ObamaCare: Still More Work to be Done

As the health care reform comes closer to full implementation, there is much to be learned as we move forward.

A few weeks ago we saw how even the best intentions for health care reform may sometimes just not be enough.

I’m referring to the Administration’s ruling on health care subsidies and the employer-sponsored health insurance market.  Under ACA, if your employer offers you “affordable” coverage (“affordable” being defined as premiums costing less than 9.5% of income), you are not eligible for financial help - the idea being, since your employer is paying part of your health care costs, you’re already receiving help. Sounds logical.  However, according to the recently announced regulation, the 9.5% maximum pay out applies to the cost of individual coverage for the employee.  The additional cost to insure dependents would not be considered in the formula.  So if your employer’s-offered policy charges a lot more in premiums when dependents are added, the real cost of insurance for the entire family could exceed the 9.5% maximum yet the family will not be eligible for a subsidy.  The result is some low-income families will be left with the same options they had before the reform that being either pay the high premiums or go without insurance.

Although I’ve not seen anything written so far to back this up, there may be another option available to these dependents.  That is, they could go to their state exchange and buy health insurance in the individual market where they may be eligible for assistance if the family income does not exceed 400 % above the Federal poverty level.  I don’t know if this scenario will work but it seems a possibility.

In any event, “relative to the tens of millions of Americans” Obamacare will help the group of people affected by this ruling is small in comparison.   Even so, covering everyone is the reform’s goal and efforts to avert this problem were considered.   As was stated in Jonathan Cohn’s article, “Not-So-Universal Health Care Slipping through the Cracks of Obamacare,” the Government Accounting Office recommendation to the Administration was to consider making dependents eligible for subsidies but critics protested with legal and policy objections.  Cost was also an issue, as one analysis suggested it would cost the government tens of billions of dollars each year.  Later this figure was seen as an exaggeration.   Nonetheless finding even a few more billion to allocate would have been difficult so trying was not pursued.  However, if the previously mentioned option for dependents buying insurance in their state exchange is valid, the government may in fact wind up paying out more than they have anticipated anyway.  We’ll see.

So what does all this say?  Something supporters of the health care reform have known all along – that more work needs to be done in the design of the reform.   I think Senator Tom Harkin, the retiring Chairman of the Health, Education, Labor and Pensions Committee, said it most aptly when he compared the reform to a “starter home”—with a solid foundation, a sturdy roof, and room for expansion. The recent regulation is a good reminder to us all that Obamacare is not the final but the first step toward building a health care system that works for everyone.

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canaan guy February 27, 2013 at 05:17 AM
Yes, more work to be done.......... get rid of it.
sebastian dangerfield February 27, 2013 at 03:16 PM
obamacare is a well intentioned disaster -a politically expedient talking point that , in the end, only went to serve special interest groups. Costs were by and large not addressed--the ability for medicare to negotiate lower costs was shelved in the interest of lobbyists -who pay these politicians. And the Democrats got a bigger government and more votes while sticking it to "those wealthy americans who can afford to pay more." How many times is this guy gonna use the same tag line--and target the same people to pay for his programs. The sequester kicks in after tomorrow. And instead of working out a compromise, Obama is out campaigning to tell the american people the republcians are at fault. This is an AUTOMATIC plan--if you want to stop it from being put in place, its obama who needs to realize he got his tax hikes 2 months ago--and the American people dont have that short of a memory.
maddi winkles February 27, 2013 at 04:35 PM
I knew if i wrote anything to criticize Obamacare in any way, the critics - those that simply hate the idea and Obama - would take the opportunity to bash it completely. But I did it anyway because being able to objectively evaluate legislation I feel is key to understanding and more importantly improving it.
Boggs February 27, 2013 at 04:47 PM
Republican governors on jumping on board your so called disaster...... After taking his time to do the research rather than simply reacting in a politically expedient way that put party before the people of his state, New Jersey Governor Chris Christie has concluded that accepting the expanded Medicaid portion of the Affordable Care Act for New Jersey is, in the Governor’s words, “the smart thing to do for our fiscal and public health.” Christie becomes the latest Republican governor, following on the heels of Florida GOP Governor Rick Scott, to set aside the Republican anti-Obamacare agenda, no matter who gets hurt, and do what is in the best interest of his state.
Boggs February 27, 2013 at 05:14 PM
and more... New Jersey Governor Chris Christie announced, an opponent of the Affordable Care Act, aka Obamacare, said Tuesday that his state will participate in Medicaid expansion that is a centerpiece of the law's attempt to give health insurance to the uninsured. Christie's is the eighth Republican Republican governor to buy into the Medicaid expansion, which was made optional by the U.S. Supreme Court decision on Obamacare. "While we already have one of the most expansive and generous Medicaid programs in the nation, including the second-highest eligibility rate for children, we have an opportunity to ensure an even greater number of New Jerseyans who are at or near the poverty line have access to critical health services beginning in January 2014," Christie said at the State House today during an address on the New Jersey budget. Half the states have agreed to participate in Medicaid expansion, according to health consulting firm the Advisory Board.
Sandra February 27, 2013 at 05:38 PM
Sebastian- How can the Republicans compete with this smooth talker in the White House? Did you catch Michelle Obama at the Oscars? It's all party time for these folks.
Reverend Barbara Sexton February 27, 2013 at 06:23 PM
Madaline: So I take the time to read this article in an effort to further understand Obamacare. Then you tell us, flat out, that you meant only to incite controversy..and that only those who agree with you are capable of 'objective evaluation'. Lesson learned!
Sandra February 27, 2013 at 08:18 PM
Pelosi "We have to pass the bill so you can see what is in it." Seems a total of 2000 unions, companies and health insurance providers so far have received a waiver from Obamacare. However the more you "read it" the more you hate it. Just ask these democrats. http://www.breitbart.com/Big-Government/2012/12/12/Senate-Democrats-Urge-Undoing-of-ObamaCare
Siwanoy February 27, 2013 at 08:34 PM
cutting of quote/ taking quotes out of context, again... Your arguments would be much more sound if you didn't rely on dumb tricks like that. "You've heard about the controversies within the bill, the process about the bill, one or the other. But I don't know if you have heard that it is legislation for the future, not just about health care for America, but about a healthier America, where preventive care is not something that you have to pay a deductible for or out of pocket. Prevention, prevention, prevention—it's about diet, not diabetes. It's going to be very, very exciting. But we have to pass the bill so that you can find out what is in it, away from the fog of the controversy. "
Siwanoy February 27, 2013 at 08:34 PM
Also, since you pay so much attention to the news, i'm surprised you didn't see or hear what she said while meeting at the Capitol with opinion writers: “In the fall of the year,” Pelosi said today, “the outside groups...were saying ‘it’s about abortion,’ which it never was. ‘It’s about ‘death panels,’’ which it never was. ‘It’s about a job-killer,’ which it creates four million. ‘It’s about increasing the deficit’; well, the main reason to pass it was to decrease the deficit.” Her contention was that the Senate “didn’t have a bill.” And until the Senate produced an actual piece of legislation that could be matched up and debated against what was passed by the House, no one truly knew what would be voted on. “They were still trying to woo the Republicans,” Pelosi said of the Senate leadership and the White House, trying to “get that 60th vote that never was coming. That’s why [there was a] reconciliation [vote]” that required only a simple majority. “So, that’s why I was saying we have to pass a bill so we can see so that we can show you what it is and what it isn’t,” Pelosi continued. “It is none of these things. It’s not going to be any of these things.” She recognized that her comment was “a good statement to take out of context.” But the minority leader added, “But the fact is, until you have a bill, you can’t really, we can’t really debunk what they’re saying....”
Siwanoy February 27, 2013 at 08:36 PM
fyi, even if you decide to cut off a quote short, at least do it correctly, in the quote you ended it with ." that's is not how it works, since it continued after that point, and in her text you see there is a comma followed by more words, the quote should have ended ..." implying that more was said after you clipped the quote.
Sandra February 27, 2013 at 08:56 PM
Siwanoy-Defending Pelosi? Covers abortion- uh if you live in a state that allows it. http://www.politifact.com/georgia/statements/2012/sep/24/karen-handel/karen-handel-lays-out-case-against-obama-others-ne/ Death panel- funny how words matter to the Left so much. Death panel is too scary to describe a panel of un-elected bureaucrats deciding whether you NEED a procedure based on cost. Pro-life vs Pro-death?
Sandra February 27, 2013 at 09:05 PM
Siwanoy -I think the LADY doth protests too much. Bottom line buddy- IT WILL DESTROY THE QUALITY OF HEALTH CARE AND BANKRUPT THE COUNTRY!!
Sandra February 27, 2013 at 09:06 PM
Siwanoy-just so you know any delay in my responses to you is a deliberate action on the part of the editors on this Patch. Liberals!!!
Charley February 27, 2013 at 09:18 PM
Do you seriously think the politicians would have read it, much less passed it, had obamacare applied to them, I think not.
Siwanoy February 27, 2013 at 10:03 PM
It happens to me as well, I get the "pending approval" all the time...
Siwanoy February 27, 2013 at 10:04 PM
i'm not going to re-respond to the lie about death panels, the fact that you're still hanging on to it is telling I'm not defending Pelosi, i'm calling you out on editing quotes to try to prove your point. If you have to edit quotes to prove you point, maybe your point isn't that strong.
Boggs February 27, 2013 at 10:51 PM
Honey, so WHY are so many CONSERVATIVE repubics jumping on board?


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