Posted on 06/30/2015 5:42:54 AM PDT by Cincinatus' Wife
The White House’s victory at the Supreme Court last week removed a major threat to ObamaCare that could have rolled back coverage for 6.4 million people.
President Obama declared after the ruling that the law has “been woven into the fabric of America,” while allies said the new insurance program and its related policy changes are here to stay.
But the law is hardly out of the woods. The battle of public opinion over the Affordable Care Act rages on, with Republicans expressing confidence they will ultimately prevail.
Here are five remaining threats to Obama’s signature domestic program.
1.) Repeal
Republicans are already turning their attention back to repealing the law, perhaps using a fast-track process called reconciliation that could move legislation through the Senate with just 51 votes.
But there are major obstacles ahead. Senate rules limit what parts of the law can be repealed using the process, and whatever legislation emerges would likely face a veto from Obama.
Facing long odds for success through reconciliation, many Republicans are pinning their hopes on the 2016 presidential election, when they hope their party will recapture the White House and control the legislative agenda.
But even if they won control of Congress and the White House, Republicans could find it difficult to get ObamaCare repeal past a Democratic filibuster in the Senate.
Under questioning from radio host Hugh Hewitt last week, presidential candidate Jeb Bush said he was open to the idea of curbing the filibuster to repeal ObamaCare.
2.) Marketplaces failing
Some of the 13 states that opted to set up ObamaCare marketplaces, known as exchanges, are considering turning over part of all of their operations to the federal government due to financial and technical problems.
New Mexico, Nevada, and Oregon have already handed over the toughest aspects of their operations to the federal IT system. Hawaii decided earlier this year to follow suit, and other states, including Vermont and Minnesota, are considering their options.
“The chances are good that some of the state-based marketplaces struggle, especially in the smaller states,” said Michael Adelberg, who formerly helped oversee the exchanges in the Obama administration and is now a consultant at FaegreBD.
The stakes of failing state exchanges are far lower now that the Supreme Court has ruled that subsidies can be made available on federal or state exchanges. But states have invested significant resources into their exchanges, with some costing as much as $200 million.
“We’re going to work with states that want to do state-based exchanges,” Health and Human Services Secretary Sylvia Mathews Burwell told reporters last week. “We’ll do federal exchanges where there aren’t those.”
3.) Rising costs
Republicans have latched on to proposed 2016 premium increases of as much as 30 percent in some states to argue that costs are skyrocketing under ObamaCare.
States are likely to block any premium increases of that size, and the average premium increase appears to be trending at somewhere between 4 percent and 6 percent.
A Kaiser Family Foundation study found that in eleven cities with complete data so far, premiums are set to rise 4.4 percent, compared to 2 percent last year. Similarly, an analysis from Avalere Health, a consulting firm, found that premiums will rise 5.8 percent across eight states with complete data.
“The growth looks to be pretty modest,” said Larry Levitt, a vice president at the Kaiser Family Foundation, though “somewhat bigger this year than last year.”
Perhaps a bigger problem for the law is the cost of deductibles — the amount patients have to pay before insurance kicks in. A study from the Commonwealth Fund finds that 31 million people are “underinsured” because they face such high deductibles and out-of-pocket costs.
“Are the people buying lower cost plans in the Exchanges underinsured?” Adelberg said. “That is one place people are going to turn their attention.”
4.) Enrollment challenges
Expanding coverage is the main goal of ObamaCare, and the administration faces a daunting projection, set by the Congressional Budget Office, of 20 million sign-ups by 2016, up from 10.2 million currently.
Robust enrollment is important for creating the mix of healthy and sick that is needed to limit increases in premiums.
“The biggest challenge ahead is increasing enrollment. Getting more people signed up is central to the law's primary aim,” Levitt said. “Increasing enrollment is also key to keeping premiums under control.”
People who have signed up for ObamaCare so far tend to be sicker and poorer than the population at large. The challenge for the administration will be getting middle-income, healthier people enrolled. A higher penalty for lacking insurance next year (the greater of $695 or 2.5 percent of income) could help.
5.) Another lawsuit
The legal challenges to the law are not over.
House Republicans have sued Obama over his handling of ObamaCare, citing executive overreach. They say he has spent money on the law’s cost-sharing reductions, which give money to insurers so that they can reduce deductibles and co-pays for low-income people, even though Congress declined to appropriate the money.
“It could have very serious ramifications because about 60 percent of ACA enrollees receive cost-sharing reductions,” said Tim Jost, a health law expert at Washington and Lee University.
The case is still in its early stages, and at the lowest level of federal courts. One court has yet to decide whether it will allow the case to go forward, given precedent saying that Congress does not have legal standing to sue the president. But at a hearing on a motion to dismiss the case last month, the judge levied tough questions at the Obama administration’s lawyer.
Some Republicans are putting the focus on 2016, however.
“I think next steps, whatever they are, really do need to include the ballot box and 2016 election,” Rep. Michael Burgess (R-Texas) said last week.
“Obviously, I don’t see any other court challenges coming in the next 18 months,” he added. “So we’re probably done with the court as a remedy.”
Repeal?
The GOP promised that, and demonstrated they are LIARS.
Why? Because they, their staff and families are EXEMPT.
The Constitution
Why The Affordable Care Act Isn’t ‘Here To Stay’—In One Picture
Good article by someone who is well-respected on the subject.
1) Repeal - won't happen, the MSM and Obama will be all over that and the RINOs won't have the stomach to weather that storm.
2) Marketplace failures - no biggie, the feds will just take it all over, they've got a printing press and the ability to create money out of thin air.
3) Rising costs - hey, then bent down the cost curve, what are you talking about, it is saving millions of Americans thousands of dollars.
4) Enrollment challenges - millions of Americans have gotten coverage that they didn't have before. Who cares if millions more have lost theirs, they can get it back if they apply.
5) Another Lawsuit - you think John Roberts is going away anytime soon? You've got to be kidding.
“The White House’s victory at the Supreme Court last week removed a major threat to ObamaCare that could have rolled back coverage for 6.4 million people. “
As opposed to the millions who lost affordable coverage due to ObamaCare.
“If you like your Supreme Court, you can keep your Supreme Court”
Oh wait.........
It’s engineered to fail catastrophically in order to create a crisis moment where even Republican Congresscritters will be compelled to vote yea on single payer.
Thanks for the link. I hope his crystal ball is right.
“As opposed to the millions who lost affordable coverage due to ObamaCare.”
I lost my private plan when the ACA requirements came into effect. The insurance company canceled it and I ended up buying a plan with less coverage for more than double the cost and higher deductibles. Now, my new insurance carrier, Assurant, has announced it is going out of business at the end of the year. It can’t make money under the ACA. Once again I’ll have to shop for a new policy, as well as carrier.
How many people are losing insurance this year due to insurance companies dropping out of the business? How many more companies will drop out during the next 2-3 years leaving their customers hanging?
Interesting the nation is focused on the Confederate flag, Bruce Jenner, and gay marriage when there is a very real health insurance crisis impacting millions of people.
He’s been “right on” so far. You should read the article just previous which made me think pretty hard about the SCOTUS decision and what it means.
To be clear, I think what SCOTUS did, taking the clear meaning of the law regarding subsidies and twisting it the way they did is horrible and wrong. They have basically made the rule of law the rule of anything goes ... whatever the powers that be want it to be. That being said .....
IF they had ruled the subsidies were illegal, the pressure would be on the Republicans to fix it. Burwell said multiple times the administration had no fix, no plans if the SCOTUS ruling went against them. They wanted maximum “hurt” on the American people and thus, maximum leverage.
The stupid Republicans would have tried to tinker with Obamacare & win concessions from Obama (like repealing the medical device tax) in exchange for continuing subsidies.
Obama would have called their bluff and REFUSED to sign anything but a fix making state/federal subsidies one and the same. If the Republicans caved, fine ... he would have them legalize what he had done illegally and they would have added their fingerprints to Obamacare, which up until then had not a single Repub vote.
If the Repubs didn’t cave (ha!), then Obama would have had this as an issue for the rest of his term and the Dems would have had it for the election .... the cruel, hard hearted Republicans, keeping poor, hardworking people who need insurance from getting it & even worse, those who had it, would be losing it because they are too poor to pay for it. This would have been a never-ending disaster for Republicans ... who could have put the blame squarely on Democrats who wrote/voted for this monstrosity in the first place, BUT Republicans seem incapable of standing up for themselves and communicating issues like this clearly.
Since SCOTUS ruled the way they did, there still is not one Republican fingerprint/vote on Obamacare. The Dems cannot use it for campaign purposes. The bill will continue to be unpopular and will eventually fail under its own weight. As its popularity declines and the ill effects on the economy and peoples’ lives continue to add up, it will be easier politically to do something about it ... assuming we get a Repub president for starters & can get rid of the likes of Boehner, McConnell, etc. & have more David Brats (lot could be said here, but I’m cutting it short)
All this being said, while Obama is gloating and doing his little SCOTUS victory tour regarding Obamacare, I would hazard a guess that behind closed doors, he’s not as happy about the ruling as one would think. He lost out on a “crisis” that he could have used greatly to his/Dems advantage. In his narcissistic view, one reinforced by past experience, I’m sure he was absolutely confident that he could get the Republicans to cave yet again and vote the subsidies as legal. Just my 2 cents - YMMV.
To be fair, repeal is not possible with obama’s veto in the White Hut, so why tilt at windmills?
A lot of food for thought.
Thanks.
It’s been ruled on now we need to move to the next line of defense (electing conservatives!!!!!!).
I lost my private plan when the ACA requirements came into effect. The insurance company canceled it and I ended up buying a plan with less coverage for more than double the cost and higher deductibles. Now, my new insurance carrier, Assurant, has announced it is going out of business at the end of the year. It can’t make money under the ACA. Once again I’ll have to shop for a new policy, as well as carrier.
...
Some insurance companies are doing extremely well. Especially the ones that do Medicaid HMO type plans. Their stock prices have already gone way up.
Most hospital stocks are doing well, too. Pharmaceutical stocks have been going straight up for a couple of years.
Because they promised.
There may be lingering threats, but Republicans aren’t one of them.
.... now we need to move to the next line of defense (electing conservatives!!!!!!).
********************************
I did my part .... supported and voted for David Brat!! :-) A lot of us are STILL smiling every time we think of Cantor being gone (not that there aren’t enough like him still left). Now ... if we can only do something about Timmy “The Eyebrow” Kaine and Mark Warner. Terry McAwful just promised Hildabeast, at a fundraiser, he’d “deliver” Va’s electoral votes for her - would like to see that NOT happen as well.
We have a winner! Exactly the goal all along (along with wealth taking and redistribution).
That’s true of many of them, but I believe that the House passed several bills that repealed major parts of OCare. Of course, they never went any further in the Senate.
Disclaimer: Opinions posted on Free Republic are those of the individual posters and do not necessarily represent the opinion of Free Republic or its management. All materials posted herein are protected by copyright law and the exemption for fair use of copyrighted works.