Ongoing Train Wreck: Pew Poll: 50% Still Disapprove Of Obamacare | Technological Problems Plague Medicaid Applications | Some Patients Without Doctors

Today in Washington, D.C. - April 10, 2014
The Senate reconvened at 9:30 AM today. Following an hour of morning business, the Senate voted 56-41 to invoke cloture on the nomination of Michelle Friedland, to be a United States Circuit Judge for the 9th Circuit, using the precedent Democrats set by using the nuclear option to break Senate rules.

Senate Majority Leader Harry Reid (D-NV) has said that he plans to force a vote on the controversial nomination of David Weil, to be the administrator of the wage and hour division at the Department of Labor today or tomorrow.

Yesterday, after Democrats failed to get the 60 votes needed to proceed to S. 2199, their trial lawyer giveaway marketed as a bill about “paycheck fairness,” the Senate voted 75- 21 to confirm Wanda Felton to be first VP of the Export Import Bank of the U.S. and 95-1 to confirm Terrell McSweeny to be a Federal Trade Commissioner. Three other nominees were confirmed by voice vote.

The House reconvened at 9:00 AM. Today the took up Rep. Paul Ryan's final Budget Proposal that would cut more than $5 Trillion of expected spending.  The plan was  H. Con. Res. 96 — "Establishing the budget for the United States Government for fiscal year 2015 and setting forth appropriate budgetary levels for fiscal years 2016 through 2024."  At  12:02 PM, the bill passed by a vote of 219-205 - 219 Republicans for the budget plan and 193 Democrats voted against the plan.   Twelve Republicans also voted against the Ryan measure because the didn't believeit was not conservative enough.

The House then immediately passed by unanimous consent S. 2195 — "To deny admission to the United States to any representative to the United Nations who has engaged in espionage activities against the United States, poses a threat to United States national security interests, or has engaged in a terrorist activity against the United States." No other bills are expected to be considered today.

Yesterday the House passed H.R. 4414 (257-159) — "To clarify the treatment under the Patient Protection and Affordable Care Act of health plans in which expatriates are the primary enrollees, and for other purposes."

Today, the House Oversight Committee voted 21-12 along party lines to cite IRS' Lois G. Lerner for contempt of Congress! The vote sends the contempt charge to the whole House for consideration. Yesterday, the House Ways and Means Committee, which has apparently gained more access to documentation of actions by the IRS, voted to ask the Justice Department asking it to pursue criminal charges against Ms. Lerner. That referral, must alsogo to the full House floor for a vote.

Other media sources on the actions by the House Ways and Means Committee:
WaPo: House committee votes to request criminal prosecution of ex-IRS official Lois Lerner
WSJ: Lois Lerner Pushed for IRS Action Against Crossroads, House Panel Says
Politico: GOP says IRS’ Lois Lerner targeted Crossroads
NYT:
Examiner: Issa says emails suggest Elijah Cummings prompted IRS targeting of True the Vote
WT: Displays of Obama, Democratic support common at some IRS offices
Fix: IRS employees accused of donning pro-Obama gear, urging callers to vote for him

In addition, tensions within the House Oversight Committee are heating up. Yesterday, Republicans accused the House Oversight and Government Reform Committee's ranking member, Rep. Elijah Cummings (D-MD), of lying about staff members conspiring with former IRS official Lois Lerner to target the conservative group True the Vote in 2012. Chairman of the House Oversight Committee, Rep. Daniel Issa (R-CA), and five Subcommittee chairmen sent Rep. Cummings a letter asking him to explain why his committee staff contacted the IRS about True the Vote, why that contact was hidden from Republicans, and why the Ranking Member denied those staffers actions in February. Excerpt follows:


"Although you have previously denied that your staff made inquiries to the IRS about conservative organization True the Vote that may have led to additional agency scrutiny, communication records between your staff and IRS officials – which you did not disclose to Majority Members or staff – indicates otherwise. ... You have an obligation to fully explain your staff’s undisclosed contacts with the IRS."
President Obama declared during his victory lap over Obamacare enrollments last week that “the debate over repealing this law is over” and said, “It’s working. It’s helping people from coast to coast . . . .” But once again, the president didn’t take into account the views of the American people.

USA Today writes, “The Affordable Care Act looms as a powerful issue in this year's congressional elections, a USA TODAY/Pew Research Center Poll finds, and one that is reverberating in ways likely to boost the GOP. In the survey, taken after President Obama announced a surprising 7.1 million Americans had signed up for health care through the law's exchanges, more than eight in 10 registered voters say a candidate's stance on the law will be an important factor in determining their vote. A 54% majority call it very important. By 2-1, those who rate the issue as very important disapprove of the law. That means it is more likely to motivate opponents than supporters to vote — a critical element in midterm elections when turnout often is low. . . . Americans continue to disapprove of the law, now by 50%-37%. . . . In coming years, they predict by 35%-29% that it will have a mostly negative effect on them. . . . Asked about the effect on the country as a whole so far, 43% say it has been mostly negative, 30% mostly positive. . . . Still, the downbeat assessment of the health care law over the long term hasn't budged. By 44%-38%, those surveyed say its overall effect in coming years will be mostly negative.”

So clearly the debate isn’t over. And it’s not hard to see why Americans continue to strongly disapprove of Obamacare, given the disastrous consequences it’s had all across the country.

Even the Huffington Post can’t ignore the serious disruptions to Americans’ health care that Obamacare is causing. In a must-read report titled, “How Obamacare Leaves Some Patients Without Doctors,” the Huffington Post writes, “In January, a doctor told Noam Friedlander, who was suffering from excruciating lower back pain, that she needed surgery to remove part of a severely herniated disc. Friedlander had Blue Shield insurance through Covered California, California's version of Obamacare, and planned to use it to cover the costs of the operation. But when she started to call surgeons covered by Blue Shield, she ran into a roadblock. Surgeons who were covered by her insurance operated out of hospitals no longer covered by her insurance -- or vice versa. Friedlander spent days on the phone, hours on hold, making dozens of calls across Southern California, trying to match a surgeon with a hospital that would both be covered. In total, she reached out to 20 surgeons and five hospitals. ‘No one could help me. Some expressed sympathy,’ Friedlander, 40, told The Huffington Post in an email. ‘They told me, “I'm so sorry -- it's all just so new. You're a victim of the changes. No one knows what they're doing.”’ . . . Unable to match a hospital and a surgeon that were both covered, Friedlander started haggling between doctors for a cash price for the surgery. . . . . In the end, she had to take out two credit cards so she could pay $16,000 out of pocket.”

“[N]ationwide,” the Huffington Post explains, “about 70 percent of Obamacare plans offer fewer hospitals and doctors than employer-sponsored group plans or pre-ACA individual market plans, according to a study by consulting firm McKinsey & Company released in December. This narrowed number of doctors and hospitals is what Friedlander encountered when trying to match a surgeon and hospital that would both be covered. Covered California is aware of the problem. Blue Shield and Anthem Blue Cross -- the largest Covered California providers, each carrying about 30 percent of all Covered California enrollees -- have both narrowed their networks, according to Jeff Rideout, senior medical adviser for Covered California. . . . The Affordable Care Act increased insurers' costs by forbidding denial of coverage to consumers with pre-existing conditions and by imposing taxes and fees to fund aspects of the new law. To make up for ACA costs and keep premiums low, Blue Shield asked its doctors and hospitals to accept payments from the insurer at rates reduced up to 30 percent. Not surprisingly, some doctors and hospitals rejected Blue Shield's reduced payment rates and decided not to re-sign contracts with the insurer. At least three major Los Angeles hospitals previously covered by Blue Shield -- UCLA, Cedars Sinai and Good Samaritan -- have opted out of the insurer's new network, said Lindy Wagner, corporate communications manager of Blue Shield. According to Wagner, Blue Shield of California now has about 40 percent fewer physicians and 25 percent fewer hospitals in its network than last year.”

Further, “[W]hen signing up for a plan, it's difficult to determine which doctors and hospitals are still covered. ‘You can sign up on Covered California and think you're totally fine, only to find out later that you're totally hosed,’ [David Fear, an insurance agent in Sacramento,] said. Specialist doctors, such as surgeons, ob-gyns and urologists, declined Blue Cross and Blue Shield's lower payments most frequently. Fear estimates that about two-thirds of Blue Cross and Blue Shield's specialists have opted out of the networks. Like Friedlander, Ruth Iorio, a 35-year-old new mother from Los Angeles, is struggling to find the care she needs in Blue Shield's smaller network. She signed up for Blue Shield through Covered California in November because the Covered California website listed her hospital, UCLA, as accepting Blue Shield, she said. However, after Iorio gave birth in December, she was told that her ob-gyn at UCLA was not covered by her insurance. So she paid out of pocket. Iorio has not been able to find a urologist for her son or an ob-gyn who is both covered by her insurance and practicing in a hospital that is covered. She's called over a dozen doctors who are covered by her insurance, and each has told her that if she or her son needs an operation in the hospitals the doctor contracts with, it won't be covered. ‘My insurance is pretty useless. And I'm not fussy about what doctor I see,’ Iorio said. ‘I don't know what to do. I may just drop it for myself and keep my son on it. It's really depressing.’”

And of course the technological problems that Democrats in Congress and the Obama administration assumed would simply be solved or never surface in trying to create such a complicated system continue to plague Obamacare. National Journal reports, “The technology behind a huge part of Obamacare's efforts to expand insurance coverage—the part aimed at low-income Americans—remains far from fixed, and the glitches are keeping some of the nation's most vulnerable patients from getting insured. The administration launched a ‘tech surge’ to improve the HealthCare.gov experience for those shopping for private insurance, but the website's process for enrolling in Medicaid remained mired in glitches. And for President Obama's efforts to expand health coverage that's a major problem. To reach would-be Medicaid recipients, the Affordable Care Act relies on potential enrollees being able to effectively navigate the law's website to enroll. And there, just as with the early days of HealthCare.gov, technical failures have created a high hurdle for those looking to join the ranks of the newly insured. Some applications sent from the exchanges never make it to the state Medicaid offices. Of those that do, jumbled or missing data can make the applications impossible to process in any kind of automated way. In the meantime, these individuals are without coverage as they wait for their applications to be reviewed, and their prospects for getting insured soon are dimming as backlogs build. And then there's the extreme example, where some applicants—typically those whose incomes put them on the cusp of Medicaid eligibility—have been trapped in a circular purgatory. Consumers are incorrectly deemed eligible for Medicaid by the exchanges, then rejected by the Medicaid offices. Their applications then need to be sent back over to the marketplaces, but they don't always make it there.”

Obamacare is still a mess, it’s still causing chaos in the American health insurance system, it’s still resulting in higher premiums, canceled coverage, narrow networks, and endless technological and administrative problems. It’s still, as former Sen. Max Baucus (D-MT), one of the architects of the law warned a year ago, “a huge train wreck.”

As Senate Republican Leader Mitch McConnell said, “Kentuckians, and the countless Americans suffering under Obamacare, need real solutions. . . . Washington Democrats forced America’s Middle Class into this impossible situation. They basically blocked every reasonable attempt to reform this law – or to change it in any meaningful way. Yet now that Obamacare’s become politically difficult for them, they’re deflecting blame. . . . “Americans agree that it’s time for Washington Democrats to work with us to remedy the mess they created — and that means repealing this law and replacing it with real reforms. It’s time for them to work with us on a real jobs agenda too – to take up the numerous jobs bills the House has already sent over and get them onto the President’s desk.”

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