I'm hardly a conspiracy theorist. As anyone can tell you, I try to keep my paranoia on a personal level. But every day that dawns with some new court ruling, cabinet-level decision or presidential directive regarding the Patient Protection and Affordable Care Act, the more I wonder just what the hell is going on.
This thing was bad enough to begin with, but now that it's been covered with more waivers, grants and loans than a college admissions department, it's getting more and more difficult to figure out what anything means.
(Former Speaker Pelosi must have seen this coming, explaining her now-infamous argument to pass the bill to find out what was in it. She's clearly much more of a pro than me.)
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It started with the medical-loss ratio waivers, which Secretary Sebelius's office had rolling off the printer like support group flyers on a college campus.
Then along came the Medicare reimbursement fee cut delays, which of course, got touted early on as a funding cornerstone for this whole mess so that we could call it "deficit neutral." I think we all know how that's going to turn out.
And speaking of deficits, now we've got the feds handing out more borrowed money – to the tune of $638 million – for these great new co-ops springing up across the country. One of the most popular of which is the Freelancers Union, which hauled in more than $340 million itself. Keep in mind these federally backed nonprofits will be competing directly with private insurers. But I'm betting they're getting a better interest rate. I'm not sure if – or how much we budgeted for these babies, but it smells an awful lot like solar power to me. Or just Chicago-style politics as usual.
(By the way, did anybody catch the study recently that found out Chicago's apparently the most corrupt city in the country? I'm sure it's just a coincidence.)
Now we've also got the grants rolling out to the states for the exchanges, with another 10 states collecting $230 million just this week. And that's all well and good, since that's actually provided for in the original legislation, but what's troubling is a new Associated Press study that shows way too many of these states collecting money still don't have actual plans in place. And for someone as mathematically challenged as myself, I can see how that might make actual budgeting a little problematic.
And never mind that the Supreme Court will be mulling this over soon – as the general election heats up – and could throw the whole thing out, just part of it or do absolutely nothing.
So you see how this all might add up to patchwork implementation, shoddy funding and just plain sloppy oversight – and a future as uncertain as our own president's.
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