Surprised by the recent waivers from the Obama administration on the Affordable Care Act? Get ready for more, writes Margot Sanger-Katz at National Journal, because the employer mandate is far from the only piece of ObamaCare that’s not ready for prime time. In fact, it might be easier to select the few components that might be ready for the implementation target date than to number those that won’t:
If you’ve been reading all the Obamacare stories lately, you might get the impression that the administration has just realized it will not be able to implement the massive health reform as designed.
It has known for months.
As far back as March, a top IT official at the Department of Health and Human Services said the department’s current ambition for the law’s new online insurance marketplaces was that they not be “a Third-World experience.” Several provisions had already been abandoned in an effort to simplify the administration’s task and maximize the chances that the new systems would be ready to go live in October, when customers are supposed to start signing up for insurance.
In April, several consultants focusing on the new online marketplaces, known as exchanges, told National Journal that the idealized, seamless user experience initially envisioned under the Affordable Care Act was no longer possible, as the administration axed non-essential provisions that were too complex to implement in time. (Read the story for some examples and commentary.) That focus has intensified lately, as officials announced that they would not be requiring employers to cover their workers next year or states to verify residents’ incomes before signing them up for insurance.
“There’s been a focusing in not on: ‘What is the full ACA vision?’ but: ‘What are the pieces we have to get running by October 1?” said Cindy Gillespie, senior managing director at McKenna Long and Aldridge, who is working with states and health plans.
Remember the impossibly-complicated flow charts produced by ObamaCare opponents to demonstrate the folly of the ACA? At the time, proponents of the bill insisted that those were just scare tactics designed to irrationally frighten voters from the benefits of change. Now, though, it’s the ACA’s supporters producing similar flow charts to demonstrate why they can’t meet their deadline:
“Bear in mind,” Sanger-Katz notes, “this chart is supposed to simplify and explain.” It comes from a consultant group assisting in the process of getting states to create the exchanges that will interface with the IRS, HHS, and other federal agencies. What it does explain is the mess that the ACA created, and how the administration cannot make it work more than three years after its passage.
Another point to bear in mind: this is the Obama administration’s signature accomplishment. For the past five years, they have had no higher priority than to make this work, which at the time of passage they claimed would be nowhere near as complicated as their critics claimed. Now they can’t even make the key employer mandate work after three years — three years in which employers and their employees have been forced to adjust to it by taking on more expensive insurance or cutting hours to their staffs.
Some smokers trying to get coverage next year under President Obama’s health care law may get a break from tobacco-use penalties that could have made their premiums unaffordable.
The Obama administration — in yet another health care overhaul delay — has quietly notified insurers that a computer system glitch will limit penalties that the law says the companies may charge smokers. A fix will take at least a year to put in place.
Older smokers are more likely to benefit from the glitch, experts say. But depending on how insurers respond to it, it’s also possible that younger smokers could wind up facing higher penalties than they otherwise would have.
Again, the administration has had three years to figure out how to charge smokers a higher rate. Insurance companies have done this for much longer than that; how difficult could it be?
If the Obama administration is this incompetent at running its highest priority, just how badly are they bungling everything else?