Tuesday, July 9, 2013

Is Obamacare Crashing?

Since March 23, 2010 the country has been living in a constant psychotic state when it comes to reforming health care. While some have tried to implement the legislation and rules of the Affordable Care Act (Obamacare) others have religiously tried get rid of it altogether. Neither side has actually “won” as we have moved through the process but as a result we are now facing a health insurance market that doesn’t look anything like what those who supported the original legislation had hoped. It’s a mess.

Nobody should be surprised that there are going to need to be changes to what was originally written. The original legislation was much too complex, confusing, (and costly?) considering where the country was
positioned economically and politically. Unless the majority of Americans were on board, there is no way it was going to work.

The Treasury Department announced last week that they are pushing the employer requirement for providing health insurance (over 50 employees) until 2015. Additionally, the Department of Health and Human Services published rules that stated they were going to allow self-reporting of income information to determine insurance subsidies instead of verifying the information through the government.

Some believe this is the “beginning of the end” of Obamacare. (Republicans) Others view this as simply making the necessary changes to respond to the market realities. (Democrats/White House) Still others see these changes as the predictable outcome of creating something that was too big, too confusing, and too complex combined with poor implementation and terrible communication. (including me)

An opinion essay in the Wall Street Journal (Obamacare’s ‘Lair’ Subsidies; July 7, 2013) stated, “All of this fits with Obamacare’s entire bloody-minded history. Democrats were determined to make their rendeveous with the liberal destiny of government-run health care, so they imposed this debacle on the country on a partisan vote and despite public opposition.”

I don’t think it’s quite as bad as the Wall Street Journal describes it (and the position that Obamacare is “government-run” health care is a stretch) but  illustrates just how far apart the country continues to be when it comes to health care reform.

Many will continue to move forward to try to implement what was originally designed. Others will continue to oppose every aspect of the Affordable Care Act. At the same time, more changes to the original rules will likely occur and who knows what kind of health care system we’ll ultimately create- and at what cost?

In the meantime many individuals will have to continue to simply cope with the expensive and selective health system model we have today and try their best to understand the rules they are expected to follow. Citizens are going to need to be much more engaged in health care reform than they are today to break the political impasse. In the book Health Care Reform and American Politics; What Everyone Needs to Know, authors Lawrence Jacobs and Theda Skoopol summarize where we are; “We will continue to live in interesting times, where each citizen’s understanding, voice, and actions can make a difference.” 

Changes to the Affordable Care Act will continue to occur. The more individual citizens understand the basics of what is going on, the better the chances they will have to make a difference to influence the results.


Obamacare isn’t crashing, it’s just continuing to lose altitude due to economics and politics. Ultimately, it’s going to be up to the individual citizen to get health care reform on the right track again. As in the past, they will be forced to live with the results.  

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