Obamacare: The good, the bad and the uncertain

We have never seen a major federal bill with so many conflicting and uncertain parts as Obamacare. Some are clearly good, some clearly bad and some still totally unclear – the result of legislation by technocrats, lawyers, data drones and health insurance lobbyists  rather than by smart politicians. Here are some of the elements of Obamacare, sorted by virtue or lack thereof. We will update this from time to time, with updates in bold

Good

Over 39 million women no longer have lifetime limits on their health plans

Insurers can’t discriminate because of preexisting conditions

Extends Medicaid to those with incomes up to 138% of federal poverty level

Makes price discrimination against women more difficult

Covers preventive measures for women such as contraception. Also covered are vistis concerning breastfeeding, domestic violence, gestational diabetes, HIV screening and counseling, sexual diseases and wellness visits

Reduces costs of those making less than 400% of the federal poverty level

As of 2015, requires health insurance from large employers

Small businesses can get tax credits for up to 50% of medical insurance costs

Obamacare eliminates the doughnut hole in Medicare drug plans, where there is a gap in coverage between roughly $3000 and $4700 which had to be paid for entirely by the patient.

The bill prevents excessive premiums for pre-existing conditions or because of age.

Children can get insurance under their parents’ policies up to the age of 26.

Bad

Those who lack health insurance are liable to an annual fine. Many of these are people who didn’t buy health insurance because they couldn’t afford it

Many states have opted out of the planned Medicaid expansion

Increased requirements for coverage of sick employees will raise overall rates

Bill addresses coverage but not realistic cost limitations

Many companies used Obamacare to dump their existing plans

Those who did not sign up by March 31, 2014 are unable to get insurance through exchanges

There is no public option.

According to The Hill, health industry officials say Obamacare-related premiums will double in some parts of the country, countering claims made by the administration.

An analysis by The New York Times shows the cost of premiums for people who just miss qualifying for subsidies varies widely across the country and rises rapidly for people in their 50s and 60s. In some places, prices can quickly approach 20 percent of a person’s income.

A number of states wasted large amounts of money building their own health exchanges.

The Christian Science Monitor reported that about 30 percent of small franchises and 12 percent of other small businesses say they are cutting work hours – or swapping full-time for part-time workers – because of the law..

Economic Policy Journal reported in 2013 that since March 2010, when President Barack Obama signed the act, the administration had published 109 final regulations adding up to to 10,516 pages in the Federal Register.

Forbes reported in 2013 that representatives of three of the nation’s largest unions had fired off a letter to Harry Reid and Nancy Pelosi, warning that Obamacare would “shatter not only our hard-earned health benefits, but destroy the foundation of the 40 hour work week that is the backbone of the American middle class.”

Unknown or uncertain

Increasing signs that corporations want use Obamacare to dump their current health programs This could affect quality of healthcare and especially those earning more than would permit a subsidy under Obamacare.

Uncertainty of how much insurance companies will raise prices. Some of the predictions are scary.

What will be the effect of businesses changing the nature of their employment to ease the cost of Obamacare?

Obamacare will create an uncertain burden and confusion on small business owners.

We still have no clear picture of the economic effects of the individual mandates. In a recession even a 5-10% increase in personal costs can be major.

Some hospitals are limiting the number of insurance plans they will accept. The effects of this are unclear. According to Huffington Post, “about 70 percent of Obamacare plans offer fewer hospitals and doctors than employer-sponsored group plans or pre-ACA individual market plans, according to a study by consulting firm McKinsey & Company released in December.”

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