2015-16 OBAMACARE'S HIDDEN STINGER: ONCE YOU ENROLL, YOU NEED TO KEEP COMING BACK TO HEALTHCARE.GOV OR THE GOVERNMENT MIGHT ASSIGN YOU TO A NEW POLICY

One Citizen Speaking...

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2015-16 OBAMACARE'S HIDDEN STINGER: ONCE YOU ENROLL, YOU NEED TO KEEP COMING BACK TO HEALTHCARE.GOV OR THE GOVERNMENT MIGHT ASSIGN YOU TO A NEW POLICY Posted: 22 Dec 2014 12:51 AM PST Another way Obamacare will intrude into your life and complicate your medical care?  CMS is proposing a new rule that may have dangerous and unwanted consequences for those who choose to simply accept their current plan for the coming year and fail to revisit the insecure healthcare.gov website to shop for a new policy. According to the proposed rule, those who fail to re-visit the site or otherwise communicate new choices to the government, the system will arbitrarily try to find you a suitable lower cost program. I say arbitrarily because the proposed system would be blind to your wishes as to hospitals, doctors, and specific healthcare providers. See the proposal [my comments and clarifications are in blue italic] … Centers for Medicare Medicaid Services (CMS) Proposed Rule: Patient Protection and Affordable Care Act: HHS Notice of Benefit and Payment Parameters for 2016   3. Exchange Functions in the Individual Market: Eligibility Determinations for Exchange Participation and Insurance Affordability Programs a. Annual Eligibility Redetermination (§ 155.335) The current re-enrollment provisions codified at § 155.335(j) prioritize reenrollment with the same issuer in the same or a similar plan with the goal of maximizing continuity of coverage and care.  [For those with life-threatening illnesses, when did saving a relatively few dollars trump the continuity of coverage and care by medical professionals who know you, your condition, and do not have to reinvent the wheel – including new histories and other tests and procedures? And, don’t tell me about the benefits of the Electronic Health Records (EHRs) because those are still woefully inadequate and problematical.] However, because premiums may change significantly from one year to the next, the plans that are most competitively priced in one year may not continue to be the most competitively priced in subsequent years. For this reason, default enrollment in the same or similar plan may sometimes encourage consumers to remain in plans that are significantly more expensive than the lowest cost plans in the market. Because we believe that many consumers place a high value on low premiums when selecting a plan, we believe that consumers could benefit from alternative re-enrollment hierarchies. [This is the phrase that pays: “Because we believe.” There are a number of reasons a person might want to forgo choosing a low premium option, specifically because the person might want to keep their current insurance provider, keep their current hospital, and keep their current doctor. Something that President Obama lied to America’s face about and his administration is now telling you that if you do not visit the still insecure healthcare.gov website and re-shop your insurance, the government, in it’s infinite wisdom, will shop for you.] In particular, we are exploring implementing in the FFE [Federally-facilitated Exchanges] an approach under which an enrollee, at the time of initial enrollment, would be offered a choice of re-enrollment hierarchies and could opt into being re-enrolled by default for the subsequent year into a low-cost plan (such as the QHP [Qualified Health Plan] of the same metal [Bronze, Silver, Gold Platinum] level with the lowest premium in the enrollee’s service area, or one of the three such QHPs with the lowest premiums by random allocation), rather than his or her current plan or the plan specified in the current reenrollment hierarchy. This alternative enrollment hierarchy could be triggered if the enrollee’s current plan’s premium increased from the prior year, or increased relative to the premium of other similar plans (such as plans of the same metal tier), by more than a threshold amount, such as 5 percent or 10 percent. As is the case under the existing approach, a consumer would retain the option to take action to enroll in a different plan during open enrollment if he or she wished to do so. We are considering applying an alternative hierarchy for the first time when re-enrolling consumers for the 2017 coverage year. On this timeline, consumers could opt in to the alternative hierarchy during open enrollment in 2015 (or during special enrollment periods occurring during 2016).  We seek comment on such an approach, including with respect to how to ensure that consumers understand the risk of being default re-enrolled in a plan with a significantly different provider network, benefits, cost-sharing [co-pays, and deductibles] structure, or service area; what premium growth in the current plan (or what growth relative to other similar plans) would trigger re-enrollment into a low-cost plan, and how to determine which enrollees get assigned to which plans, if random enrollment into one of the three lowest cost QHPs of the metal level in the enrollee’s service area is implemented.  We also seek comment on how these types of default re-enrollment procedures have functioned in other programs and settings, and what lessons can be drawn from those experiences. Finally, we seek comment on whether such approaches may influence issuers’ pricing decisions, such as by causing them to price more competitively in order to retain or attract enrollees who have opted to be re-enrolled into a low-cost plan. [The lying liars that lie talk about competition, yet refuse to allow insurers to compete across state lines; therefore insuring that their will be one or two monopoly providers in most of the smaller states and districts. As opposed to allowing the consumer to purchase the best coverage at the most cost-effective price.] We are also considering providing this flexibility to State-based Exchanges to implement alternative re-enrollment hierarchies such as the one described above, beginning in 2016, at their option. [Most of the screwed-up state exchanges can barely function let alone implement new programming of any complexity. Eventually, the natural or designed chaotic nature of the state exchanges will lead to their consolidation into the federal exchanges and then the progressive’s dreams of a “single payer system” will come to fruition. Allowing the government to exert unprecedented and unconstitutional control over every aspect of a consumer’s life and to maintain the type of individual dossiers and tracking information that is the dream of every despotic and tyrannical state.] We believe that providing this flexibility could offer an opportunity to gather valuable information about alternative re-enrollment structures and share lessons learned across Exchanges in hopes of improving the re-enrollment process and the consumer experience. We seek comment on whether to permit State-based Exchanges the flexibility to implement these alternative re-enrollment hierarchies beginning with 2016 open enrollment, whether to provide flexibility to SBEs to establish other hierarchies, and whether to adopt any such alternatives in the FFE for 2017 open enrollment. <Source>   No matter how much “education” is provided, is it unlikely that most ordinary people will understand what is being proposed and how it might affect them. Hell, even the so-called experts do not know how it is likely to affect consumers because there is no hard data available and the whole program is an experimental crap-shoot. While forced alternative plan choices may result in premium cost savings to the consumer, no government re-enrollment hierarchy algorithm will be able understand the individual circumstances of the consumer and their relationship with their doctor. The risk of being assigned an arbitrary plan that has a different provider network, prescription drug formularies, out-of-pocket costs and unwanted benefits represents a clear and present danger to the individual and their family. This is the methodology of tyranny … It is your government agency telling you what they are going to do in advance; and then simply waiting for consumers to react. If consumer are unwilling to read the 88-pages of the proposed rule and understand what they are reading, they are unlikely to comment. The rule was posted November 26, 2014 – one day prior to Thanksgiving on November 27th – and the comment period closes December 22nd – a few days before Christmas. Bottom line … You must sign-on to healthcare.gov, refresh your pertinent information, and then make a guess at what you want to do for the coming year. Imagine the surprise of those who believe they are insured and face a denial at their doctors – or even worse – the hospital. Remember the MIT economist, Jonathan Gruber, who was bragging that Obamacare only passed due to the "stupidity" of the American voter and a lack of "transparency,” this type of legislation is what he really meant. An example of his on-camera musings … “This bill was written in a tortured way to make sure [the Congressional Budget Office] did not score the mandate as taxes. If CBO scored the mandate as taxes, the bill dies. OK? So it's written to do that. In terms of risk-rated subsidies, if you had a law which said healthy people are going to pay in — you made explicit that healthy people pay in and sick people get money — it would not have passed. OK? Lack of transparency is a huge political advantage. And basically, call it the stupidity of the American voter or whatever, but basically that was really, really critical to get the thing to pass. Look, I wish ... we could make it all transparent, but I'd rather have this law than not.” The Patient Protection and Affordable Care Act does not protect every patient and for many is certainly not affordable. What the insurers have is a government guarantee of subsidies if they fail to earn a profit (or fund those outrageous executive bonuses) until the government moves to a single payer plan that converts insurers into government clerical workers. Obamacare is a clear and present danger to your future healthcare and the Constitutional independence of our nation. The mere fact that the government can demand that taxpayers cover the non-emergency costs of illegal aliens shipped here for medical care is an example of an economic at of war on the United States. -- steve

TIME TO END THE TYRANNY OF THE VOCAL MINORITIES Posted: 20 Dec 2014 04:16 PM PST One of the pitfalls of a nation that is divided into relatively equal proportions is that fringe groups of activists appear to yield disproportionate power as they market their support to one side or the other; extracting political power, funding, and sometimes outrageous concessions for their support … Unfortunately, we find the progressive socialist democrats actively engaged in this activity – dividing up the nation into groups of victims, each with their own real or imagined grievances and being promised redress if only their join the progressive socialist democrat coalition against the dreaded bogeyman of the GOP. In essence creating caricatured characters like Darth Cheney, the man who would deny you life, liberty, and the pursuit of happiness to turn a profit in the oil patch or creating a war to fund the military-industrial complex. Other than the usual progressive socialist democrat suspects, Blacks, Hispanics, Women, Gays, and the Poor, we are seeing the rise of political exploitation in a new subset of the gay culture – the transgendered. People who are unsure of their sexual identity or believe that they are born with the wrong set of plumbing. Another segment of the population that can be divided and played for political power. So why am I not surprised that groups in Nebraska and elsewhere are exploiting a training handout and suggesting that using the descriptive appellation boys and girls is somehow not inclusive of transgendered children; suggesting that some neutral phrase, like purple penguins, be used. Curious as the color purple is most often associated with gays? Imagine the brouhaha if teachers divided students into red and blue groups? (blue + red = purple) Gender Spectrum provides education, training and support to help create a gender sensitive and inclusive environment for children of all ages. Thinking Critically About Difference Schools that explicitly recognize gender diversity establish conditions in which conversations and activities exploring other forms of difference become possible. In embarking on a path to expand students’ understanding about gender diversity, schools set a tone in which the examination of differences across multiple domains is accepted and encouraged. Exploring gender becomes an on ramp for students to consider complex issues in other aspects of their lives. Racial, cultural, religious, linguistic, socioeconomic and many other forms of difference can now be examined from the perspective of critical analysis grounded in this initial study and understanding of gender. Coming to recognize gender in all of its complexity allows students to see concepts in more realistic terms. Helping them understand the idea of a spectrum—a range of possibilities and not simply the “opposite ends” of a binary—builds their capacity to critically examine concepts in other areas of learning as well as building their appreciation for gender and other forms of diversity. In building students’ perspectives about gender and gender diversity, schools are able to introduce notions of ambiguity and degree that will serve them they explore other complex topics for the rest of their lives. Interpersonal entry points are the various ways in which individual interactions and communications are utilized to reinforce a school’s commitment to gender inclusion. Supported by many of the structural components, these relational aspects nonetheless require intentional behaviors in the day-to-day interrelationships of a campus. They literally voice a school’s commitment to honoring the gender diversity of all students. From the manner in which they set up and run classrooms to their use of language with students, and parents, teachers and leaders can literally “walk the talk” through these relational and conversational approaches. <Source> I can understand the “neutrality” of calling children students, so where are the “purple penguins?” Playing for the “other side” – used for fundraising or making a point to a “political base” …  The concept of “purple penguins” appears to have originated in a training handout – obviously targeted at elementary children. And, unlike the assertions put forth in various publications, this does not appear to be the policy of any particular school board or school. School Told to Call Kids ‘Purple Penguins’ Because ‘Boys and Girls’ Is Not Inclusive to Transgender Nebraska teachers are instructed to ask students what their preferred pronouns are. A Nebraska school district has instructed its teachers to stop referring to students by “gendered expressions” such as “boys and girls,” and use “gender inclusive” ones such as “purple penguins” instead. “Don’t use phrases such as ‘boys and girls,’ ‘you guys,’ ‘ladies and gentlemen,’ and similarly gendered expressions to get kids’ attention,” instructs a training document given to middle-school teachers at the Lincoln Public Schools. “Create classroom names and then ask all of the ‘purple penguins’ to meet on the rug,” it advises. The document also warns against asking students to “line up as boys or girls,” and suggests asking them to line up by whether they prefer “skateboards or bikes/milk or juice/dogs or cats/summer or winter/talking or listening.” <Source> The truth is that, no matter what inclusivity training might be provided, children are aware enough of the differences and will use these differences to bully other children. So, perhaps an anti-bullying campaign would be more effective than some program designed to benefit one segment of the minority population. You would think that those who are making a big deal out of “purple penguins” would be out gathering support for traditional teaching: reading, writing, arithmetic, history, civics, useful skills, and respect for individual students no matter who or what they may be. No more trying to politicalize sexual identity or engage in revisionist history for the benefit of one group or the other. Bottom line … This “purple penguins” kerfuffle is indicative of the hyper-politicization of school curriculum which has failed students and has produced yet another generation of functional illiterates. Children so dependent on digital devices that they cannot tell time using an analog watch or “make change” without a computer. Today, writing no longer involves critical thinking, but Google searches and cutting-and-pasting. All while teachers’ unions blather on about competing in a global economy – full well knowing that many of the graduates cannot compete in their home town. It is not the duty of a school system to replace parental instruction or inculcate students with a progressive viewpoint. If a child is struggling with personal issues, perhaps it is time for a parent-teacher conference and a referral to specialized resources. But, you do not mandatorily force everyone to acknowledge and accept non-traditional viewpoints for the purpose of political “inclusiveness.” Nor do you teach to the lowest common denominator while overlooking the best and brightest who will become the backbone of the next generation. No more gold stars and ribbons for just showing up. No more rewarding incorrect answers to precise mathematical questions. No more overlooking poor grammar or not correcting slang or ethnic speech. And, above all – it is time to punish thuggish behavior and demand discipline in the classrooms. If that means segregating the malcontents and disrupters in other facilities – let the be the basis of a bussing program.  Rather than be concerned with “purple penguins,” school systems should be more concerned with cultures that do not embrace education and/or allow children to denigrate, berate, and bully those children that do well in school. It is time to break the lock-step of the teachers’ unions who believe that they have the sole rights to students and their funding. More competitive teachers, more competitive schools, and more control over the long tail of the union pensions that are now wagging the dog. No more using a school board as a stepping stone to higher political office. No more accommodating education-based special interests – in today’s digital age, there can be no justification of $50 textbooks that contain material that was developed decades – if not centuries – ago. No more expensive artificial de-segregation in communities that purposefully self-segregate. It is time that “We the People” took back our schools, our communities, and our nation from the political activists who have turned politics into a well-paying profession that does little or nothing to serve the public need. It is time to come back to American values – where people are not hyphenated-Americans, but Americans; and where loyalties are not to foreign sovereign states. You are part of America or you are welcome to go elsewhere. -- steve