Nancy Pelosi famously said that we would have to pass the Affordable Care Act to find out what was in it. The statement wasn’t as silly as it sounded, at least back then. What she meant, I think, was that there were a lot of provisions in the law and that people would not be able to find out about them, and appreciate how good they were, until the law was passed and put into effect. What has happened, of course, is something very different.
The way things are going now, it is going to a long time before we know we know what was supposed to be in the law. I say that because the Obama administration has changed so many things about the law, as they try to implement it, that we have no idea what was originally supposed to be in it.
First, they put off the employer mandate by a year. Then they said the small business website would be late. The Spanish language website. Only started in December. Megan McArdle reported Thursday on yet another set of “fixes”:
“Insurers will be required to accept payment for policies beginning Jan. 1 as late as Dec. 31, and they will be ‘encouraged’ to accept payment after that. …
Insurers are being ‘strongly encouraged’ to treat out-of-network doctors as in-network doctors for acute-care episodes, or if the provider was listed in the plan’s provider directory when the patient enrolled.
Insurers are also being ‘strongly encouraged’ to refill prescriptions in the month of January, even if they aren’t covered under the new plan, if they were covered under the patient’s old plan.”
It is becoming increasingly clear the Administration is out of its depth in implementing the law. They started late. They didn’t issue rules and regulations early enough to get things done. Now, as things are falling apart all around them, they are running around like a bunch of Keystone Kops, trying to get something in place on January 1. But what they succeed, and what will it be? Who knows? It certainly doesn’t look like they do.
It has reached the point, as shown by Ms. McArdle’s article on Thursday, among many others, that the Administration is relying on the good faith and cooperation of the insurance companies, and the willingness of the insurance companies to do things they are not legally and/or contractually obligated to do, to get something in place.
Three questions in this regard, one semi-sarcastic and two real. First, the semi-sarcastic one: We all remember how President Obama campaigned against the evil insurance companies when he was running for president and then trying to get the Affordable Care Act passed. Why are those mean, stingy insurance companies going to be nice now?
Second, a real one: Insurance companies have shareholders. Management is supposed to work to maximize profits and the value of the company for the shareholders. How does giving away free health care and/or not charging the proper price for it, accomplish that? Or is it okay for them to do it because if they don’t, the Administration will come after them like the IRS went after those Tea Party groups?
Third, another real one: Congress passed a law, and the President signed it. It’s in effect, and it has real obligations and requirements. How does the Administration get the right to keep changing things, waiving this requirement and modifying that one? Congress passed a law with real provisions. They didn’t just tell the President to make up whatever new health system he wanted to. They passed a specific law. How does the President have the right to change whatever he wants?
“Pass the law to find out what’s in it”? Heck, the Obama administration doesn’t even know on December 15 what is going to be in it on January 1.
Comments