Everyone Wants Another Serving of the ACA

Looks like the nation's local and state governments did not get the message---"No one is supposed to jeopardize the success of the ACA before this fall's upcoming elections by trying to sneak extra people on the private plans." And no, I am not talking about crafty red state urban county hospital districts, like Grady in Atlanta or Parkland in Dallas that might be tempted to pay the premiums so that their sickest uninsured patients are suddenly insured with silver policies that they ordinarily would not be able to afford. No, this time, it's savvy, cost conscious politicians in blue states.

http://www.mercurynews.com/health/ci_26013042/stanford-study-moving-some-public-workers-obamacare-could

Shifting hundreds of thousands of state and local government workers to less expensive coverage under the new health care law would save California about $1.4 billion a year, according to a study released this month by a group of Stanford University academics.

Taxpayers could save almost $12 billion a year nationwide if two segments of America's public employee sector -- retirees under 65 and low-income government workers -- were moved to coverage under the Affordable Care Act, the study found.

In California, it's just talk. But...

The concept is already being tested in Chicago. Last month, Mayor Rahm Emanuel, Obama's former chief of staff, alerted more than 30,000 retired city workers that he plans to move their health insurance plans to Obamacare. Unions are fighting back.

http://articles.chicagotribune.com/2013-05-15/news/chi-emanuel-to-shift-retired-city-workers-to-obamacare-20130515_1_retired-city-workers-health-care-health-insurance

Now, retired government workers are not the best risk for private insurers. They tend to be older. They tend to have health issues---in some cases, because of their age. In other cases, health issues may be the very reason they retired. Typically, privates will write a policy for retirees because they also get to write a policy for the healthy, low risk active workers. But, in this case, the government gets to unbundle the two. They can dump their expensive high risk retirees on the ACA---and get a better deal on their low risk current employees. Great way to cut taxes and make yourself a local hero and win re-election.

Good thing Obama stepped up to the plate and declared that no private plan participating in the ACA would have to risk a financial loss---presumably because of stuff like the above that the authors of the law could not have anticipated five years ago, anymore than they anticipated Citizens United.

http://www.oleantimesherald.com/commentary/article_96a57968-ecc4-11e3-b436-001a4bcf887a.html?mode=print

We are now witnessing one of the weaknesses of the law as written. In the U.S., it is "Everyman for himself" when it comes to federal pork, and ACA's federal insurance subsidies are no exception. What cashed strapped government would not be tempted to balance its budget on the back of the program that was intended to provide health care for the uninsured? It's better than the alternative, right? No one wants to see Chicago---or California--go bankrupt---under the burden of keeping their part of contracts that they made with their retired workers.

Seriously, I can not believe that sane people thought that the same local and state government official who fight like rabid wolverines over funds for bridges to nowhere would miss the chance to grab more than their fair share of ACA funding. Shows why we need a functional House with a Dem majority so that we can do a little repair work on the law.

Single payer is sounding better all the time. Pretty soon, the private plans that have signed up to take part in the ACA are going to see the writing on the wall, and they may be the next voice demanding a great big single payer system---one that they administer for a "fee". It beats being saddled with all the high risk members, while employers and government officials hand out lucrative low risk contracts to certain preferred insurers--or, worse, yet, self insure. It could happen. I wouldn't shed any tears for United Health, Cigna or Blue Cross---but I would for sicker than average members they serve, because the private insurers are not in this to do good deeds. They need to post a profit. And the profit incentive that got them at the table on the ACA is being yanked out from under them by folks that have more political clout than they do---the people in charge of our country's wealthiest cities and states.

You don't think the state of California has political clout? Put California and the Koch Brothers in a ring. I'll give you any odds on California by a KO in the first round. There is a reason the Kochs decided to buy Wisconsin. They can't afford California.

There really is only one solution to this madness, and it is called Single Payer. It works in France. It works in Canada. It can work here if we just give it a chance.