Block Expansion Of IRS To Administer ObamaCare
by Peter Ferrara and Lewis Uhler
July 05, 2013
The sudden one-year delay in Obama-Care's employer mandate is an admission by the Obama administration that its flagship domestic policy initiative will not be functional even by 2014, despite four years of lead time from passage of the legislation.
Nor will the health care exchanges be ready in most of the country, so the individual mandate should be delayed as well. Ditto that for the taxes to fund ObamaCare.
The IRS scandal has created a further chokepoint to force the reconsideration of Obama-Care. If House Republicans stand firm and refuse to fund any expansion of the IRS to administer ObamaCare, the public will support them in any confrontation with Obama.
Thousands of new IRS agents and employees costing billions will be needed to determine and verify eligibility for the ObamaCare tax credits for the purchase of health insurance. They are also needed to enforce the employer mandate, if it ever becomes effective, requiring employers of more than 50 full-time workers to buy certain health insurance for their workers.
They will also enforce the individual mandate requiring every individual without employer insurance to purchase the health insurance mandated by the federal government. This includes verifying that the insurance purchased by employers and individuals meets federal requirements, including designated benefits.
Without those new IRS resources Obama-Care will cause even more chaos, which we predict will include increasing the number of uninsured, rather than achieving universal coverage.
That's because both employers and individuals will scramble to avoid the mandate, and many, especially healthy younger adults, will rely on the regulations requiring insurers to sell to them no matter how sick they become, at the same price as for those not sick.
The chaos will also include the soaring health insurance premiums we are already seeing because of the guaranteed issue and community rating regulations and all the additional required "free" benefits. That will further increase the number of uninsured.
Lower Incomes, Higher Unemployment
ObamaCare — and the uncertainty that surrounds it — will exacerbate declining real incomes and persistent high unemployment among middle-class working people as employers reduce millions to part-time employment, and restrict employment altogether, to evade ObamaCare.
This is part of the reason for the delay in the employer mandate, but a one-year delay is not a fix. Rising health insurance premiums are another form of "taxation," burdening further an economy still in recession.
The ObamaCare chaos will further restrict access to health care in the form of $716 billion in Medicare cuts, and the limits on health care access contained in health insurance offered on the ObamaCare exchanges (attempting to keep costs down).
Such chaos will increasingly force congressional Democrats to consider alternatives to ObamaCare. House Republicans should take advantage of that by targeting some of the most politically vulnerable components of ObamaCare, namely:
- Passing a bill prohibiting ObamaCare from denying health care to anyone based on age.
- Repealing the Medicare cuts contained in ObamaCare. Medicare's chief actuary says those cuts will cause chaos as a result of closed hospitals and other facilities and denials of health care for seniors.
- Repealing the ObamaCare Independent Payment Advisory Board (IPAB), which has the authority to adopt further cuts to Medicare without congressional approval.
- Also voting to repeal the unpopular Obama-Care medical device tax and the counterproductive $100 billion a year tax on health insurance (which would also increase the uninsured).
- Repealing as well the ObamaCare slush fund that smuggles billions of taxpayer dollars to left-wing, "progressive," Obama political activists ostensibly to help explain how to navigate ObamaCare, but actually to help further build a national political machine, effectively taking the Chicago political machine national.
- Voting to give Obama his one-year delay in the employer mandate, along with a one-year delay in the individual mandate, and the rest of the ObamaCare taxes. Or maybe they should just vote to delay the whole thing to 2017, after the next presidential election.
These actions are not intended to "fix" Obama-Care, which is not fixable, but only to further highlight what is wrong with it and challenge Democrats to abandon it. These actions will build the momentum for what ultimately needs to be done: House approval of a full Republican alternative to ObamaCare.
Such an alternative should draw upon the proposal from NCPA President John Goodman, president of the National Center for Policy Analysis (John Goodman and Peter Ferrara, "Health Care for All Without the Affordable Care Act," NCPA Issue Brief No. 116, October 17, 2012), which assures universal health care, with no individual mandate, and no employer mandate, at a savings of $2 trillion over current law.
All-Inclusive Safety Net
The proposal offers a safety-net approach for essential health care, catching all those in need. That safety net includes sending the federal financing for Medicaid back to the states through fixed, finite block grants, along with complete authority to use that money for essential health coverage for the poor. That approach worked spectacularly in the 1996 welfare reforms of the old Aid to Families with Dependent Children (AFDC) program.
For the uninsured who have pre-existing conditions, the plan provides for high-risk pools, where the uninsured would pay the premiums according to their ability (means-tested), and taxpayers would otherwise subsidize their coverage.
The plan also provides for the insured to buy health status insurance, so if they get sick and want to change insurers to those better suited to treat their illness, their insurer would cover any additional premiums charged by the new insurer to do so.
That would help create a market where insurers would compete to cover the sick. The plan provides as well for guaranteed renewability, so those with insurance can keep it as long as they continue to pay the same standard premiums as others.
Consistent with its "patient power" theme, the plan makes the tax preference for health insurance equal for everyone, whether their employer provides their health insurance or not, with an equal, refundable, tax credit for health insurance and/or out-of-pocket medical expenses for everyone.
That would create real, cost-conscious consumers of health care services. For those who do not use the credit to get health insurance, the unclaimed funds would be sent to a safety-net institution in their community.
House passage of such a popular alternative to ObamaCare would transform the debate, putting conservatives and Republicans on the offensive, rather than the defensive.
- Uhler is president and founder of the National Tax Limitation Committee and National Tax Limitation Foundation.
- Ferrara is director of entitlement and budget policy for the Heartland Institute, a senior fellow at the National Center for Policy Analysis and senior policy adviser to the National Tax Limitation Foundation on entitlement reform and the federal budget.