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Sunday, Nov 23, 2014
Commentary

A mother's questions about Obamacare that government can't answer


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Back in 2010, when the U.S. Department of Health and Human Services missed its first deadline under Obamacare, it was foretelling what was to come. The task was merely to publish a list of all their new powers under the law. Struggling with such a boundless task, they embarrassingly opted to simply reprint the bill's table of contents. And despite having three years since then to implement their own policies, things have only gone further downhill.

With July half over and this administration facing a potentially disastrous midterm election, they finally admitted to being unable to implement major portions of the law and arbitrarily announced a year-long delay.

Along with the delay came another whopping admission of the administration's inability to verify Americans' income or insurance status before signing them up for Obamacare health insurance exchanges, a fundamental component of the law. That's right; merely claiming that you are low-income and that your employer is not providing you affordable coverage will now be enough to draw down money from your fellow taxpayer, opening the door to rampant fraud and abuse. It's calamities like these that led one of the bill's primary authors, Sen. Max Baucus, to privately fret over the rollout becoming a "train wreck."

It's also why average Americans have a lot of questions about what is next to come down the pike. Although then-House Speaker Nancy Pelosi once notoriously said we have to pass the bill to find out what's in it, apparently that's not enough, either. The government has itself so tied in knots trying to understand its interlocking regulations it can't even tell us what things will look like by the October implementation deadline.

It's under this unfortunate set of circumstances that Americans for Prosperity is beginning an effort this summer throughout Florida, featuring Julie, a mother of two, who has serious questions about Obamacare and what it will mean for her growing family. Julie isn't an actress - she has a young son who has suffered seizures in the past, and another baby on the way. She rightfully wants to know what might happen to the top-flight care her son has received.

Her first question is simple: "If we can't pick our own doctor, how do I know my family's going to get the care they need?" Progressives howl at the suggestion that Obamacare will be anything short of a bonanza of primary care providers lined up to serve Americans around the clock. In reality, the CBO estimates 7 million people will lose their employer-sponsored health insurance, thereby limiting their health care choices. And Julie ought to hope she doesn't live in California, where only one provider has bothered to roll out a qualifying individual insurance plan - this, due to the perverse incentives written into the law. If her preferred physician is outside that plan's network, she's out of luck.

Julie would also do well to hope she isn't priced out of the shiny new health care pseudo-market, where costs are already skyrocketing in parts of the country. If she finds herself on Medicaid in order to avoid paying the IRS a penalty for going uninsured, she'll also have trouble finding a doctor willing to accept new patients. In Florida, at least 41 percent of doctors have already admitted they currently refuse to accept new Medicaid patients due to poor reimbursement rates. For many in need of care, that means their Medicaid card will have a lot in common with a day-old lottery ticket: It won't be worth much.

All of this is without mentioning the doctor shortage experts say is imminent under the law. According to the Association of Medical Colleges, the U.S will be short 91,000 doctors by 2020 - and half that shortfall will be among primary care physicians like the ones Julie will use for her kids' routine checkups.

This average mom would also like to know what she's getting "in exchange for higher premiums and smaller paychecks," as Stanford expert Daniel Kessler has estimated that 10 million people will see rate hikes right away in 2014. One could imagine administration officials stumped with this one at the moment. Bad answers might range from "getting dumped from my employer's plan" to "paying for grossly unnecessary coverage," while good answers appear to be in short supply.

Instead of blame-shifting, the president should start showing some accountability for signing a law that was designed for a favorable CBO score instead of actually improving the care most Americans were already satisfied with.

Slade O'Brien directs the Florida chapter of Americans for Prosperity

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