When Elizabeth Festa posted a news article about Jay Angoff, a former director of the Center for Consumer Information and Insurance Oversight (CCIIO) — the U.S. Department of Health and Human Services (HHS) division in charge of implementing the Patient Protection and Affordable Care Act (PPACA) — I found myself getting snarky.
I don't want to have partisan views about PPACA, because, really why bother to read an article by folks who already have their minds made up and has no willingness to acknowledge the flaws on their favored side or acknowledge when something on the other side seems pretty reasonable?
Even the most anguished critic of PPACA has to acknowledge that there's something acceptable about PPACA (maybe the typography in the PPACA-related Federal Register documents; the proofreading of those giant documents is also pretty awe-inspiring).
Even the most fervent supporter of PPACA has to acknowledge that implementing such a big, quickly created package of laws and programs is going to lead to problems and oddities of all shapes and sizes. Anyone who has an open mind has to admit that seeing regulators trying to estimate how much the regulations they are writing will actually cost in, say, 2023 is pretty funny.
Most of us can barely guess what a restaurant tab will be in an hour, even when the menu is right in front of us, let alone how many hours the employees of health insurance companies will devote to filling out exchange HHS exchange plan enrollee satisfaction questionnaires in a decade.
Similarly, the idea Angoff will be leaving CCIIO to help classes of plaintiffs that want to sue employers, insurers, exchanges, or someone — someone with impressive pockets — under PPACA just strikes me as funny, in a sad and grim way.
Some readers then went and posted kind of mean comments after our article about Angoff moving to a class-action firm.
But, of course, in all fairness, this economy is a terrible economy, and former government officials have to make a living. If Angoff had gone to a health insurance company, or a health insurance trade group, consumer groups would be complaining about the revolving door revolving in that direction. Unless the guy signed up to be a monk (at a monastery with no ties to health insurers, plaintiffs' law firms, or health care provider organizations) or a professor (at one of the last solvent universities with no ties to health insurers, plaintiffs' law firms, or health care provider organizations), there was pretty much no way he could avoid snark.
On the one hand, LifeHealthPro.com readers are, understandably, concerned about the idea that PPACA is going to create a giant flood of lawsuits.
On the other hand: The class-action law firms can't create class-action lawsuits with any oomph if PPACA works smoothly and everyone is happy. Or even if PPACA works very badly but the problems clearly are the fault of the law, not the fault of the insurers, employers and others trying to implement the law.
Assuming that health insurers make even a half-hearted effort to comply with a law, chances are they'll do a good job of complying with practical, clear requirements that they actually understand. As much as people complain about the insurers, they already do a fine job of meeting the letters of many laws.
It seems as if the inspiration for a lot of lawsuits may be that parts of PPACA are — whether you hate it or love it — so vague, inflexible, confusing, or wrong-headed that HHS hints in the official regulatory documents that those provisions are a little nuts. HHS seems to be begging someone to fix the law without changing the law so much that it has to restart the implementation process from scratch.
In a normal year, maybe HHS could get Congress to work in a bipartisan way to fix really dumb problems, including the kinds of problems that could lead to class-action lawsuits against well-intentioned insurers, providers or employers that simply interpreted PPACA in what seemed to be a reasonable way to them but seemed to be an unreasonable way to the plaintiffs.
On the third hand, we know that Democrats and Republicans could never work together to make PPACA a little more clear and a little less likely to lead to lawsuits, because that would be a matter of putting the needs of the country ahead of showing that Obama is a Marxist meanie, or that the Republicans are plutocratic meanies, and, of course, that would be completely unacceptable.
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