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CCHF Health Freedom eNews

December 5, 2012

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President's Commentary

President Obama is in the giving mood. With just 20 days until Christmas, the White House has sent you seven gifts -- and it's not seven swans a-swimming. 

You may decide these shouldn't be called gifts. I agree. He's given us a stack of proposed Obamacare rules prepared well before the election and released to the public just two days before, and eight days after, Thanksgiving.

In a nutshell, here is what's inside these 871 pages of federal regulatory "gift-wrapping":

  • Health Insurance Market Rules (131 pp) - rules on ending health insurance (as we know it no pre-existing condition exclusions) and nationalizing coverage, leading to higher costs.
  • Wellness Program Incentives (81 pp) - rules on behavioral modifications, leading to higher premiums for the non-healthy and non-compliant.
  • Standards for "Essential Health Benefits" (119 pp) - rules on HHS-mandated coverage, leading to higher premiums and violated consciences.
  • "Qualified Health Plan" Certification Notice (3 pp) - federal control over health plan certification, leading to limited options and higher premiums. 
  • Benefit and Payment Parameters (373 pp) - rules for user fees (new taxes), intrusive individualized risk scores, and redistribution of dollars.
  • Additional Medicare Tax (42 pp) - collection requirements for 0.9% tax on "high-earners."
  • Multi-State Federal Plans for Exchanges (122 pp) - rules that force exchanges to offer national health plans (single-payer foot in door).

And since a picture is worth a thousand are the rule in living color. Guess which proposed rule is at the bottom...

There are even more "gifts" to come. In 2013, there are six Obamacare  tax increases

  • Limits on Flexible Spending Account - the amount you can contribute to an FSA is limited to $2,500 per year, with an annual cost of living increase. (raises $13 billion)
  • Reduced Ability to Deduct Medical Expenses - threshold for deducting unreimbursed medical expenses raised from $7.5% to 10%. ($15.2 billion)
  • Medicare Payroll Tax Increase - If you earn > $200,000 (individual) or > $250,000 (couple), your payroll tax will be 0.9% higher. ($86.8 billion)
  • Investment Tax Assessment - A new 3.8% tax on unearned income for higher-income taxpayers. ($123 billion)
  • Employer Retiree Coverage Subsidy Eliminated - Medicare Part D retiree drug subsidy payments to employers are eliminated. ( $4.5 billion)
  • Tax on Medical Devices - A new 2.3% excise tax is imposed on the sale of any taxable medical device. ($20 billion)

I count 13 "gifts" in 41 days. The President started his "12 days of Christmas" too early, ends it too late, his count is off, and they aren't even gifts. Then again, perhaps his wooing days are over. Maybe that's why he waited until after the election and right before the holidays to spring them on the American people. 

NOTE: The 373-page rule allows only 30 days for public comments. The deadline is January 5, 2013. Happy New Year!

ACTION ITEM: Please go online here and send HHS a simple message: "The public comment period for the proposed rule for Benefit and Payment Parameters should be extended. Thirty days during the holiday is poor timing and not enough time to read or respond to 373 pages of information. Please extend the comment period to 90 days. Please inform me of the change."

Obamacare is a runaway entitlement train racing over an ever-increasing rack of rules -- more than 13,000 pages to date. Consider this  chart from Avik Roy at Forbes:

Starting in 2014, Obamacare will rapidly build on an already dangerous "fiscal cliff" of entitlement. The time to cut Obamacare off at the pass is now.


News to Know:

The Obamacare Pay Cut

Will your hours be cut? Obamacare has redefined "full time employee." Full-time now means working 30 hours or more. Employers with 50 or more full-time employees must offer government-approved health insurance or pay a fine of up to $2,000 per employee (starting with employee #31). Employers can avoid the penalty by cutting hours. At a time when premiums are about to skyrocket under Obamacare, Darden Restaurants, which owns Olive Garden, Red Lobster and Applebees, has discussed  cutting hours to keep employees under 30 hours. Other employers may end insurance for low-wage workers who are eligible for Medicaid under Obamacare. NOTE: 1/3 of physicians currently refuse to accept new Medicaid patients.

Ping! Ping! Ping!

The exchange must confirm what you say is true. As puts it, " exchange could use a database to check applicant attestations about access to employer-sponsored coverage...[It] would check private and public data sources through a  CMS data services hub...Exchanges must be able to determine also whether individuals are eligible to receive advance payments of the premium tax credit, cost-sharing reductions and  exemptions from the individual responsibility requirement. Income levels are available from individual confirmation and data from federal, state and commercial sources." In short, like submarine sonar operators, Exchanges must ping the  Hub and see what data (income, taxes, citizenship, employment, etc.) comes back.

Are You Exempt?

There are  9 exemptions from the individual mandate to purchase health insurance. Well, actually, there are four exemptions from the mandate to purchase health insurance, and there are five exemptions from the penalty-tax for not purchasing health insurance. In other words, although the mandate applies, five categories of individuals don't have to pay the penalty-tax. For instance, American Indians are not exempt, but if they go uninsured, they don't have to pay. Case Western University and Cato Institute provides the following  estimates by state :

Federalism Protects Individuals

As states consider whether to cooperate with the federal takeover of health care (set up exchanges), consider Justice Anthony Kennedy's words on federalism:

Federalism is more than an exercise in setting the boundary between different institutions of government for their own integrity...Federalism secures the freedom of the individual. ...By denying any one government complete jurisdiction over all the concerns of public life, federalism protects the liberty of the individual from arbitrary power...." - Justice Anthony Kennedy, writing Unanimous Majority Opinion, Bond v. United States, June 16, 2011.
Bypassing the ID Prohibition?

Thanks to Congressman Ron Paul (R-TX), current law prohibits HHS funding for the creation of a national Unique Patient Identifier as required by the 1996 HIPAA law. But the U.S. Department of Commerce's National Institute of Standards and Technology (NIST) "is  working with industry to develop a standards based registry infrastructure that will allow healthcare professionals to find and access all pertinent patient clinical information regardless of the healthcare organization that creates and manages the documents...Sharing is managed through document repositories and a document registry to create a longitudinal patient information record within a given clinical domain..." Resilient Networks, which received a  $1,999,371 federal grant is doing the work.   CCHF's "National Patient ID" report.


Quotes of the Week:


"As long as they don't cut eligibility or raise the retirement age...But if they want to cut down on how much we're paying to providers, and to insurance companies, device manufacturers, things like that, sure, fine." -- Iowa Democrat Sen. Tom Harkin on fiscal cliff negotiations, (forgetting that doctors are dropping Medicare and 1/3 of doctors refuse Medicaid patients due to low payments) to reporters at U.S. Capitol, Politico Pro, December 2, 2012.




"Some say don't touch entitlements. I don't think that's a responsible approach. Untouched, unchanged, Medicare runs out of money in 12 years - 12 years." -- Senate Majority Whip Dick Durbin (D - IL), Politico Pro, November 27, 2012.





"Absolutely. In fact, [Health and Human Services Secretary Kathleen] Sebelius specifically said that to me. She said she considered the stimulus, and especially health IT, as the foundation for Obamacare....Putting the bill together there were all kinds of disputes that had to be worked out. Privacy is one of them: How hard are you going to make it to share this information? If you make it too hard, then it's kind of useless. By putting this stuff online, not only are you making the act of providing healthcare easier and more efficient, but you're also providing data. There are really important potential uses for this stuff." -- Michael Grunwald, author and TIME reporter, answering interview question on whether health IT in the Recovery Act (stimulus) was viewed as groundwork for broader policy reform,  Healthcare IT News, November 2012.

Stats of the Week:

3.5% - NEW proposed tax on premiums (user fee) to pay for Federal Exchange

2,217 - hospitals penalized by Medicare for too many readmissions.

$2 million - Barnes-Jewish Hospital losses from readmissions penalty (payment cuts.)

49 - states with prescription drug monitoring programs (Missouri has none).

38 - percent of large companies asking employees to take health risk assessment.

6,500 - staff and contractors for the Centers for Medicare and Medicaid Services.

News Release of the Week:

CCHF Questions Definitions of Fraud, Waste and Abuse in Medicare, States Lack of Definitions Will Create Denials of Necessary Care

ST. PAUL, Minn. - The House Energy and Commerce Subcommittee on Health met last Wednesday to hear testimony on ways to reduce fraud, waste, and abuse in the Medicare system. While few deny the need to reform Medicare and cut payments based on fraudulent claims by common thieves, the lack of definitions around "fraud," "waste," and "abuse" are troubling, according to the Citizens' Council for Health Freedom (CCHF). Continue reading

Featured Health Freedom Minute:

Just 299 Days to Takeover?

Itʼs just 299 days until Obamaʼs federal takeover centers are supposed to be operating in every state on October 1, 2013. The Exchanges are supposed to be selling insurance, tracking insurance status, monitoring the practice of medicine, forcing people into Medicaid, and reporting to the IRS. Continue reading

Twila Brase broadcasts a daily, 60-second radio feature, Health Freedom Minute, which brings health care issues to light for the American public. Health Freedom Minute airs on the entire American Family Radio Network, with more than 150 stations nationwide in addition to Bott Radio Network with over 80 stations nationwide.

Click here to listen to this week's features.

Reading Now...

"Choke the Life Out of Obamacare" - WND commentary by Chuck Norris....

"GOP issues 'fiscal cliff' counteroffer," USAToday, Dec 3

"Analysis: Health Exchanges and the Litigation Landscape," Kaiser Health News...

"New Fracas Over Chinese Buying Genetics Firm," (Morning Tech), Dec 2 -  national security risks with Chinese accessing human DNA being decoded... 

"The Debate Over Providers' Use of Health Data for Marketing Purposes," Healthcare Informatics, November 15, 2012.

Citizens' Council for Health Freedom
161 St. Anthony Avenue, Ste 923
St. Paul, MN 55103
Phone: 651.646.8935 • Fax: 651.646.0100

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