February 10, 2014 was marked by the second delay of the Affordable Care Act’s business mandate. The irony of this latest development is two-fold. First, the growing perception that the Obama Administration is catering to business interests runs counter to the Democratic President’s fervent criticism of lobbyist influence. Second, President Obama originally wanted a public option and agreed to an individual mandate to garner the support of healthcare interests while he is now defending the individual mandate against Republicans, who originally proposed the provision in the 90’s.
Although it is reasonable that seasonable/temporary workers and part-time workers with few hours are no longer included under the business mandate, the outright delay of this provision essentially displaces costs onto workers. While companies of 50 to 99 workers with multimillion-dollar payrolls are pleading poverty, the Obama Administration is now forcing workers, who would have otherwise been covered by their employers had the business mandate been enforced, to find coverage at a higher cost for individual plans, thanks to the individual mandate. Meanwhile, 25 states have yet to expand Medicaid mainly for political reasons, thus the uninsured continue to go uninsured. For the sake of Equal Protection and the need to avoid creating unnecessary costs, as well confusion and uncertainty, the Obama Administration needs to delay the individual mandate as well.
Clearly, Republicans will try to take advantage of this concession as they wish to eliminate the business and individual mandate, but their plans to replace Obamacare are far from superior. In fact, the so-called Patient Care Act, which is probably the most comprehensive Republican plan to date, includes taxing most people’s healthcare benefits, which means employees need to set aside additional cash to pay taxes, reduces eligibility for tax credits, undermines Medicaid expansion with tax credits that may or may not cover the cost of a healthcare plan that low income beneficiaries probably cannot afford, and increases tax credits based on age instead of income as it allows insurance providers to charge older Americans five times the amont they charge younger American, thereby using the inflationary pressure of subsidies to increase costs while making healthcare less affordable for younger Americans, who are expected to have smaller incomes than their less healthy older counterparts. Given the CBO estimates Obamacare will incentivize workers to reduce their hours by the equivalent of 2 million plus fulltime workers, it is likely the income eligibility for credits needs to be expanded, not decreased. Meanwhile, the GOP alternative also weakens the elimination of the precondition clause and other provisions that seek to address the issue of junk insurance.
It goes to show you that no politician can be trusted to look after your interests. Quite frankly, Obamacare has problems and the only solutions on the table create more problems while doing nothing for those who needed healthcare reform to get them reliable, affordable coverage and the overall system. Under traditional political thinking, the fact that healthcare reform was passed with faults should have worked as an incentive for Republicans to reach out to Democrats, so further reforms could be made reality. Instead, we end up with two polarized parties offering competing visions with technical differences that do nothing to solve the problems in our healthcare system. At this point, a public option delivered by private firms, which would also offer supplemental plans, is looking far more attractive than the complicated, inflation driving, ineffective alternatives we see today. Clearly, reactionary, divisive politics is the reason we are at this juncture, so it is no surprise the issues with Obamacare are not being addressed properly.
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