The Not-Affordable Care Act

Christmas was quiet in Ironwood County--just as everyone wishes it. The cold snap has descended onto the Midwest with little hope of lifting for the new year. However, colder yet is what the government has done to much of southeastern Minnesota--allowing insurance companies to dump the highest rates in the Midwest onto a handful of counties.

Jack Kiln, resident and armchair politician, spouted off about it at Bill's Café on Monday. Andrew Johanson, newly retired local newspaper editor, was there to capture his comments:

"The “Affordable” care act has marched directly into the same bureaucratic swamp where the No Child Left Behind act disappeared. Both are excellent, simple ideas that bureaucrats who do not understand real-world living conditions twisted into a Gordian knot. These people—legislators on down—do not understand because they have always had a well-funded health plan handed to them.

"Notice that I’m not talking about website fiascoes or President Obama’s rule-changing, but the legislation itself. If someone had been covered under an insurance plan of any sort—even catastrophic—why did the law make anyone change in the first place? Isn’t the idea that everyone should have insurance, not legislate what type of insurance an individual should have? If people don’t feel that they need or want chemical dependency coverage, for example, why mandate it?  Ah, the knot begins to form . . .

"Secondly, the legislation requires employers to provide group insurance. Why? Thee are many ways to ensure that people are covered. For example, if a company wishes to provide money for workers to buy their own individual insurance (called an HRA), why does the government care so long as individuals have insurance? Isn’t that what the tax penalties are for? The knot gets every bigger . . .

"Next. Where’s family insurance in this legislation? Single coverage is mandated. Family coverage is not. Previously, a family was covered either by a family policy taken out by the family itself or, most likely, through an employer. Now, however, the family rates are going up (as are the single rates) to pay for mandates, and yet only single is required by the employer. Hm. Employers know finances, even if the bureaucrats don’t. Put the benefit dollars into the single plans. Let the families fend for themselves. That’s what the government has done.

"So, for any family who is lower-middle class, that family probably qualifies for a subsidy. The best option is for one (or both) wage earners to take the company’s paid insurance for the single and put children on the exchange where they can get free health insurance.

"Does this make sense? Previously, families covered themselves through the employer or their own resources; now they are financially rewarded for tossing their kids onto public subsidies.

"I am not making this up. This “solution” has appeared in various publications and on several health care websites. The bureaucrats’ rationale is that now all children are covered—even those who previously didn’t have insurance.

"Now we see the heart of the knot—a good idea corrupted by details, proving, once again, the old adage that the “Devil is in the details.” How does this happen? Details destroyed No Child Left Behind—sledgehammers were legislated where a scalpel was required. Why? Because the government uses top-down legislation rather than foster bottom-up solutions.

"As always, there is only one way of getting out of a Gordian knot—cutting it—which will prove nearly impossible because Republicans have failed to find another solution to the health care crisis and Democrats are afraid to lose face and fix the Affordable Care Act.

"Because of an unwillingness in both parties to fix it , we might end up with what no one wanted—a government-run, rationed health care system."

Finally done with his tirade, Jack Kiln sat back and drank his hot chocolate. The boys at the café nodded and refilled their coffee. Most had no clue what he had said.