Running from ObamaCare

The August town hall meetings were outwardly calmer this year, but reports from members of Congress say their constituents are steaming mad and can’t wait until November 2 to register their votes against ObamaCare.

And members themselves — even Democrats — are airing TV ads against the health overhaul law in their election campaigns, as The Wall Street Journal chronicles in its lead editorial today. Democrats like Idaho freshman Rep. Walt Minnick boast about voting against the health care law. Ditto Rep. Frank Kratovil of Maryland, South Dakota Rep. Stephanie Herseth Sandlin, and many others.

Even Oregon Democratic Sen. Ron Wyden, one of his party’s leading experts on health care, is trying to free his state from the grip of ObamaCare. He wants to dump the individual mandate, the centerpiece of ObamaCare, and is encouraging his state to seek a waiver to “come up with innovative solutions that the Federal government has never had the flexibility or will to implement.”

And Senate Finance Chairman Max Baucus, who actually wrote the health law, tried to calm his angry constituents in Montana by saying, “Mark my words: Several years from now, you are going to look back and say, ‘Well, that wasn’t so bad after all.'”

Yikes! Is that the best that defenders of the legislation can claim?

Democrats are running from the law. Even President Obama has reneged on his promise to help Democrats who voted for it by selling the law so people will like it. He gives only brief mentions to health reform in his speeches because every time he talks about it, his poll numbers fall farther.

People don’t like ObamaCare. Many hate it. And their minds are made up.

The problem is that the tsunami of changes the law commands are very real. This is the law of the land… The trillions of dollars in new spending for massive entitlement programs… The freedom-robbing mandate that individuals must purchase expensive government-approved health insurance… The crippling mandates and regulatory burdens on American businesses and the medical profession… The escalating spending and higher health costs… Drastic cuts to the popular Medicare Advantage program… $500 billion in new taxes and fees that will suffocate innovation and force health costs to go higher…

Neither the president nor anyone else is talking about this. And the American people need to know they are all coming and what impact they will have on our health sector, the federal deficit, and the economy.

Making sure people know will be Job One for the next Congress.

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Action items for Congress: I outlined in my Wall Street Journal commentary on August 25 key steps the next Congress could take to begin to undo this monstrous law. Here’s the Cliff’s Notes version in case you actually got a vacation in August and a break from this ongoing debate:


  • Defund it. Target the most unpopular provisions and just don’t fund them, such as hiring 16,000 more IRS agents to enforce the mandates in the new law.
  • Dismantle it. Look for provisions that Democrats oppose where it could be possible to garner a veto-proof majority of support. The 1099 filing requirement and the long-term-care CLASS Act come to mind because dozens of Democrats are on record as opposing them.
  • Delay it. Postponing cuts to the popular Medicare Advantage program and putting off $500 billion in new taxes would be a good place to start until the whole law can be repealed.
  • Disapprove regulations. The Congressional Review Act gives Congress leverage to review the avalanche of new regulations to implement ObamaCare and to shine a light on the most egregious ones.
  • Direct oversight and investigation. Former CBO Director Doug Holtz-Eakin estimates subsidies for health insurance could cost as much as $1.4 trillion, not $450 billion as promised. Congress has a responsibility to protect taxpayers from the flood of new red ink.
  • Delegate to the states. States have new incentives to implement their own programs, possibly on the models of the Healthy Indiana Plan or the Utah Health Exchange. If states have a good idea, Congress should free them from the shackles of ObamaCare so they can go with it.


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    Cost, Cost, Cost: The bad news just keeps coming about ObamaCare — this week about rising health insurance premiums. Whenever President Obama talks about health reform, he mentions the early provisions like 26-year-olds staying on their parents’ policies, “free” preventive care, eliminating coverage caps, etc.

    Yet it is these very provisions that are forcing insurers to raise their rates for next year by 1 to 9 percent, or more. Here’s a link to my post yesterday in National Review about it.

    The real problem that the White House has is this: Passing this law was a huge mistake, and the news is only going to get worse. The more people learn about the law, the more they will support repeal.


    Gov. Mitch Daniels on ObamaCare’s Devastating Consequences

    In this video from The Heritage Foundation, Governor Mitch Daniels describes the successful health reforms implemented in Indiana before the passage of the health law, and the impact of ObamaCare on those reforms and the economy.
    Watch now >>



    We reached more than 23 million readers in August and September with our commentaries on the risks and damages of the health overhaul law, including high health costs, and the value of health savings accounts and innovation in the health sector. Grace-Marie Turner also participated in a pro/con published debate with Rep. Jim McDermott (D-WA), responding to the question of whether the health overhaul law will lead to greater prosperity for American workers. Dozens of major publications featured our work, including an article by Galen Institute adjunct scholar Jim Capretta in USA Today about his paper on entitlement reform. Here’s a partial list of our recent commentaries:




    Doctor Drain Turns to Gain: Physicians Move North

    Tom Blackwell
    National Post, 09/09/10

    For years, an exodus of doctors to the U.S. helped fuel Canada’s growing shortage of medical staff, and gave emotional ammunition to opponents of Canadian-style health reform in the United States. But medical recruiters and migration statistics suggest a surprising new trend has emerged over the past few years; a net movement of physicians from the U.S. to Canada, Blackwell writes. The reasons they are coming are equally unexpected: pay that is reportedly much better in some specialties; more freedom in their practices; and uncertainty about the impact of health reform in the U.S. One recruiter explained: “Obama’s health plan is scaring the life out of all the doctors in the United States.”
    Read More »

    Even with Malpractice Insurance, Doctors Opt for Expensive, Defensive Medicine

    Manoj Jain, Emory University
    The Washington Post, 08/31/10

    The health overhaul law was a missed opportunity to improve the malpractice system, writes Dr. Jain, who describes his personal encounter with a malpractice suit. Most malpractice suits turn out to be against doctors who were not at fault. Of every 100 malpractice claims filed, only 17 appeared to involve a negligent injury, such as a medication overdose resulting in death, according to The New England Journal of Medicine. Further, surveys of physicians conducted by the Massachusetts Medical Society found that 80% practice “defensive medicine,” ordering extra tests that some say add billions annually to our health care expenditure. Legislation could have devised a “safe harbor” standard ensuring that a doctor who follows guidelines won’t be sued if a patient is injured. Also, special medical courts could have been created to determine negligence and compensation. The new overhaul law encourages states to explore these kinds of remedies, but this is unlikely to happen.

    Read More »

    Health Insurance Agents, RIP

    Merrill Matthews, Institute for Policy Innovation
    Forbes, 08/30/10

    The first casualties of ObamaCare will be health insurance agents — that proud army of tens of thousands of Americans whose calling was to help individuals and employers work through the maze of available health insurance policies to find one that met their clients’ needs, Matthews writes. With a handful of insurance options available online, consumers won’t need an agent. Besides, the health overhaul law’s provision mandating what health insurers must spend on claims, known as a minimum loss ratio — 80% of the premiums for small employers and 85% for large employers — will leave little money to pay agent commissions. Additionally, ObamaCare envisions getting most individuals and small employers in the newly created “exchanges,” which will make agents’ problems even worse.

    Read More »


    Consumer-Directed Health Plans: Health Status, Spending, Utilization of Enrollees in Plans Based on Health Reimbursement Arrangements

    Government Accountability Office, 07/10

    Enrollees in consumer-driven health plans (CDHP) spend less and generally use fewer health care services compared to those enrolled in traditional plans, according to the GAO. The GAO compared changes in health spending and utilization from two large employers — one public and one private — before and after 2003 for enrollees who switched from a PPO into a Health Reimbursement Arrangement (HRA) with those who stayed in a PPO. Average annual spending per enrollee for the public employer’s HRA group was $1,505 lower than the PPO group for the 2-year period prior to switching. Likewise, the private employer’s HRA group spent $566 less per enrollee. Of the 21 studies that GAO reviewed, which assessed the health status of HRA and other CDHP enrollees, 18 found they were healthier than traditional plan enrollees based on utilization of health care services, self-reported health status, or the prevalence of certain diseases or disease indicators.
    Read More »

    Consumer-driven health plans experienced continued growth this year — albeit at a slower rate than in 2009 — according to preliminary results from United Benefit Advisors’ 2010 Health Plan Survey. CDHPs grew at a rate of 18.1% this past year. The survey also finds that the average cost increase for all CDHPs at 7.3% was slightly lower than that of the average of all plan types, which increased by 8% this year.


    The Federal Health-Care Tease

    The Wall Street Journal, 09/09/10

    Minnesota Governor Tim Pawlenty last week issued an executive order forbidding any Minnesota department or agency from applying for grant funding or demonstration projects under ObamaCare, unless clearing it with his office (or unless required by law). The Governor’s order is designed to make sure grants-with-strings don’t slip through the state bureaucracy and that Minnesota isn’t wasting federal tax dollars on duplicate projects. For example, Minnesota was one of 11 states offered the “opportunity” to expand its Medicaid program before 2014, with the federal government initially footing much of the bill. Mr. Pawlenty turned the offer down in June, on grounds that even if the feds make good on the estimated $1.4 billion they would owe Minnesota over the first three years, the state would still be on the hook for $430 million — and for increasing amounts after that. The Governor tells the Journal the health overhaul legislation offers “dozens” of such “teaser” grants designed to hook a state into a “new initiative or a new commitment or new spending that is federally directed.” Only after the states are firmly ensconced do they become responsible for the huge bills.

    Read More »

    Opposition to the health overhaul law is continuing to grow in the states, writes Sally Pipes of the Pacific Research Institute. Colorado, for instance, just placed an initiative on the ballot that would, if passed, block many aspects of ObamaCare. A similar measure was overwhelmingly approved by voters in Missouri last month. With actions like these, the message to Washington is clear: If Congress doesn’t repeal ObamaCare, the states just might do it themselves.


    National Health Spending Projections: The Estimated Impact of Reform Through 2019

    Andrea M. Sisko, Christopher J. Truffer, Sean P. Keehan, John A. Poisal, M. Kent Clemens, and Andrew J. Madison, CMS Office of the Actuary
    Health Affairs, 09/09/10

    Health spending in 2010 is projected to reach $2.6 trillion and account for 17.5% of GDP, up 0.2% from pre-reform estimates, according to economists at the Centers for Medicare and Medicaid Services. This is an update of their February report to reflect changes in the new health overhaul law. Health spending is projected to rise significantly in 2014, when health coverage is expanded to millions of uninsured Americans. Expanded coverage means overall spending is expected to increase by 9.2%, significantly higher than the 6.6% rate put forward in February. Public spending is expected to increase by 9.7% in 2014, while private spending is anticipated to increase by 8.6%. By 2019, Medicaid and CHIP expenditures are projected to represent nearly 20% of national health spending, up from nearly 18% in the pre-reform estimate.

    Read More »

    2010 Employer Health Benefits Survey


    Kaiser Family Foundation and Health Research & Educational Trust, 09/02/10

    The average annual premiums for employer-sponsored health insurance in 2010 are $5,049 for single coverage and $13,770 for family coverage, according to an annual survey released by the Kaiser Family Foundation and HRET. Preferred provider organizations continue to dominate the employer market, enrolling 58% of covered workers. Among other plan types, only consumer-driven plans saw growth in their market share. Such plans now enroll 13% of covered workers, up from 8% last year.

    Read More »


    Healthcare Reform and Medicaid: Patient Access, Emergency Department Use, and Financial Implications for States and Hospitals

    Douglas Holtz-Eakin and Michael Ramlet
    American Action Forum, 09/10

    The health overhaul law’s expansion of Medicaid is likely to dramatically expand the use of emergency room care as Medicaid’s low reimbursement rates limit beneficiaries’ access to primary care physicians, write Holtz-Eakin and Ramlet. The National Hospital Ambulatory Medical Care Survey revealed that Medicaid enrollees access care through the emergency room at twice the rate of the uninsured and privately covered populations. Holtz-Eakin and Ramlet estimate that emergency department impacts alone will generate 68 million visits and add $36 billion to the nation’s health care bill. These additional costs will pose a financial threat to state budgets and hospital finances, especially as the reform also reduces funding dedicated to reimbursing hospitals for uncompensated care.

    Read More »

    How ObamaCare Guts Medicare

    Peter Ferrara, Institute for Policy Innovation and Larry Hunter, Social Security Institute
    The Wall Street Journal, 09/09/10

    The drastic reductions in Medicare reimbursements under ObamaCare will create havoc and chaos in health care for seniors, Ferrara and Hunter write. Richard Foster, Medicare’s chief actuary, recently reported that Medicare payment rates for doctors and hospitals serving seniors will be cut by 30% over the next three years. By the end of the 75-year projection period in the Annual Medicare Trustees Report, Medicare payment rates will be one-third of what will be paid by private insurance, and only half of what is paid by Medicaid. Many doctors, surgeons and specialists providing critical care to the elderly — such as surgery for hip and knee replacements, sophisticated diagnostics through MRIs and CT scans, and even treatment for cancer and heart disease — will cease serving Medicare patients. If the government is not going to pay, then seniors are not going to get the health services, treatment and care they expect.

    Read More »


    Debt, Deficits, and the Health Care Law: What do they mean for seniors and future generations?
    Galen Institute Event
    Thursday, September 16, 2010
    10:00am – 11:30am
    Springfield, VA

    On the Mend: Putting Culture Change at the Heart of a Lean Healthcare Transformation
    Lean Enterprise Institute Webinar
    Monday, September 13, 2010
    2:00pm EDT

    ObamaCare At Six Months: What Else Have We Learned? Event
    Tuesday, September 14, 2010
    12:00pm – 2:00pm
    Washington, DC

    The Truth about Obamacare: What They Don’t Want You to Know about our New Health Care Law
    The Heritage Foundation Book Event
    Tuesday, September 14, 2010
    12:00pm – 1:00pm
    Washington, DC

    Turning Up the Heat on Medicare
    American Enterprise Institute Event
    Wednesday, September 15, 2010
    9:15am – 11:15am
    Washington, DC

    Obamacare — Rewarding the Trial Bar and Promoting Litigation?
    The Heritage Foundation Event
    Wednesday, September 15, 2010
    11:00am – 1:00pm
    Washington, DC

    Healthcare: A 6-month Checkup with Secretary Kathleen Sebelius
    National Journal Event
    Monday, September 20, 2010
    8:00am – 10:00am
    Washington, DC

    Are We Counting What Counts?
    National Journal Policy Summit
    Tuesday, September 21, 2010
    8:00am – 10:00am
    Washington, DC