January 12

COMMENTARY: Affordable Care Act a hideous tangle of mandates, prohibitions, subsidies, fees, penalties, pitfalls

John Frary

“Things and actions are what they are, and the consequences of them will be what they will be: why then should we desire to be deceived?” — Bishop Joseph Butler (1692-1752)

On Wednesday, I was a guest at a summary presentation on the past, present and future implementation of the Affordable Care Act (aka, Obamacare) by Eric Cioppa, superintendent of Maine’s Bureau of Insurance. It is no criticism of the speaker to describe him as somewhat baffled by the workings of this law. So was everyone present, so is everyone in the United States, the planet Earth and the entire known universe.

To say that the presentation was too long and complex to summarize in this column is to say the plain truth. To say that I understood it all would be a flagrant lie. Cioppa’s explanation, enriched with a PowerPoint presentation, was clear, well-organized and succinct in relation to the subject matter. The problem was that my comprehension was not congruent with his presentation.

Go to the Maine Bureau of Insurance website and you can downloand the “Bureau PowerPoint Presentation on ACA and Maine.” It’s not an easy read, but it’s readily available if your computer has the Adobe Reader program. Whether you understand it clearly is less important for purposes of this column than your grasp of the fact that the actions dictated by this law are hugely complicated. It involves a hideous tangle of mandates, prohibitions, tax credits, subsidies, fees, penalties, delays, suspensions and legal pitfalls.

There is no way that the superintendent of Maine’s or any state’s Bureau of Insurance can summarize the law so that its workings would be fully understandable. Every business, large or small, will have to hire an insurance expert to work out their own individual responses.

More than 30 years ago, Sen. Daniel Patrick Moynihan, D-N.Y., then still a Harvard professor, examined the many failures of President Lyndon Johnson’s Great Society programs. Moynihan was a devout liberal to the day he died. He believed in the benevolent potentials of the federal government, but he was concerned about how well government programs worked, not merely with the intentions of those who designed them.

Moynihan’s study of successful and failed programs led him to one clear and salient conclusion. Administratively simple government programs with clear and constrained objectives were the ones he expected to succeed. Bureaucratically complicated programs with vague and over-ambitious objectives were doomed to fail. His model legislation was the Social Security law in its original form, based on sound actuarial principles and without the later expansions.

The news media and public have paid a lot of attention to the Obamacare website rollout, into the ditch. Supporters are embarrassed at the multiple glitches. Opponents take pleasure in reporting that more deer were shot in New Sharon on its first day than the number of citizens enrolled in the entire United States.

Cioppa had nothing to say about the website vaudeville show. He spoke as an insurance specialist, not as a political partisan. He was focused on the complications to come. He did not offer reassurance because his understanding of the problems did not allow him to do so.

I talked to a few businessmen present at this meeting. They all agreed that Cioppa did an excellent job. And they all agreed that they were not clear about the ACA consequences for their businesses but felt certain there was nothing to which they could look forward. One attendant argued that the ACA dog’s mess made sense only if it was designed to fail, thus opening the way to a nationalized single-payer insurance program. Maybe, but my preference is always to assume that stupidity rather than diabolical cunning explains disastrous policies and programs.

Readers desiring reassurance will find all they need in a Jan. 9 Washington Post column by Adam Meyerson headlined “Despite what the critics say Obamacare is working.” Meyerson is a career promoter of liberal causes, not an insurance specialist. He considers the website difficulties a minor glitch. He does not claim that people can keep their pre-ACA insurance policies or doctors. He doesn’t claim that total health care costs are going down. He doesn’t explain the funding of Obamacare. He shows no interest in the problems that concern and puzzle Maine’s insurance superintendent. He does explain, however, that Obamacare is already a great success — a “manifest” success in fact — and its only problems can be blamed on Republicans.

John Frary of Farmington is a former congressional candidate and retired history professor, a board member of Maine Taxpayers United and publisher of www.fraryhomecompanion.com. Email to jfrary8070@aol.com
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