The Moth Returns

I just can’t resist returning to health care — or The Affordable Health Care Act (AHCA/Obamacare) as that wonderful piece of legislation is known.  It’s such an oxymoron, I can’t resist.

I had my interest piqued the other day by a notice I received on AHCA — it was a notification from the Department of Health and Human Services on the development of standards for the Affordable Insurance Exchanges (45 CFR Parts 155 and 157 for you geeky types).  These are the state run exchanges which “will provide competitive marketplaces for individuals and small employers to directly compare available private health insurance options on the basis of price, quality, and other factors.”

I don’t know what I was thinking (or was I?), but I started reading the 35 pages of details in the Federal Register — and rapidly determined that the Exchanges (as they are known) are going to make Homeland Security seem like a micro agency.  The scope of detail which will be monitored and regulated by the Exchanges is very broad and will necessitate a very large bureaucracy.  The exchanges will be responsible to make sure that individuals have valid social security numbers; that they qualify for appropriate discounts (which means they’ll have to interface with the IRS and/or employers);  coordinate with Medicare/Medicaid/CHIP to ensure that the individuals don’t qualify for those plans — and these rules didn’t even mention how the Exchanges are going to work with insurance carriers to make sure that the coverage is “affordable.”

I’m amazed at how our government has determined that the “initial” cost of the exchanges will be expensive, but long term costs will be reduced because of the “use of efficient systems.”  Hmm.  Government and efficient systems — another oxymoron.  In my opinion, this solution is not going to be affordable — in the short-run or long-run.  But it sounds like a pretty creative way to reduce unemployment.

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