May 24, 2013
As the January 1, 2014 date, when the main body of President Obama’s health care plan takes effect, comes closer Republicans are getting ever more frantic. After all, the risk to the country is enormous. The program will extend health care insurance to tens of millions of people and provide real security to tens of millions more (suppose you get sick now and lose the job that provides you insurance).
Now that is really scary. People may like the plan and actually look to extend it and improve it in various ways that could mean lower incomes for insurers, doctors, and other providers. This is why the Republicans are pulling out all the stops to sink the plan now before it’s too late.
Robert Samuelson carries the torch today in his column “the fog of Obamacare,” the point of which is that it is all so confusing. As evidence he cites polls showing that people don’t know what the main provisions of the bill are or when they take effect or even if the bill was passed into law.
Yes, that is bad news. It probably didn’t help matters in this area that we had many Republicans talking about death panels or that the government was going to take over the health care system.
Unfortunately the public is often less informed that many of us might like. They think that welfare and foreign aid are among the largest items in the federal budget. Many also thought that Saddam Hussein was behind the September 11th attacks. In other areas Samuelson has not been especially concerned about public ignorance.
But Samuelson tells us that employers are also confused about their responsibilities. He knows this because he talked to the heads of four employer consulting companies. He tells readers that many of these companies “are only now coming to grips with the ACA, because they’d assumed that the Supreme Court would invalidate it or that a Republican White House would repeal it.”
So employers rely on consultants who had not paid attention to the ACA because they thought the Supreme Court would repeal it or that Romney would win the election? Now that is scary.
But what of the substance? Samuelson tells readers:
“First, some companies now providing insurance are being hit with huge premium increases. Before Obamacare, said one PEO [professional employer organization, a.k.a. a consultant] adviser, his clients typically received annual increases of 6 percent to 12 percent. ‘This year we’re seeing 30 percent rate hikes,’ he said. The surge is blamed, rightly or wrongly, on the ACA’s requirement for more comprehensive coverage and on its formula for calculating premiums (aka “community rating”).”
As the manager of a small non-profit that provides insurance I remember being hit with some double-digit premium increases before Obamacare was even a Republican nightmare. So what?
We are told some companies may drop insurance. That is true. Those of us who live in the real world know that companies had been dropping insurance at a rapid pace even before Obamacare was on the table.
Then we are told that some companies will try to game the 50 employee cutoff, where the insurance requirement first kicks in. They may also game the 30-hour cutoff for full-time workers.
These are both real concerns, the latter more than the former. (Contrary to what you hear from Republican columnists, the number of workers employed in firms with close to 50 employees that do not already provide coverage is small.) It is very bad to have laws that allow for easy gaming and these provisions do that.
Of course the gaming does not plausibly threaten the survival of the program. It just allows some number of sleazy employers to cheat taxpayers. (Hey, if it’s “taxpayers” when the government spends the money then it’s also “taxpayers” when the government is supposed to get the money.)
This one actually could be easily fixed if Congress were interested, but the Republicans in Congress have zero interest in doing anything that might actually improve the bill. Like the consultants whom Samuelson spoke with, they are still praying that the Affordable Care Act will go away.
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