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Unhappy New Year: Obamacare's Road Ahead in 2015

New Year, same trend. In spite of supporters' insistent assertions to the contrary, Obamacare is not working well for most Americans.  The law is unpopular, is hurting far more people than it's helping, and routinely confirms that the "Affordable" Care Act was a terrible misnomer.  Late in 2014, we learned that the administration's (dubious and flawed) enrollment figures had been deliberately goosed, that the government drastically pared back its updated enrollment projections, and that consumers should expect that many patients enrolled in Medicaid -- an empirically failing, recklessly expanded program -- will soon be forced to grapple with a fresh bout of access shock due to impending reimbursement cuts.  Now that the calendar has flipped to 2015, key elements of the program's website are still under construction, and Obamacare consumers have more treats to look forward to, including "ballooning" deductibles for the middle class.  USA Today reports:

Patients with job-based plans, he says, will say: " 'My deductible is so high. I'm trying to come to the doctor as little as possible. … What is the minimum I can get done?' They're really worried about cost." It's a deep and common concern across the USA, where employer plans cover 60% of working-age Americans, or about 150 million people. Coverage long considered the gold standard of health insurance now often requires workers to pay so much out-of-pocket that many feel they must skip doctor visits, put off medical procedures, avoid filling prescriptions and ration pills — much as the uninsured have done...A recent Commonwealth Fund survey found that four in 10 working-age adults skipped some kind of care because of the cost, and other surveys have found much the same. The portion of workers with annual deductibles — what consumers must pay before insurance kicks in — rose from 55% eight years ago to 80% today, according to research by the Kaiser Family Foundation.

Just so we're clear, this data is drawn from Americans still on their employer-based plans -- not those enrolled through Obamacare's exchanges, whose deductibles are substantially higher.  Deductibles are mandatory minimum costs consumers must pay before their coverage (into which they pay with monthly premiums) kicks in.  Those premium payments continue to rise, by the way.  Obamacare defenders say that rate increases are lower than expected, an argument that fails on two levels:  First, Americans 
were promised sharply reduced premiums.  Second, some experts are warning that monthly costs are likely to to accelerate faster in a few years, after the law's artificial price control provisions ("the three R's") sunset.  Couple consumers' bloating deductible payments with rising rates, and it becomes clear that for all of his revisionism and smugness, Obamacare architect Jonathan Gruber was right.  Cost containment was never a genuine goal of the "Affordable" Care Act; Democrats only emphasized it as a means of placating the masses.  Meanwhile, other wonks have been predicting that a messy tax season, replete with many unhappy surprises, awaits many Obamacare consumers.  As Kevin noted last night, the government screweth up, and the tax man cometh:

As many as 3.4 million people who received Obamacare subsidies may owe refunds to the federal government, according to an estimate by a tax preparation firm. H&R Block is estimating that as many as half of the 6.8 million people who received insurance premium subsidies under the Affordable Care Act benefited from subsidies that were too large, the Wall Street Journal reported Thursday. “The ACA is going to result in more confusion for existing clients, and many taxpayers may well be very disappointed by getting less money and possibly even owing money," the president of a tax preparation and education school told the Journal..."Eighty-five percent of our customers get a refund," said Kathy Pickering, who directs the H&R Block Tax Institute, according to the Washington Post. "That refund could be offset by the penalty. And if that happens, they're going to be understandably angry."

Another line in this Washington Examiner story is worth highlighting, too: "The fine for not having insurance in the second year of Obamacare is $325 or 2 percent of taxable income, whichever is greater."  The individual mandate tax is growing, as several major mandates kick into effect following political delays -- even as loopholes and postponements remain.  And we'd be remiss to write a post on Obamacare's new year without mentioning the legal cloud hanging over the law, threatening to plunge it into total chaos.  If the Supreme Court rules that consumers living in the majority of states that declined to set up their own exchanges are ineligible to receive federal subsidies -- which is what the law explicitly states in its text, and Jon Gruber repeatedly affirmed -- it will result in a political earthquake.  Contra Kathleen Sebelius, "rebranding" (or "re-education," as she once put it) won't save Obamacare.  Perhaps she and the administration may have been wise to listen more carefully to Chuck Schumer.

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