An unsettled act

Not so long ago — prior to its Oct. 1 rollout — we were repeatedly told that Obamacare was settled law and Republican efforts to repeal or defund it were little more than partisan showboating.

Certainly, the GOP plan to defund the Affordable Care Act or shut down the federal government was a political debacle. But the idea the health care act is settled law that will not be changed seems to be taking another hit every day.

We don’t believe Obamacare will be repealed. But it seems increasingly likely that some changes will be made. Consider the developments that have occurred just this week:

✔ Growing numbers of Democrats in the U.S. Senate are pushing for an amendment to the law that would allow Americans to keep existing insurance plans, at least for another year. This includes the likes of California Sen. Dianne Feinstein, a reliable supporter of President Barack Obama, who told The Washington Post she was backing a change because she has received more than 30,000 communications from her constituents upset about the cancellations of their existing policies.

✔ Former President Bill Clinton on Tuesday said Obama should “honor the commitment the federal government made to those people and let them keep” their existing insurance plans, even if it means changing the law.

A number of observers believe Clinton’s comments are a way for his wife, Hillary, to begin to distance herself from the problems of Obamacare as she prepares for a 2016 presidential bid. Even so, such a strong statement from a former president of the same party as Obama carries a good deal of weight.

✔ Another bill in the House to allow insurance companies to continue offering policies like those already in existence — which the White House vehemently opposes — already has more than 160 cosponsors, including a number of Democrats. It will need 218 votes to pass in the House.

✔ The website HealthCare.gov, which is supposed to allow people to sign up for new insurance policies under Obamacare, continues to be plagued with problems. On Wednesday, The Washington Post reported that it’s unlikely all of the website’s problems will be repaired by the end of this month, as Obama pledged last month. If it isn’t fully operational by Nov. 30, there will be calls from members of both parties to extend the date when the individual mandate is supposed to take effect.

✔ Even states that have their own health exchanges and aren’t tied to HealthCare.gov, such as Colorado, are facing difficulties. For example, officials with Connect for Health Colorado this week were pushing Medicaid authorities for a faster turnaround time to determine whether insurance applicants qualify for Medicaid. If the process isn’t speeded up, they say, many people will miss the Dec. 15 deadline to sign up for insurance that can take effect Jan. 1.

Others argue the Colorado process, which requires the Medicaid status to be determined before an application can move forward, is a mistake that must be corrected.

All of these items suggest that changes are coming, and that Obamacare is far from settled law.


COMMENTS

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You know what? If the damned thing got passed into law it can be passed out of law. So what if the Republicans were gonna shut down the country. The Democrat party didnt need to rollout out on 1 Oct 2013. As usual the belief that the dems were right and republicans wrong is propagated by the staff.

The Sentinel’s timely editorial – “An unsettled act” – aptly captures the inherent tension between the substantive public policy underlying the Affordable Care Act (“ACA”) and the political posturing prompted by its lamentably incompetent “roll out”.

It remains indisputable that the ACA—as enacted – explicitly “grandfathered” all then-existing policies, regardless of whether they complied with its minimum standards.  That fact justified President Obama’s well-intentioned but inadequately qualified assurances that “if you like your health insurance policy, you can keep it”.

What the ACA failed to anticipate was health insurers’ profit-driven motive to “bait and switch” trusting policyholders out of “grandfathered” policies into “non-grandfathered” policies – and to market noncompliant policies after March 20, 2010 – which the issuer knew (but did not inform purchasers) would have to be cancelled by January 1, 2014.

While critics of the ACA too-readily accuse President Obama of “deliberate deception”, responsible state insurance regulators fully recognize that nothing in “ObamaCare” or state insurance law required the issuance of deceptive cancellation letters.

What the ACA also failed to anticipate was the cost-driven incentive for some employers to cancel their employees’ insurance plans, forcing them (and/or dependents) onto state or federal health insurance exchanges.  If those exchanges worked properly, many of those affected would end-up better off – with at least equal coverage, if not lower cost.

Other than permitting (or state insurance regulators requiring) insurers to rescind dubious cancellation letters, the ill-conceived “quick fixes” sought by Republicans – and supported by some Democrats – threaten to undermine the ACA’s actuarial viability by distorting the composition of the overall “risk pool”.

Of course, if website flaws are not comprehensively corrected, debates over responsibility for “sabotaging” the ACA will become academic.  Nevertheless, it is somewhat discouraging to see spineless Democrats already “hedging their bets” when the next election is still almost a year away.

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