The Ridgewood Blog Brings a Free Market Laissez-faire Point of View to Local, New Jersey State and National Issues.
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Middletown NJ, Assemblyman Gerry Scharfenberger (R-Monmouth) is speaking out against a recent bill seeking to impose a new “health tax” throughout New Jersey. This legislation comes at a time when businesses, residents, low-income families, and countless others are severely struggling to make ends meet in the wake of crushing financial waves due to the COVID-19 pandemic:
Continue reading Democrats Introduce New “Health Tax” bill for New Jersey Residents
the staff of the Ridgewood blog
Trenton NJ, Governor Phil Murphy today signed a package of bills to safeguard the provisions of the Affordable Care Act (ACA) in New Jersey. The bills, which will codify into state law the basic protections for health care consumers that are part of the Affordable Care Act, include protections for no-cost preventative care and contraception, prohibit exclusions for pre-existing conditions, allow children to stay on their parents’ plan until age 26, and incorporate mental health and maternity care as part of essential benefits, among others. The Governor highlighted the importance of these bills during an armchair discussion with Hackensack Meridian Health Chief Executive Officer Bob Garret.
Any reasonable person could have predicted this when analyzing the Affordable Care Act as written. Premiums rise, payments to physicians go down, and those who want to fix this law believe that increased subsidies to insurance companies will help. It is truly time to scrap ObamaCare and start over. Minimizing the federal role would be a great place to start , Alieta Eck, MD For Real Health Care Reform
Government control of healthcare is reducing access
by Dr. Deane Waldman and Jennifer Minjarez | Aug 29, 2017, 12:01 AM
The Affordable Care Act has made health insurance even more unaffordable than before Obamacare was enacted. Many insurers have lost hundreds of millions of dollars selling Obamacare insurance and have exited the market. The remaining insurance sellers are charging prices many cannot afford and are planning to raise rates an average of 19 percent.
To make the situation worse, payment schedules to doctors continue to go down, making care even less accessible.
By Anjalee Khemlani, August 11, 2017 at 8:05 AM
Weeks after the collapse of the attempt to repeal and replace the Affordable Care Act, uncertainty around federal action is affecting premium rates and continues to unsettle the health insurance industry.
“The continued uncertainty is making it very difficult for carriers,” said New Jersey Association of Health Plans president Ward Sanders.
In two recent reports, from the Kaiser Family Foundation and the Stop the Health Insurance Tax Coalition lobbying firm, premiums are estimated to increase by hundreds of dollars for New Jerseyans.
According to Stop the HIT, with the reintroduction of the premium fee:
Individuals will see an increase of at least $178.
Small group plans will increase by $209 for individuals and $556 for families.
Large groups will see an increase of $207 for individuals and $615 for family.
Seniors and disabled individuals in Medicare Advantage will see their premiums increase $516 per couple (or $248 for every individual).
State Medicaid programs will incur an additional cost of $268 for each of their insured Medicaid enrollees in 2018.
“From what we’ve seen from other state filings (as highlighted in the KFF report), the cost sharing reduction payments, if they are not going to be there, it is going to have a significant impact on insurance premiums,” Sanders said.
Whether or not the individual mandate and federal subsidies are kept intact, plus the reintroduction of the premium fee on insurers — which alone will increase premiums by close to 3 percent — are forcing significant increases for 2018 plans.
If subsidies are cut off for marketplace enrollees and the individual mandate is removed, insurers are likely to see fewer (mostly healthy) enrollees and therefore need to increase premiums.
the staff of the Ridgewood blog
Ridgewood Nj, you have heard it over and over again ,”20 million people gained healthcare due to Obamacare. This confirms that Obamacare was successfully addressing the underlying problems within the healthcare market.”
The reality is far different ,the majority of these people were simply placed on an expanded version of Medicaid, meaning, rather than addressing the issues plaguing the dysfunctional healthcare market, Obamacare did little to improve markets and simply pushed people into government-run healthcare, paid by taxpayers.
People keep touting, as though it were some sort of success story, that “more people have health insurance today due to Obamacare.” This particular talking point seems astonishingly absurd, however, since Obamacare contained within it a MANDATE that FORCED people to get health insurance. Of course, if you put a gun to someone’s head and tell them to buy something, they’re more likely to buy it. This is akin to passing a law requiring everybody to buy one additional pair of shoes, then proclaiming yourself a business genius because you then saw shoe sales increase. If sales didn’t increase because the product became more affordable or more desirable, however, it should be obvious that you didn’t actually “fix” anything.
Let’s take a look at the numbers:
• A 2015 estimate showed that, of the 20 million newly insured people, 14.5 million were put on Medicaid and CHIP (Children’s Health Insurance Program). [a]
• Of this 14.5 million placed on tax-payer financed health insurance, about 3.4 million were previously eligible before Obamacare [b], but hadn’t enrolled because they didn’t need it. That means tax payers are paying the health insurance costs of 3.4 million people who knew they didn’t actually need it but were forced to accept the hand-out anyways since Obamacare mandates they have insurance.
• Additionally, of the 20 million, 2.3 million were simply young adults (aged 19 to 25) who gained coverage between 2010 and 2013 as a result of Obamacare’s provision which said they got to stay on their parent’s insurance until they were 26. [c] People 19-25 rarely require extensive healthcare, however, which is why they rarely choose to buy it themselves. So while letting them stay on their parent’s insurance may have been helpful in a handful of circumstances, it was mostly “fixing” a problem which did not exist. Matter of fact, the reason the ACA wanted younger people insured was precisely BECAUSE they don’t get sick enough to cost money, and thus represent income for health insurance providers rather than costs.
• Lastly, in 2016, the numbers didn’t look much better. Preliminary data indicated that net total enrollment increased by “2,535,020 individuals in the first three-quarters of 2016.” [d] But of that 2.5 million increase, the net increase in PRIVATE (market) insurance was actually only “490,211 individuals.” Again, Medicaid accounted for “81 percent of the incremental growth in enrollment in 2016.” [d]
Thus, roughly 81% of the newly insured people in 2016 were simply given free insurance which everyone else funded. How is that a success? A successful reform would have seen people affording their own private health insurance – when and only IF they wanted it – because the product would have gotten better, cheaper, or both. Instead, since that wasn’t accomplished, Obamacare simply pushed people into government-run insurance to pretend it had “solved” the problem. It was called “The AFFORDABLE Care Act,” but a more appropriate name would have been “The Forced Welfare Expansion Act.”
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Sources:
[a]
https://aspe.hhs.gov/…/de…/files/pdf/187551/ACA2010-2016.pdf
[b]
https://kff.org/…/state-indi…/medicaid-expansion-enrollment/…
[c]
https://aspe.hhs.gov/syst…/files/pdf/187551/ACA2010-2016.pdf
[d]
https://budget.house.gov/…/house_budget_testimony-haislmaier…
By Alieta Eck, MD
As the controversy rages between those Republicans who want full repeal and those who want to retain what might be “good” about ObamaCare, we are not asking the right questions. While they are arguing whether or not to keep the ObamaCare subsidies (or the equivalent as “tax credits”), is anyone asking what it is we are subsidizing?
Why has medical care in the United States gotten so expensive? Why did the cost of a hospital stay go from an average of $17,000 in 2000 to $33,000 in 2010, while the average length of stay declined? Why do our hospital stays cost three times more than in other industrialized countries?
The dirty little secret is that having insurance might be a guarantee that the insured pays MORE. And because deductibles have risen dramatically along with premiums, a family needs to pay thousands of dollars out of pocket before insurance kicks in. But how does this work?
Most insurance companies have networks of “preferred providers.” One would assume that a “preferred provider” is a doctor or a lab that gives better rates, but the opposite is the case. As an example, one patient spent a day in the emergency room where the total bill came to $12,000. The “preferred provider” rate brought the bill down to $10,000, which happened to be that patient’s deductible. Upon further scrutiny, the breakdown of the bill showed a lab fee of $3,500—labs that would have cost less than 100 cash on the outside.
When the hospital patient advocate was queried, the answer came back, “Your insurance company negotiated $10,000 and, since you have not met your deductible, you are bound it pay it. Paying the cash price is not an option.” She acknowledged that this seemed unfair, but would not budge.
Another patient discovered that his insurance had lapsed and was given a cash price of $75 for an office visit. Once insurance was restored, the submitted fee was $275. Since he had not met his deductible, he was expected to personally pay the higher fee.
Since 92% of people will not incur more than $5,000 per year in medical expenses, the middle class has been fleeced under ObamaCare in so many ways. Many patients have received subsidies. But this just means that taxpayers are forced to pay part of their premiums, and the patients are still stuck with those deductibles and the higher negotiated fees.
So what is really happening?
Insurance premiums have soared, and the insurance companies love it. They keep a percentage of the bloated premiums for “operating costs.” Hospitals are buying physician practices, and Medicaid and Medicare have agreed to pay the hospitals higher fees for the same service in the same location. No government official has been able to explain why.
The ratepayers and taxpayers are the “forgotten men” in our medical system. Hospital and Insurance executives are now commanding compensation that exceeds $1 million. One CEO of a consolidated hospital system in central New Jersey receives $9 million per year. What exactly does he do to merit this high salary? The usual reason for lavish executive pay is that the official brings lots of revenue into the business. The big hospital systems are businesses that profit massively at the expense of patients and taxpayers—although the excess might be called something other than profit if the hospital is tax-exempt (allegedly “nonprofit”).
Our politicians are complicit in this heist, as last year insurance companies and hospitals were among the ten greatest contributors to the campaigns of legislators who allow this scam on the middle class to continue.
The best recommendation would be for patients with high deductibles to hide any connection with an insurance company and negotiate the best cash prices for services. Find a physician who is in no network and who can help navigate where to find cash-friendly sources of medicines, labs, and x-rays.
Patients with their doctors need to take control of medical care once again.
________________________________
Dr. Alieta Eck graduated from the Rutgers College of Pharmacy and the St. Louis University School of Medicine in St. Louis, MO. She studied Internal Medicine at Robert Wood Johnson University Hospital in New Brunswick, NJ and has been in private practice with her husband, Dr. John Eck, MD in Piscataway, NJ since 1988, affordablehealthinc.org. She has been involved in health care reform since residency and is convinced that the government is a poor provider of medical care.
Dr. Eck testified before the Joint Economic Committee of the US Congress in 2004 about better ways to deliver medical care in the United States. In 2011, she testified before a Senate Health Committee chaired by Senators Bernie Sanders and Rand Paul– about ways to avoid non-urgent visits to the emergency rooms.
In 2003, she and her husband founded the Zarephath Health Center, a non-government free clinic for the poor and uninsured that currently care for about 300 patients per month utilizing the donated services of volunteer physicians and nurses. It is only open 12 hours per week. zhcenter.org
She is working to pass NJ S239, a bill that would provide medical malpractice protection for the private practices of physicians who donate 4 hours per week in a clinic like the ZHC. njaaps.org
Dr. Eck was the 2012 President of the Association of American Physicians and Surgeons and serves on the board of Christian Care Medi-Share, a faith based medical cost sharing ministry.
She was the Republican nominee for the US Congress for NJ12 in 2014.
In March, 2015, she chaired a meeting of the National Physicians Coalition for Freedom in Medicine, about 30 physicians, who gathered in Washington, DC to draft a “One-Page Plan” to restore affordability, promote patient choice and retain quality in medical care. https://aaps.wufoo.com/forms/m11okp2x1yjc8qf/
Dr. Eck spoke at the National Press Club in Washington, DC in June, 2016 to help unveil the Wedge of Health Freedom, an initiative of the Citizens’ Council for Health Freedom, with President Twila Brase. JointheWedge.com
https://aapsonline.org/obamacare-subsidies-rob-middle-class/
It is time to repeal each and every one of Obamacare’s tax increases. The full list is below:
Individual Mandate Non-Compliance Tax: Anyone not buying “qualifying” health insurance – as defined by President Obama’s Department of Health and Human Services — must pay an income surtax to the IRS. In 2014, close to 7.5 million households paid this tax. Most make less than $250,000. The Obama administration uses the Orwellian phrase “shared responsibility payment” to describe this tax.
For tax year 2016, the tax is a minimum of $695 for individuals, while families of four have to pay a minimum of $2,085.
| Households w/ 1 Adult | Households w/ 2 Adults | Households w/ 2 Adults & 2 children | ||
| 2.5% AGI/$695 | 2.5% AGI/$1390 | 2.5% AGI/$2085 |
A recent analysis by the Congressional Budget Office (CBO) found that repealing this tax would decrease spending by $311 billion over ten years.
Medicine Cabinet Tax on HSAs and FSAs: Since 2011 millions of Americans are no longer able to purchase over-the-counter medicines using pre-tax Flexible Spending Accounts or Health Savings Accounts dollars. Examples include cold, cough, and flu medicine, menstrual cramp relief medication, allergy medicines, and dozens of other common medicine cabinet health items. This tax costs FSA and HSA users $6.7 billion over ten years.
Flexible Spending Account Tax: The 30 – 35 million Americans who use a pre-tax Flexible Spending Account (FSA) at work to pay for their family’s basic medical needs face an Obamacare-imposed cap of $2,500. This tax will hit Americans $32 billion over the next ten years.
Before Obamacare, the accounts were unlimited under federal law, though employers were allowed to set a cap. Now, parents looking to sock away extra money to pay for braces find themselves quickly hitting this new cap, meaning they have to pony up some or all of the cost with after-tax dollars. Needless to say, this tax especially impacts middle class families.
There is one group of FSA owners for whom this new cap is particularly cruel and onerous: parents of special needs children. Families with special needs children often use FSAs to pay for special needs education. Tuition rates at special needs schools can run thousands of dollars per year. Under tax rules, FSA dollars can be used to pay for this type of special needs education. This Obamacare tax increase limits the options available to these families.
Chronic Care Tax: This income tax increase directly targets middle class Americans with high medical bills. The tax hits 10 million households every year. Before Obamacare, Americans facing high medical expenses were allowed an income tax deduction to the extent that those expenses exceeded 7.5 percent of adjusted gross income (AGI). Obamacare now imposes a threshold of 10 percent of AGI. Therefore, Obamacare not only makes it more difficult to claim this deduction, it widens the net of taxable income. This income tax increase will cost Americans $40 billion over the next ten years.
According to the IRS, approximately 10 million families took advantage of this tax deduction each year before Obamacare. Almost all were middle class: The average taxpayer claiming this deduction earned just over $53,000 annually in 2010. ATR estimates that the average income tax increase for the average family claiming this tax benefit is about $200 – $400 per year.
HSA Withdrawal Tax Hike: This provision increases the tax on non-medical early withdrawals from an HSA from 10 to 20 percent, disadvantaging them relative to IRAs and other tax-advantaged accounts, which remain at 10 percent.
Ten Percent Excise Tax on Indoor Tanning: The Obamacare 10 percent tanning tax has wiped out an estimated 10,000 tanning salons, many owned by women. This $800 million Obamacare tax increase was the first to go into effect (July 2010). This petty, burdensome, nanny-state tax affects both the business owner and the end user. Industry estimates show that 30 million Americans visit an indoor tanning facility in a given year, and over 50 percent of salon owners are women. There is no exception granted for those making less than $250,000 meaning it is yet another tax that violates Obama’s “firm pledge” not to raise “any form” of tax on Americans making less than this amount.
“Cadillac Tax” — Excise Tax on Comprehensive Health Insurance Plans: In 2020, a new 40 percent excise tax on employer provided health insurance plans is scheduled to kick in, on plans exceeding $10,200 for individuals and $27,500 for families. According to research by the Kaiser Family Foundation, the Cadillac tax will hit 26 percent of employer provided plans by 2020 and 42 percent of employer provided plans by 2028. Over time, this will decrease care and increase costs for millions of American families across the country.
Health Insurance Tax: In addition to mandating the purchase of health insurance through the individual mandate tax, Obamacare directly increases the cost of insurance through the health insurance tax. The tax is projected to cost taxpayers – including those in the middle class – $130 billion over the next decade.
The total revenue this tax collects is set annually by Treasury and is then divided amongst insurers relative to the premiums they collect each year. While it is directly levied on the industry, the costs of the health insurance tax are inevitably passed on to small businesses that provide healthcare to their employees, middle class families through higher premiums, seniors who purchase Medicare advantage coverage, and the poor who rely on Medicaid managed care.
According to the American Action Forum, the Obamacare health insurance tax will increase premiums by up to $5,000 over a decade and will directly impact 1.7 million small businesses, 11 million households that purchase through the individual insurance market and 23 million households covered through their jobs. The tax is also economically destructive – the National Federation for Independent Businesses estimates the tax could cost up to 286,000 in new jobs and cost small businesses $33 billion in lost sales by 2023.
Employer Mandate Tax: This provision forces employers to pay a $2,000 tax per full time employee if they do not offer “qualifying” – as defined by the government — health coverage, and at least one employee qualifies for a health tax credit. According to the Congressional Budget Office, the Employer Mandate Tax raises taxes on businesses by $166.9 billion over the ten years.
Surtax on Investment Income: Obamacare created a new, 3.8 percent surtax on investment income earned in households making at least $250,000 ($200,000 for singles). This created a new top capital gains tax rate of 23.8% and increased taxes by $222.8 billion over ten years.
The capital gains tax hits income that has already been subjected to individual income taxes and is then reinvested in assets that spur new jobs, higher wages, and increased economic growth. Much of the “gains” associated with the capital gains tax is due to inflation and studies have shown that even supposedly modest increases in the capital gains tax have strong negative economic effects.
Payroll Tax Hike: Obamacare imposes an additional 0.9 percent payroll tax on individuals making $200,000 or couples making more than $250,000. This tax increase costs Americans $123 billion over ten years.
Tax on Medical Device Manufacturers: This law imposes a new 2.3% excise tax on all sales of medical devices. The tax applies even if the company has no profits in a given year. The tax was recently paused for tax years 2016 and 2017. It will cost Americans $20 billion by 2025.
Tax on Prescription Medicine: Obamacare imposed a tax on the producers of prescription medicine based on relative share of sales. This is a $29.6 billion tax hike over the next ten years.
Codification of the “economic substance doctrine”: This provision allows the IRS to disallow completely legal tax deductions and other legal tax-minimizing plans just because the IRS deems that the action lacks “substance” and is merely intended to reduce taxes owed. This costs taxpayers $5.8 billion over ten years.
Elimination of Deduction for Retiree Prescription Drug Coverage: The elimination of this deduction is a $1.8 billion tax hike over ten years.
$500,000 Annual Executive Compensation Limit for Health Insurance Executives: This deduction limitation is a $600 million tax hike over ten years.
Read more: https://www.atr.org/list-obamacare-tax-hikes#ixzz4ZYl6YNSg
Aetna CEO: Obamacare markets are in a ‘death spiral’
By PAUL DEMKO
Updated 02/15/17 10:28 AM EST
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Obamacare is in a “death spiral,” the influential CEO of Aetna, Mark Bertolini, declared Wednesday morning.
Bertolini’s doomsday prophesy: More insurers will pull out of the government-run marketplaces in the coming weeks and many areas will have no insurers to provide Affordable Care Act coverage in 2018.
“It’s not going to get any better; it’s getting worse,” Bertolini said in an interview at a Wall Street Journal event. But he declined to say whether Aetna would completely pull out of Obamacare markets next year.
Humana, which had already significantly limited its exchange footprint this year, announced Tuesday that it would completely pull out of the exchange markets next year after determining its customer base would still be unprofitable. That followed major pullbacks this year from other national insurers, including Aetna and UnitedHealth Group.
https://www.politico.com/story/2017/02/obamacare-market-death-spiral-aetna-mark-bertolini-235041
Reader comments , “The individual mandate ensured that the pool would not only be sick people.
The mandate also protects taxpayers. People without health insurance will get sick and wind up in hospitals. The uninsured will be a burden to hospitals that do charity work (not Valley). They are healthy right now. Eventually some will find out that they have an illness or they may have an accident. Then they will need charity care and can run the risk of going bankrupt. I do not want to underwrite their medical bills- the way we used to. I don’t care if they go bankrupt.”
Obamacare Architect Jonathan Gruber Twice Admits Fooling Stupid Americans
Ridgewood NJ, In the clip , Massachusetts Institute of Technology Professor Jonathan Gruber appears on a panel and discusses how the reform earned enough votes to pass.
He suggested that many lawmakers and voters didn’t know what was in the law or how its financing worked, and that this helped it win approval.
“Lack of transparency is a huge political advantage,” Gruber said. “And basically, call it the stupidity of the American voter or whatever, but basically that was really, really critical for the thing to pass.”
