The first breach of the Obamacare fortress?
There have been other changes already made in the Affordable Care Act , a.k.a. Obamacare, such as delaying the employer mandate for a year and freeing religious organizations from providing birth control coverage to employees. Obamacare opponents, however, got little traction on those retrenchments.
But President Obama’s declaration yesterday that those who have substandard insurance plans can keep them for another year is going to have a ripple effect on the basic foundation of health care reform and could be the first breach in the wall of solidarity among supporters. Even the debacle that was the launch of the healthcare.gov website will not galvanize the opposition like this about-face. This has “I told you so” written all over it, and the president’s contrite delivery and acknowledgment that he bollixed it will fuel the fire for the entire coming election cycle.
A basic tenet of the health care reform law was not only to ensure all Americans had access to health care but to make sure the plans provided meaningful, comprehensive coverage. In the 2006 Massachusetts law, the mother of Obamacare, it’s called minimum creditable coverage. It’s a requirement that health plans meet a baseline standard of coverage for things such as well-baby visits, preventive and immunization visits with no copay or deductible, and a cap on out-of-pocket expenses. The federal health reform adopted some of the same mandates as well as eliminating the lifetime cap on coverage and barring health insurers from denying coverage to those with pre-existing conditions. Insurance companies went along with it because they could afford the coverage as long as everybody – young, old, healthy, infirmed – was in the same pool.
But the president didn’t do himself or his supporters any favors by declaring that people can keep the coverage they have if they like it. What he didn’t add was they could keep it as long as the plans included the new minimal mandatory coverage. People, especially the young and healthy, bought bare-bones plans that provided catastrophic insurance with none of the required coverage on it thinking they could bypass the expense of the penalty for the individual mandate. But as the January 1, 2014, deadline for the mandate got closer, insurance companies sent notices to those people canceling their plans because they don’t meet guidelines. So much for that presidential promise.
In addition, insurers are livid that they were not included in the decision-making. Many are saying this will roil the entire market because rates were based on everyone buying plans or paying the penalties.They worry that premiums will have to rocket up to cover the loss of individuals going back to bare-bones plans. On top of that, most of the insurers didn’t bother asking state regulators for rates for those particular plans because they thought they were being phased out so now they don’t know what they can charge. Some may continue to send out the cancellation notices because the policy change is not law.
On top of all that, some of the states that have well-functioning exchanges, such as California and Washington state, say they will not abide by the president’s announced extension and will force their residents to buy insurance with the minimal coverage. That presents another problem for Obama and Democrats: it’s up to the states whether or not they’ll grant the extension.
Individuals, states, insurers, supporters, Democrats – it’s hard to find anyone who’s not angry with Obama or the fallout. About the only ones who are happy are Republicans. The Globe’s Scot Lehigh says Obama needs to come clean with the country and make his case in a way that’s more presidential than cheerleader.
About the most stinging observation of the change came from the New York Times , which compared Obama’s handling of health care reform to former President George W. Bush ’s performance with Hurricane Katrina and the Iraq War . Ouch, that’ll leave a mark. Hope he’s got a plan to cover that.
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Cobb County in Georgia agrees to pay $300 million to help the Atlanta Braves move to a new stadium, Governing reports. Even though the county forced school department employees to take furloughs last year due to budget shortfalls.
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Web glitches snarl health enrollment in Massachusetts, WBUR reports.
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Transportation is now almost as expensive as housing in Minnesota’s Twin Cities , Governing reports.
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