Posted on 10/18/2025 6:51:20 AM PDT by MtnClimber
The Democrats are pretending this shutdown is about your health care.
It’s not—it’s about fraud.
They want you to believe the sky is falling—your health care is going to double in cost (or go away completely, depending on the day), and low-income ObamaCare enrollees are going to get left out in the rain.
These are scare tactics, designed to cover up for the proposal they’re really pushing: an extension of temporary COVID-era subsidies, riddled with fraud they’d rather not admit exists.
As many Americans know, ObamaCare operates by households purchasing health insurance through the exchange. Based on the enrollee’s income, the insurance premium is offset by a federal subsidy, paid directly from the government to the insurer. In nearly every case, this results in a big discount on the monthly premium.
In 2021, President Biden and Democrats in Congress included a massive sweetener to these ObamaCare credits at every income level, including those making hundreds of thousands of dollars.
For as many as half of ObamaCare enrollees, that meant a $0 out-of-pocket premium, fully covered by the taxpayer subsidies. This, predictably, led to a surge of enrollments—and very real incentives for fraud and bad actors.
That’s because ObamaCare isn’t just individual people logging on to find health insurance. Today, nearly 80 percent of all ObamaCare enrollees are signed up by an insurance agent or broker, who receive a commission for every sign-up. Their incentives are clear—sign up as many people as possible, no matter what it takes. The result: a blind eye turned toward eligibility; unwanted or unrequested insurance changes; and insurance that the taxpayers are funding but the recipient doesn’t need.
The Wall Street Journal recently exposed some of the deceitful tactics used by brokers to trick low-income Americans into signing up for these plans: fraudulent Facebook and Snapchat ads, empty promises of gift cards, and even agents switching enrollees’ plans without their knowledge. According to the Journal, “CMS has received more than 208,000 complaints this year of unauthorized ACA insurance sign-ups,” and 200 agents and brokers have been suspended on suspicion of fraud.
A shocking number of these customers never even use the health care they signed up for.
In 2024, a full 40 percent of fully subsidized (zero premium) enrollees had no health care claims whatsoever. No annual visit, no blood work, no prescriptions, nothing.
These “no-claim enrollees” are an ongoing profit stream for the insurance company paid by the taxpayers—at least $35 billion for people who pay zero and never use their plan.
During the housing market bubble of the early 2000s, unscrupulous mortgage brokers made a killing selling mortgages to “NINA” and “NINJA” borrowers: “No Income, No Asset” or “No Income, No Job, No Asset.” The broker’s incentive in this case, again, wasn’t about verification of eligibility or long-term consequence—it was sales, no matter who they were sold to. When these mortgages understandably failed and the housing market collapsed, hindsight made it clear how dangerous those loans were and how predatory these brokers were.
But the Democrats created a system to bring those same mistakes to health care. In the same way that unscrupulous mortgage lenders didn’t bother with verification, ObamaCare brokers have the same incentives today—boosted by the extra subsidies the Democrats just shut down the government to protect. And once again, the taxpayers have to bail them out in the end.
Today, as many as 6.4 million ObamaCare enrollees are receiving zero-premium plans they aren’t eligible for, at an estimated fraud cost of $27 billion per year. A staggering 1.6 million are also enrolled in Medicaid at the same time as ObamaCare, meaning the taxpayers are paying twice for health coverage the recipient may not even be using.
Most Republicans rightly want these temporary credits to expire as intended. They are backed by an overwhelming majority of voters from every party: Republican (67 percent), Democratic (67 percent), and Independent (66 percent).
And for the real people stuck in the middle of this government showdown, the real-world result is nowhere near the Democrats’ “sky is falling” rhetoric. When these credits return to pre-COVID levels, households at the poverty level will still have 98 percent of their monthly premium cost covered, paying about $3.45 a week on average in premiums.
This is hardly the first COVID-era program to expire according to the Democrats’ own sunset date. The Democrats didn’t shut down the government to protest the end of the Paycheck Protection Program, or enhanced unemployment benefits, or the Restaurant Revitalization Fund. So why won’t the Democrats allow these enhanced COVID-era credits to expire?
Maybe it’s because they know that ObamaCare doesn’t work without massive subsidies, so they don’t want to give an inch. The Washington Post recently hit the nail on the head: “The real problem is that the Affordable Care Act was never actually affordable.”
Maybe it’s because this subsidy hits all three of the Democrats’ biggest issues today: ObamaCare, COVID spending, and opposition to Trump.
No matter what is really behind the Democrats’ shutdown, the truth is clear.
The Democrats shut down the government to protect fraud—not your health care.
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Obamacare is just another genocide final solution of population control. The Democrats are bought in completely.
The traditional NHS model is the regional hospital trust, with entities corresponding to the Mayo Clinic and the Cleveland Clinic being trusts of their own.
What we have in Northern Virginia (iNova), Baltimore (Johns Hopkins) and many other places are very similar in operational structure to the tradition NHS trusts.
Other parts of my reform plan:
AFFORDABILITY
Silver plans would be limited to a maximum deductible of three times the Medicare Part A amount [2025: $1676].
I would also make bronze plans low cost by having co-insurance up to $10,000 at up to 50% with the policy upfront amount paid up front to the insurance company by the insured. Policy percentages would normally be 20% and based on the Medicare amounts unless contractually specified otherwise. Policy percentages might be less for certain things and contractually capped by time periods, by say 50% of the upfront amount the first three months of the calendar year, 60% the first six months of the calendar year, 70% the first eleven months of the calendar year and the whole amount the whole calendar year. If and how an upfront amount would get invested would be subject to contract. Unused amounts of upfront money would be refunded after each policy is closed out. A policy would not be closed out until the time allowed for claim submission has expired.
I would also make copper plans low cost by only covering Part A scope items plus what Part B would pay for any general or regional anesthesia surgery. These would be like the Blue Cross/Blue Shield plans of my youth.
I would allow Federal PPACA exchanges to offer Interstate Class Drug Plans,
exempt from state control that cover under contract at the time of policy issue at least:
1. 80% of all FDA-approved recombinant drugs by key active entity
2. 80% of all key FDA breakthrough chemical active entities under patent as of January 1 of the coverage year
used in a drug approved by the FDA by August 1 prior
3. 80% of all key chemical active entities under patent as of January 1 of the coverage year
used in a drug approved by the FDA by August 1 prior
4. 90% of all WHO “essential” drugs
This system would allow for genuine negotiation between drug plans and drug companies. Drug plans would have an incentive to try to buy drugs from drug companies and drug companies would have an incentive to make deals to make sales.
Formulary drugs would be supplied at on an all-the doctors prescribe basis. The co-pays would be roughly equal to mere manufacturing cost. Drugs not in the formulary need not be covered at all.
Some of those plans might issue vouchers to patients at 80% of average drug class (biologic large volume, biologic small volume, etc.) Canadian maximum price in lieu of purchase. Let the patients wave the voucher at Walgreen’s and CVS. The drug companies will probably gladly take $200 for a week’s supply that might cost them $60. The riders would have premiums that vary by month.
The new bronze, copper and Interstate Class Drug Plans are meant for higher income folks and would not be PPACA subsidy eligible.
TWO INPATIENT OPERATION PLAN
A possible hospital coverage mode is to cover an amount equal to twice the median Medicare DRG hospital amount plus a percentage of say 20% minimum on the Medicare amount for the first operation if the hospital agrees prior to 10 days after discharge to perform any needed second operation for the remaining amount left on the policy.
A Blue Shield equivalent rider for the amounts Medicare pays for the surgeon(s) and anesthesiologist(s) might be purchased too.
HOSPITAL EMTALA COST ASSISTANCE
I would allow hospitals collect up to $1,000 per incident of EMTALA service from employers, with payment not in excess of $50 per week per employee concerned being due to any and all EMTALA providers and not for more than 100 weeks after service. Such payments on behalf of an employee would be considered to be a debt of the employee to the employer. Employers could collect back from employees and ex-employees (and require EMTALA incident employees to participate in an employer plan).
Just imagine three types of health insurance available across the nation:
Doctor
Hospital
Prescriptions
Pay for what you need. Each is separate and distinct.
The democrats are having another TANTRUM , NO NO NO NO NO ,LOL
The DC Democrats don’t give a damned about the health of Americans nor the illegal immigrants. What they do care about are the huge pools of largely untraceable money they designate for public health purposes so they can continue to loot it. That is all this government shutdown is about!
Why would that be unusual?
The fact that 60% of people under age 65 do need health care each year strikes me as unusual.
If you are healthy, why would you go to a doctor?
That title hits the Nail squarely on the head !
There’s nothing for Democrats to Steal from after DOGE, Trump’s cuts to Democrat dream programs aka money Laundromats they have No sources of side income, No money to buy votes, No influence No future !
They have Stolen so much taxpayer money over the years that they were willing to trample on the constitution, steal the Votes of the people, make up a scam impeachment along with all the other hoaxes, and even try to Assassinate President Trump Twice ! We need mass hangings for treason and prison sentences for the rest !
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