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Sometimes called:  AFFORDABLE CARE ACT (ACA)
Usually called:  OBAMACARE
This IS NOT:  
  • Computer artwork
  • 2nd grade review of shapes
  • airport parking directions
  • eye chart

This IS:​
  • an attempt to draw a schematic of Obamacare

Obamacare highlights:
  • creates the Independent Payment Advisory Board (IPAB)
  • creates 160 new government entities
  • needs 13,000 pages to describe new regulations
  • ​needs 18 pages to describe a full-time employee
  • closes the distance between personal privacy and government invasion

​So... It is officially acceptable to be nervous. This chart is only about a third of the way through the thousands of pages​ of the new agencies. It is, in and of itself, an astonishing insult to the Constitution.  READ MORE BELOW.

When the people find they can vote themselves money, that will herald the end of the republic.”
ben franklin
Signed into law on March 23, 2010.
Provisions implemented gradually.
January, 2013, with the election past, the floodgates of implementation open.
Exchanges:  The Obamacare  Data Collection Network

An Obamacare exchange has been described as a convenient way for consumers to shop for health insurance, in a competitive, free-market setting.

In fact, the exchange's most important function is as a data-collection tool that is used to implement and enforce Obamacare.  Exchanges collect tax, income, employment, family, personal, medical, and other data on Americans in all 50 states.  This information is then shared with federal agencies (such as the IRS, HHS, SSA, DHS), used to monitor and track Obamacare compliance, and enforce Obamacare penalties. Violations are reported to the IRS for collection.

All insurance offered on the exchanges must be government-approved.  This requirement, by definition, cancels out free-market principles. Such requirements extend to political discretion. As one example, Kathleen Sebelius, the Secretary of HHS holds absolute power over the exchanges. On Sept. 9, 2010, Sebelius declared that insurance companies who attribute premium increases to Obamacare "may be excluded from health insurance Exchanges in 2014," effectively a death sentence for insurers who dare to inform citizens about Obamacare's true costs.

Never before has this federal government sought such power to reach around state borders--around state laws and protections--to monitor and control individual citizens, and mandate their behavior.

Our surest tool to defeat this disaster is education.  Learn about exchanges and discuss their implications with those in your circles.  Legislators pay CLOSE attention when their base speaks with authority and conviction about an issue!  Your involvement is critical.
IPAB is to consist of a panel of 15 people, un-elected, appointed by the President, subject to Senate approval. They will serve six year terms, no more than two terms. They must not be involved in the insurance reimbursement process, i.e., doctors’ receiving Medicare payments. Salary ranges have been listed between $165,000 and $190,000.
Their proposed function is to be a mechanism to keep Medicare expenditures down. They are unable to implement reforms, ration care, change eligibility guidelines or restrict benefits. The only alternative is to decrease allowed amounts paid to doctors. Traditionally, reimbursement rates are too low already. The result will be fewer doctors, whether through early retirement, not accepting Medicare patients or simply not enough new doctors. The most affected segment, as such, will be Seniors and the disabled. The end result WILL be rationing. Payment for a service will be weighed between the cost of treatment and a patient’s “value” to society. The chart below, illustrates how age is a major factor. Roughly, those below age 15 and above age 40 will be allowed increasingly less care as their contribution to society is compromised. 

Also very disturbing to note, Congress cannot terminate IPAB outside of some very specific, restrictive instructions. The only possible time, is a 29-day window in 2017:
"Congress must phrase its Joint Resolution in a particular way. Not any 29 days will do: Congress must introduce this Resolution between January 3 and February 1, 2017 (during which time it may be in recess). Moreover, at least 60% of all elected members of each House of Congress (whether or not they are present) must vote in favor of this Resolution, and they must do so no later than August 15, 2017. Even then, IPAB must continue to exist until 2020 no matter what Congress says.
“If Congress does not jump through all these hoops, and only 59% of each House votes for repeal, then repeals fails, and henceforth, all of IPAB's "recommendations" become law automatically, every year thereafter, no matter what a future Congress does. IPAB achieves immortality.”

Man is not free 
unless government is limited.
               ~Ronald Reagan

12. The “Clawback.” Individuals signing up for insurance on an Exchange must 
estimate annual income for the coming year. If it’s between 100% and 400% of 
the federal poverty level (FPL), federal premium subsidies are available to help 
cover the cost. However, if the income is greater or family status has changed, the 
IRS can ask for all or part of the subsidy to be repaid. Thus, “If you received a 
subsidy based on a prediction that your income was 350% FPL and it later turns 
out your income is $1 above 400% FPL—you have to pay 100% of the premium 
subsidy back,” according to Inside Health Insurance Exchanges (Aug 2011).  

13. Risk Scoring of Individuals. Under the Obamacare Exchange “risk adjustment” 
regulation, states are required to analyze data and calculate individual risk scores 
on all persons: “Individual risk score means a relative measure of predicted health 
care costs for a particular enrollee that is the result of a risk adjustment model.” 

14. Gaming the System. Health plans with the sickest enrollees receive more health 
care dollars. According to an expert cited in LDI Health Economist, “If an insurer 
is able to work [the risk adjustment system] in combination with subsidies, which 
are also complex, then that carrier may be able to enroll a lot of people who kind 
of ‘look’ sick and are subsidized and also get bonus risk-adjustment payment on 
top of that. An insurer may be able to make a killing by working both sides.” 

15. Sicker Patients on Paper. “Risk adjustment” dollars will travel on state-based 
“risk corridors” from Exchange health plans with low risk enrollees to Exchange 
health plans with high risk enrollees. Experts quoted in LDI Health Economist 
report, “the entire country is going to get a lot sicker on paper” and “an insurer 
will have an incentive to give people the absolutely most thorough physical of 
their lives when they join because if there is even a trace of conditions like cancer 
or diabetes…the insurer may be able to get more risk adjustment money.” 

Lawmakers can stop the federal takeover. State legislatures and governors must refuse to create or accept any Exchange and return Exchange funds to the federal government. Congress must not fund a Federal Exchange, must defund Exchanges and repeal the law. 

FMI: StopHealthInsuranceExchange.org  
CCHF • 161 St. Anthony Ave., Ste. 923 • St. Paul, MN 55103 • cchfreedom.org • 651-646-8935 • info@cchfreedom.org 


1. Exchanges are Federal Takeover Centers, not marketplaces. The federal 
government controls the health plans and the benefits—and oversees patient care. 
Exchanges will also become single-seller bureaucracies where only government-
approved health plans are sold and no real “market” exists. It is expected that all 
people in the future will be required to buy insurance from the Exchange. (see #5) 

2. States will lose. State-run exchanges will hide the federal takeover; enable federal 
access to state-held data on citizens, patients and providers; and shift the annual 
$10 million - $100 million cost of operating the exchange to State taxpayers. 

3. State-run Exchanges are not required. That would be commandeering of the 
state by the federal government. Obama’s health care law acknowledges this fact 
by having a fallback plan for creation of a Federal Exchange—but no money to do 
it. They’ve asked for ~$750 million, but Congress has thus far refused. 

4. All Exchanges are Federal Exchanges. State-run Exchanges must follow the 
federal law and all federal rules. They are required to report annually to the U.S. 
Secretary of Health and Human Services (HHS) and are under control of HHS. 

5. State-run Exchanges are part of a National Exchange. State exchanges are 50 
state-named website portals of a national system. They are extensions of the 
federal government into each state through the “Federal Data Services Hub,” 
which will receive and share private data. Data entered online to buy insurance is 
sent for verification through the Federal Data Services Hub (“Hub”) to at least 
five federal agencies, and compared with myriad state databases and data systems 
made accessible to the Hub by state government. 

6. The Exchange is a national registration and enforcement tool. The National 
Exchange (with 50 website portals) will register the insurance status of every 
citizen and allow the IRS to enforce the penalty-tax for refusing to buy health 
insurance. The purpose is universal coverage — national health care. Registration 
takes place through purchase of insurance or online registration of an exemption. 

​Independent Payment Advisory Board

7. The Exchange will create an unprecedented tracking system. Whether they 
pay taxes to the Federal government or not, everyone must annually register with 
the IRS either on their own through the Exchange or through their employer. State 
governments are already considering how to “pre-populate” the exchange using 
other databases such as state taxpayers, voting registration, and vital statistics. 

8. The Exchange will enable Obamacare fines. Employers face significant fines if 
even one of their employees buys health insurance on a state-based Exchange. 

9. The Exchanges will expand Medicaid and build middle-class dependency. All 
persons and families up to 400% of federal poverty levels (FPL) will be enrolled 
into Medicaid (up to 138% FPL) or be able to receive a taxpayer-funded premium 
subsidy to buy health insurance. In 2012, 400% FPL is $44,680 for an individual 
and $92,200 for a family of four. 

10. “Federally-facilitated exchanges” are a facade meant to deceive. The FFE will 
have a state name (i.e. Iowa Exchange) but operations will be conducted by the 
federal government—leaving the public in the dark about the federal takeover. 

11. Redistribution of Wealth to Health Plans. Fully 98% of the new spending 
under the federal health reform law goes directly to health plans approved by the 
government to offer health insurance on the Exchanges. Approximately $1 trillion 
will be transferred from taxpayers to health plans through federal premium 
subsidies offered on the Exchanges and through the expansion of Medicaid 
through the Exchanges. (Bloomberg.com http://bit.ly/NRxw7P and http://bit.ly/TCoVt9) 

Medicaid Expansion:
What do you mean we can't reform healthcare properly???