Health Care Exceptions Swallowing the Rules

Then-Speaker Nancy Pelosi infamously said that people who wanted to read the ObamaCare bill could do so after they passed it. Well, the more people that read it, the more problems they seem to find. As a result (and with questionable legal authority), President Obama keeps issuing exceptions to various favored groups or whenever it is politically convenient to evade the consequences of his and Congress’ hasty actions.

First, President Obama’s HHS secretary gave exceptions to some individual companies who were reporting that the high cost of ObamaCare mandates would force them to lay off workers or cut off health-care benefits.

Then President Obama issued a general delay for all businesses, staving off the job-killing effects of new health-care mandates until after the midterm elections. And since he did that nearly two yeas in advance and since a presidential election looms two years after that, more selective delays and waivers seem very likely.

Then the President quietly retracted his then-insistent promises from 2010 that people who liked their existing health coverage would be able to keep it.

Then President Obama gave in to requests from Congress to exempt them Congress and its employees the law’s mandates, allowing them to avoid paying the additional costs they voted to impose on individual taxpayers.

Now pressure is building to remove power from the Independent Payment Advisory Board (IPAB), which is the same “death panel” board that the President’s allies heretofore insisted was an entirely mythological creation of Sarah Palin.

It’s beginning to look like the only people actually affected by health care reform are going to be the individual taxpayers who have to shell out thousands of dollars a year to meet the “individual mandate” requiring them to purchase government-approved insurance plans from government-approved companies through government-run “health care exchanges” or else pay a fine “tax.” Convenient, that.

The economics of the health-care reform law are also becoming even more mysterious than they appeared when (at the direction of then-Speaker Pelosi), the Congressional Budget Office switched almost overnight from projecting massive cost increases resulting from the Affordable Care Act to projecting a $100 billion savings. How can the ACA transform the health care system and reduce systemic costs if every change gets buried under a pile of exceptions handed out to every special interest group that comes calling? Does anyone seriously believe that the so-called “cadillac tax” on high-benefit health plans will actually be implemented over the vociferous opposition of labor unions that form the core of the Democratic Party’s electoral base in almost all key swing states? Please.

There is always another election looming, so presidential administrations of either party will always have an incentive to keep giving out these legally questionable exceptions, exemptions, and waivers. Congress passed and law at the vigorous urging of the President and using every trick in the book (remember the Nebraska Kickback?), and now the same President and the same congressional leaders who passed the law are running away from it (or just hiding under a waiver) every single chance they get.

This does nothing good for health care reform because we can’t know whether ACA can reduce spiraling costs if it is never allowed to fully go into effect. It does nothing good for the credibility of the political system, where politicians are supposed to be accountable for the laws that they pass. It also does nothing good for the rule of law when the rule of law can be waived in whole or in part at presidential whim.

This is not good.


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