Today when I was looking for something else I stumbled upon a headline from the Washington Examiner — “How Obamacare keeps families trapped in poverty.” The article, by Mark Hemingway, appeared to be one more attempt to link the “doc fix” Medicare reimbursement issue to the the Patient Protection and Affordable Care Act (PPACA).
As I’ve explained in the past, the Medicare reimbursement shortfalls that have to be “fixed” every year are not the result of the PPACA, but of other legislation enacted in 1997. But demagoguing the issue and linking a looming Medicare reimbursement cut to “Obamacare” was too tempting to the Right. So, they were linked.
However, Hemingway presented a new twist. He claims the recently passed “doc fix” that postponed the cuts one more year are being paid for by a change to the PPACA, namely a provision that would heap additional financial burdens on low-income people receiving subsidies to pay for insurance.
Considering that the subsidies don’t start until 2014, and the “doc fix” bill only applies to 2011, this seemed far fetched to me. But Hemingway links to an article slugged “Obamacare Criminalizes Medicine” by Shikha Dalmia at US News and World Report, who explains,
When the government hands out subsidies, it will use a householdâ€™s income in the previous year as the basis for guessing what the household is qualified to get in the current year. But if the householdâ€™s income grows midyear, the subsidy recapture provision will require it to repay anywhere from $600 to $3,500, compared to the $450 that the law originally called for.
Never mind that such a change has “Blue Dogs and Republicans” written all over it. Hemingway and Dalmia are both outraged that this terrible burden will be placed on the poor. One suspects such tender concern for those in poverty is a tad out of character for these two. Dalmia goes on to express horror at the fact that another provision of PPACA is designed to crack down on fraud by doctors and hospitals. Imagine.
Anyway — I clicked on Dalmia’s links to see where she was getting her information, and lo, two of the links are to a blog post at Firedoglake. This post was written by David Dayen, who is still mourning the loss of the public option, and Dayen links to an article at The Politico about negotiations on the “doc fix” bill before it was passed. This article, by Jennifer Haberkorn, says,
Democrats are under pressure to pass a full-year patch of the doc-fix during the lame duck session because Republicans are already eyeing it as a vehicle to tie to repeal efforts next year.
In 2014, some consumers will be able to buy health insurance through exchanges, portals similar to Orbitz or Expedia. Low- and middle-income consumers will be eligible for tax subsidies to help pay for their coverage.
The deal on the table would change how much money consumers would have to repay if they misreport their income or their income grows mid-year, according to Congressional aides familiar with the proposal.
Under the health care reform law, if a person gets more of a tax subsidy than theyâ€™re eligible for, theyâ€™d have to repay no more than $250. Families would have to repay no more than $450.
The deal on the table would raise those caps on a sliding scale based on income. The figures havenâ€™t been finalized yet.
So, this ugly thing people are blaming on “Obamacare” is a Republican amendment. Of course.
But what does the actual bill actually say? Alas, the final bill, H. R. 4994, is not yet online through Library of Congress Thomas page, and other versions I have found online are dated way earlier than December 2010, when it was passed. So we’ll have to wait a bit.
I noticed that the folks at Free Enterprise Nation (The Voice of the Private Sector) hadn’t gotten the memo they were supposed to be angry about the oppression of impoverished people. They merely say,
The Senate approved a bill that holds off scheduled cuts to Medicare reimbursement rates through all of 2011. The $19.3 billion cost of the bill is offset by increasing the penalty to people who fraudulently receive government subsidies for healthcare insurance by understating their earnings. Without Congressional action, reimbursement rates would have been cut 25%, forcing many doctors to stop treating Medicare patients.
This new “Obama Criminalizes Medicine” meme apparently just started popping out of the Noise Machine over the past three days, so expect to hear more about it. The GPO will be done with the bill text and have it online eventually, I trust.
Update: Gallup says that Barack Obama and Hillary Clinton are America’s most admired people, but that won’t stop the GOP from trying to take him down. This created an interesting juxtaposition on Memeorandum: