Archive for Sunday, July 7, 2013

Editorial: Care act delay

The delay in implementing one of its key provisions could be beneficial for the Affordable Care Act.

July 7, 2013


Obamacare. Did administration officials blink — or did they wink?

The administration took much of the nation by surprise last week in announcing a year’s delay in implementing a key penalty-backed requirement of the new health care law. That provision would have forced medium and large companies (those with 50 or more employees) to provide health insurance for their workers. And if they didn’t, a series of tax penalties would have come into play.

The requirement was supposed to go into effect beginning Jan. 1, 2014. That scheduled start date is pushed back a year, according to an announcement by Mark Mazur, Treasury assistant secretary.

“We have heard concerns about the complexity of the requirements and the need for more time to implement them effectively. We have listened to your feedback, and we are taking action,” he said. So maybe they blinked.

Business groups applauded the decision.

Some analysts suggested the requirement was delayed in order to pull the rug out from under Republican attacks planned for next year’s congressional elections, giving Democratic candidates a bit of space. If that’s the case, the administration simply winked.

Not delayed is the requirement for all individuals to carry health insurance or face fines, starting next year, another major thrust of the health care law, which was intended to expand coverage for uninsured Americans.

If responding to concerns is indeed the reason that the administration delayed the one requirement, it’s gratifying that criticism of the new law is being considered and acted upon.

Certainly there are issues with the delivery of health care in the United States, and valid criticisms of how health care costs are administered and spread, but the way the Affordable Care Act was pushed through Congress — with key leaders acknowledging they had not read it — produced almost universal contention that flaws in the legislation needed to be addressed. It’s to be hoped that this action delaying the mandate that businesses provide coverage is the first of the needed tweaks and revisions that will be made.

It may not be necessary to throw this baby out with the bath water, if officials and lawmakers, perhaps buoyed by some Independence Day spirit of patriotism and sense of duty to country, come to their senses and compromise.


FastEddy 4 years, 10 months ago

According to the President, Obamacare is working exactly as planned. Why would implementation be delayed if the plan is working so well? Can it be that this healthcre program was intended to be an unmitigated disaster and intended as a link to single payer, government-run healthcare? Unfortunately for the left, the 2014 elections loom shortly after full implementation of a bad healthcare program. The only solution is to delay parts of Obamacare to lessen the anticipated negative impact on elections. It's always about politics with this administration. All actions are about maintaining and gaining power. The welfare of American citizens are way down the list as Obama seeks to fundamentally change the nation he despises.

Jackie Jackasserson 4 years, 10 months ago

Um not delay of the plan, delay of taxing larger businesses and corporations for not providing health care.

jafs 4 years, 10 months ago

That was part of the plan, to require employers to offer health insurance. So this is a delay in implementing part of the ACA.

Carol Bowen 4 years, 10 months ago

The ACA is a large program. Social Security has been tweaked many times since 1935. There are discussions about tweaking Social Security again. Why would you expect the ACA to be perfect the first time around? By the way, the White House and the Romney/Ryan ticket both claimed the savings from Medicare. The only difference was what to do with the savings.

There's lot more to be done to address health care costs, tort reform, ... Propose some modifications.

Alyosha 4 years, 10 months ago

Show us where the President said "Obamacare is working exactly as planned."

If you can't, the entirety of your thinking falls apart.

This comment is nothing but a list of unsubstantiated talking point claims that can't stand the light of actual facts and truth.


Liberty275 4 years, 10 months ago

The ACA is already hurting the poor and middle class as it encourages evil corporations to hire part-time workers. On the bright side, people can still get a second job to make up the difference in pay. They can use that 10 hour/week job to pay for the health insurance since they don't want to pay the uninsurance tax.

Really, I look forward to the ACA forcing young adults to spend thousands of dollars every year on something they don't want.

Making libertarians will be Obama's legacy.

Alyosha 4 years, 10 months ago

Did you have the same perspective on elements of the ACA when they were conservative Republican proposals? Or was it only when Congress passed the ACA and President Obama signed it into law that you began opposing it?

Liberty275 4 years, 10 months ago

I'm from Florida, whatever they did in Massachusetts didn't mater to me as long as they kept it in Massachusetts and it was constitutional. If it had been law in FL or KS, I would have been against it.

I don't really care about the politics in other states. I don't get a vote so it's really none of my business.

Lisa Medsker 4 years, 10 months ago

"The ACA is already hurting the poor and middle class as it encourages evil corporations to hire part-time workers." This is NOT a "new" practice. Since I entered the working world in the late '80s, employers have been hiring peoploe at "29.9 hours per week" so as not to be required to provide benefits of any kind. They would also hire "temp" workers, with the "option" of becoming permanent, full-time after 90 days. They would terminate your contract at the end of "Day 89", then hire you right back the next day. This wasn't a "new" thing back then, either. It has nothing to do with Obama or the ACA.

Trumbull 4 years, 10 months ago

Employers have been doing this for a long-time. Nothing new.

Alyosha 4 years, 10 months ago

"Some have said"? Who, exactly? Without an actual source, your statement is nothing more than hearsay. Hearsay has no place in a civic discussion of important national economic policy.

Centerville 4 years, 10 months ago

Phelps, I'm with you. The whole insane scheme depends on the IRS to force young, healthy people pay in exorbitant amounts . That, and cutting Medicare reimbursements. Well, those and the brainwashing.
Time for Congress to stick a fork in this thing.

Carol Bowen 4 years, 10 months ago

Medicare reimbursements are not being cut. Are you referring to pooled payments to hospitals?

The young are already forced by insurance companies to pay exorbitant amounts for health insurance. The ACA offers a competitive marketplace, and only 20% can be used for overhead instead of 40 to 60% in the past. ACA does not set insurance rates.

George Lippencott 4 years, 10 months ago

I guess you missed insurance 101. You pay and hope you never need it. In medical care you pay at the beginning to get more later. That is the basis of Medicare and most insurance programs. We could change that and make it everyone for themselves. If not you will have to pay upfront to avoid prohibitive costs later.

Carol Bowen 4 years, 10 months ago

Independent health insurance policies have deductibles of $1700 or higher, coverage is very limited, and companies drop policy holders with health problems. I would say that's exorbitant, especially compared to group policies. It will be interesting to see if the exchange will have any impact.

Trumbull 4 years, 10 months ago

The idea is to get everyone to pay something into the health care system. This lowers the payments per-capita (or person), and enables the system to cover its costs. I don't see what is insane about this idea itself. It may be insane to think it can be administered.

ACA is the result of a bad compromise between both congressional parties and the insurance industry. We should have gone with a public option as was President Obama's intention. Then....unfortunately, too many cooks got into the kitchen to muck the whole thing up. I do give the administration a tip for trying to enact good legislation and to improve health care. Hopefully some tinkering with the ACA can be done.

Liberty275 4 years, 10 months ago

LOL. TheNation... and people complain about Fox.

Republicans wanting federal money paid for by their constituents isn't nearly as hypocritical as you complaining about corporations using a computer that cannot exist without corporations.

Orwell 4 years, 10 months ago

So do you feel pretty good about the Kansas wingers who let us pay into the system without seeing the benefits?

Thanks a whole lot, Sam.

Liberty275 4 years, 10 months ago

How can a "Kansas Winger" let us not pay into a federal system?

jafs 4 years, 10 months ago

He can't.

But, he could let us share in the benefits.

Richard Heckler 4 years, 10 months ago

The only answer is to follow what other industrialized nations have done and they are housing zillions of USA jobs.

Healthcare Reform Report Card Comparison

Single-Payer (HR 676 and S 703) Expanded Medicare for All Vs. Proposed Healthcare “Private insurance with Public Option” ( very interesting findings) Physicians for a National Health Program

Richard Heckler 4 years, 10 months ago

The 50 million or more uninsured should simply be moved to an improved Medicare Coverage Plan instead of blowing tax dollars on the medical insurance industry. Medicare is by far the most efficient use of tax dollars whereas the medical insurance industry cannot relate to efficiency.

BTW it is my thinking that no business should be responsible for medical insurance coverage. There is no way any business can manage a budget never knowing how much money the medical insurance industry will be demanding from one year to the next. Or never knowing how coverage will be altered from one year to the next. Or never knowing what deductibles or co-pays will be necessary.

The healthcare industry is receiving more than 1 trillion health care tax $$$$$$$$ annually which is more than enough to insure all people in the USA under Medicare Single Payer Insurance. The best 24/7 coverage on the planet for the USA.

George Lippencott 4 years, 10 months ago

The uninsured number continues to grow. When will it stop.

Medicare has about a 10 to 20% fraud, waste and abuse cost. Private insurance would go broke with that level. The cost of policing such waste falls to the insurance companies in the private sector. It falls to the justice department with Medicare (&Medicaid) where it is not counted in the cost of the program.

Carol Bowen 4 years, 10 months ago

Medical services charge the maximum insurance or Medicare will allow. Sometimes, the charge is twice the actual cost. This would be another place to control costs, but how?

George Lippencott 4 years, 10 months ago

Well, if that be true perhaps the data should be more available so that the public can involve itself. My sense is that most providers are not making fortunes - but I could be wrong.

Carol Bowen 4 years, 10 months ago

i have no data, just personal experience. The equipment was a brace. The doctor stopped selling them in his office, because there was a medical supply store downstairs. (Not in Lawrence) The doctor accompanied my son to the store to select the right brace. The doctor was shocked at the markup and started ordering for his patients again. The store owner unabashedly explained that the price was the maximum allowed for coverage.

jafs 4 years, 10 months ago

Providers routinely price their services above what insurance will pay, thus ensuring that they'll get the maximum possible reimbursement.

You can see that information on your bill/statements from health care providers - it will show their charges, and then the markdown from insurance to the reimbursed level.

They're not making fortunes because the reimbursement levels may not be great for them - they accept lower levels of reimbursement in exchange for being in insurance networks.

Kirk Larson 4 years, 10 months ago

This actually affects relatively few businesses. Those with more than 50 employees that do not already offer insurance plans to their employees.

Mike Ford 4 years, 10 months ago

it's funny how naïve parts of the American constituency is. can I say boo and make you go out and buy up all of the ammunition and guns and be afraid of a president who actually looks out for people instead of the greedy you're on your own crowd? this delay is partly because some of the naïve and non reading populace believed the statements of the political establishment whose only platform is yelling boo and scaring the naïve and willingly fearful. what a platform.

Liberty275 4 years, 10 months ago

Said the guy that gets his information from HBO.

Richard Heckler 4 years, 10 months ago

Obama did improve on a very crummy system that preceded Obamacare. Bit it opened doors for the medical insurance industry to gouge consumers further. Not necessarily the fault of Obama but definitely point the fingers at the insurance industry.

Private insurers necessarily waste health dollars on things that have nothing to do with care: overhead, underwriting, billing, sales and marketing departments as well as huge profits and exorbitant executive pay. As a result, administration consumes one-third (31 percent) of Americans’ health dollars, most of which is waste.

Single-payer financing is the only way to recapture this wasted money. The potential savings on paperwork, more than $400 billion per year, are enough to provide comprehensive coverage to everyone without paying any more than we already do.

Under a single-payer system, all Americans would be covered for all medically necessary services. Patients would no longer face financial barriers to care such as co-pays and deductibles, and would regain free choice of doctor and hospital. Doctors would regain autonomy over patient care.

Physicians would be paid fee-for-service according to a negotiated formulary or receive salary from a hospital or nonprofit HMO / group practice. Hospitals would receive a global budget for operating expenses. Health facilities and expensive equipment purchases would be managed by regional health planning boards.

Costs would be controlled through negotiated fees, global budgeting and bulk purchasing.

The very crummy system that preceded Obamacare could cancel in the middle of the stream aka any time at all. No matter how much money had been contributed over many many years.

George Lippencott 4 years, 10 months ago

To echo the above. The Democratic Members of Congress in their collective wisdom put specific dates in the ACA which were signed by the President. Just how does the President obtain the authority to overrule a standing law?? Does he not require Congressional approval to change the dates? ARE WE HEADED TO THE SC ON SEPARATION OF POWER ISSUES?

Carol Bowen 4 years, 10 months ago

I did not see any dates related to small business requirements. Where did you find them and what are they?

George Lippencott 4 years, 10 months ago

The subject of the article is medium and large businesses. What did you read?

Carol Bowen 4 years, 10 months ago

Chuckle. I should have referred to medium and large businesses. I looked at the actual legislation for implementation dates. If they are not part of the legislation, they are not law, just working target dates. So again, has anyone found dates in the legislation?

George Lippencott 4 years, 10 months ago

Apparently a whole bunch of people For one see the Bloomberg article referenced elsewhere on this page.

progressive_thinker 4 years, 10 months ago

Mod: here is a Bloomberg article that gives some details on the specific action taken by the President, along with some "unintended consequences" that are likely worse than the decision heading to the Supreme Court.......

George Lippencott 4 years, 10 months ago

Good summary. You would think progressives would be leery of allowing to much power to the President least a Republican assume leadership and use the implied powers here to stop all sorts of programs that are otherwise directed in law. This is a dangerous slippery slope.

Liberty275 4 years, 10 months ago

The next republican president is going to make the left squeal. If Obama can put off parts of the ACA, so can the next right winger.

Centerville 4 years, 10 months ago

I will have to hand it to Brownback and Roberts for supporting the Sibelius nomination: pretty cunning, after all.

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