Saturday, October 14, 2017

Let's review just what "cost sharing reductions" are, and how they came to be

For starters, let's take a moment to reflect on what a gobbledygook term it is. It's a syntactical train wreck. What is being reduced? The cost? The sharing?

Like so many terms one sees in the realm of health-care insurance and "insurance" - "doughnut hole" comes to mind - it glosses over what is really happening with a surfeit of wonkiness.

Peeps, CSRs are nothing but raw redistribution:

[They] are direct payments to insurance companies that were designed to hide the true cost of Obamacare by shifting cost to taxpayers while bribing insurance giants to participate in the law’s exchanges.

Congress gave the Most Equal Comrade a big thumbs-down in 2013 to making this a component of the "Affordable" Care Act.

So the next step was . . . to do it anyway!

When Congress refused, Obama’s Treasury Secretary Jack Lew, without offering any public legal justification for the move, ordered the administration to begin making CSR payments. You can imagine the outcry if Donald Trump simply began funding a massive border wall without a congressional appropriation to authorize the funding.

Since Lew’s decision to unilaterally create a massive new appropriation, Obama (and now Trump) have been sending around $7 billion each year to insurance companies participating in the supposedly self-sufficient and competitive state health care exchanges. They continued to do so after the House sued. They continued to do so after a federal judge found the payments unconstitutional and ordered them stopped.

“Congress authorized reduced cost-sharing but did not appropriate monies for it,” U.S. District Court Judge Rosemary Collyer wrote. “Congress is the only source for such an appropriation, and no public money can be spent without one.”

So all of us taxpayers were forced at gunpoint to shore up the difference between what insurance companies needed to make a profit after being made to take all comers as customers, and what they'd actually be taking in without this scheme. And the House, where money for stuff government does is supposed to come from, per Article 1 of the Constitution, was left out of the proceedings. And the market value of a given insurance policy was distorted beyond all recognition.

That, folks, is what was undone yesterday, and not a minute too soon.
 

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