Still Crazy After All These Years - An ObamaCare October surprise.

[Ubiquitous]

Five weeks before the presidential election, a campaign surrogate is
declaring war on ObamaCare, as the Washington Times reports.

“You’ve got this crazy system where all of a sudden 25 million more
people have health care and then the people are out there busting
it, sometimes 60 hours a week, wind up with their premiums doubled
and their coverage cut in half,” the surrogate said in Flint, Mich.,
Monday. “It’s the craziest thing in the world.” Also: “The people
that are getting killed in this deal are small businesspeople and
individuals who make just a little too much to get any of these
subsidies.”

Having said all this, why aren’t Donald Trump ahead by 50 points?
you might ask. Maybe because the quote above doesn’t come from one
of Trump’s surrogates but from one of Hillary Clinton’s—and not just
any surrogate but Bill Clinton, to whom Mrs. Clinton is officially
married.

It’s something of an October surprise, and Mr. Clinton isn’t the
only unlikely critic of ObamaCare to emerge in recent days. In
yesterday’s New York Times, reporter Robert Pear described ObamaCare
as a failure while studiously avoiding the F-word: “[President]
Obama’s signature domestic achievement will almost certainly have to
change to survive.”

Since ObamaCare is not a living organism, the “survival” metaphor
obscures more than it illuminates. Just how much change could the
law take and still be deemed to have “survived,” as opposed to
having been replaced by a new scheme? We’re not sure how to answer
that other than purely subjectively. There are more maddening
metaphors, too:

Dr. John W. Rowe, who was the chief executive of Aetna from
2000 to 2006 and the president of Mount Sinai Medical Center
in New York before that, predicted that “the insurance
market will stabilize in two or three years.”

“We are not in a death spiral,” Dr. Rowe said. “If this were
a patient, I would say that he’s not in intensive care, but
he’s still in the hospital and requires careful monitoring.”

But that does not mean the act will heal on its own, said
Sara Rosenbaum, a professor of health law and policy at
George Washington University.

It doesn’t help that Rowe and Rosenbaum are describing a problem
with health-care financing using medical metaphors—though perhaps
it’s revealing that the one thing they _don’t_ discuss about the
ObamaCare “patient” is whether he has insurance, the proliferation
of which, we are supposed to believe, is ObamaCare’s great
accomplishment.

But actually ObamaCare does have insurance. “The Obama
administration is maneuvering to pay health insurers billions of
dollars the government owes under the Affordable Care Act, through a
move that could circumvent Congress and help shore up the
president’s signature legislative achievement before he leaves
office,” the Washington Post reported last week:

Justice Department officials have privately told several
health plans suing over the unpaid money that they are
eager to negotiate a broad settlement, which could end up
offering payments to about 175 health plans selling coverage
on ACA marketplaces, according to insurance executives and
lawyers familiar with the talks. . . .

The money in question involves one of three strategies to
help coax insurers into the marketplaces by promising to
cushion them from unexpectedly high expenses for their new
customers. This particular strategy, known as “risk
corridors,” was for the marketplaces’ first three years,
when it was unclear how many people would sign up and how
much medical care they would use. . . .

The risk corridors started in 2014. The crunch became
apparent last fall, when federal health officials announced
that they faced an enormous gap because so many more health
plans incurred high expenses for their ACA customers than
low ones. For that reason, HHS [the Department of Health
and Human Services] made less than $400 million in 2014
risk-corridor payments—just 12.6 percent of $2.9 billion
it owed overall.

That is, ObamaCare’s _insurance_ scheme was so badly designed that
its _reinsurance_ scheme broke down and the administration is madly
searching for tax money it can use to bail out insurance companies—
the same insurance companies Obama relentlessly vilified when he was
attempting to sell the public on ObamaCare.

In an interview with New York magazine, Obama sounds a familiar
theme about Republicans’ failure to cooperate:

[GOP lawmakers made] a calculation based on what turned out
to be pretty smart politics but really bad for the country:
If they cooperated with me, then that would validate our
efforts. If they were able to maintain uniform opposition
to whatever I proposed, that would send a signal to the
public of gridlock, dysfunction, and that would help them
win seats in the midterms. It was that second strategy that
they pursued with great discipline. It established the
dynamic for not just my presidency but for a much sharper
party-line approach to managing both the House and the
Senate that I think is going to have consequences for years
to come.

Obama himself made a similar calculation, also really bad for the
country, though one could argue either way if it was “smart
politics.” With Democratic majorities in both congressional
chambers, he worked with his party’s leaders to bully through the
law despite uniform Republican opposition and public opposition
strong enough to elect a GOP senator from Massachusetts, of all
places.

Now, as the Hill reported last month, “Democrats are beginning to
talk about changing ObamaCare to fix what they acknowledge are
growing problems in the law’s insurance marketplaces,” and they “are
also expressing hope that Republicans will work with them to make
fixes to the law when the new Congress convenes in 2017.”


Which could get interesting. With Obama gone, his veto—and ego—would
no longer be a barrier to legislation undoing ObamaCare, or at least
its worst aspects. If Trump is elected, one would expect
congressional Republicans to take the lead. As for Mrs. Clinton, who
knows? She has described herself as a supporter of ObamaCare, but
that is probably just another way of saying she’s a supporter of
Obama, who is much more popular than she is.

The Times’s Pear reports that many Democrats favor a “public option”
(a government-run medical-insurance company) or even “single payer”
(a government-run medical-insurance monopoly). But neither of those
ideas seems likely to go anywhere in a Republican-controlled House
or Senate.

Maybe Mr. Clinton’s anti-ObamaCare musings were meant to signal to
Republicans that Mrs. Clinton would be flexible enough to go along
with some reforms they would find acceptable. Or maybe Mr. Clinton
just wishes Mrs. Clinton were flexible.


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To minimize the effects of Hurricane Matthew, FEMA will be briefed
by Pres Obama, the foremost expert in damaging the country.