Tuesday, November 26, 2013
Monday, November 25, 2013
Friday, November 15, 2013
What if we bought individual health insurance through our tax preparers? At first, the idea seems bizarre, but give me a minute to explain.
Given the well-known problems of HealthCare.gov and many of the state health exchanges, people seeking insurance coverage need a better way to buy. And commercial alternatives to government sites seem an obvious portal to Affordable Care Act coverage.
You can buy directly through insurance company websites, but the Obama Administration worries that would make it impossible to compare policies offered by different carriers in the way you could on a well-functioning exchange. For instance, if I go the Blue Cross site, I'm not likely to learn much about Kaiser Permanente's offerings. On the other hand, commercial online health insurance marketplaces allow for comparison shopping, but raise issues of privacy (and perhaps even fraud from fake sites).
Or, you could make your purchase of health insurance a relatively seamless part of filing your tax return.
It actually makes a lot of sense. After all, the Affordable Care Act subsidies are tax credits and the information you need to figure out your subsidy amount is based on the income tax you pay. The penalty you'd owe for not buying insurance is a federal tax. Tax preparers already have—and are legally required to protect—nearly all the personal information they'd need to help figure the subsidy.
Storefront tax preparers can connect customers to health insurance markets through in–person contact. Or people could link electronically through a website such as Intuit's TurboTax.
Brian Haile, Jackson Hewitt's senior vp for health policy, predicts more people could end up buying through their connection with tax preparers than any other portal. "It's a no-brainer," he told me, "The Affordable Care Act is a series of amendments to the Internal Revenue Code and we help customers with their taxes. We can make this far more accessible for folks."
I'm hardly the first person to think of this. My Urban Institute colleague Stan Dorn has been exploring this idea since 2011—long before the HealthCare.gov site crashed. And now tax prep outfits are taking steps in this direction.
Tax preparers won't act as insurance brokers themselves. Instead, they are partnering with commercial online health marketplaces to ease enrollment.
For example, Jackson Hewitt is working with the online marketplace Getinsured to enroll people. Jackson Hewitt will calculate subsidies and potential penalties and, if customers choose, transmit that information to Getinsured. If the Jackson Hewitt customer wants to buy coverage, all she'll need to do is pick an insurance plan. Jackson Hewitt can even fill out all the paperwork for people to enroll in Medicaid. It says it will not charge for any of these insurance-related services.
Because Jackson Hewitt has 2800 locations in Walmart stores, it could be an especially important link to the uninsured.
H&R Block announced in September that it is partnering with the commercial online health exchange GoHealth to help people enroll through Block-branded online chat and phone support. Block also announced that it will have insurance agents located in its Arizona tax offices as part of a pilot program.
Intuit has created a product called TurboTax Health to assist buyers and has entered into its own partnership with the commercial online marketplace eHealth Inc.
Combined, these three firms alone claim to help file nearly 50 million returns—making them a huge potential portal for insurance buyers. The IRS estimates that about two-thirds of low-income taxpayers use paid preparers–many use walk-in firms such as Block and Jackson Hewitt. And Haile estimates that 90 percent of the uninsured get refunds. He predicts these individuals will be far more interested in buying insurance with those refunds in-hand than they are today, when they are focused on holiday shopping.
Using tax prep firms as a link into the health insurance market won't solve all the problems of the Affordable Care Act. For instance, the Obama Administration still needs to make sure the back end of its electronic system works, including the government data hub needed to verify buyer information. But Haile is right: For many people-especially those eligible for subsidies—the tax filing season is a perfect time to enroll and tax preparers are a great way to connect them to plan options.
Given its problems with the government site, the Administration ought to be promoting these commercial alternatives. And tax prep firms ought to seize the opportunity.
Once upon a time, Obamacare was "settled" law that was "here to stay." Or so President Obama said—before Obamacare failed to survive contact with reality.
The reality is that the Administration is delaying the impact of major parts of the law, including the employer mandate and now the benefit mandates for health plans.
There's a slight problem: As the President so readily reminded us, Obamacare is still the law of the land. Without undoing the law, everything that has people up in arms—the higher costs, mandates, plan cancellations—will still happen.
And this latest one-year "fix" isn't a given. As Heritage's Chris Jacobs put it: "The President's promise that his new 'plan' can allow people to keep their plans is just as flawed and false as his original 'like your plan/keep it' pledge."
The "fix" is another Obama attempt to go outside the law and around Congress. But even the President can't just un-cancel people's insurance plans.
Insurance commissioners in several states have already said no, we can't change the rules again and allow companies to un-cancel plans in our states. Two warnings from insurance officials:
Disrupting the market even further. "I have serious concerns about how President Obama's proposal would be implemented and more significantly, its potential impact on the overall stability of our health insurance market," said Washington State Insurance Commissioner Mike Kreidler. He announced that "We will not be allowing insurance companies to extend their policies."
Hurting consumers. "Changing the rules after health plans have already met the requirements of [Obamacare] could destabilize the market and result in higher premiums for consumers," said Karen Ignagni, CEO of insurance trade association America's Health Insurance Plans.
Heritage's Jacobs points out that President Obama's extra-legal "fix" could even result in the Administration offering insurers a bailout if they bring back canceled plans. It's just one debacle after another.
People don't trust President Obama on this anymore. And they shouldn't. Because Obamacare is doing exactly what it was intended to do—and no amount of delays can change that.
That's why we need a different direction for health reform that people can trust.
Read the Morning Bell and more en español every day at Heritage Libertad.
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Thursday, November 14, 2013
"The Tonight Show" is a cultural bellwether, so when its studio audience roars its approval at Senator Ted Cruz's (R-TX) quip that Obamacare is "the biggest job killer in this country," you know something's happening across our land.
The truth is now gushing out on the President's signature legislation, which has become a late-night punchline that not even reliably liberal "Saturday Night Live" or Jon Stewart can keep from satirizing. The fact that fewer than 27,000 people "selected" plans—but didn't necessarily buy them—on HealthCare.gov in five and a half weeks tells a tale in itself. (We had a little fun with it here.)
Conservatives who sought to defund this law can take pride in taking a stand that is looking better and better with each passing day—one that will not be forgotten. Progressives who shut down the government because they would not compromise are, on the other hand, looking over their shoulders and taking arrows, even from the left.
This is why the President's approval ratings are at an all-time low, according to an impartial Quinnipiac poll released this week. It said that only 36 percent approve of the President's job on health care; 38 percent on foreign policy; 32 percent on the economy; and 35 percent on immigration. By a margin of 52 percent to 44 percent, Americans say their President is a dishonest man.
Late-night comedians notwithstanding, Obamacare isn't funny to the millions losing their insurance after being repeatedly reassured by the President that "if you like your present insurance you can keep it. Period." For many of those losing their coverage, the options they have are anything but cheap.
It is even less funny that this lie was essential to passage of the law. Obamacare squeezed through on the narrowest of margins—no Republican voted for it, and Senate rules had to be twisted—and the bill would have died had President Obama spoken the truth and said "millions will lose their insurance coverage."
It also isn't funny to those who are seeing their premiums go up. According to Heritage researcher Drew Gonshorowski, premiums are going to increase for individuals buying insurance in the exchanges in at least 42 of 47 states.
In fact, health care costs will rise across the board. As Bob Moffit, a Senior Fellow for Health Policy Studies at Heritage, has said, "No matter how you look at this, health care costs both for individuals and for the country as a whole are going to increase." There are many reasons for this, as Moffit mentioned—namely, 18 new tax hikes, $1.8 trillion in new health care entitlement spending, and new benefit mandates.
And the worst part, of course, is what Obamacare will do to our national psyche, how it will affect the relationship between government and the governed. None other than V.I. Lenin said that "medicine is the keystone of the arch of socialism." Lenin founded a communist empire that lasted 70 years. Lenin also said "a lie told often enough becomes the truth."
In other words, Obamacare is an unmitigated disaster for our country. This is why it would have been better to defund it before it took the toll that it is already taking on so many American citizens.
The Heritage Foundation and its sister organization Heritage Action took the lead this fall in bringing these truths home to Americans, and I'm so proud of them.
When this law passed on March 22, 2010, I wrote in this space that Heritage would fight with all its might to repeal Obamacare:
I write to reassure our supporters, the conservative movement, and the American people at large that The Heritage Foundation will do all within its power to keep this issue alive in the public square and make the intellectual case for the repeal of this act. We will bring all our resources to bear on behalf of those who believe America is and will always remain the Land of the Free.
This remains as true as ever. I'm so glad that Jim DeMint, now at the helm, has decided to continue this fight.
Founder, The Heritage Foundation
Read the Morning Bell and more en español every day at Heritage Libertad.
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