Is Trump’s Obamacare Executive Order Constitutional?

There has been a lot of discussion about President Trump’s healthcare Executive Order. Most of the discussion centers around the likely effects of the order while little has been said about the constitutionality of Trump’s executive action. For a party that roundly condemned President Obama’s abuse of executive authority, a big question should be whether Trump has the legal authority to make the changes that he proposes.

The bottom line is that Trump’s Executive Order doesn’t actually make any changes to the Affordable Care Act. What it does do is to order cabinet secretaries to “consider proposing regulations or revising guidance, consistent with law.” In other words, Trump isn’t proposing changes to laws passed by Congress, he is considering changes to regulatory laws enacted by bureaucrats. These changes will be “considered” in three main areas.

First, the president wants to expand access to association health plans (AHPs). Health Affairs notes that these plans are more loosely regulated than traditional insurance plans. They are normally regulated by the states, but can be regulated by the federal government in the case of some national associations. The order instructs the Secretary of Labor to “consider” expanding the definition of “employer” under ERISA to allow more groups to sell AHPs and to “promote AHP formation on the basis of common geography or industry.” To purchase insurance, consumers would have to be a member of the association.

Second, the Executive Order moves to expand Short-Term, Limited-Duration Insurance (STLDI) policies. The order notes that STLDIs are “exempt from the onerous and expensive insurance mandates and regulations” of the Affordable Care Act, but that “the previous administration took steps to restrict access to this market by reducing the allowable coverage period” to less than three months. “To the extent permitted by law and supported by sound policy,” the president directs cabinet members to “consider allowing such insurance to cover longer periods and be renewed by the consumer.”

STLDIs are not considered to be individual health insurance policies and do not have to meet the insurance policy requirements of the Affordable Care Act. The policies are governed by rulemaking agencies of the Department of the Treasury, Department of Labor, and Department of Health and Human Services. Therefore, these departments can amend the rules for STLDIs without going through Congress.

Third, the Executive Order instructs relevant cabinet secretaries to “consider proposing regulations or revising guidance, to the extent permitted by law and supported by sound policy, to increase the usability of HRAs, to expand employers’ ability to offer HRAs to their employees, and to allow HRAs to be used in conjunction with nongroup coverage.”

HRAs are health reimbursement accounts. They allow employers to contribute money on a pre-tax basis to reimburse employees for health insurance premiums and out-of-pocket expenses. HRAs were created by Congress, but executive branch agencies have leeway in how to regulate them.

President Trump’s decision to halt Obamacare subsidies to insurance companies is not part of the Executive Order, but is on firm legal ground. House Republicans sued the Obama Administration over the subsidies in 2014. In May 2016, a federal judge ruled that Congress had authorized the payments, but had never appropriated money for them. The Obama Administration appealed the ruling, but the decision by President Trump seems to be merely accepting the court’s initial decision and dropping the appeal.

This doesn’t mean that the Trump Administration will be able to stop making the payments. Several states ultimately joined the appeal, claiming that the Trump Administration was not adequately defending their interests. Now 18 states have filed a new lawsuit seeking an injunction against President Trump’s decision.

Because the President Trump’s Executive Order does not change existing law and only instructs cabinet members to “consider” making changes to bureaucratic regulations within the framework of the law, the order is constitutional. It remains to be seen what regulatory changes the various cabinet secretaries will propose, but the changes will probably be much less sweeping than claimed by either right or left-wing pundits.

President Trump’s Executive Order is legal in large part because it doesn’t do much. The president simply does not have much authority to change laws that have been passed by Congress. The decision to stop insurance company subsidies is a more serious threat to Obamacare, but even this is unlikely to take effect until the lawsuit by the states is settled.

Bernie Sanders: GOP Healthcare Bill Like 9/11 Every Year

Last month, Elizabeth Warren took to the Senate floor and cried that cuts in the GOP healthcare legislation were “blood money.” Over the weekend on “Meet The Press,” Tom Perez literally claimed people will die if the bill is passed. On Sunday, Bernie Senders said the proposed healthcare overhaul is synonymous to the 9/11 terrorist attacks – every year.

OK now I’m scared.

Giving a speech in Morgantown, West Virginia on Sunday, Sen. Sanders loosely correlated the loss of health insurance to sure death. He then compared the number of estimated lives lost to the number of people killed on September 11, 2001. He didn’t stop there. Sanders suggested it would be like 9/11 EVERY YEAR.

“Now, obviously nobody can predict exactly how many people will die if they lose their coverage. Nobody can make that prediction,” Sanders said. “But what experts at the Harvard School of Public Health estimate is that if 23 million Americans were to be thrown off the insurance they currently have, which is what the House bill would do, up to, up to 28,000 Americans every single year could die.”

“That is nine times more than the tragic losses we suffered on 9/11, every single year,” he stated.

A bit harsh, no?

This kind of language should have no place in political discourse. It gives fodder to the extremes in our country and makes negotiation in Washington almost impossible. Opponents should be allowed to disagree with the legislation – that’s their right. But let’s not act like this is a bill calling for the end of times. You’d think Sen. Sanders would have learned this after one the volunteers for his presidential campaign attempted to go on a Republican killing spree because he genuinely believed the GOP wanted to kill people.

Unfortunately, this isn’t the first time Sanders has spoken gravely about the healthcare bill pushed by the Trump administration. Basically as soon as it was released he’s been crying doomsday:

By the way, many healthcare experts don’t buy Democrats’ doomsday prophecies. The Congressional Budget Office’s estimates of people to be bumped off heath insurance, should the GOP alternative pass, are based off assumptions of Obamacare enrollment skyrocketing – which many argue won’t happen. Avik Roy gives a superb analysis to the National Review.

Obamacare Reform Is Looking Doubtful This Year

If you’re wondering whatever happened to the Republican health care reform bill, you are not alone. When we last heard from the American Health Care Act, House Republican leaders were waiting on the Congressional Budget Office to score the bill before submitting the legislation passed in the House to the Senate. The CBO scored the bill in late May, but the silence from the Republican ranks has been deafening. The congressional website does not show any action on the bill since it passed the House on May 4.

Readers of The Resurgent are aware that the Republican health care bill falls short of full repeal. Senate rules require 60 votes for cloture on a repeal bill and Republicans would not be able to find eight Democrats to join them in ending a Democrat filibuster. Even if Republicans eliminated the filibuster entirely, they would not have enough votes for full repeal because at least four Republicans have pledged to oppose a repeal bill that does not provide for a phase out of the Obamacare Medicaid expansion.

Now some Republicans are saying that it is doubtful that they will be able to pass even an incomplete health care reform bill. “I don’t see a comprehensive health care plan this year,” Senator Richard Burr (R-N.C.) said in Politico. “It’s unlikely that we will get a health care deal, which means that most of my time has been spent trying to figure out solutions to Iowa losing all of its insurers.” Burr serves on the Senate Heath, Education, Labor and Pensions Committee.

In the Wisconsin State Journal, Senator Ron Johnson (R-Wisc.) agreed that the first priority to would probably be to act to preserve the health insurance markets in their current form. Johnson said that a short-term “market stabilization” bill could be passed that would fund the Obamacare exchanges with billions of dollars to help prevent insurers from exiting the marketplaces. Such an approach would reduce volatility in the Obamacare markets and buy time for Republicans to agree on a reform bill.

“To me, this may be a two-part process. I would admit that’s probably a minority view in the Republican Senate right now,” Johnson said.

Senator Jeff Flake (R-Ariz.) also tried to tamp down expectations. “There are some still saying that we’ll vote before the August break,” he told the Washington Post. “I have a hard time believing that.”

The fundamental problem is that conservative and moderate Republicans do not agree how to handle various aspects of the health care issue. Although Republicans have been united in their desire to repeal and replace Obamacare since the day it was passed, they disagree on the details of what should come next.

In the eight years since Obamacare became law, Republicans such as Tom Price, formerly a Georgia congressman and now Secretary of Health and Human Services, have written legislation to repeal Obamacare and reform the health insurance industry, but the party has not coalesced around any single bill. When Donald Trump eked out a squeaker of a victory in the Electoral College, Republicans were caught flat-footed and did not have a plan for how to exploit his victory. Indications were that, as late as early February, Republicans had not even started writing an Obamacare reform bill. The Senate considers the House bill dead on arrival and is writing its own version of health care reform, which may be available as early as this week.

President Trump’s antics are also hurting the possibility of passing a health care bill. The investigation into the Trump campaign’s possible connections with Russia and the firing of FBI Director James Comey are distractions that make it even more difficult to find a compromise that is acceptable to all GOP factions. The president showed leadership in the fight to pass the AHCA in the House, but has largely been missing-in-action on the issue in the month since the House vote.

Not all Republicans are pessimistic on health care. Senator John Cornyn (R-Texas) was quoted in The Hill as saying, “We do need to take care of our business, and I think you mentioned healthcare, and that’s certainly front and center in the United States Senate — something we’re going to have to get resolved here in the next few weeks.” Cornyn said that he thought a Senate bill would be “done by the end of July at the latest.”

Repeal of Obamacare has been the centerpiece of the Republican platform since 2010. The fact that repeal is not possible, even with Republican majorities in Congress and a Republican president, is not going to please most Republican voters. If the new Republican administration leaves Obamacare completely intact, it may well face a mutiny from the grass roots.

Trump Administration to Continue Obamacare Subsidies to Insurers

The Trump Administration has announced that it will continue to pay subsidies to insurance companies under the Affordable Care Act says the New York Times. Separate from the subsidies paid to individuals, the subsidies to insurance companies are intended to offset losses that they incur under the Affordable Care Act and total $7 billion per year.

Without the subsidies, more insurance companies would exit the Obamacare marketplaces. Already one-third of counties have only one Obamacare insurer according to the Kaiser Foundation. Kaiser also estimated that without the subsidies, average premiums for the Obamacare silver plan would rise by 19 percent.

The failure of their health care reform bill has left the Republicans between a rock and a hard place. On one hand, disagreement between rival Republican factions makes repealing large parts of Obamacare and reforming the remainder impossible. On the other hand, if the GOP does nothing and Obamacare implodes with prices spiraling out of control, President Trump and Republican leadership would likely bear the brunt of the public displeasure.

The Trump Administration seems to have decided that the least bad option is keep the Affordable Care Act on life support for the time being. Continuing the subsidies will not be popular with the Republican base, but it might buy the president and congressional leaders time to iron out differences between the Freedom Caucus and moderates for a second attempt at reform.

Ironically, the subsidies were the subject of a lawsuit filed by House Republicans against the Obama Administration. The GOP won the case on the grounds that Congress had authorized the subsidies, but had never appropriated funds for them.

“Congress is the only source for such an appropriation, and no public money can be spent without one,” wrote US District Judge Rosemary Collyer in her decision. Ultimately the ruling against the president was stayed pending appeal, allowing the unappropriated subsidies to continue.

At least two Republican leaders say that Congress should appropriate the money. “I don’t think anybody wants to disrupt the markets more than they already are,” Rep. Tom Cole, chairman of the Appropriations subcommittee responsible for health spending told the Times. “It’s a very unstable market.”

“I will do everything I can to make sure that the cost-sharing reduction payments get made,” Rep. Greg Walden (R-Oreg.), chairman of the Energy and Commerce Committee said. Walden said the subsidies are “an obligation we have not only to the insurers,” but also to consumers, and “we cannot leave them high and dry.”

A bill appropriating money for the subsidies might make unlikely bedfellows. Moderate Republicans and those who don’t want to see upheaval in the health insurance industry might find themselves voting with Democrats to preserve the Obamacare subsidy… if only for a little while.

If the appeal continues, the Trump Administration can make the payments without an appropriation from Congress for the time being. This puts the Trump Administration in the awkward position of defending an Obama-era end run around Congress in federal court against House Republicans.

The critical nature of the subsidies on making Obamacare’s health care marketplaces work illustrates a fundamental flaw in the Affordable Care Act. The ACA did nothing to reduce the cost of health care or health insurance, it merely changed who pays. Obamacare shifted the burden of paying the bills from consumers and health insurance companies to the taxpayers. Without government subsidies paid for by taxpayers, the whole house of cards will fall.

 

Obama Administration Shelled Out $77 Million In 2016 To Shove Obamacare Down Our Throats

Six years into the nightmare that is Obamacare, you would think that most Americans would be painfully aware of the regulation that mandates the purchase of insurance, raises premiums through the roof, and often threatened faith-based institutions.

The ubiquity of Obamacare didn’t stop the Obama administration from spending $77 million (you read that figure right) in 2016 to promote the former president’s pet domestic project.

…the federal government contracted with Democratic-leaning p.r. firm Weber Shandwick to spend $74.15 million on July 28, 2016, and another $3.69 million on Sept. 9, 2016, promoting the plan.

Of that, $64 million funded an advertising blitz — including TV, digital and radio — $4 million went to creative development and production, $5 million to direct response marketing, $2 million to campaign strategy, $1 million to branding and $1.5 million to encourage small business enrollment.

The bid for the public relations blitz for Obamacare went to – surprise, surprise – an Obama donor.

The Weber Shandwick contract was signed by Pam Jenkins, president of the firm. Its chairman, Jack Leslie, was picked by Obama in 2009 to be chairman of the US African Development Foundation.

Leslie donated $1,000 to Obama’s 2012 re-election campaign and $2,700 in December 2015 to Hillary Clinton’s failed presidential campaign.

Jenkins and Leslie did not provide comment.

The revelations about the Obama administration’s wild spending on Obamacare promotion come as the GOP is working on an alternative to the onerous legislation that became one of the centerpieces of the Obama years. It will be interesting in the long run to see if any Republican plans to replace Obamacare will succeed – and whether a new plan will require the kind of media and PR blitz that Obamacare apparently needed.

The Idiocy of How We Buy Healthcare

Seven years ago, President Obama and the Democrats said that they had solved the healthcare crisis. Their Affordable Care Act promised universal coverage for the uninsured and lower prices for the rest of us. Their calculations were wrong and Obamacare ended up making America’s healthcare mess even worse.

While there are many problems with the current healthcare system, one seems to stand out among all the rest for its sheer stupidity. The most idiotic thing about the American healthcare system is that when we buy healthcare, we have no idea how much we are buying it for. This problem seems to have been worsened by Obamacare.

Aside from suffering from steadily rising premiums and higher deductibles since the onset of Obamacare, we are being blindsided by unexpected medical bills that come out of nowhere. When we go to the doctor for an office visit or check into a hospital, we have no idea what it will cost.

Medical care is the only commodity that we buy in such an insane fashion. Can you imagine going to your local car dealership and signing a contract to buy a new car without knowing how much it would cost or even what kind of car you’d be driving home? Not many people would be willing to take such a deal, but we do it every time we step into a doctor’s office.

When we go to the doctor, all most of us know for sure is that we’ll be paying the insurance copayment. My copay has gone from $20 for an office visit a few years ago to $35 today. In addition to higher copays, my PPO also makes me pay a share of many tests and procedures through deductibles and coinsurance. With my HMO from years past, I only had to pay the copayment for most services.

Not once, but twice in the past two years I have had large bills come from out of the blue for tests that doctors had ordered for members of my family that were denied by the insurance company. In both cases, I took the bills to the doctor to ask them to appeal the insurance company’s denial. In both cases, the doctors said that lab was only supposed to bill the insurance company, not their patients, for the tests in question.

This seems to represent something of a scam. The doctors order tests that aren’t universally recognized and approved and then the lab bills the insurance company. If the insurance company doesn’t pay for the questionable test, apparently the lab takes the loss rather than billing the patient. Occasionally, a bill for thousands of dollars for a test for a routine health condition slips through the cracks to the patient, but normally the patients never know how much money the insurance company is paying out on their behalf unless they actually look at those Explanation of Benefits forms that normally go straight from the mail to the trash.

A third of medical tests are considered unnecessary according to a paper in the Journal of American Medicine. This mountain of needless testing costs hundreds of millions of dollars. When the insurance companies are billed for these expensive tests, it translates in to higher premiums.

Even when you try to find out how much your healthcare costs, you might still be surprised. When I went in for a colonoscopy two years ago, I paid the doctor and the hospital in advance. I thought that this would eliminate any problems with the billing.

Since I had already paid for the procedure, it came as quite a surprise when I started getting more bills in the mail, again for more than a thousand dollars, a few weeks later. After spending countless hours on the phone getting the runaround between the insurance company, the hospital and the doctor’s office, I traced the problem to a diagnostic code that had been entered incorrectly. The confusion was over whether the scan was medically necessary or preventive care. Under the ACA, preventive care was covered at a higher rate than a procedure that is needed for an actual existing health reason. Go figure that one out.

Even after finding the problem, it took many more hours on the phone to get it corrected. Total time to resolve the issue was about six months. Many people probably would have simply paid these bills when they received them and couldn’t get them dismissed immediately. Alternatively, many others might have ignored the bills and suffered credit damage as a result. I have to wonder how many people are paying outlandish medical bills that they don’t really owe.

Some uncertainty in medicine is legitimate. It is possible to go into a hospital and have real, unexpected complications that make your stay more expensive. However, there shouldn’t be any fear of going in for a routine doctor visit and coming out with thousands of dollars for routine and unnecessary tests, even when you have insurance. The price of a colonoscopy shouldn’t double because you have a medical problem that requires you to get a colonoscopy.

There are many problems with the health care system and Obamacare, but one of the biggest is the lack of transparency in pricing. Patients should have an idea how much they will owe before they commit to a procedure. Too often now, cost is never considered by the doctor and never known by the patient. At least not until the bills start showing up in the mail.

To take it a step further, patients should be able to compare the rates of various doctors and hospitals. With any other commodity, if you want the best you’d better be prepared to pay a little extra. If you desperately need a procedure, but don’t have much money, you might prefer a safe, but less prestigious hospital or clinic. Before you pooh-pooh this idea, consider that medical tourism is already gaining in popularity as people travel to countries with better doctors, advanced treatments that may not be approved at home or less expensive care.

In short, health care reform needs to reintroduce real competition and markets. People can’t make intelligent decisions if they have no information about what a transaction will cost them. The illusion that their copayment is their only cost for care is leading to wasteful practices, large bills and inefficient medical care. Give patients the information to make good healthcare choices and the freedom to choose.

 

 

Obamacare Repeal Faces Bipartisan Challenges

The Republican promise to repeal Obamacare is meeting bipartisan opposition. Democrats are protesting the entire idea of repeal. Meanwhile, some Republicans are seeking to delay the repeal or protect some facets of the Affordable Care Act until a replacement can be written.

A core dispute among Republicans is whether Obamacare should be repealed before a replacement bill is ready. Obamacare can’t simply be repealed because it remade the American health care system. Not all of the healthcare eggs that Obamacare scrambled can be unbroken. Removing the law would not restore healthcare to its previous status quo, which was unpopular anyway.

The ultimate solution must take into consideration that an estimated 20 million people are insured under Obamacare. And, believe it or not, some of them even like it. To be politically viable, the Republican plan for repeal and replacement must find more coverage for these Americans.

Democrats contributed to the discussion about how to handle Obamacare with a five-hour talkathon on the Senate floor. The evening bull session among Democrats began at 6:45 p.m. on Monday and lasted into the wee hours of Tuesday morning. The Democrats boiled down their message to what The Hill calls “The Pottery Barn” rule: You break it, you buy it. Ironically, this is the same rule that gave Republicans control of Congress after Democrats passed Obamacare in 2010.

“Get real, [Republicans] don’t have a clue what to do next,” Sen. Elizabeth Warren (D-Mass.) said in The Hill. “Repeal and run. That’s the Republican plan.”

Some Republicans agree that they don’t know what to do next. That is the essence of the debate among Republicans. One faction wants to pass a budget resolution to start the repeal and then follow up with a replacement later. The budget reconciliation is the same trick that Democrats used in passing the original Affordable Care Act to avoid a filibuster by Republicans. The resolution contains language that would direct House and Senate committees to write a bill to repeal and replace Obamacare by Jan. 27.

An amendment introduced by Sen. Bob Corker (R-Tenn.) would extend the deadline to craft a replacement law until March 3. Corker is joined by Rob Portman (R-Ohio), Lisa Murkowski (R-Alaska), Susan Collins (R-Maine) and Bill Cassidy (R-La.) in favoring more time to write the new law.

“This amendment will give the incoming administration more time to outline its priorities after its chief healthcare official assumes office and fully reviews the tools currently at his disposal,” Corker told the Washington Examiner. “By extending the deadline for budget reconciliation instructions until March, Congress and the incoming administration will each have additional time to get the policy right.

Republicans all favor a repeal of Obamacare, but they have not agreed on a replacement. The original bill allows only a few weeks to write a complex bill to restructure the health insurance industry. Corker’s amendment would extend that time to a few months.

In either case, Obamacare will probably not go away instantly. MarketWatch reports that Republicans may delay full repeal for two to four years while the replacement law is written and implemented. At the same time, they will also be working on reforming the tax code, another massive undertaking which will be passed by the same budget resolution tactic.

While the budget reconciliation to repeal Obamacare would be passed by a simple majority vote, subsequent bills to replace it would be subject to cloture votes that require 60 votes. This would allow the 48 Senate Democrats to block bills that Republicans try to pass separately from the budget resolution.

Republicans can’t count on the Democrats to pitch in. “I take (Senate Minority Leader Chuck) Schumer at his word that if we just go ahead and repeal, Democrats won’t provide one vote for enacting the replacement,” Sen. Ron Johnson (R-Wis.) told CNN. “So I think we need to actually have a game plan.

One sticking point among Republicans is whether Obamacare’s taxes should be repealed immediately. Bloomberg reports that some Republicans, among them Sen. Cassidy and Rep. Pete Sessions of Texas, believe that the Obamacare taxes should be repealed as part of the tax reform.

The problem, according to Cassidy, is that most Republicans have taken a pledge not to raise taxes. If the Obamacare taxes are repealed immediately, “then you’re in a hole” where Republicans politically cannot enact a new healthcare law because they can’t vote to pay for it.

“If we don’t like ’em, we can replace them,” Cassidy said. “But we can do it in a way where you overall are lowering tax rates and making the tax code more efficient. There will be enough there for people to win.”

Other Republicans say that the taxes must go immediately. “Repeal it, get rid of it, every single bit of it, don’t keep any of it,” said Rep. Jim Jordan (R-Ohio). “That’s all the taxes, all the mandates, all the things that are in this thing that the American people don’t like and that I think have driven up the cost of medicine, hurt economic growth. I think we’ve got to do what we told voters we were going to do.”

A second problem is defunding Planned Parenthood, which will also be part of the budget reconciliation. Pro-abortion Republicans Susan Collins and Lisa Murkowski may not vote for the budget bill if it defunds the abortion provider. The loss of their votes could derail the repeal effort.

Corker told CNN that it “doesn’t seem very intelligent” to repeal the law without knowing what is going to replace it. Rand Paul agreed, “I will do everything in my power to have a vote on it the day we repeal Obamacare.”

Nevertheless, the Republican leadership is still pressing for a quick repeal and eventual replacement. “We’re not going to do a comprehensive bill,” said Sen. John Cornyn (R-Tex.). “We are going to do it in a step-by-step basis” with a series of smaller bills.

The direction that the GOP will take will soon be evident. The Senate plans to vote on the budget reconciliation authorizing the repeal of Obamacare this week.

Insurance Options Drop For WI Population Centers

Wisconsinites living in key population centers have seen their health insurance choices limited since the implementation of the Affordable Care Act’s health insurance exchange. Launched three years ago, the ObamaCare exchange provides a marketplace for consumers to purchase government-mandated health insurance coverage while potentially receiving a federal subsidy for the cost of that insurance. While anyone can use the exchange, subsidies are allocated based on the annual income of the person seeking coverage.

A Media Trackers review of data collected by the state Office of the Commissioner of Insurance finds that in the ten most populous counties in Wisconsin, the number of health insurance providers has significantly decreased since 2013, the year the ObamaCare exchange launched. OCI regulates insurance companies and tracks data about plans offered in Wisconsin, both on and off the federal exchange. Data for insurers offering health plans in 2017 is available because insurers must submit their plans to the OCI for review.

In 2014, there were a total of 20 insurance companies that competed to offer health insurance to Wisconsin consumers. Thirteen of those companies offered plans on the ObamaCare exchange. Those numbers remain relatively unchanged for 2017 with the exception that three large insurers, United Healthcare, Humana and WPS’s Arise Health, have left the market along with several smaller companies who have stopped or started offering health plans in the state.

The total number of insurers competing in Wisconsin for 2017 currently stands at 17, with 14 of them offering plans on the ObamaCare exchange.

But a deeper dive into county-by-county statistics reveals that in Wisconsin’s most populous areas, the number of options available both on and off the exchange has dropped noticeably.

Milwaukee County, the most populated county in the state, had 9 companies offering insurance plans to residents in 2014, with 4 of them offering plans via the exchange at HealthCare.gov. For 2017, only 4 companies will offer plans in the county and all 4 will have offerings on the exchange.

In northeast Wisconsin, Brown County, home to Green Bay, had 11 insurers competing for business and 5 of them offering plans on the exchange in 2014. Next year, residents will have to pick a plan from one of 4 companies with 3 of them offering plans on the federal exchange.

The chart below shows the decline in competition for the top ten most populous counties in the state:

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While options have declined in populated areas, health insurance premium costs have risen across the state, socking consumers’ pocketbooks as they try to avoid the penalties imposed by ObamaCare on those who don’t buy mandated minimum coverage.

The decline in health insurance options available in population centers across Wisconsin, along with the decision of several large health insurance companies to stop offering plans in the state, once again proves President Barack Obama’s now-infamous claim of “If you like your health care plan, you can keep it” to be false.