ObamaCare & more:

The Galen Institute: 

Obamacare: What is in it?  Open Doc

Healthcare Lawsuits
About HealthCareLawsuits.org
Across the country, Americans are fighting against the new health care law, the Patient Protection and Affordable Care Act (PPACA). On this site, you’ll find a list of the challenges that are currently moving through our court system, which you can click on to get more information. As of today, more than 30 cases have been filed challenging Obama’s health care reform, with 28 states as Plaintiffs.
About The Independent Women’s Forum:
Healthcarelawsuits.org is a project of the Independent Women’s Forum, which is a nonprofit group dedicated to promoting the principles of economic liberty, free markets, and personal responsibility. Learn more about the Independent Women’s Forum at www.iwf.org. To support our efforts to keep the public informed about the legal challenges to the health care law, please make a donation here.
Do you see any information our site is missing? Do you have any questions? Feel free to contact us at info@healthcarelawsuits.org


Obama Care Smells!
Obamacare organization chart prior to passage
Original Org chart

We peel, You cry.

Obamacare organization chart after passage
Latest Org chart

This is not an exhaustive list of the findings – there is just too much!
Readers are encouraged to forward tips and links of items you discover hidden within Obamacare.
Many of the horrors are to be found buried deep in the finances and the regulations of the
various new agencies and departments created by Obamacare. TYSK would like your
help in finding news articles on these subjects in particular. Contact TYSK here.

Note that there were many iterations of Obamacare as it passed from the House to the Senate
and back again before passage. Some of the items listed are not in the offical bill. However,
certainly the intent was present and are included here as they may reappear in the form of
additions to the bill, additional bills or, within various regulations never presented to either house for a vote!

Health Care Exchanges: Another Obamacare
High-Speed Train Wreck To Nowhere

Steven Hayward
Because of the mix of federal programs such as Medicaid and Medicare, and the various regulations pertaining to eligibility, guaranteed issue, and other features of Obamacare, the states are having a hard time figuring out how they are going to do it.  And time is running out.
HHS Sec. Sebelius says, ‘We Will Have Our Way’
Even if Supreme Court Strikes Down Obamacare Mandate

There are other ways to bring healthy people into the healthcare system if the Supreme Court strikes down the individual mandate in President Obama’s healthcare law, Health and Human Services Secretary Kathleen Sebelius said in an interview Monday. She’s confident the Supreme Court will uphold the mandate, but that there are alternatives if it doesn’t.
Barney Frank Joins Effort to Repeal Obamacare ‘death panels’
Frank, who announced Monday that he would retire at the end of his current term in office, became the 12th Democrat, and the 212th member of the House, to co-sponsor Tennessee Republican Rep. Phil Roe’s bill aimed at repealing the Independent Payment Advisory Board.
Obamacare Mandate Costs 100,000 Jobs in January
In an environment where jobs are hard to find, the Obama administration has thrown more than 100,000 health insurance agents and brokers under the bus and given them the gift of an unemployment line just before the holidays.
Socialized Medicine: Death Panels Alive and Well
Laura Donnelly and Alastair Jamieson
Elderly patients are being condemned to an early death by hospitals making secret use of “do not resuscitate” orders, an investigation has found. The orders – which record an advance decision that a patient’s life should not be saved if their heart stops – are routinely being applied without the knowledge of the patient or their relatives.
Another ObamaCare Glitch
Congress made a legal mistake while rushing through the health law.

Jonathan H. Adler and Michael F. Cannon
ObamaCare authorizes premium assistance in state-run exchanges (Section 1311) but not federal ones (Section 1321). In other words, states that refuse to create an exchange can block much of ObamaCare’s spending and practically force Congress to reopen the law for revisions.
Survey: Almost 10% of Employers May End Health Insurance,
Another 20% Unsure

Nearly one in 10 midsize or large employers expects to stop offering health coverage to workers once federal insurance exchanges start in 2014, according to a survey from a large benefits consultant.
Wisconsin: Insurance Market Analysis – Effect of Obamacare
The majority of individuals in the non-group (individual) and small group markets will pay more in premiums for health insurance by 2016 than they pay today. Prior to the application of tax credits, 87% of individuals in the non-group market will receive an average premium increase of 41%.
Fed Backed High-Risk Pool Burning Through Money Fast;
Former State Plan was Working Well for Patients in Trouble

The federally sanctioned high-risk insurance pool for Colorado is signing up fewer patients and burning through its limited cash faster than expected, as the plan attracts the sickest of the sick.
How Obamacare Is Holding Back Business
James Sherk
It’s a simple fact: healthy economic recovery depends on job creation. The challenge is empowering businesses to create those new jobs while they shoulder an increasing burden of health insurance regulation.
Governors Seek Waivers on Obamacare Costs
Washington Gov. Chris Gregoire (D) is hitting the road to win federal help for some major health care changes she and other governors are seeking. “It’s my role as head of the National Governors Association,” Gregoire said, “So on behalf of the governors, I’m going to be presenting some agreed-upon ideas where we seek flexibility from health and human services in administering the Medicaid program.”
A Twist In Obama’s Health Care Law
Millions of Middle Class will get Free Health Car
President Barack Obama’s health care law would let several million middle-class people get nearly free insurance meant for the poor, a twist government number crunchers say they discovered only after the complex bill was signed. Up to 3 million more people could qualify for Medicaid in 2014 as a result of the anomaly.
Obama Solicitor General: If You Don’t Like Obamacare Mandate,
Earn Less Money!

President Obama’s solicitor general, defending the national health care law on Wednesday, told a federal appeals court that Americans who didn’t like the individual mandate could always avoid it by choosing to earn less money.
Once Obamacare Starts
30% of Companies will Drop Current Coverage

While only 7% of employees will be forced to switch to subsidized-exchange programs, at least 30% of companies say they will “definitely or probably” stop offering employer-sponsored coverage, according to the study published in McKinsey Quarterly.
20% of New Obamacare Waivers are Gourmet Restaurants,
Nightclubs, Fancy Hotels in Nancy Pelosi’s District

Of the 204 new Obamacare waivers President Barack Obama’s administration approved in April, 38 are for fancy eateries, hip nightclubs and decadent hotels in House Minority Leader Nancy Pelosi’s Northern California district.
Report: Obamacare at Root of 8.5% Cost Increase for 2012
U.S. employers can expect an 8.5 percent increase in their medical costs next year due in some part to the healthcare reform law, the consulting firm PwC said in a report Wednesday. The widely read annual report on cost trends points to three main drivers of healthcare costs, two of which are exacerbated by the new law.
Obamacare ‘unworkable’ Says Mayo Clinic, 400 Others
President Barack Obama’s main idea for getting quality health care at less cost was in jeopardy Wednesday after key medical providers called his administration’s initial blueprint so complex it’s unworkable. 90% of umbrella group would not participate because the rules as written are so onerous it would be nearly impossible for them to succeed.
Over Half of All Obamacare Waivers Given to Union Members
In what is fast becoming a weekly event, the Obama administration granted 200 more companies aivers from the Democrats’ sweeping health care law in the Friday (13may2011) night news dump. That brings the number of companies receiving waivers to 1,372.
(You can get a full list of the companies exempted here.)
Obamacare Is ‘Platform’ for Creating Single-Payer System
Rep. John Conyers (D-Mich.), the ranking member of the House Judiciary Committee, told CNSNews.com today that the health-care law that President Barack Obama signed last March is a “platform” for building a single-payer health care system in the United States.
Top 10 Failures of ObamaCare After One Year
Emily Miller
President Obama signed the Patient Protection and Affordable Care Act into law on March 23, 2010.  In just the year since, the law known as ObamaCare has already severely crippled the nation’s economy and health care system.
And So Rationing Begins: ObamaCare vs. Breast Cancer Patients
The Avastin case is the rationing camel nose under America’s health care tent. Should the FDA successfully introduce cost into the drug approval process, the long-term implications will be enormous. It will not be breast cancer patients alone who will suffer. Avastin is first step on the slippery slope toward rationing. The FDA’s action is dangerous and cannot stand.
Law of Unintended Consequences Bites Obamacare
Stephen M. Bainbridge
This is the sort of thing that happens when you have a massive bill, which nobody has a chance to read and evaluate front to back before it is passed. Instead, you get small groups working on little pieces and if they miss something you get screwed.
Children Face Reduced Access to Coverage
Under Obamacare

While the Senate failed last week to pass a full repeal of Obamacare, the negative effects of the health care overhaul continue to build the case for scrapping it and starting over.
CBO Director Says Obamacare Would Cost 800,000 Jobs
Testifying today before the House Budget Committee, Congressional Budget Office (CBO) Director Doug Elmendorf confirmed that Obamacare is expected to reduce the number of jobs in the labor market by an estimated 800,000.
HHS Releases Obamacare Propaganda “Report”
Guy Benson
The Department of Health and Human Services says Obamacare is already a great success. Senate Republicans aren’t too convinced. They set out to fact check the administration’s claims, and gosh darned if they didn’t find loads of contravening evidence:
The Tawdry Details of Obamacare
Dr. Milton R. Wolf
If you would like to know what the White House really thinks of Obamacare, there’s an easy way. Ignore its promises. Forget its talking points. Instead, simply witness for yourself the outrageous way the White House protects its best friends from Obamacare.
Survey: Nation’s Frontline Physicians Unhappy With
Health Care Reform Measures

Key research findings include: 60% said health reform will compel them to close or significantly restrict their practices to certain categories of patients. Of these, 87% said they would be forced to close or significantly restrict their practices to Medicare patients.
Rep. Paul Ryan on why Obamacare CBO ‘scoring’ was Bogus
On the floor of the U.S. House Rep. Paul Ryan demonstrated how the Congressional Budget Office (CBO) was obligated to score Obamacare based on the false premise provided by the Democrats and the proof was that the CBO calculated that Obamacare would INCREASE our national debt.
Half of All States Now Suing to Stop Obamacare
While Obamacare is more of a long-term threat to fiscal health at the federal level, it is a  clear and present danger to the states. [It] amounts to billions in unfunded federal mandates for states to absorb.
Comprehensive List of Tax Hikes in Obamacare
Below is a comprehensive list of the two dozen new or higher taxes that pay for Obamacare’s expansion of government spending and interference between doctors and patients.
An Early Sign of Obamacare Failure
Health plans for high-risk patients attracting fewer, costing more than expected. An early feature of the new health-care law that allows people who are already sick to get insurance to cover their medical costs isn’t attracting as many customers as expected.
Obamacare Stops Construction at
45 Physician Owned Hospitals Nationwid

Rick Moran
Stopping construction at doctor-owned hospitals might not seem like the best way to boost the economy or to promote greater access and choice in health care, but that exactly what Obamacare is doing.
Obama Returns to End-of-Life Plan That Caused Stir
When a proposal to encourage end-of-life planning touched off a political storm over “death panels,” Democrats dropped it from legislation to overhaul the health care system. But the Obama administration will achieve the same goal by regulation, starting Jan. 1.
Email Reveals Attempt to Hide Obamacare Priviso
James Taranto
It’s partly a matter of form: It looks bad for the administration to impose by executive fiat a provision that the people’s representatives had expressly rejected, though of course the inevitable discovery of the effort to keep the secret only compounds that problem.
Are “Death Panels” Part of Health Care Reform?
Roger Stark, MD
The enlarged comparative effectiveness research agenvy CER will be established by 2013 and will decide what patients benefit most from what treatments. The next step will be to reimburse providers for using only approved treatments. CER, therefore, will become the mechanism for rationing health care in this country.
Consumer Risks Feared as
Health Law Spurs Mergers

Consumer advocates fear that the health care law could worsen some of the very problems it was meant to solve – by reducing competition, driving up costs and creating incentives for doctors and hospitals to stint on care, in order to retain their cost-saving bonuses.
Health Care Reform Blamed for 47% Premium Hike in Connecticut
“The rates that were filed and approved reflect the current cost to deliver care and the impact of more comprehensive benefit designs required under the federal healthcare reform law. If the attorney general wants to complain to someone, he should complain to Congress.” –Insurance Commissioner Thomas Sullivan
CBO Confirms: ObamaCare Discourages Work
Congressional Budget Office director Doug Elmendorf said Friday that ObamaCare includes work disincentives likely to shrink the amount of labor used in the economy. In a speech on ObamaCare’s economic impact outside the health care sector, Elmendorf said that those effects will primarily be related to the labor market and “will probably be small.”
Health Costs to $oar
Despite assurances from the Obama administration that the recently signed healthcare reform law would save Americans money, benefit professionals are seeing huge medical premium hikes and decreased benefits. Employers and ultimately taxpayers could get sticker shock as plans companies begin to renew their medical benefits packages for 2011.
Obamacare Claims Another Victim as
Principal Financial Quits Writing Health-Care Policies

Financial services provider Principal Financial Group  Inc. is exiting the health-insurance business in an early sign of expected consolidation as the impact of the health overhaul becomes clearer.
Obamacare Is Even Worse Than Critics Thought
Half a year removed from the unprecedented legislative chicanery and backroom dealing that characterized the bill’s passage, we know much more about the bill than we did then. A few of the revelations:
New Rules Make Medicare Advantage Plan Close Up Shop
Harvard Pilgrim Health Care has notified customers that it will drop its Medicare Advantage health insurance program at the end of the year, forcing 22,000 senior citizens in Massachusetts, New Hampshire, and Maine to seek alternative supplemental coverage.
The Era of Health Care Rationing Begins
Sally C. Pipes
Supporters of health reform said it would never happen. Maybe they got caught up in their own rhetoric. Maybe they just didn’t want to believe it was possible. But rationing in America has started. This week, the Food and Drug Administration is expected to revoke approval of the drug Avastin for the treatment of advanced breast cancer.
White House Health Savings Challenged

When a government report found that President Barack Obama’s health overhaul would modestly raise the nation’s total health care tab, the White House responded with a statistic suggesting costs would go down. It turns out that may be fuzzy math.
Doctors Limit New Medicare Patients
The number of doctors refusing new Medicare patients because of low government payment rates is setting a new high, just six months before millions of Baby Boomers begin enrolling in the government health care program.
$5 Billion Isn’t Enough!
Obamacare Risks Turning Away Sick

Healthcare experts of all stripes warned during the healthcare debate that $5 billion would likely not last until 2014. Republicans continued to hammer that point on Thursday, asking HHS officials to brief them about the program.
Obamacare will Kill Mini-Med Plans for Low Income Workers
Part of the health care overhaul due to kick in this September could strip more than 1 million people of their insurance coverage, violating a key goal of President Barack Obama’s reforms. Employer groups say the ban could essentially wipe out a niche insurance market that many part-time workers and retail and restaurant employees have come to rely on.
Obama: You Can Keep Your Health Plan
Fact: 51% of Companies’ Plans Won’t Measure Up

Internal WH documents reveal that 51% of employers may have to relinquish their current health care coverage by 2013 due to ObamaCare. That numbers soars to 66% for small-business employers. The documents are a joint project of the Labor Dept., HHS and the IRS.
“Little-Noticed” is the New “Unexpected”
What began as a single item turned into a catalog of horrors unnoticed (or, intentionally unrevealed) by the Democrat congress and the MSM that carries their water. Truly Peeling Back Obamacare big time! As Prof. William Jacobson writes:

Getting the facts on ObamacareYesterday I read an article in The NY Times about something unexpected in Obamacare,
and one term jumped out at me (emphasis mine):

About one-third of employers subject to major requirements of the new health care law may face tax penalties because they offer health insurance that could be considered unaffordable to some employees, a new study says…. It suggests that a little-noticed provision of the law could affect far more employers than Congress had assumed.
That term, “little-noticed,” sure sounded familiar. It seems that we hear that term a lot.
Obamacare real deficit $562 BillionFormer CBO Director Reveals the Real Arithmetic of Health Care Reform
If you strip out all the gimmicks and budgetary games and rework the calculus, a wholly different picture emerges: The health care reform legislation would raise, not lower, federal deficits, by $562 billion… The bottom line is that Congress would spend a lot more; steal funds from education, Social Security and long-term care to cover the gap; and promise that future Congresses will make up for it by taxing more and spending less.

As documented in another recent budget office analysis, the federal deficit is already expected to exceed at least $700 billion every year over the next decade, doubling the national debt to more than $20 trillion. By 2020, the federal deficit – the amount the government must borrow to meet its expenses – is projected to be $1.2 trillion, $900 billion of which represents interest on previous debt.

Nominee to Run Medicare: “romantic about” Socialized Medicine;
Applauds “leaders” Making Health Care Decisions

Dr. Donald Berwick, nominated by President Barack Obama to head the Centers for Medicare and Medicaid Services (CMS), the agency that runs Medicare, published an article in the British Medical Journal (BMJ), advising leaders of Britain’s socialized health care system: “Please don’t put your faith in market forces.”
Obamacare Skipped the ‘Doc Fix’ Due to Cost
Now Medicare Patients and Doctors are Uneasy

For the third time this year, Congress is scrambling to stave off a hefty pay cut to doctors treating Medicare patients – even as the Obama administration mails out a glossy brochure to reassure seniors the health care program is on solid ground.
Healthcare Law Tax Credits Encourage Small Businesses
To Stay Small, Not Hire

A study by the National Center for Policy Analysis shows that tax credits in the new healthcare law could negatively impact small-business hiring decisions. The new law provides a 50 percent tax credit to companies offering health coverage that have fewer than 10 workers who, on average, earn $25,000 a year.
WH: Rationing OK. It’ll be Transparent
In choosing Donald Berwick, the Obama administration is implicitly admitting that the health care law passed by the Democrats in March will lead to the rationing of health care, said Sen. Pat Roberts (R-Kan.) in a May 19 press release. “This is really a fascinating response. Instead of flat out denials of government rationing we have excuses,” Roberts said on the Senate floor.
Texas Doctors Opting Out of Medicare at Alarming Rate
Two years after a survey found nearly half of Texas doctors weren’t taking some new Medicare patients, new data shows 100 to 200 a year are now ending all involvement with the program. Before 2007, the number of doctors opting out averaged less than a handful a year.
Goodbye, Employer-Sponsored Insurance
John C. Goodman
Millions of American workers could discover that they no longer have employer-provided health insurance as ObamaCare is phased in. That’s because employers are quickly discovering that it may be cheaper to pay fines to the government than to insure workers.
ObamaCare’s Massive, Hidden Tax Change
Section 9006 of the health care bill – just a few lines buried in the 2,409-page document – mandates that beginning in 2012 all companies will have to issue 1099 tax forms not just to contract workers but to any individual or corporation from which they buy more than $600 in goods or services in a tax year.
Obamacare Threatens To Cram Already Overwhelmed ERs
A chief aim of the new healthcare law was to take the pressure off emergency rooms by mandating that people either have insurance coverage. The idea was that if people have insurance, they will go to a doctor rather than putting off care until they faced an emergency.
AT&T Power Point SlideCan Obamacare Survive?
A TYSK Newsletter reprint
Bottom line, not a single member of Congress that voted for Obamacare should be allowed to remain in office. We warned everyone that failure to read, understand and fully discuss this massive overtaking of 1/6th of our economy and perhaps the most important issue affecting all of our personal lives would lead to dramatic and disastrous consequences.

Only by replacing enough of these congresscritters that a presidential veto can be overridden, can we repeal Obamacare and start anew with a sane and thoughtful plan for fixing the problems with health care costs without ruining the best health care system in the world.

CBO: Medicare Payment ‘Doc Fix’
Is More Expensive Than Expected

The Congressional Budget Office said that just freezing current Medicare payment rates to doctors would likely cost nearly $276 billion through 2020, a 33 percent increase from legislation that would “accomplish that goal introduced late last year by Sen. Debbie Stabenow, D-Mich., estimated to cost $207 billion at the time” according to CongressDaily.
ObamaCare Fraud Already Underway
Scam Artists Using ObamaCare To Prey On Victims

The new federal health-care law, or “ObamaCare,” claiming to eventually provide coverage to more than 30 million uninsured Americans, is already being used by scam artists to prey on those in need of care, state Insurance Commissioner Joel Ario said Monday.
Obamacare’s Danger Signs
Grace-Marie Turner
Not one of its major programs has gotten started, and already the wheels are starting to come off of Obamacare. The administration’s own actuary reported on Thursday that millions of people could lose their health insurance, that health-care costs will rise faster than they would have if the law hadn’t passed…
Why Waxman Canceled the Health Care Write-Down Hearings
Peter Suderman
[A] new report from committee Republicans reveals the documents Waxman obtained included embarrassing evidence that the health-care law could drive up insurance premiums and force employers to dump employees from their health plans.
Sebelius: We don’t know what ObamaCare costs will be
On Wednesday [4/21/2010], Kathleen Sebelius appeared before the House Appropriations Committee to discuss the appropriations for high-risk pool subsidies that ObamaCare provides to the states. The bill appropriated $5 billion for this program, but as Sebelius tells the committee, that was just a spit-balling number.
We Told You So!
It’s Official – CMS Says Higher Health Care Costs

Yesterday [4/22/2010], the actuaries at the Centers for Medicare and Medicaid Services (CMS), the agency that runs the giant entitlement programs, released their analysis of the new health care law.
Healthcare Law to Sock Middle Class
With a $3.9 Billion Tax Increase in 2019

Taxpayers earning less than $200,000 a year will pay roughly $3.9 billion more in taxes – in 2019 alone – due to healthcare reform, according to the Joint Committee on Taxation, Congress’s official scorekeeper.
Nearly 4M People Could Pay Without Health Coverage
Nearly 4 million Americans – the vast majority of them middle class – will have to pay a penalty if they don’t get insurance when President Barack Obama’s health care overhaul law kicks in, according to congressional estimates released Thursday.
Baffled by Health Plan? So Are Some Lawmakers
The confusion raises the inevitable question: If they did not know exactly what they were doing to themselves, did lawmakers who wrote and passed the bill fully grasp the details of how it would influence the lives of other Americans?
Feinstein: Loophole in Health Care Reform
Leads to Double-Digit Premium Increases

Connie Hair
Less than one month after passage of the nearly 3,000-page Obamacare bill the President then signed into law, dire consequences – intended or otherwise – continue to surface.
The Impact of National Health Care Reform on Washington State
Dr. Roger Stark, Health Care Policy Analyst
The Seattle area has growing industries in biotech and medical device manufacturing. The Senate bill would add a 10% to 20% tax on these businesses. The cost would either be passed on to consumers or, more likely, would cause a reduction in medical research and development.
By Pulling His Punches,
Bernanke Shatters ObamaCare’s Credibility

Michael F. Cannon
Federal Reserve Chairman Ben Bernanke gave a speech in Dallas yesterday where he inadvertently discredited claims that ObamaCare would reduce health care costs and the federal deficit.
Amish, Muslims to be Excused From Obamacare Mandate?
The Senate health care bill just signed contains some exemptions to the “pay-or-play” mandate requiring purchase of Obamacare-approved health insurance or payment of a penalty fine. As Fox News has pointed out, for instance, the Amish are excused from the mandate. Apparently, this exemption will apply similarly to believers in Islam.
Shades of Obamacare?
Bay State, Insurers Up The Ante Over Health Rates

People seeking to buy health insurance for the first time, or existing customers looking to change policies, found themselves out of luck, at least temporarily, in the aftermath of last week’s decision by the state Division of Insurance to reject 235 of 274 premium increases proposed by insurers for what is known as the small group market.
IRS Says It Needs More ‘Resources’ to
Implement Tax Provisions of New Law

Republicans on the House Ways and Means Committee warn that as many as 16,500 new IRS auditors and investigators – or 17 percent of the agency’s current work force – could be needed to administer and enforce new health insurance rules under the law.
Medicare Benefit Reductions Hurting Elderly Heart Patients
A. Allen Seals
On Jan. 1, the Center for Medicare and Medicaid Services (CMS), under the direction of HHS Sec. Kathleen Sebelius, unilaterally cut Medicare benefits by a draconian 40 percent to 60 percent, for cardiac services!
How Obamacare Hits Industry and Threatens Jobs
Byron York
The people at Zoll Medical Corp. saw a ray of hope in January when Scott Brown was elected senator from Massachusetts. Located in Chelmsford, 30 miles outside of Boston, Zoll is the nation’s leading manufacturer of heart defibrillators, which save the lives of thousands of heart-attack victims each year.
Houston Increases Insurance Premiums of City Retirees 50%
Working to close a looming $100 million budget shortfall projected for next year, Mayor Annise Parker has sharply increased the monthly insurance premiums that thousands of retired city of Houston employees must pay, prompting outrage from retirees.
Does Medicare Care?
Investor’s Business Daily
Throughout the health care debate, insurance companies have been cast as greedy villains that gleefully deny medical claims. But when it comes to rejecting claims, they can’t hold a candle to the government.
2008 National Health Insurer Report Card
The purpose of the AMA’s National Health Insurer Report Card (NHIRC) is to provide physicians and the general public a reliable and defensible source of critical metrics concerning the timeliness, transparency and accuracy of claims processing by the health insurance companies that are responsible for paying these claims. [16-page PDF]
AP: Health Overhaul Likely To Strain Doctor Shortage
Better beat the crowd and find a doctor. Primary care physicians already are in short supply in parts of the country, and the landmark health overhaul that will bring them millions more newly insured patients in the next few years promises extra strain.
The Dems Bring the Pain
CATO Inst. – Michael D. Tanner
Even by the president’s circumscribed accounting, this bill will increase government spending by roughly $1 trillion over the next 10 years. But that estimate obscures the real cost behind a smokescreen of accounting gimmicks. Estimates of the bill’s real cost over 10 years of actual operation run as high as $3.5 trillion.
Caterpillar: Health Care Bill Would Cost It $100M
In a letter Thursday to House Speaker Nancy Pelosi (D-Calif.) and House Republican Leader John Boehner of Ohio, Caterpillar urged lawmakers to vote against the plan “because of the substantial cost burdens it would place on our shareholders, employees and retirees.”
Arizona Faces Initial $3.8B Medicaid Cost Hike
Arizona must drop a plan to cut its Medicaid program’s generous eligibility and instead pay an additional $3.8 billion over the next three years under the federal health care overhaul, state officials reported Thursday.
Doctors Going Galt: Health Reform May Lead to
Significant Reduction in Physician Workforce

What if nearly half of all physicians in America stopped practicing medicine? While a sudden loss of half of the nations physicians seems unlikely, a very dramatic decrease in the physician workforce could become a reality as an unexpected side effect of health reform.
Wash. State Losing Pharmacies Willing to Fill Medicaid RXs
Effective April 16, Walgreens drugstores across the state won’t take any new Medicaid patients, saying that filling their prescriptions is a money-losing proposition – the latest development in an ongoing dispute over Medicaid reimbursement.
The Truth About the Left’s Health Care Paradise
Liberals pushing for free health care often site Fidel Castro’s fiefdom as evidence of how to do it right. Problem is, foreign leaders, celebrities, patients and media are shown only the good stuff that is maintained for PR purposes and for the Cuban elite.
WARNING: Disturbing photos
Obamacare Expands IRS Authority,
may cause greater tax non-compliance

J.P. Freire
Under the proposed health care legislation, they would get another assignment: checking to see whether Americans have health insurance. The House and Senate bills require most Americans to have health insurance and to prove it on their annual federal tax return. Those who don’t would pay a penalty to the IRS.
Change: Mayo Clinic to Stop Treating Some Medicare Patients
The Mayo Clinic, praised by President Barack Obama as a national model for efficient health care, will stop accepting Medicare patients as of tomorrow at one of its primary-care clinics in Arizona, saying the U.S. government pays too little. More than 3,000 patients eligible for Medicare will be forced to pay cash if they want to continue seeing their doctors at a Mayo family clinic in Glendale.
Trial Lawyers Win Added Clout from Democrats in Health Bill
Investor’s Business Daily
The Senate health care bill includes a gift to trial lawyers: a five-year, $50 million program to encourage states to consult with them on “alternatives” to malpractice claims. Though presented as a reform, critics say the program will simply encourage states to create an additional option for lawyers and plaintiffs to pursue claims, without requiring them to give up anything in return.
CBO: Real 10-Year Cost of Senate Bill Still $2.5 Trillion
Jeffrey H. Anderson
With Obamacare, you get the good, the bad, and the ugly – except for the first part. The Congressional Budget Office’s score is in for the final Senate health bill, and it’s amazing how little Americans would get for so much. The Democrats are irresponsibly and disingenuously claiming that the bill would cost $871 billion over 10 years. But that’s not what the CBO says.
Critical Health Cuts Underway NOW
American College of Cardiologists Warns of Dire Consequences

The Centers for Medicare and Medicaid Services (CMS) on Oct. 30 released its 2010 Medicare Physician Fee Schedule final rule, which includes policy proposals that significantly reduce payments for cardiovascular-related services.
Criminalizing Health-Care Freedom;
Severe Penalties are Tucked into the I.R.S. Code

Walsh & von Spakovsky
The Congressional Budget Office stated on October 29 that the House bill would generate $167 billion in revenue from “penalty payments.” Individual Americans are expected to pay $33 billion of these penalties, with employers paying the rest.
La Raza President Wants Health Care Reform for ‘Everyone,’
Including Illegal Aliens

National Council of La Raza President Janet Murguia said that health care reform should include “everyone,” and this means illegal immigrants as well because with more people paying into the system it might lower the costs of health care.
Pelosi Health Care Bill Blows a Kiss to Trial Lawyers
The health care bill recently unveiled by Speaker Nancy Pelosi is over 1,900 pages for a reason. It is much easier to dispense goodies to favored interest groups if they are surrounded by a lot of legislative legalese. For example, check out this juicy morsel to the trial lawyers (page 1431-1433 of the bill):
Democrats Turn Back ID requirement
for Immigrant Healthcare Benefits

Along a party-line vote, Senate Finance Committee Democrats rejected a proposed a requirement that immigrants prove their identity with photo identification when signing up for federal healthcare programs.


Overview:H.R.3590- Patient Protection and Affordable Care Act

For Review
: The Healthcare Compact

Commerce Clause

The Commerce Clause is an enumerated power listed in the United States Constitution (Article I, Section 8, Clause 3). The clause states that the United States Congress shall have power “To regulate Commerce with foreign Nations, and among the several States, and with the Indian Tribes”. Courts and commentators have tended to discuss each of these three areas of commerce as a separate power granted to Congress. It is common to see the Commerce Clause referred to as “the Foreign Commerce Clause”, “the Interstate Commerce Clause”, and “the Indian Commerce Clause”, each of which refers to a different application of the same sentence in the Constitution.
Dispute exists as to the range of powers granted to Congress by the Commerce Clause. As noted below, the clause is often paired with the Necessary and Proper Clause, the combination used to take a broad, expansive perspective of these powers. Many strict constructionists deny that this is the proper application of the Commerce Clause because it refers specifically to “the foregoing Powers”.

For added info: go to ‘Resources’, Web Links by Category, Healthcare & Healthcare Compact!


ALEC’s Freedom of Choice in Health Care Act
How Your State Can Protect Patients’ Rights
Press Release: ALEC Applauds Missouri Passage of Health Care Act

In December 2008, ALEC’s Freedom of Choice in Health Care Act became model legislation. The model language mirrors Arizona Proposition 101, which was narrowly defeated in 2008.

ALEC’s Freedom of Choice in Health Care Act protects the rights of patients to pay directly for medical services, and it prohibits penalties levied on patients for declining participation in a particular health plan.

The Freedom of Choice in Health Care Act, which was the subject of a front-page New York Times article, has already been filed or prefiled in 38 states—Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Michigan, Minnesota, Mississippi, Missouri, Nebraska, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Virginia, Washington, West Virginia, Wisconsin, and Wyoming. Lawmakers in an additional three states—Montana, Texas, and Utah—have publicly announced their intentions to file the legislation.

STATUTORY MEASURES ENACTED: Virginia, Idaho, Arizona, Georgia, Missouri, Louisiana



Heritage Foundation
Health Care Exchanges: Obamacare Isn’t the Answer
Published on April 4, 2011 FACTSHEET #84

Conservative, Market-Based State Exchanges:
*Defined-Contribution Model v. Government Model: A conservative, market-based exchange is an administrative mechanism for enabling businesses to offer workers a way to choose and own their health insurance while still benefiting from the current tax breaks for employer-sponsored coverage. In sharp contrast, an Obamacare exchange is intended to be a bureaucratic tool for the federal government to subsidize, standardize, and micromanage health insurance coverage.
*Separate and Independent from Obamacare: States shouldn’t try to “shoehorn” a conservative, market-based exchange into the Obamacare architecture; it isn’t a viable strategy either practically or politically. States should instead advance separate conservative, patient-centered, market-based health care reforms that offer Americans concrete examples of a positive, alternative vision to Obamacare and reinforce congressional efforts to repeal it.

Benefits of a Conservative Exchange:
*Provides More Health Plan Options for Workers: Today, workers get the plans their employers select for them. Under a defined-contribution exchange, workers would instead be able to choose from a wide and varied menu of competing plans and plan designs based on their own needs and preferences.
*Expands Employer Options: Today, employers either offer coverage, sometimes at great cost and time, or they offer nothing. A defined-contribution exchange option offers an easier and less costly way for employers to offer coverage to their workers. It also enables employers, particularly small ones, who don’t offer traditional group coverage a way to contribute to their workers’ plans, even for part-time employees.
*Achieves Portability: Today, workers who leave their employers also leave behind their health plans. Under a defined-contribution exchange, when a worker leaves his job, he can keep his plan. Moreover, if he doesn’t like his current plan, he can pick a different one at the next “open season.”
*Creates New Incentives for Insurers and Providers to Compete: Today, insurers are accountable to the employer, the owner of the health plan. Under a defined contribution exchange, individuals are the owners, so insurers and providers would be more likely to collaborate to develop plans that offer better value at lower prices to patients.
*Creates a Pathway to Convert Public Programs into Private Coverage: The defined-contribution exchange model can also be used by states to reprogram Medicaid and CHIP funding to “mainstream” beneficiaries into better quality private coverage.

Don’t Give Up—Take a Leadership Role
*Forge Ahead with State Health Reforms: States must take a leadership role in advancing conservative, market-based health care reforms that expand choice and competition; put countervailing pressure on federal officials; and create an alternative, “non-qualified” health care market if Congress fails to repeal Obamacare before 2014.
*Consider a “Defensive” Exchange to Preserve State Authority: In addition to pursuing their own reforms independent and separate from Obamacare, states will also need to decide whether it is in their best interests to create a limited, “defensive” exchange designed to minimize federal interference, preserve state authority to regulate insurance, and maintain state control over Medicaid eligibility until Obamacare is eventually repealed.
*Beware of Federal Money: As Utah has shown, creating a conservative, market-based exchange doesn’t require significant expenditures. Therefore, states should use only their own funds when setting up market-based exchanges that are independent of Obamacare. Separately, if a state decides to authorize a limited, “defensive” exchange—so as to preempt Washington from establishing a federal Obamacare exchange in the state—state lawmakers should take care to ensure that such a defensive exchange does not accept any federal funding that directly or indirectly obligates the state to abide by federal requirements.

What Most Needs Repealing and Replacing
Filed in Health Alerts on January 17, 2011 with 41 comments


Tomorrow night the House of Representatives will debate the repeal of the Patient Protection and Affordable Care Act (ACA), what many call “ObamaCare.” Some critics complain that this is a futile exercise because there is little chance of short-term success. But that’s the wrong way to look at it.

At the time of its passage, most members of Congress had no idea what was in the ACA. Nancy Pelosi was more correct than she realized when she said, “We have to pass it to see what’s in it.” Even now, we don’t know half of “what’s in it,” but we know enough to have an intelligent debate. Ideally, tomorrow night’s proceedings will be educational — in a way that the debate last spring was not.

In anticipation of the event, representatives from the National Center for Policy Analysis, the Heritage Foundation, the American Enterprise Institute, the Cato Institute and the American Action Forum will conduct a briefing on Capitol Hill tomorrow at noon. Our goal: to discuss ten structural flaws in the Affordable Care Act. We believe each of these is so potentially damaging, Congress will have to resort to major corrective action even if the critics of the ACA are not involved. Further, each must be addressed in any new attempt to create workable health care reform.

1. An Impossible Mandate

Problem: The ACA requires individuals to buy a health insurance plan whose cost will grow at twice the rate of growth of their incomes. Not only will health care claim more and more of every family’s disposable income, the act takes away many of the tools the private sector now uses to control costs.

Solution: 1) Repeal the individual and employer mandates, 2) offer a generous tax subsidy to people to obtain insurance, but 3) allow them the freedom and flexibility to adjust their benefits and cost-sharing in order to control costs.

2. A Bizarre System of Subsidies

Problem: The ACA offers radically different subsidies to people at the same income level, depending on where they obtain their health insurance — at work, through an exchange or through Medicaid. The subsidies (and the accompanying mandates) will cause millions of employees to lose their employer plans and may cause them to lose their jobs as well. At a minimum, these subsidies will cause a huge, uneconomical restructuring of American industry.

Solution: Offer people the same tax relief for health insurance, regardless of where it is obtained or purchased — preferably in the form of a lump-sum, refundable tax credit.

3. Perverse Incentives for Insurers

Problem: The ACA creates perverse incentives for insurers and employers (worse than under the current system) to attract the healthy and avoid the sick, and to overprovide to the healthy (to encourage them to stay) and underprovide to the sick (to encourage them to leave).

Solution: Instead of requiring insurers to ignore the fact that some people are sicker and more costly to insure than others, adopt a system that compensates them for the higher expected costs — ideally making a high-cost enrollee just as attractive to an insurer as low-cost enrollee.

4. Perverse Incentives for Individuals

Problem: The ACA allows individuals to remain uninsured while they are healthy (paying a small fine or no fine at all) and to enroll in a health plan after they get sick (paying the same premium everyone else is paying). No insurance pool can survive the gaming of the system that is likely to ensue.

Solution: People who remain continuously insured should not be penalized if they have to change insurers; but people who are willfully uninsured should not be able to completely free ride on others by gaming the system.

5. Impossible Expectations/A Tattered Safety Net

Problem: The ACA aims to insure as many as 34 million uninsured people. Economic studies suggest they will try to double their consumption of medical care. Yet the act creates not one new doctor, nurse or paramedical personnel. We can expect as many as 900,000 additional emergency room visits every year — mainly by new enrollees in Medicaid — and 23 million are expected to remain uninsured. Yet, as was the case in Massachusetts, not only is there no mechanism to ensure that funding will be there for safety net institutions that will shoulder the biggest burdens, their “disproportionate share” funds are slated to be cut.

Solution: 1) Liberate the supply side of the market by allowing nurses, paramedics and pharmacists to deliver care they are competent to deliver; 2) allow Medicare and Medicaid to cover walk-in clinics at shopping malls and other unconventional care — paying market prices; 3) free doctors to provide lower-cost, higher-quality services in the manner described below; and 4) redirect unclaimed health insurance tax credits (for people who elect to remain uninsured) to the safety net institutions in the areas where they live — to provide a source of funds in case they cannot pay their own medical bills.

6. Impossible Benefit Cuts for Seniors

Problem: The ACA’s cuts in Medicare are draconian. By 2017, seniors in such cities as Dallas, Houston and San Antonio will lose one-third of their benefits. By 2020, Medicare nationwide will pay doctors and hospitals less than what Medicaid pays. Seniors will be lined up behind Medicaid patients at community health centers and safety net hospitals unless this is changed. Either 1) these cuts were never a serious way to fund the ACA, because Congress will cave and restore them, or 2) the elderly and the disabled will be in a separate (and inferior) health care system.

Solution: Many of the cuts to Medicare will have to be restored. However, Medicare cost increases can be slowed by empowering patients and doctors to find efficiencies and eliminate waste in the manner described below.

7. Impossible Burden for the States

Problem: Even as the ACA requires people to obtain insurance and fines them if they do not, the states will receive no additional help if the estimated 10 million currently Medicaid-eligible people decide to enroll. Although there is substantial help for the newly eligible enrollees, the states will still face a multibillion dollar, unfunded liability the states cannot afford.

Solution: States need the opportunity and flexibility to manage their own health programs — without federal interference. Ideally, they should receive a block grant with each state’s proportion determined by its percent of the nation’s poverty population.

8. Lack of Portability

Problem: The single biggest health insurance problem for most Americans is the lack of portability. If history is a guide, 80% of the 78 million baby boomers will retire before they become eligible for Medicare. Two-thirds of them have no promise of postretirement health care from an employer. If they have above-average incomes, they will receive little or no tax relief when they try to purchase insurance in the newly created health insurance exchange. To make matters worse, the ACA appears to encourage employers to drop the postretirement health plans that are now in place.

Solution: 1) Allow employers to do something they are now barred from doing: purchase personally-owned, portable health insurance for their employees. Such insurance should travel with the individual — from job to job and in and out of the labor market; 2) Give retirees the same tax relief now available only to employees; and 3) Allow employers and employees to save for postretirement care in tax-free accounts.

9. Over-Regulated Patients

Problem: The ACA forces people to spend their premium dollars on first-dollar coverage for a long list of diagnostic tests. Yet if everyone in America takes advantage of all of the free preventative care the ACA promises, family doctors will be spending all their time delivering care to basically healthy people — with no time to do anything else. At the same time, the ACA encourages the healthy to over consume care, it leaves chronic patients trapped in a third-party payment system that is fragmented, uncoordinated, wasteful and designed for everyone other than the patient.

Solution: 1) Instead of dictating deductibles and copayments, give patients greater freedom to save for their own small dollar expenses in health savings accounts, which they own and control; and let them make their own consumption decisions. 2) Allow the chronically ill access to special health accounts, following the example of Medicaid’s highly successful Cash and Counseling program, which allows home-bound, low-income disabled patients to control their own budgets and hire and fire those who provide them with services.

10. Over-Regulated Doctors

Problem: The people in the best position to find ways to reduce costs and increase quality are the nation’s 778,000 doctors. Yet today they are trapped in a payment system virtually dictated by Medicare. The ACA promises to make this problem worse by encouraging even more unhealthy government intervention into the practice of medicine.

Solution: Providers should be free to repackage and reprice their services under Medicare. As long as their proposals reduce costs and raise quality, Medicare should encourage resourceful, innovative attempts to create a better health care system.


How the States Can Carry the Torch to Repeal Obamacare
Posted January 21st, 2011 at 5:00pm in Health Care 0 Print This Post

Last night, the House of Representatives passed H.R. 2, which would scrap Obamacare in its entirety. Regardless of whether this legislation makes it to the President’s desk, supporters of a new direction for health care reform have reason to be encouraged: Implementation of Obamacare faces an uphill battle in the states as well.

So far, 27 states have filed suit against the new law’s individual mandate and requirements forbidding states from reducing eligibility for their Medicaid programs. But the legal battle isn’t the only way states can throw a wrench in the health care overhaul. This week, the American Legislative Exchange Council (ALEC) debuts “The State Legislators Guide to Repealing Obamacare” highlighting ways in which states can continue the battle.

States face some of the most detrimental effects of the new health law. Obamacare significantly expands eligibility for Medicaid, and though the federal government will foot the bill in the first years of its enactment, in the end states still will be left picking up a portion of the cost.

This, however, doesn’t include administrative costs of expanding the program; nor does it consider the “woodwork effect.” According to ALEC, one out of every four uninsured Americans currently qualifies for Medicaid but is not enrolled. As these eligible individuals participate as a result of the new law’s requirement to carry coverage or pay a penalty, state costs will grow, but the federal government will not provide the enhanced matching rate.

States will also experience other negative economic effects of Obamacare. New penalties will threaten job creation, and states where life sciences industries employ a significant portion of the workforce may see jobs go overseas as a result of new taxes on drug and medical device manufacturers. Finally, Obamacare marks a federal overreach into insurance regulation, which has hitherto been overseen by the states.

ALEC provides strategies for state legislators to stop Obamacare, beginning with refusing to create the foundation required for the new law to take shape. ALEC’s Freedom of Choice in Health Care Act, which has been introduced or announced in 42 states, “prohibits any person, employer, or healthcare provider from being compelled to purchase or provide health insurance; protects the right of a person or employer to pay directly for lawful healthcare services; protects the right of a health care provider to accept direct payment for lawful healthcare services, and protects the existence of a private health insurance market.” States can also apply for waivers for certain insurance provisions, reject federal grants for implementation, and let Washington enforce federally created “consumer protections.”

Finally, state legislators should engage in careful oversight of the new law, commissioning outside reports on the effects of Obamacare at the state level. State lawmakers should hold hearings to highlight the unintended consequences of the new law, such as incentives for states to drop their Medicaid programs or businesses to drop employer-sponsored coverage. Drawing public attention to the negative effects of Obamacare will build the case for repeal.

Under Obamacare, states will be charged with enacting several provisions of the law without the flexibility to tailor changes to the unique demands of their residents. States can use this opportunity to fight for repeal and to empower state legislators to pursue the health care reform that best suits their needs.

Tags: individual mandate, medicaid, Obamacare, states

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