With reports that by mid- December, 2014 enrollment in Obamacare (ACA) had soared, those wishing the health care reform law had died of its own causes had reason to be disappointed. The much maligned law has risen like a phoenix from the ashes of computer mess-ups it experienced in its first two months of life in 2013. There are still those who would like to shoot it down. Obamacare is not yet flown out of harm’s way.
By the same date in 2013, in 2014 twice the number of people had signed up with the Federal plans through the exchanges, bringing total enrollees close to seven million, including the 700,000 enrolled through state plans. The state run market places are running smoothly. (Expectations are over 9 million customers when the open enrollment period ends; we are only half way through the period.) Many automatically rolled over their old plans, and of the 1.9 million new enrollees in the federal plans, about 87% needed a government subsidy to be able to afford the premiums of insurance sold through the federal exchange.
Per the Commonwealth Fund's recent survey, US adults who did not get needed care because of cost from dropped from 43 percent in 2012 to 36 percent last year. (Denver Post, 1/15/2015)
Per the Commonwealth Fund's recent survey, US adults who did not get needed care because of cost from dropped from 43 percent in 2012 to 36 percent last year. (Denver Post, 1/15/2015)
The future of plans bought through the federal exchange is now up in the air thanks to an anticipated Supreme Court ruling to be released later this year. If the Court takes the law’s wording literally, as the plaintiffs charge they should, subsidies could only be provided to enrollees in the 15 states who set up their own exchanges, including Colorado. In the 37 states with no state exchanges, consumers would not get their federally bought plans subsidized unless their state governments set up their own state run exchanges. Most would be unable to afford health insurance without the premium lowering subsidies and would be faced again with the financial strain and consequences of lack of access to health care as in past years. Those most affected would be consumers in red and southern states dominated by GOP legislatures and state houses that were and are least likely to set up state run exchanges.
Often however, legislative intent is also considered in court rulings on statutes as well as the exact wording of the law. The defense will argue that the intent was for everyone to be able to have access to Obamacare and receive subsidies if they needed to make it affordable, whether they set up their state exchanges or left citizens to sign up with the federal marketplace.
Early reports are that the newly GOP dominated Senate and the overwhelmingly Republican lopsided House may try to take some pot shots at the ACA instead of trying to repeal the law. They rightly assume the President would veto any repeal legislation. One volley is removing the medical device tax, but it would increase the federal deficit unless some other funding sources are found to take its place. The other would change the definition of full time employers so that employers would not have to insure so many employees. None of these legislative actions fundamentally change Obamacare; they just either hurt consumers or will add to the deficit.
A version of this appeared in the Sky Hi Daily News January 15, 2015
http://aspe.hhs.gov/health/reports/2014/MarketPlaceEnrollment/Dec2014/ib_2014Dec_enrollment.pdf
http://www.nasdaq.com/article/7-obamacare-facts-you-need-to-know-at-the-halfway-point-of-enrollment-cm429184
No comments:
Post a Comment