With the Dec. 23 deadline looming for signing up for health insurance under ObamaCare, consumers rushing to purchase new coverage may be in for a rude shock if they focus principally on finding the least expensive premiums, according to experts.

That’s because many people buying coverage on the federal exchanges either to replace old policies or to obtain coverage for the first time could get hit with deductibles and other out-of-pocket costs much higher than is typical in employer-sponsored health plans.

Perhaps more importantly, they may find themselves excluded from some of the best hospitals in the country and their affiliated doctors.

Deductible Sticker Shock

Gail Wilensky, a senior fellow for Project HOPE and the Medicare director for the first Bush Administration, said on Monday that consumers should be as mindful of deductibles and the hospitals and doctors in network as the monthly premium costs in shopping around.

“What you’re buying is not just the benefits specified in the law but whom you will have access to in getting the service delivered,” she said in an interview. Many of the policies being offered on the federal and state exchanges carry annual deductibles that often top $5,000 for an individual and $10,000 for a couple, according to The New York Times.

“Right now, most of the focus has been on the cost of the monthly premium and occasionally people have remembered to . . .look at what the deductible and the co-insurance is, because that is as important as the premium,” she added. “Whether a hospital is in or out of network is really the third piece: don’t forget to look at what you’re buying.”

Like most insurance policies, the lower the premium the higher the deductible. For example, in El Paso, Tex., for a couple both age 35, one of the cheapest plans on the federal exchange, offered by Blue Cross and Blue Shield, has a premium of less than $300 a month but an annual deductible of more than $12,000, according to the Times. In the case of a 45-year-old couple purchasing insurance on the federal exchange in Saginaw, Mich., a policy with a premium of $515 a month carries a deductible of $10,000 a year.

Some of the Best Hospitals Are Off Limits
Americans purchasing health insurance on the federal and state exchanges may be in for an even bigger shock when they discover some of the best hospitals in the country out of reach, even when those hospitals were previously available to them under their personal policies. That’s because most of the top hospitals in the country will accept insurance from only one or two companies operating under Obamacare.

Obamacare regulations and government subsidies are likely to make insurance more affordable for millions of Americans, as President Obama and senior aides have repeatedly boasted. But many insurers have responded to Obamacare caps on premiums by offering top-tier hospitals and physicians far less money for services rendered. And they’re responding by strictly limiting the number of policies they will accept.

Watchdog.org  recently looked at the top 18 hospitals nationwide as ranked by U.S. News and World Report for 2013-2014 – contacting each hospital to determine their contracts and policies. The government watchdog group found that many of the best hospitals in the country were simply opting out of Obamacare – much to the detriment of people in search of the best or most specialized health care.

Both Ohio and California have a dozen insurance companies on their exchanges, yet two of the states’ premier hospitals — Cleveland Clinic and Cedars-Sinai Medical Center — have only one company in their respective networks.

A few, such as top rated Johns Hopkins in Baltimore, are mandated under state law to accept all insurance companies. Other than that, the hospital with the largest number of insurance companies is University Hospitals Case Medical Center in Cleveland with just four. Fully 11 of the 18 hospitals had just one or two carriers, according to Watchdog.org.

Amid a drive by insurers to limit costs, the majority of insurance plans being sold on the new health care exchanges in New York, Texas and California will not offer patients access to Memorial Sloan Kettering in New York City or MD Anderson Cancer Center in Houston, two top cancer centers, according to the Financial Times.

“We shouldn’t be surprised by this,” Wilensky said. “There was a lot of pressure that exchanges placed on insurance plans to keep premiums low, and the benefits are specified in law for each of the four levels of health care plans. If the benefits are specified and the premiums are pressed low – sometimes lower than the insurance companies thought was appropriate, a major way to try to accommodate that financial pressure is to limit the number of physicians and hospitals.”

“And by limiting the number of physicians and hospitals, you may get those that you include to accept a lower reimbursement,” she added.

Consumers have until Dec. 23 to enroll in new health insurance under Obamacare to qualify for coverage beginning Jan. 1. However, open enrollment will continue through the end of March.

Enroll America, the group leading efforts to enroll Americans in ObamaCare, is facing accusations again that it has violated its tax-exempt nonprofit status by engaging in partisan politics — following the release of a video in which a top official seems to brag about his political connections.

The complaint was filed Friday by the group with the IRS.

In the video, Christopher Tarango, a communications director for the group, says: “I’m doing Enroll America right now. But I’m also, I shouldn’t be saying this, but I’m also helping out with HD 50, so that’s as partisan as it gets.

“There’s a lot of talent that got sucked into Organizing for Action. I mean, there’s a lot of talent that got sucked into Enroll America, but we are all Obama people.”

Tarango was referring to a Texas House race when he says “HD 50,” in the video, secretly record by Project Veritas in an Austin coffee shop on Nov. 8, according to Cause of Action.

Tarango also seems to be telling an actor posing as a Democratic political operative that he might be able to help in a deal to sell ObamaCare applicant information, after first rejecting the notion.

He suggests he knows a high-ranking company official “well enough that, to feel like if we had a few beers, this would not be the craziest conversation that he’s ever heard.”

Cause of Action — a self-described nonprofit, nonpartisan government accountability group — also wrote a letter Nov. 13 to Texas Attorney General Greg Abbott asking him in part to evaluate whether entities such as Enroll America and Battleground Texas have violated the IRS code and his state’s laws.

The letter followed at least one other video by the conservative group Project Veritas and called into question the validity of so-called “navigators” that help Americans sign up for ObamaCare.

“Despite its claims of serving the public good, it appears that Enroll America has abused its tax-exempt status by using donor contributions for political and other impermissible purposes,” the group said Friday.

Cause of Action also argues Tarango’s comments indicate Enroll is “engaging in political activity by coordinating with the pro-President Obama group Organizing for Action, a 501(c)(4) organization.

Battleground Texas is a 527 political action committee. The letter this week to the IRS suggests some people who helped get Obama elected in 2012 are now with that group.

This is the second IRS complaint filed by the Cause of  Action against Enroll American.

The group filed the first complaint in July, asking the IRS to investigate Enroll America’s tax status due to failing to operate for a charitable purpose.

The group purportedly collected $3.8 million in donations just in 2011.

This spring, House Republicans started a probe into Health and Human Services Secretary Kathleen Sebelius soliciting donations from companies her agency might regulate, to help sign up uninsured Americans for ObamaCare.

Sebelius asked charitable foundations, businesses executives, churches and doctors to donate money to Enroll America and other nonprofits that are helping to implement Obama’s health care overhaul.

The agency has said there is a special section within the Public Health Services Act that allows the secretary to solicit financial support for nonprofit organizations conducting public health work.

I have read a number of articles discussing the most recent Hollywood installment of The Hunger Games — Catching Fire — and am astonished that they appear to entirely miss the point of the story.

A recent opinion article on FoxNews.com by Sandra Lee Dixon bemoans the violence against children depicted in the series, and this book in particular, sharing her opinion:

Supporters say the themes that arise are important for the national conversation: the world is not always nice, children need to learn about war and destruction, and artists can help us experience such things vicariously and discuss them. My take: there is more admirable literature that already addresses these themes.

We don’t need the overt violence and the panicked faces of the characters for a coming of age story to teach us to say no to excesses of wealth and power.

Sandra entirely misses the point of the story. It is not to promote a national dialog on violence or the evils of concentrated wealth, or even their destructive influences on society’s children.

Indeed, societies and nations where widespread violence exists are horrible places for all humanity, and especially heinous for children. The nationalization of violence is especially prominent where totalitarian governments control–exactly as depicted in The Hunger Games.

In this story, the democratic republic of the United States of America has been usurped by a totalitarian regime–one which controls every aspect of American’s lives: the economy, health care, food distribution, labor, production, etc.  Does any of this sound familiar? At some point in the story’s past, the government took over total control, dictating where citizens could live, what they could produce, what they could eat, and what activities they could engage in.  Anything familiar yet? There is no way to fight against the government, because all weapons have been taken from the citizens, and only the government can have them.  Anything? How about this–friends of the regime share its power and control of the masses, and have access to the wealth created by the citizens through over-taxation and confiscation of their property.

The bottom line is that the Hunger Games is an accurate portrayal of a controlling totalitarian government and its elite ruling class in our own future if we continue on the path we were currently pursuing. The only question is this: will we rise up and overthrow tyrants as they are in the process of usurping our constitutional form of government, or will we wait until it is too late and the struggle is nearly impossible–as it is in The Hunger Games?

PUBLIUS

Republican lawmakers are pushing back hard against the Obama administration’s decision to delay next year’s open enrollment season for health coverage under ObamaCare until after the 2014 midterm elections.

The Department of Health and Human Services announced Friday it would allow consumers to start signing up for coverage under ObamaCare on Nov. 15, 2014, a month later than originally scheduled. The change does not affect those trying to enroll this year.

Congressional Republicans accused the administration of shifting the dates for political reasons, to hide a spike in 2015 premiums, though information may already be available about 2015 premiums before the elections on Nov. 4.

“That means that if premiums go through the roof in the first year of ObamaCare, no one will know about it until after the election,” Sen. Chuck Grassley, R-Iowa, said in a statement. “This is clearly a cynical political move by the Obama administration to use extra-regulatory, by any means necessary tools to keep this program afloat and hide key information from voters.”

Sen. Lamar Alexander, R-Tenn., accused the White House of moving next year’s open enrollment date to shield Democrats up for reelection next year who supported the law.

“The only American consumers this change will help are Democratic politicians who voted for Obamacare, because it delays disclosure of some of the law’s most insidious effects until after the election,” Alexander said in a statement.

He said he plans to introduce legislation that would require insurers to provide Americans with “proper notice” of premium increases before open enrollment period on the exchanges starts.

The administration says the change is to allow insurers more time to prepare and submit premiums.

“This change is good news for consumers, who will have more time to learn about plans before enrolling and an open enrollment period that’s a week longer,” an HHS official told Fox News.

This year, 17 states and Washington, D.C., posted the data publicly ahead of the administration. “We’ll definitely start seeing some premiums earlier from state insurance departments,” said Larry Levitt of the nonpartisan Kaiser Family Foundation.

However, there is one possible way that Democrats could benefit politically. If lighting strikes twice and the website sputters again during the next open enrollment season, that second act would not take place until after the voting is done.

Separately, the administration also announced a small schedule change in this year’s open enrollment season, pushing that deadline to Dec. 23. The administration has rebuffed calls to delay or extend the current enrollment period beyond March 31, 2014.

A new and independent analysis of ObamaCare warns of a ticking time bomb, predicting a second wave of 50 million to 100 million insurance policy cancellations next fall — right before the mid-term elections.

The next round of cancellations and premium hikes is expected to hit employees, particularly of small businesses. While the administration has tried to downplay the cancellation notices hitting policyholders on the individual market by noting they represent a relatively small fraction of the population, the swath of people who will be affected by the shakeup in employer-sponsored coverage will be much broader.

An analysis by the American Enterprise Institute, a conservative think tank, shows the administration anticipates half to two-thirds of small businesses would have policies canceled or be compelled to send workers onto the ObamaCare exchanges. They predict up to 100 million small and large business policies could be canceled next year.

“The impact I’m mostly worried about is on small young, entrepreneurial firms that will suddenly face much higher health insurance premiums if they want to offer health insurance to their employees,” said AEI resident scholar Stan Veuger. “I think for a lot of other businesses … they can just send their employees to the exchanges or offer them a fixed subsidy every month to buy health insurance themselves.”

Under the health care law, businesses with fewer than 50 workers do not have to provide health coverage. But if they do, the policies will still have to meet the benefit standards set by ObamaCare.

As reported by AEI’s Scott Gottlieb, some businesses got around this by renewing their policies before the end of 2013. But the relief is temporary, and they are expected to have to offer in-compliance plans for 2015. According to Gottlieb, that means beginning in October 2014 the cancellation notices will start to go out.

Then, businesses will have to either find a new plan — which could be considerably more expensive — or send workers onto the ObamaCare exchanges.

For workers, their experience could mirror that of the 5 million or so on the individual market who already received cancellation notices because their plans did not meet new standards under the Affordable Care Act.

President Obama announced last week that insurance companies could offer out-of-compliance plans for another year. But that only means the cancellation notices will resume late next year.

The business community has already been hit with another side effect from ObamaCare. Because the law will require businesses with more than 50 full-time workers to offer health coverage, there are reports that companies are shifting employees to part-time status to avoid hitting the threshold.

Though the administration describes these accounts as anecdotal — and has already delayed the employer mandate by a year — studies suggest otherwise.

The International Franchise Association and the U.S. Chamber of Commerce have studied the impact and say the president’s health care law has resulted in higher costs and fewer full-time positions.

A survey showed 31 percent of franchise businesses, and 12 percent of non-franchise businesses, have already reduced worker hours. It also showed 27 percent of franchise businesses, and 12 percent of non-franchise businesses, have replaced full-time workers with part-time employees.

On October 21st, President Barack Obama touted Jessica Sanford as a success story of ObamaCare. Unfortunately for Obama, Jessica Sanford was dropped from her HealthCare plan and will receive no tax credits.

In one of his famous photo-ops in the Rose Garden with an array of touted beneficiaries of the Affordable Care Act behind him, President Obama read a letter from Jessica Sanford of Federal Way, Wash., to explain why the Affordable Care Act, with all its rollout flaws, was still needed.

The letter told a sad tale of a grateful single mom with a son with ADHD.

But now, like so many of ObamaCare’s false promises and outright lies, the safe and secure future which Sanford thought she had found and which the president boasted of has crumbled into dust.

As the Washington State Wire reports, the Washington state exchange and enrollment website, like its national cousin, had problems. It had told Sanford originally she and her child would get a whopping tax credit that would reduce her total premium to $169 a month for an ObamaCare “gold” plan.

Then she got letters from the state telling her — just like so many others who have had their plans canceled after being told they could keep them — what she had been promised was not true.

Four days after President Obama made his address, the state health exchange publicly revealed a grievous error — its tax-credit calculations were all wrong.

Washington state had been submitting monthly income information to the federal data hub when it was expecting yearly data. Oops!

“It was a huge disappointment… I just felt really embarrassed that, you know, he had quoted my story and then come to find that the Washington Healthplan Finder, the website here in our state, had grossly miscalculated, or they’re having a problem figuring their tax credits. So at least for right now I’m not going to be getting insurance.” – Jessica Sanford

So everyone who bought a subsidized health insurance policy through the Washington state exchange prior to Oct. 23 was being quoted too low a rate.

Sanford, 48, doesn’t make a lot — a little less than $50,000 a year as a freelance court reporter.

But Washington state reported her income as $4,166, which the feds took as her annual salary. It was that, er, “glitch” that allowed Sanford to qualify for a discount of $452 a month. It was that good news that prompted her to write a thank-you note to the president.

Brokers had been informing the state for three weeks that the calculations were screwy but the state, like the proverbial Department of Motor Vehicles, was slow to respond. When it informed Sanford of the mistake, knocking her tax credit down to $110 a month, she went back to her broker and signed up for a “silver” plan with higher deductibles and co-pays.

Investors.com

Public opposition to the health care overhaul and disappointment in President Obama’s job performance are hitting all-time highs, with new polls showing the botched rollout of the law has seriously damaged confidence in the administration.

A Washington Post-ABC poll released Tuesday showed Obama’s job approval rating at a meager 42 percent — and his disapproval rating at 55 percent, the worst of his five years in office.

That figure matches the disapproval rating he received in a recent Fox News poll.

The latest surveys show how much the launch of the health law has damaged the president’s image and the public’s faith in his administration.

The Post-ABC poll showed opposition to ObamaCare has hit an all-time high, with 57 percent opposing the law. The public was roughly evenly divided a month ago.

And 63 percent disapprove of the president’s handling of the law’s rollout. In the recent Fox News poll, that figure was 61 percent.

The plummeting figures are traced in part to self-identified independents losing patience with the president.

The president is at least trying to keep his own supporters on board. In a conference call with Obama loyalists Monday night — hosted by campaign arm Organizing for Action — Obama urged supporters to keep fighting with him.  He defended the overall aim of the health law, despite the problems with rolling it out.

“Effectively, in a month, you’ve already got half a million Americans who will likely have the security of health care for the first time, in some cases in their lives, as soon as January 1. And that is life-changing,” Obama said.

The Post-ABC poll of 1,006 adults was conducted Nov. 14-17. It had a margin of error of 3.5 percentage points.

In another problematic study for the administration, Gallup on Tuesday reported that 56 percent of Americans say it is not the federal government’s job to ensure health care coverage.

The poll showed an abrupt reversal on that question from just a few years ago — in 2006, 69 percent said it was the government’s responsibility to ensure health coverage.

Prediction: even if HealthCare.gov is fixed by the end of the month (unlikely), Obamacare is going to be repealed well in advance of next year’s election.  And if the website continues to fail, the push for repeal—from endangered Democrats—will occur very rapidly.  The website is a sideshow: the real action is the number of people and businesses who are losing their health plans or having to pay a lot more.  Fixing the website will only delay the inevitable.

It is important to remember why it was so important for Obama to promise repeatedly that “if you like your health insurance/doctor, you can keep your health insurance/doctor.”  Cast your mind back to the ignominious collapse of Hillarycare in 1994.  Hillarycare came out of the box in September 1993 to high public support according to the early polls.  This was not a surprise.  Opinion polls for decades have shown a large majority of Americans support the general idea of universal health coverage.  But Hillarycare came apart as the bureaucratic details came out, the most important one being that you couldn’t be sure you’d be able to keep your doctors or select specialists of your choice.  The Clintons refused to consider a compromise, but even with large Democratic Senate and House majorities the bill was so dead it was never brought up for a vote.

Remember “Harry and Louise”?  Obama did, which is why he portrayed Obamacare as simply expanding coverage to the uninsured, and improving coverage for the underinsured while leaving the already insured undisturbed.  But the redistributive arithmetic of Obamacare’s architecture could never add up, which is what the bureaucrats knew early on—as early as 2010 according to many documents that have leaked.  The wonder is that Obama’s political team didn’t see this coming and prepare a pre-emptive strategy for dealing with the inevitable exposure of the duplicity at the heart of Obamacare’s logic.  Now that people are losing their insurance and finding that they may not be able to keep their doctor after all, Obamacare has become the domestic policy equivalent of the Iraq War: a protracted fiasco that is proving fatal to a president’s credibility and approval rating.  The only thing missing is calling in FEMA to help fix this Category-5 political disaster.

Senate Democrats endangered for re-election will lead the charge for repeal perhaps as soon as January, after they get an earful over the Christmas break.  They’ll call it “reform,” and clothe it in calls for delaying the individual mandate and allowing people and businesses to keep their existing health insurance policies.  But it is probably too late to go back in many cases.  With the political damage guaranteed to continue, the momentum toward repeal will be unstoppable.  Democrats will not want to face the voters next November with the albatross of Obamacare.

The politics of the repeal effort will be a game theorist’s dream.  Tea Party Republicans will resist “reforms” to Obamacare in favor of complete repeal.  Democrats will try to turn the tables and set up Republicans as obstacles to reform, hoping to inoculate themselves prospectively from mayhem at the polls next November. The House might want to insist that the Senate go first; after all, it was the Senate version of the bill that the House had to swallow after Scott Brown’s election in January 2010.  The House can rightly insist that the Senate needs to clean up the mess they made.  Obama may well give Capitol Hill Democrats a pass on a repeal vote, and veto any bill that emerges.  He’ll never face the voters again.

This wouldn’t be the first time that a health care entitlement was repealed.  The same thing happened in the late 1980s with catastrophic coverage for seniors.  Because seniors were made to pay for their benefits under that scheme, the uproar forced Congress to repeal the measure barely a year after it went into effect.  Obamacare looks to be on the same political trajectory, and for the same reason.  Obamacare represents the crisis of big government; the limits of administrative government have finally been breached.  For the first time ever, some polls are showing a majority of Americans doubting the goal of universal health coverage.

The hazard of the moment is that a compromise “reform” that drops the mandate and attempts to restore the insurance status quo ante could leave us with an unfunded expansion of Medicaid and a badly disrupted private insurance market.  Republicans should avoid both the political traps and a new fiscal time bomb by being ready with a serious replacement policy, based on the premium support tax credit ideas that John McCain advocated (poorly) in 2008.  While anxious liberals are in dismay, they should recognize that Obamacare may well have achieved its chief purpose of making universal or at least greatly expanded health coverage a fixture of American social policy.  The cost to liberalism may prove fatal, however.

Steven Hayward, Contributor, Forbes

The Obama administration was warned as early as March about potential risks with the implementation of HealthCare.gov, according to documents released by the House Energy and Commerce Committee Monday night.

Key administration officials at the White House and Department of Health and Human Services received briefings this past spring from McKinsey & Co., a private consulting firm that reviewed more than 200 documents and conducted interviews with HHS staff to identify potential problems before the Oct. 1 rollout.

A report prepared by McKinsey in late March discussed several issues that could hamper the implementation of ObamaCare, including insufficient testing and evolving requirements. The report also warned that the program relied too heavily on outside contractors.

In one page of the presentation, the company specifically warned about a “failure to resolve post-launch issues rapidly” — a scenario that ended up playing out last month. The company cautioned that a “compressed testing window and volume uncertainty,” coupled with the fact that response teams were not yet in place, would drag out the process of fixing problems after launch.

Health and Human Services Secretary Kathleen Sebelius, Medicare Chief Marilyn Tavenner, and Gary Cohen, a Medicare and Medicaid oversight official, attended a briefing on the firm’s analysis on April 4, a Capitol Hill source said. Sebelius then testified at an oversight committee hearing two weeks after being briefed on the McKinsey report that the implementation of ObamaCare was on track, according to the Hill source.

Tim Murphy, R-Pa., a member of the Energy and Commerce Committee, called into question the administration’s assurances, arguing that the report suggests the administration was aware the implementation was in trouble months before the fall rollout.

“Despite assurances from Secretary Sebelius, Marilyn Tavenner, and Gary Cohen that ‘all was well’ and ‘on track’ with the launch of the Affordable Care Act, we now have documents dating back to April that call into question what they told us,” Murphy said.

White House spokesman Eric Schultz acknowledged late Monday that red flags were raised as the website was being developed and recommendations were taken up by a development team at the Centers for Medicare and Medicaid Services.

“But nobody anticipated the size and scope of the problems we experienced once the site launched. Since that time, experts have been working night and day to get it functioning – and that is where our focus is, and should be, right now,” Schultz told Fox News in a statement.

CMS pushed back against the release of the report late Monday, stating that the agency has “continually evaluated progress” and has taken steps to mitigate risks and address concerns with the ObamaCare website rollout.

“The review was completed six months before the beginning of open enrollment, was in line with industry best practices, and was followed by concrete action to address potential risks—as was intended,” the agency said in a statement.

The District of Columbia’s insurance commissioner says he was fired after questioning President Obama’s plan to fix ObamaCare and saying the city might not follow his suggestions.

Commissioner William White told The Washington Post on Saturday that he was called into Mayor Vincent Gray’s office the prior day and told the Democratic mayor “wants to go in a different direction.”

The president said Thursday that the millions of insurance plans scheduled to be canceled next year to comply with ObamaCare regulations could be extended for a year, after he told Americans prior to the law’s passage that they could keep their existing plans.

However, White and other insurance commissioners across the country have questioned the president’s proposed solution because it could create a mess in the marketplace.

Some of the top reasons for the commissioners’ objections are: policy prices are already locked in to comply with changes in ObamaCare; an extension could conflict with state-level laws to comply with the law and younger Americans needed to join the federal exchange to keep down costs will wait to enroll.

White told the newspaper that the deputy mayor who asked him to leave didn’t say the request was about his remarks.

City officials have not commented on the situation, saying they cannot discuss personnel issues. However, a city official suggested to The Post, on the condition anonymity, that White posted the statement on the city’s website before getting it approved.

The District and 16 states run their own health-care exchange, compared to the 36 states that have instead chosen to let residents shop and purchase insurance on the federal exchange.

“The action today undercuts the purpose of the exchanges, including the District’s DC Health Link, by creating exceptions that make it more difficult for them to operate,” White said Thursday in a statement.

He also agrees with a National Association of Insurance Commissioners statement that said Obama’s order “threatens to undermine the new market, and may lead to higher premiums and market disruptions in 2014 and beyond.”