WWL>Topics>>8-11-14 12:10pm Garland: on Obamacare

8-11-14 12:10pm Garland: on Obamacare

Aug 11, 2014|

Garland talks Obamacare with Michael Cannon of the Cato Institute and Joe Antos of the American Enterprise Institute.

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Automatically Generated Transcript (may not be 100% accurate)

I've got a competitor -- but sure roads that we don't over obamacare. Earlier understand it I think I understand little bits and pieces bootable out of the two and yet -- I've. Understood that -- Colby individual mandate that discoverable. At the old comments that use. To increase of the number of people that -- There for maximizing. The number of people in the pool money that the role. And about thought supposed to keep the pool from just being old people. Trying to spread it -- -- most of the wrong because every display week. Almost 9% of the mentions thirty million uninsured. Won't pay a penalty. Under review reported here. Because of the growing batch of the exemptions. On on the -- Colbert Report. And with the whenever -- could -- -- to go to the effort Michael can once again. A -- enables you some of his son and director of health policy you'd kid -- student Michael welcome back thank you so much for the time it'd be. What demise at ground -- important and not understanding. I understand that most of them I -- -- impeachment board. How can we have 90%. Of the thirty million uninsured. Not penalized. And exempted. That. Well at a certain number of ways and there's actually a long list of ways that people can either be exempted from the individual. War. Can avoid paying eighty it's not a there's an article recently in the Wall Street Journal that looked at this question. And so. And reported that 90% of the uninsured will be paying any penalties under the individual and this confirms what. People like I think it's that for a long time as mandated largely to. If you get. There's -- there -- to exemptions built into the law itself there additional exemptions to the administration has offered with varying degrees of legality. And what he wants some of them are if you deal it if you have your utilities shut off. You get an exemption. It did not you have to pay out of pocket for your health insurance is. More than 8% of your household income you get an exemption. To plant was canceled because of Obama care for some other reason you get an exemption. And on down the law. That don't -- exemptions that exist but even if you don't get an exemption. You can avoid paying the penalty. Simply Barney. Setting up your income tax withholding the right way. The way it works is that. The only tools of the iris has to collect that money from view. Our. It's -- if you. -- them or sorry they you're refunded the end of the year. That's basically the only way to the -- can get that money front beauty can -- fines or liens on property or threats of criminal. Sanctions. All they can do is. Take any money that you left with then by mistake. So if you re configure income tax withholding -- that you will owe the IRS money at the end of the year. Then they can't come after you for that money so it is really it is a toothless mandate. And that is. I think it could. Good things for. 44 liberty but I think it's a -- saying because. Well actually -- -- -- -- it anyway it's a bad thing what it will do it will expo -- A lot of the cost of obamacare that that mandated trot would debates. Thought the mandate might try to obscured by forcing help -- people. To prop up the program by -- overpriced -- And and to try to read correctly. Goes all the way back 2002. And when the exemptions include. Illegal immigrants a number of native American tribes and -- whole bunch of religious sects from. Well that's correct those those exist also that if you live in the one of the US territories here also have to individuals and. They were two. I mean do you think. Insurance weren't really -- a pot of money. That almost her blog punts and two detector. Of those that. Can report take care of and so and those that and uses -- of 9%. And giving exit. Wouldn't have to insurance is -- tool for subsidizing people who need help who can't afford the medical care that they need. And that's why people buy health insurance voluntarily. One obamacare try to do it is. Force the insurance markets. To cover people who. Are not at risk of the expensive medical care but whose -- bet that people would it -- already material. And insurance just doesn't work that way. If you. You know everyone complains about our insurance premiums for the sick but really what they -- insurance companies ways that -- -- market's way of saying hey. Subsidized in the -- through insurance. Circulating these folks through insurance were already sick is extremely expensive. You need to find a better way. But that would into those markets signals the president try to do is viewed he has slapped price controls on insurance that. On health insurance that forces insurers. To suppress those markets signals everyone ignores the reality that they today and then. And then in order to keep the market from collapsing. Because we -- talent -- stupid that they have to. Provide insurance -- so what is gonna cost 400000 dollars a year purchased a 101000 dollar premium. They're going to go out of business. To keep that from happening the president wants to force healthy people two vital that your -- the whole idea of individual mandate you don't need a band aid in order for health insurance market to work. You need a bandy and some other provisions to keep health insurance markets from collapsing would government slaps the sort of price controls on the and it's an open question as to whether or not the health insurance markets. In the fifty states will collapse. Given those price controls and the fact that this individual mandate is largely -- And again foyer of the -- reading. Congressional report left cited in the authors of Obama here initially thought. About six million people we're gonna -- -- now they think it's going to be moral like for three and and get 41 states that like Louisiana have opted not to expand Medicaid so those residents are exempt from the penalty. Is there any way be it can't collapse based -- Let the people who would otherwise have been eligible for Medicaid under the Medicaid expansion will not be penalized for not obtaining health insurance. Under the individual mandate and and is it the question is is. -- the whole thing collapsed. Well at that it is very well could you could get what economists call an adverse selection death spiral where with these. But these -- control reduce the amount that insurers Turkic people. And increased even opposite church -- church helping people. The healthy people leave the market knowing that. Because of obamacare. They can buy health insurance. That we they get -- at the same premium the but he sure -- -- and their health. So there's really not much incentive to do it elect is an individual mandate and he against the -- they can -- to close but another dimension to this that. That could accelerate that that adverse selection death spiral. Infected would have accelerated it by now if President Obama had been -- Beijing don't health care law. Is that. In Louisiana and 35 other states that opted not to establish his general health insurance exchanges. And in which the federal government has stepped in to establish an exchange. The law does not authorize. The -- 5000 dollars subsidies. To help people purchase health insurance in those states that it does authorizes states to establish their -- exchange. Nevertheless the president offering those subsidies in the 36 states anyway. That is currently being litigated there was a ruling -- it really the second highest court in the nation saying that those subsidies. Or illegal. And the president do not have the authority to offer them. And that they must stop. I'll -- that your taxes that are legal and the courts and the president did the president did not have the authority proposal taxes either. That ruling and expects. Then you're gonna see a much more rapid adverse selection death spiral whereas if it did. It doesn't take it might just be a pace slow work pretty good -- more of the people drop out of the market had essentially. And the profits just repeats itself. -- love to see how that. And lawsuits to seek out and probably insurance market checked. You're good future income sorting and we'll come back and finish -- -- -- true of Michael cannon. Director of health policy that general institute right at adults. This sentences. What caused me decide do we showed today. What it comes Obama Carol almost 90%. Of the nation's thirty million uninsured will -- of note today. Under obamacare. Big cause -- -- extremely. It's growing number of exemptions. In the country. A better run since the Michael cannon is with the the director bill policies Cato Institute. Michael court -- upon mr. in pursuit. One of the individual mandate. Implemented. And in order to can't force people that probably would not have voluntarily -- and tool obamacare. And and the very -- than that so many people getting exemptions. That is the individual mandate to understand that apparently you were. Don't nodded then you write a whole. Dual mandate. Once -- force people to buy the overpriced health insurance that obamacare mandated purchase and they would not. Choose to purchase substantially. So. If you take away. He these individual mandates force if you keep exemptions to everybody and the recommitment to do it and because this and so so unpopular not just. Because it's an affront to individual choice and freedom. But also because it's just cool the way obamacare has increased some people's premiums and yet. If they don't buy that. That extensive -- are going to be penalized. For that indeed it just seems cruel many cases -- to do that so. The Obama first congress voted for the law a whole bunch exemptions that the Obama administration's answer expanded on them. Precisely because that mandated so popular but you know that being. As these -- companies like to remind us. Obama -- regulatory scheme you know it's it's. It's that -- of reinventing. Health insurance market only works if there's a strong individual mandate. If the individual mandate had enough force that can make people do what they don't want to do which is by -- over pretzel church. What that means it. The individual mandate is really that costs. All of this law part of the cost of obamacare. People like to tell pollsters that oh I like that. The benefits of obamacare like the idea of insurance companies not being able to discriminate against people with preexisting conditions for example let's -- -- the price controls talked about before. They like those in theory but we get apps we need to hide the costs to the benefits if you ask them about both of those things. Then it's a port forward those. That that ban on discrimination against people with preexisting condition. Plummets. What that tells you is that people don't want this law. You might want the benefits of it but that's like saying -- -- free -- The horror or other due out free money you know -- These sorts of these sort of things. People are not willing to swallow the individual mandate and it. The open Obama administration's own behaviors shows us that the American public is not willing to swallow because. That's why be -- administrations that is easily sentient. Than the American public still does not want this law. Berrian pursuing. One -- portion. I'm reading about Arkansas. They or are crafting of the cold only alternative Medicaid expansion Reagan called that private option. Events I understand the -- can expand to -- that channels. Rather than through public program even though Medicaid stupid so the bill are you aware of that and can you explain it -- -- Yet there's really not much difference here between what they called pride that option. Form of Medicaid expansion and -- State Street government expand should of them that the Medicaid program has existed. Authority exists. And that's because under. The Medicaid program and this is the governor joint state federal program that its stated simply exist that provides medical care the report. Bunch of the medical care was already be provided through private health insurance companies anyway. Instead of the government writing checks to doctors and hospitals that that Medicaid programs writing checks to insurance company. And so in states like Arkansas say it will work it is something different we're having a free market urgent that the Medicaid expansion because -- to -- in his private option thing where we -- people private health insurance. Personalized I don't know what free market about the government writing checks to insurance company instead of doctors and hospitals to people government run to beat by. In addition to that the Medicaid program as -- parties -- Already did it wrote it checks to insurance companies to so there's nothing negative about this. What it is his return to -- with some window dressing to hide the fact that this is just. An expansion of the same. Inefficient. And Medicaid program that's questionable results that -- trying to hide the fact that it's part of obamacare and trying to do anything they can't get Republicans it's. To sign an important thing they think the -- price -- on that than they can do that particular nothing private sector of our corporate market about it at all. Michael. Complicated issues always projected time. Richard give those you have a great day. -- -- I would come right back twosome will talk to the American enterprise institute and so and subject fraud figure out. Of if Obama -- -- they -- note saying that. In the use and but let's just give hypothetical. Book -- news. How do that with the all. Individual mandate were people literally ports to get into the entry routes. So lives and uploaded for a seeing delegate might view problem. What do you think comments questions were about the experts 2601. -- separated told three. 866. Aided and zero -- Very good about your portable secure -- sometimes cold ball McCarron. Got a confessed. Under a number of shows on this over the use and still compute that don't quite. Understand. What we understand -- -- bomb terrible one of the things. The owners who was the individual mandate. I thought that was something that. Required. Penalties. In almost. Out across the back head dude to increase the number of people that signed up. Could you want to maximize. The financial poll that supports the -- technical -- A must be wrong because I'm reading as soon again. Wall Street Journal sort of -- conservative but salutes figures that a bear pardon a couple of vote publications that sets. Almost 90%. Of the nation's thirty million uninsured won't -- penalty. Under Obama care because of growing that all of exemptions. I mean it's exemptions for it pure electricity god Schiavo to you've got. In the kind of verifiable hardship records including domestic violence there. The Little League fourteen different ways you can qualify and ought to -- in laws. So to better understand that we always bring in their first we drew went to those. Really damaged him scholar in health care and retirement. At the American Enterprise Institute Joseph appreciate cult thing. I thank you Becky Garland and you are absolutely right. -- is the whole idea behind insurance to get. A lot of people to enroll in the coverage. With the idea that some people will need to draw on the payments and other people. You know -- of the largest and other people won't and and that will make it financially viable and if you don't have that you do you don't have insurance. World beaten paths these two liberal. Conservative debate they're obamacare -- bad. And we ought to do away with the houses -- sustained. -- really good question the. The you know other reports -- that up to 90% of the uninsured. Won't have to pay a penalty now. That while that's true I think a lot of people. And a worm. Affected by how all the publicity and -- line and the idea that. You're breaking a lot people the average person doesn't -- -- a feeling they're breaking a law. So I think that the the individual mandate from that standpoint. Saying you must do this is certainly -- -- Telling you what to do you know tie your shoes in the morning before you go to school. Think it's the same sort of opinions and a lot of people responded that the -- -- Because he -- guys who don't kind of issues before they left school and I think. It will affect the younger people who will quickly realize. That two it's Saddam's. By health insurance is expensive. That is the presidents minimum requirements -- call for just probably a little portrait that. Edward and every good liberal publications one of the league liberal representatives. Fallen. All and -- and oversimplify but the basically two quarts of things wrong commentary very complicated. In the coming health care and -- -- Anywhere in the world even the best filters systems or all the -- and growing in depth so bidders. There's no blueprint out there that says school buddhists and that's going to be okay but. -- go back to congressional report live split -- in this is in June report. The the authors of Obama care. Initially said the we're going to be about six million people lose expected -- of pollen. Now they're saying formula and plus she got toward New England states. That or not gonna expand Medicaid. So -- are residents are exempt from mobile while penalty. It is this something that might field down the road or is this feeling that. Well you know the in his hands. A couple of certainly is failing now financially but the -- failing instantly most government programs fail which is to say that the every taxpayer will see higher and higher taxes. Or are we gonna have. An accelerating. Gets a national debt in national deficit. Which will eventually lead to higher taxes and it just no getting around it. If they used to play and failed to bring in people voluntarily. -- and they have a lot of taxpayers'. Kicking in more than their share. Your taxes were gonna have all of those who are buying insurance. They're going to be seeing higher and higher premiums. And four against for lower income people are gonna see higher premiums and -- such wonderful benefits. They're gonna wonder why am buying this coverage. The middle class -- they would their coverage a lot of middle class people get their coverage -- players but -- concede they're rates go up to. All right secured court Greg were taken about Obama care -- on one side. Things have been put in place to penalize people that the -- applaud attitude to get into the program but don't. But at the same time and there's of load of exempting the very people that were we were told. Needed to be in this -- -- in order put the -- and -- -- financially. More details coming up next questions comments Gibbs called to -- 01. Eats up. We're we're looking nuclear revelation. Dead at the numbers wouldn't be believable almost 90%. Of the nation's thirty million uninsured. Won't be paying the penalties that attempts of the individual mandate. Because. As long carriers being implement exemptions keep growing and growing and growing and would suggest that as he school and there will not be the pool of money. To take care of program and it could run into major problems. In the relatively near future. Two. Give -- -- experts on this we drew went to a -- in the aged two scholar health care and retirement. American Enterprise Institute. Joseph always try and to put the pollutants and in -- via the league tonight. We're back cut and kept a number of files and portable Kara when tempers cuts ordered. And a award proceed that it those that disagree with. A couple of predictions they had weathered they have a poker you think the moderate core. -- predicted. Premium deaths by Euro in in Wednesday. Unnamed. I'm storied that's -- says there's no -- enjoyable premium deaths borrowing in Tuesday. The two doomsayers have predicted -- collapse of insurance markets as carriers acts. That's what people or Obama here it says it. Is there really evidence of a premium death spiral or insurance companies getting out of the market. Well as a matter of fact. It's going the other way and at least two terms as insurance companies going into. Exit the in the market as far as the premiums deaths are less concerned though. And depends what you mean by death spiral I think I think this is the -- is to you too loosely used. But it is there is absolutely no question. They had to make it work for the very very large taxpayer provided subsidies and on the exchanges. That. Premiums. If for next year would be -- Over fifteen or 20% in most in most markets. In California for example they were they were admitting. That. Premiums. On subsidized premiums would be killing by as much as 80%. Depending -- the -- and you pick. They also said that if you account for did the subsidies. The average person would be paying 4% more. And that's the average person receiving subsidies quest is the average taxpayer how much the average taxpayer paying for that. And the answer is they're picking up there and -- most of the -- very tiny increases in premiums they were seeing. On top of that. High premiums don't necessarily buy that kind of coverage it seems like you're going to get. People buying this so called silver planters are still seeing. Deductibles. It's 2500 dollars to 5000 dollars. For low income people that's a lot of money. So they're not really getting coverage at what they're mitigating is that serious coverage. Add to premiums that are. Heavily subsidized that's still going up. And there's still going to be facing very very large bills that for a while low income people are just an affordable. How about the fear when Obama care reforms implemented. -- so many people gonna get drug coverage doctors and nurses we're going to be overwhelmed in particular primary doctors primary care doctors. The don't get paid a whole. -- that that's a big issue that is that this city obamacare and I issue happiness is. This is it should be concerned for everybody looking and looking forward to the future. We need more are internists in primary care doctors. We don't have. -- to meet the requirements that we now have. That's just you know. On the care but he generals. We haven't however seen. Some explosion. People. We had serious problems coming in and getting all kinds of services. And that they just have worked out that way. But but over the over the long term we're gonna run into a real problem. One of the things that. The president's health plan did -- they -- OK we will have Medicaid pays some extra money. Two premiere here primary care doctors for a few years let extra money is now right now. And you know it's kind of like at nine tip it's not gonna solve the problem we're gonna have to do. They're going to change -- where healthcare is delivered broken after a lot more and nurses and other other. Highly skilled professionals in the -- and India after the game. 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