High Stakes - Mounting Healthcare Costs and Miscalculations

Bronze Medical Symbol
September 10, 2014

Regardless of your political leanings, there’s a disturbing trend lately that doesn’t bode well for health care costs for all of us as individuals, or for employers working hard every day to make ends meet. Some call Speaker Boehner’s recent move to sue the Obama administration as a political stunt. Is it? Might he actually win? Could be a long while before we know but it’s important to look at the underlying costs of these decisions.

The Obama administration has taken two bold steps lately to change The Affordable Care Act without seeking legislative amendment. First, they temporarily waived the employer mandate under the law and then, more recently, they determined that employees who had enrolled in the federal exchange, did not have to re-enroll in 2015. We’re not here to discuss at any length whether it’s legal to make these moves administratively or even to determine if Boehner has any legal standing to bring his suit. As my grandfather always said “we don’t have a dog in the fight.”  What we can say is that moves that are made without thoroughly assessing the fiscal impact scare the heck out of us.

Waiving the employer mandate likely costs the federal government millions of dollars. Not requiring employees to re-enroll will do the same. How much exactly would be difficult to calculate. Practically speaking, however, it must be, has to be, a significant amount. The simple fact that so many individuals had such a hard time signing onto the federal exchange made the whole thing ripe for fraud and abuse. Is there anyone out there who doesn’t think that is possible?

It’s more than possible, it’s highly probable. So now, grandfathering in countless individuals who seized the opportunity to get a subsidy, receive a tax break or otherwise game the system supports ongoing fraud. Individuals are required to proactively change their plans if their income and eligibility change.  How likely are individuals to do so in the coming year? How long will it take the federal government to catch up with the fact that they did not make the changes? These questions make our heads spin.

So, we won’t waste our time analyzing the legality of anyone’s actions here, but we will say that decisions being made without a sound assessment are something we think all taxpayers ought to take a note of. In the private sector, this lack of accountability wouldn’t stand. We’d be out of business tomorrow if we turned a blind eye to costs and fraud. If ever there was a time to find a trusted, transparent and secure private health exchange, it is now. There’s no doubt.

Originally posted by Pierce McNally of CieloStar on July 22, 2014.

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