The fines begin for Obamacare abortifacient mandate

The $100 per day, per employee, fines have gone into effect for employers that refuse to provide insurance that includes free contraception and abortion-causing drugs.

Churches are exempt, and non-profit religious organizations were granted a one-year reprieve, but companies owned by pro-life individuals must either comply or start paying the fines.

Meanwhile, court cases have ruled all over the map on this issue.  For where things stand now, see   Courts Issue Contradictory Rulings as Contracepti… | Christianity Today.

Pain medication scandal

One of the biggest drug problems today is addiction to prescription pain medication like OxyContin, Vicodin, and Percocet.  These are “opioids,” derived from natural or synthetic opium. They used to be prescribed for specific cases of acute pain, but back in the 1990s they began to be prescribed longer-term for chronic pain such as back problems.  Most people who get addicted–from celebrities like Rush Limbaugh to untold numbers of coal miners and other physical laborers–got their start from legitimate medical prescriptions for chronic pain.

Doctors started prescribing the opioids for chronic conditions because of research published in the New England Journal of Medicine and other key medical journals that said the drugs posted only “a minimal risk of addiction.”

But it’s coming out now that those scientific studies were not only sponsored by the pharmaceutical companies that sold the drug, but they also systematically failed to consider withdrawal symptoms in the patients they studied.  One participant in the studies now confesses that they were  “trying to create a narrative so that the primary care audience would . . . feel more comfortable about opioids.”

Investigative reporter Peter Whoriskey is digging out the details: Read Rising painkiller addiction shows damage from drugmakers’ role in shaping medical opinion – The Washington Post.

Opium is addictive!  Who knew?  Only 19th century literature fans who know their de Quincy and their Coleridge.  Scientific studies that maintain the contrary should have provoked suspicion.

I think pharmaceutical companies have been unfairly demonized–they are even showing up as stock villains in television and films–since their products do great good.  New drugs require huge investments and the federal approval process demands expensive testing.  Who else can pay for that?  That drug companies paid for a study does not necessarily invalidate it.  Still, scientific research is not always as objective as it appears.  The appearance of commercial bias here, though, in drugs that have become so widely prescribed and that can do so much harm is disturbing.

Good news/bad news on abortifacient mandate

An appeals courts has given a victory to Christian colleges suing over Obamacare’s requirement that they provide free contraceptives and morning-after pills.  But another appeals court has upheld the requirement for Christian-owned businesses.

A federal appeals court on Tuesday sided with Wheaton College and Belmont Abbey College in a decision related to the ongoing court challenges to the Obama administration’s birth control mandate. The court said it would hold the Obama administration to its promise to never implement the current birth control mandate and to create a new rule by August, as part of the court decision.

The U.S. Court of Appeals for the D.C. Circuit ordered Health and Human Services Secretary Kathleen Sebelius to give it updates every 60 days, beginning in February, until a new rule is issued in August. The lawsuits will be held in abeyance until that time.

“There will, the government said, be a different rule for entities like the appellants,” the court wrote, “and we take that as a binding commitment. The government further represented that it would publish a Notice of Proposed Rulemaking for the new rule in the first quarter of 2013 and would issue a new Final Rule before August 2013. We take the government at its word and will hold it to it.”

Sebelius first issued the rule in January. As part of the Affordable Care Act, or “Obamacare,” she ruled that employers must cover contraception, sterilization and some abortifacient drugs in their health care insurance for employees. There is a religious exemption, but the exemption is so narrow that most religious employers, including religious schools, are not exempt. There have been about 40 lawsuits related to the mandate.

via Christian Colleges Score Win: Court Orders Rewrite of Birth Control Mandate.

No such good news for Hobby Lobby, whose owners are devout pro-life Christians:

A federal appeals court on Thursday refused to shield Hobby Lobby Stores from the Obama administration’s contraception mandate — and the fines that come with it for not complying — in a blow to the largest employer to challenge the ObamaCare rule.

In response, the Christian-owned company vowed to appeal the case to the Supreme Court.

CEO David Green, who had taken his case to the appeals court after losing in a lower-court ruling, had argued that his family would have to either “violate their faith by covering abortion-causing drugs or be exposed to severe penalties.”

The mandate requires businesses and organizations, with some exceptions, to provide access to contraception coverage — Hobby Lobby was most concerned about coverage for the morning-after pill, which some consider tantamount to an abortion-causing drug. Hobby Lobby has refused to comply, while saying the fines could add up to $1.3 million a day. . . .

There are currently more than 40 cases pending against that rule, though the Supreme Court has not yet stepped into the fray.

In its ruling, the 10th Circuit Court of Appeals said the company did not prove the rule would “substantially burden” its religious freedom. Though the mandate has exemptions for religious entities like churches, the lower court ruled that Hobby Lobby is not a religious group.

Surprise in Obamacare

Obamacare was passed so quickly that, admittedly, lawmakers did not have time to so much as read the multi-volume bill.  Hardly anyone, opponent or proponent, knows everything that Affordable Health Care law will do.  So as it is being implemented over the next two years, we will probably keep getting surprises.  Here is the latest, from the Associated Press:

Your medical plan is facing an unexpected expense, so you probably are, too. It’s a new, $63-per-head fee to cushion the cost of covering people with pre-existing conditions under President Barack Obama’s health care overhaul.

The charge, buried in a recent regulation, works out to tens of millions of dollars for the largest companies, employers say. Most of that is likely to be passed on to workers.

Employee benefits lawyer Chantel Sheaks calls it a “sleeper issue” with significant financial consequences, particularly for large employers.

“Especially at a time when we are facing economic uncertainty, [companies will] be hit with a multi-million dollar assessment without getting anything back for it,” said Sheaks, a principal at Buck Consultants, a Xerox subsidiary.

Based on figures provided in the regulation, employer and individual health plans covering an estimated 190 million Americans could owe the per-person fee.

The Obama administration says it is a temporary assessment levied for three years starting in 2014, designed to raise $25 billion. It starts at $63 and then declines.

Most of the money will go into a fund administered by the Health and Human Services Department. It will be used to cushion health insurance companies from the initial hard-to-predict costs of covering uninsured people with medical problems. Under the law, insurers will be forbidden from turning away the sick as of Jan. 1, 2014.

via Surprise: New Insurance Fee in Health Care Reform Law – DailyFinance.

Yes, it’s nice that pre-existing conditions will be covered.  Yet another thing we don’t know (“hard-to-predict”) is how much this will cost.  Normally, businesses–and especially insurance companies with their actuarial charts and calculations–would need to have those figures.  I doubt that $63 dollars per insured person would come anywhere near paying for the nation’s pre-existing conditions.  But at least something is budgeted for it.  Still, this amounts to a tax on everyone with health insurance, whether paid by the company or the insured.  I believe we were told that taxes would only go up for the wealthy.

HT:  Jackie

More Obamacare rules

Now that Obamacare has passed the hurdles of the Supreme Court and Obama’s re-election, there is a mad scramble to make the necessary preparations before the health care program goes into effect in 2014.  The government is adding more requirements of what health insurance companies will have to cover while also allowing them to charge higher deductibles.

The Obama administration proposed new rules Tuesday that would loosen some of the 2010 health-care law’s mandates on insurers while tightening others.

Certain health plans, for instance, would be able to charge customers higher deductibles than originally allowed under the legislation. But all plans would be required to cover a larger selection of drugs than under an earlier approach outlined by the administration.

Similarly, the law permits insurers to set their premiums for tobacco users 1.5 times higher than those for non-smokers. But insurers wouldn’t be allowed to impose the surcharge on smokers enrolled in smoking-cessation programs.

The changes were included in the fine print of three regulations the Department of Health and Human Services proposed to flesh out key parts of the statute. For the most part, the regulations — which will be open for comment until Dec. 26 — would simply codify mandates in the law or in earlier administration guidance.

Those policies include a prohibition on insurers denying coverage to people with preexisting medical conditions. They also limit how much plans can vary rates based on, for example, a person’s age. Most provisions will take effect in 2014.

But Tuesday’s proposals also included a few significant tweaks.

The suggestion to grant insurers greater flexibility in setting deductibles, for example, reflected concerns that health plans would have a hard time meeting the law’s original requirements.

Specifically, the legislation prohibits plans sold to small businesses from setting deductibles higher than $2,000 for individuals and $4,000 for families. But the law also limits how big a share of total health-care expenses must be paid out of pocket by individuals or families, including through co-pays and co-insurance.

Insurers have complained that it could prove impossible to design a package of benefits that meets that requirements while keeping the deductible below $2,000.

Administration officials agreed. So the proposed new rule would exempt insurers from the deductible limit if that’s necessary to achieve the plan’s overall cost-sharing target.

Karen Ignagni, president and chief executive of America’s Health Insurance Plans, a trade group, said in a statement Tuesday that the “additional flexibility” is a “positive step.” But she added that “we remain concerned that many families and small businesses will be required to purchase coverage that is more costly than they have today.”

via Obama officials tweak rules for health insurers – The Washington Post.

You think?  With all of these requirements, how could insurance NOT cost more?  But if deductibles are going to have to go up considerably, won’t that mean lots of families that won’t be able to afford health-care after all?

Will Obamacare decrease health benefits?

The Washington Post‘s Ezra Klein tries to assure businesses that Obamacare won’t be so bad.  But in doing so, he makes me wonder whether a program built largely around employer-provided health insurance might have the effect of eliminating many people’s employer-provided health insurance:

The health-care law’s treatment of larger employers is almost laughably complicated. If you’ve got fewer than 50 employees, nothing is asked of you, and if you’re willing to provide insurance for your employees, you get a giant tax credit, at least for awhile.

But if you’re a business with more than 50 full-time employees, matters become considerably more complex.

If you’ve got more than 50 full-time employees and you already offer them health insurance, you can stop reading now. You’re in the clear.

If you’ve got more than 50 full-time employees and you don’t offer them coverage and you don’t pay them enough to buy coverage on their own without using subsidies, then you have to pay $2,000 for each employee, except for your first 30 employees.

If you’ve got more than 50 full-time employees and you offer some of them coverage but others have to apply for federal subsidies and buy coverage themselves, then you pay the lesser of $3,000 for each employee receiving insurance subsidies or $2,000 for each full-time employee, once again excluding the first 30 employees.

Weird, right? But the complexities of this policy obscure a huge win for employers. In 1974, President Richard Nixon’s health-care plan proposed forcing employers to pay 75 percent of the cost of basic health insurance for their employees, though there would be some assistance for smaller businesses. In 1994, President Bill Clinton proposed forcing employers to pay 80 percent of the cost of basic heath insurance for their employees, though a somewhat confusing series of caps meant that smaller businesses would end up paying much less.

In other words, both Democratic and Republican presidents used to think the proper role for business in the American health-care system was to pay most of the cost of their employee’s health-care insurance.

Under the Affordable Care Act, the principle is different, and much less onerous: Employers don’t need to offer health care, and they don’t need to pay for most of the cost of their employee’s health care, but if their employees are taking advantage of public subsidies, then the employer should have to pay a penalty equal to about 1/8th the cost of the average employer-provided health-insurance plan.

via Cheer up, Papa John’s. Obamacare gave you a good deal..

So if a company has a choice between paying $16,000 (or more, or a large percentage of this amount) for an employee’s health insurance or paying a $2,000 fine, since de-stigmatized as a “tax,” won’t companies have an overwhelming economic incentive to drop health benefits altogether?  It would be far cheaper to pay the tax than to pay for health benefits.

Employees would then have to turn to the “insurance exchanges” to buy their own insurance, possibly with a government subsidy (shooting up the cost to taxpayers), though still with a large expenditure out of their own pockets.  Or they might just join the ranks of the uninsured, paying their own necessary fines or taxes.

Am I missing something, or might Obamacare have exactly the opposite effect that it intended?

 


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