius has demanded total transparency of state health insurance exchanges yet planning for the federal exchanges has been done almost entirely behind closed doors.
“We have gotten little bits of information here and there about how the federal exchange might operate,” said Linda J. Sheppard, a senior official at the Kansas Insurance Department.
“I was on a panel at Rockhurst University here, and I was asked, ‘Where is the Web site for the federal exchange?’ I chuckled. There really isn’t any federal exchange Web site.”
In New Hampshire, Thomas M. Harte, the president of Landmark Benefits, which arranges health insurance for 300 employers of all sizes, said:
“Nobody has any idea what the federal exchange will look like. There has not been much communication between officials drafting plans for the federal exchange and the people who will use it: consumers, employers, brokers and insurers.”
Administration officials have not set forth a budget for the federal exchanges.
“They said they intended to charge “user fees” to the participating health insurance plans.
It is unclear whether the fees are subject to approval by Congress or whether insurers could pass the costs on to consumers.”
I get it.
The Federal Government is not telling us what they are going to do because they probably want to follow its non-transparent regulations.
It is pretty clear this will be one of many steps toward the destruction of the healthcare system. The healthcare system will self implode. At that point everyone will be begging the government to take over.
It will be impossible for President Obama to take over a business system it cannot afford.
A key to Repairing the Healthcare System is to decrease the outsourcing and bureaucratic complexity.
The opinions expressed in the blog “Repairing The Healthcare System” are, mine and mine alone
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