Friday, October 4, 2013

The ACA and "if we only knew then what we know now".


Did you ever notice the number of unintended consequences to federal government action?

During WWI, federal farm policies artificially inflated wheat prices causing over production. That not only caused a huge surplus of wheat and eventually a bust in wheat prices; but they lead to the over planting of the land that then lead to the dust bowl.    

In an attempt to spur low income home ownership, Bill Clinton’s “Community Reinvestment Act” encouraged banks, along with Fanny Mae and Freddie Mack to make more risky loans to people who traditionally would not qualify for traditional mortages.  This law led directly to the housing bubble and subsequent recession. 

Mandatory air bag laws lead to the deaths of thousands of children who were buckled in child seats placed in front seat positions.

The banning of DDT chemicals lead directly to worldwide outbreaks of malaria that has killed millions.

Of course no one supporting these actions intended for bad things to happen, it’s just hard to see all the ramifications for huge far reaching programs on all 50 states when the programs are conceived and enacted in Washington.

This brings us to the so called “Affordable Care Act” (ACA).

In my home state of North Carolina, Blue Cross and Blue Shield has just announced price increases of 50-100% for many health insurance policies.  The “affordable” part is a little hard to see.  We have already learned that the President’s promise that “if you like your insurance policy you can keep it” was a bold face lie. And just in case anyone thinks criticism of the ACA is just from right wing extremists, we have Sen. Max Baucus, (D-Mont) calling the bill a “train wreak” and major union leaders calling for massive changes to the bill in the letter below to Democratic leaders in Congress.

               

Dear Leader Reid and Leader Pelosi:

When you and the President sought our support for the Affordable Care Act (ACA), you pledged that if we liked the health plans we have now, we could keep them. Sadly, that promise is under threat. Right now, unless you and the Obama Administration enact an equitable fix, the ACA will shatter not only our hard-earned health benefits, but destroy the foundation of the 40 hour work week that is the backbone of the American middle class.

Like millions of other Americans, our members are front-line workers in the American economy. We have been strong supporters of the notion that all Americans should have access to quality, affordable health care. We have also been strong supporters of you. In campaign after campaign we have put boots on the ground, gone door-to-door to get out the vote, run phone banks and raised money to secure this vision.

Now this vision has come back to haunt us.

Since the ACA was enacted, we have been bringing our deep concerns to the Administration, seeking reasonable regulatory interpretations to the statute that would help prevent the destruction of non-profit health plans. As you both know first-hand, our persuasive arguments have been disregarded and met with a stone wall by the White House and the pertinent agencies. This is especially stinging because other stakeholders have repeatedly received successful interpretations for their respective grievances. Most disconcerting of course is last week’s huge accommodation for the employer community—extending the statutorily mandated “December 31, 2013” deadline for the employer mandate and penalties.

Time is running out: Congress wrote this law; we voted for you. We have a problem; you need to fix it. The unintended consequences of the ACA are severe. Perverse incentives are already creating nightmare scenarios:

First, the law creates an incentive for employers to keep employees’ work hours below 30 hours a week. Numerous employers have begun to cut workers’ hours to avoid this obligation, and many of them are doing so openly. The impact is two-fold: fewer hours means less pay while also losing our current health benefits.

 Second, millions of Americans are covered by non-profit health insurance plans like the ones in which most of our members participate. These non-profit plans are governed jointly by unions and companies under the Taft-Hartley Act. Our health plans have been built over decades by working men and women. Under the ACA as interpreted by the Administration, our employees will treated differently and not be eligible for subsidies afforded other citizens. As such, many employees will be relegated to second-class status and shut out of the help the law offers to for-profit insurance plans.

And finally, even though non-profit plans like ours won’t receive the same subsidies as for-profit plans, they’ll be taxed to pay for those subsidies. Taken together, these restrictions will make non-profit plans like ours unsustainable, and will undermine the health-care market of viable alternatives to the big health insurance companies.

On behalf of the millions of working men and women we represent and the families they support, we can no longer stand silent in the face of elements of the Affordable Care Act that will destroy the very health and wellbeing of our members along with millions of other hardworking Americans.

We believe that there are common-sense corrections that can be made within the existing statute that will allow our members to continue to keep their current health plans and benefits just as you and the President pledged. Unless changes are made, however, that promise is hollow.

We continue to stand behind real health care reform, but the law as it stands will hurt millions of Americans including the members of our respective unions.

We are looking to you to make sure these changes are made.

                               

I have no doubt that the bill was conceived, written and voted on with the best possible intentions. But as a wise man once said, “the road to hell is paved with good intentions”. It is time that the government stops making citizens pay for their bad decisions. (Actually it is time for our elected officials to stop making bad decisions!) Since the ramifications are hard to see and understand of a bill one thousand pages in length, maybe the government should take a line from the Hippocratic oath and at first “do no harm”.
A limited federal government is the only why I can see this happening.

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