Delays in Affordable Care Act throw health care reform into question

Delays in Affordable Care Act throw health care reform into question

As has been widely publicized, the Obama administration has delayed implementation of much of the Affordable Care Act, most notably the employer mandate. As the WANADA Bulletin previously reported, employers with 50 or more full-time employees will now be required to provide insurance starting January 1, 2015, a year later than originally scheduled. The administration has said that in the first year, it wont be able to verify the income of people applying for income-based federal subsidies.

Does that mean the law is doomed and it wont work as planned? Nobody knows at this point. What is clear is the need for an extended bureaucracy, a large portion of which wont be in place on time, by the administrations own admission. Another piece that will be delayed is the complex, massive data hub that will collect information from different government agencies –e.g., the Veterans Administration, the Defense Department, Office of Personnel Management, etc.– which in turn will need to communicate with the state health exchanges.

Indeed, the state health care exchanges mandated by the law are critical to the success of health care reform. These entities, by the way, are supposed to start enrolling people October 1 and be open for business January 1, 2014.

There will be a Web portal, and there will be call centers, and they will enroll people in products and put them on tax credits, Cindy Gillespie, senior managing director of the law firm McKenna Long & Aldridge, told the National Journal. Thats the plan. How smoothly the eligibility process works? Who knows? Who makes it work depends on the state, where, for example, Maryland has elected to be engaged, while Virginia, opting not to operate a state exchange, will defer to the federal government to operate an exchange there.

And the cost of premiums? Also uncertain, due in part because the answer depends on how many young, healthy people enroll in the exchanges. As with any insurance system, if enough healthy people enroll, they balance out the sick who require more health services which ramps up the costs.

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