The Chopping Block | Delayed Press Comments

by William Warren

Following the announcement on Wednesday that the Obama administration would be delaying Obamacare’s employer mandate past the 2014 elections, the press has used the last couple of days to survey the broken and battered landscape of the president’s unpopular health care law.

The AP writes today, “Nothing's ever easy with President Barack Obama's health care law. The latest hitch gives employers an additional year before they must offer medical coverage to their workers or pay a fine. . . . Is this a downward spiral? The delay adds to an appearance of disarray surrounding the law.”

In a story headlined, “Blows to Health-Care Law Pile Up, Cutting Its Sweep,” The Wall Street Journal pointed out yesterday, “The big expansion of health insurance envisioned under the 2010 Affordable Care Act is now looking less sweeping. The latest indication that the coverage net won't be as wide as initially expected came this week when the Obama administration delayed for a year a requirement that larger employers offer health insurance to workers or pay a penalty. . . . While the unexpected move received attention, it is at least the third time that a development since the law's passage has potentially limited the expansion of insurance. The two earlier snags involve Medicaid, a federal-state program for the poor, and the new health-insurance exchanges where individuals can buy coverage. The law was supposed to expand Medicaid to include more of the poorest Americans, but a Supreme Court ruling last year allowed states to opt out of that expansion; at least half are poised to do so. At the same time, analysts warn that hiccups are possible in implementing the exchanges after more than 30 states refused to set up their own versions, forcing the federal government to operate them on states' behalf. ‘You've got three body blows toward expansion of coverage,’ said Paul Keckley, executive director of the Deloitte Center for Health Solutions, a research unit of Deloitte LLP. ‘It's three punches in a row.’”

And at Ezra Klein’s left-wing blog at The Washington Post, Sarah Kliff reports, “Facing tight deadlines and daunting workloads, states across the country are scaling back ambitions for implementing the Affordable Care Act. At a monthly board meeting of Connecticut’s health insurance exchange, members of the standing-room-only crowd got a reminder that they, too, were behind schedule. The insurance marketplace they were working on nights and weekends won’t be completely ready on time. ‘It is highly complex, it’s unprecedented and it’s not going to be smooth,’ Kevin Counihan, chief executive of the state’s exchange, Access Health CT, told the group. . . . Although the states are promising to provide new marketplaces for individuals to compare and buy health insurance plans, the Web portals will be a bare-bones version of what was initially envisioned. . . . ‘We were beginning to slip in timing,” Counihan said. “We were getting these messages that we weren’t going to be able to hit our timelines because of the complexity. Some things were either requiring more time or coding than we had expected.’ . . . Across the country, other states report similar problems. . . . The federal government has faced multiple delays on health-care provisions affecting employers. . . . The Government Accountability Office recently questioned the federal government’s ability to launch the federal exchange, which will serve the majority of states in 2014 next year.”

Meanwhile, according to another WSJ report, “The Obama administration's surprise decision to delay penalties for some employers who don't offer health insurance led to a new debate Wednesday over whether the move could undermine efforts to expand access to health insurance for individuals. Supporters of the 2010 Affordable Care Act characterized the delay as a hiccup and said new health-insurance exchanges for individuals will likely go ahead as planned. But other observers said that by declining to enforce the rules on employers, the Obama administration might find it harder to carry out the individual mandate under which people must carry health insurance or pay a tax penalty. . . . [Q]uestions were raised Wednesday about how the new exchanges would operate in the absence of information from employers about whether they were offering coverage. To get subsidized coverage on exchanges, people are supposed to show they can't get employer-backed coverage. But without information from employers on their health-insurance offerings—or lack thereof—it isn't clear how the Internal Revenue Service would determine an individual's eligibility. ‘It is going to be very difficult to implement the exchange when you don't know,’ said Timothy Finnell, president of Group Benefits LLC, a Memphis health-care brokerage and consultancy.”

An AP story from Wednesday highlights the same problem: “Democrats have always been dogged by the fact that few Americans understand the law and many fear its effect. In the most recent polling, the Kaiser Family Foundation found that more Americans view the law unfavorably than favorably, a negative tilt that has remained steady since Obama signed it in March 2010. The foundation's survey this spring found 43 percent with an unfavorable opinion of the law, 35 percent with a favorable view and 23 percent undecided. The poll also found more people saying the nation will be worse off under the law than better off, a switch from public opinion immediately following its passage.”

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