29 thoughts on “The ObamaCare Financial Unraveling”

  1. But the Court rendered Medicaid expansion optional for states, thus giving them an incentive to let the federal government shoulder the entire cost of subsidizing more generous insurance coverage for those above the poverty line.

    That’s hilariously wrong. The original idea was that the feds would pay for Medicaid for anyone up to 138% of the poverty line. But about half of the states, including ones like Texas with huge numbers of poor uninsured, are saying no to the federal money. That’s a moral atrocity and human tragedy, but it is saving the federal government billions.

    2. Yes, a moral atrocity, a human tragedy, and a right granted by the United States Supreme Court in upholding the health care law.

      1. Therefore it’s settled law and Baghdad Jim needs to STFU about it. I believe that’s the Party Line about Obamacare, isn’t it?

        1. Over time more and more states will expand Medicaid. Medicaid itself is optional, and it was decades before all fifty states implemented it (I believe Arizona was the last). Medicaid expansion is an even better deal for states than original Medicaid (the federal-state money split is 90-10 rather than about 60-40), so I expect it to spread more quickly.

      2. “…………..and a right granted by the United States Supreme Court in upholding the health care law.”

        Evidently your education is also an atrocity as the Supreme Court does *NOT* grant rights.

          1. p.s. there’s something funky going on with this version of the web page – though maybe only on my machine. Sometimes reply links are there..sometimes not.

            Also the main display will say that a topic has replies but when you click on the replies link there are none. This caused me to enter a post twice.

            Don’t know if anyone else sees this.

          2. The “reply” link disappears after a particular set of replies gets about 4 or 5 deep. It does make it harder to keep a subthread going. As for the number of replies on the main display, that’s an annoyance. Sometimes it’ll show there are many replies but when you open them, nothing is there. I often have to refresh multiple times to get the replies to show at all.

          3. Also the main display will say that a topic has replies but when you click on the replies link there are none.

            Clicking the “switch to our mobile site” link seems to correct this for me.

          4. There’s certain level at which it’s impractical to display any more. I might be able to reset that, but unless I go to a wider column, you’d end up with a column of single words at some point.

  2. Rand:

    Thanks for the link. Four years ago, when healthcare reform was still in the house (HR 3200), I read the full 1000-page bill and did an analysis from a systems design point of view (my professional specialty). That analysis predicted many of the political, legal, and implementation problems that Obamacare has had. Here’s one passage, discussing HR 3200 in context of the time-honored systems development maxim that “A complex system that works is found to have invariably evolved from a simple system that worked.” (Gall’s Law)

    ==================================
    First, HR 3200 isn’t “designed from scratch.” As noted in Part I [of my analysis], many sections of HR 3200 are modifying various existing laws and regulations, such as the Internal Revenue Code, the Public Health Service Act, Employee Retirement Income Security Act, the Social Security Act, and the United States Code.

    However, leveraging upon and modifying several existing systems is not the same as building a “simple system that works” and evolving it into a complex system that works. I can create a large, complex piece of software that calls upon and even modifies existing systems and libraries — but that doesn’t necessarily mean I’m evolving something from a “small, simple system that works”. This is especially true when I’m pulling together from several disjoint or unrelated systems (such as those listed above).

    Second, legislation is more robust than software, for exactly the differences outlined in part I, namely that legislation is executed by people rather than machines and operating systems. If I create an ill-formed piece of software, there’s a good chance it won’t even compile (or interpret); if it does, then it may run into linking or integration errors; and if it gets past those, it may crash, lock up, or behave bizarrely upon execution.

    If, however, I create an ill-formed piece of legislation, it can be (and often is!) be put into practice, with various human either officially or unofficially working around the defects to make it “work”. Of course, that ‘deployment’ of the legislation may end up drifting or even veering sharply from the stated or actual intent of the legislation. (In a way, this is reminiscent of the early PL/1 compilers that would, upon encountering a syntax error, make a best guess as to what you might have meant to write and compile that instead.)

    Courts can shift this ‘deployment’ in both directions. They may “find” meaning or functionality in the law never contemplated or even explicitly disavowed by those who crafted and voted for the legislation, or they may prohibit some portion of explicit functionality due to conflicts with the Constitution, prior judicial rulings, or simply their own judgment. As noted in Part I, judges don’t always agree with one another, either, so whether a given piece of legislation (or a subportion thereof) is upheld, modified, or rejected entirely depends upon which courts or individual judges end up reviewing it.

    Third, there are serious and compelling arguments as to how well the current government health care programs (such as Medicare and the VA hospital system) work, not to mention the government systems modified and relied upon by HR 3200 (such as the IRS and Social Security). While you may argue with Gall’s maxims above, I know of no serious systems designer who will state that it is possible to build a large, complex system that works from complex systems that work poorly, if at all. The quality of your original and leveraged systems provides an upper bound on the quality of your final system. To believe otherwise is to succumb to wishful thinking.
    ==================================

    As I said, this was all written and posted in 2009. You can read the whole thing here:
    http://brucefwebster.com/2009/09/07/hr-3200-from-a-systems-design-perspective-part-i/
    http://brucefwebster.com/2009/09/08/hr-3200-from-a-systems-design-perspective-part-ii/

  3. Breaking news! You heard it here first!

    The computer glitches in the Exchanges are no accident. They are meant to protect Obamacare from court challenge.

    You see, there are other lawsuits or persons seeking to file lawsuits to thwart the Affordable Care Act, but they couldn’t go ahead because in legalize, they weren’t “ripe.” In other words, for someone to have “standing” to sue the gummint over Obamacare, they have to experience Obamacare by being enrolled in it to claim harm.

    But no one can enroll in Obamcare, so these suits cannot go forward, hence the law is safe. The shutting down the government thing is just a smokescreen to avoid outside scrutiny of this, but of course, they were unsuccessful in fooling me.

    Remember, you heard it here first on Rand’s fine, fine Web site.

    1. But no one can enroll in Obamcare

      I get that your comment is tongue-in-cheek, but it’s worth pointing out that both California and New York reported tens of thousands of enrollees in the first week. And that’s people willing to pay premiums three months in advance; most people (including me) will wait until closer to January to finish enrolling.

      1. Show the report.

        They reported no such thing. Sebilius said so, on national TV. What they DID get was thousands of people creating accounts. That is *NOT* the same as enrolling.

        Distortionary spin from Circular Jim.

        1. This Bloomberg report says:

          California said 28,699 people were signed up in the state’s health-insurance exchange in the first week, while New York had more than 40,000 sign up.

          This Sacramento Bee article says that:

          The head of California’s health insurance marketplace said Tuesday that more than 16,000 households have completed applications in the first five days of enrollment, largely overcoming early technical setbacks that continue to hamper other states.
          …
          California officials determined that 28,699 people in the 16,311 households that have applied are eligible for coverage. Another 27,305 households have partially completed their applications, Lee said. In addition, 430 small businesses registered with the state agency.

          It isn’t clear whether they’ve paid premiums, but it does say that they’ve completed applications and been found eligible, which is more than just creating an account.

          1. Baghdad Jim’s using the Chad Henderson strategy: claiming “creating an account” is “enrolling.”

            We’re on to you, BJ.

          2. (And yes, I know you said “more than simply creating an account.” But you said enrolled at first, and that requires you to make up your own meaning for the word. That’s standard response #8.

          3. There are 4 steps:

            1) Create an account
            2) Apply
            3) Pick a plan
            4) Enroll.

            To when you quote:

            “The head of California’s health insurance marketplace said Tuesday that more than 16,000 households have completed applications in the first five days of enrollment, largely overcoming early technical setbacks that continue to hamper other states.”

            It’s perfectly clear that those people DID NOT pay premiums (applications).

            And so once again you’ve distorted your own sources to back up your totally false narrative.

    2. In a sane world that would open up another court challenge. If the government prevents compliance, the penalty for non-compliance (the “tax” for not having medical coverage) is rightly void.

  4. This, too, was predicted…years ago. And you can bet it will happen more and more:

    White House, IRS exchanged confidential taxpayer info

    Top Internal Revenue Service Obamacare official Sarah Hall Ingram discussed confidential taxpayer information with senior Obama White House officials, according to 2012 emails obtained by the House Oversight and Government Reform Committee and provided to The Daily Caller.

    http://dailycaller.com/2013/10/09/white-house-irs-exchanged-confidential-taxpayer-info/

    1. To clarify: Issa has emails with redacted content. If the redacted information is in fact confidential taxpayer info, then the Daily Caller headline is correct. We won’t know until Issa gets the unredacted emails; it could be that the content was incorrectly redacted, and isn’t actually confidential taxpayer information.

      1. Yes, of course. That has to be the explanation, because despite all the evidence of abuse, the IRS couldn’t possibly have done anything wrong. They must continually be given the full benefit of the doubt.

        1. Maybe you’re right, but we won’t know until someone gets the un-redacted emails. The headline is premature, and if the story doesn’t pan out you can be pretty sure there won’t be a correction or retraction.

          2. If Issa really thinks there’s proof of lawbreaking I expect he’ll keep asking until he gets them. Otherwise he’ll quietly drop the inquiry.

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