Opponents of the new health care law in the United States are seeking to make the law too convoluted to be successful.
For a law so fraught with delays and false starts, it is fitting that the first open-enrollment period for the Affordable Care Act has been kind of, sort of, extended past its original end date of March 31. It is just another example of the ups and downs that have characterized the four-year-long roll out of Obamacare.
March 31 had long been scheduled to be the last day to enroll in health insurance through the new statewide systems set up under the law. Although the deadline remains, it is a deadline in name only. The system will remain open for those who have been unable to enroll due to the technical difficulties caused by the disastrous Obamacare website (the site has been completely overhauled since it first made headlines in October), but the administrators have chosen to use the honor system for late applicants. Essentially, the deadline has been extended for anyone willing to say that they tried to apply before the deadline but were unable to complete the application.
Why the Department of Health and Human Services (HHS), led by Secretary Kathleen Sebelius, would do this is an open question. There is speculation that enrollment of young people — referred to as ‘young invincibles‘ because of their belief that they are too young and healthy to need health insurance — is too low. Only 25% of total enrollees are under 35. Another theory is that most of the enrollees so far already had insurance, which would present a difficult eventuality to the administration: perhaps the expensive and controversial law they worked so hard for did not get that many uninsured people covered. Seeing as only four of ten uninsured Americans are aware of the deadline, this theory is also reasonable.
But taking a step back, these issues may not pose significant problems for the implementation of the law, or its political success. Enrollment is now up to over 7 million, which after months of sluggish numbers, exceeds the HHS goal.
Paralyzed by exception
The more pressing issue for Obamacare is the long line of states and interest groups looking for exceptions. With each state or group looking to chip away at a bit of the law, the legislation’s ability to deliver a competent product could be affected.
Utah wants to tap into the federal grants for expanding Medicaid to more low-income earners, but without putting them on Medicaid. Instead, Utah Governor Gary Herbert wants to use the money to buy private insurance coverage for them. Similar measures have already been approved for two other states. Twenty-one other states have not yet accepted the Medicaid expansion and are watching to see if state-by-state negotiations will be beneficial for them.
Whether Utah’s plan is better or worse than what was already in the Affordable Care Act is subject to ideological preferences, but the fact that it would make Obamacare more complicated is not. The regulations for the law are already 11,000 pages long. These state-by-state exceptions would increase that number and bring more attention to it. There are few things more hated in US politics than the idea of excessive regulation, and Obamacare’s opponents are putting that sentiment to use.
Republicans have an interest in derailing the program while still getting the federal money for their respective states in the meantime. On the other hand, supporters of Obamacare have devoted their resources to expanding healthcare coverage instead of selling the merits of the law. With Utah serving as a guide, the Republican Party may be trying to make Obamacare so complicated that it cannot be successful, at least in a political sense. While the program has never been broadly popular, Republicans worry that it will eventually become so when the public sees it working. By highlighting that the law is convoluted and paralyzed by exceptions and bureaucracy, they may still win the political debate over Obamacare.
This is just one way that Obamacare opponents are trying to weaken the law. The other major tactic is to use the constitutional protections on religious freedom to strike down the requirement that employers that provide health insurance also cover birth control for their employees. A case filed by the retailer Hobby Lobby is being argued in the Supreme Court.
The longer these one-off challenges and exceptions to Obamacare persist, the most troublesome they become – not only to the political success of the law, but also to the businesses and industries affected by the law. Adjustments to the new health care law may have been significant, but the transition stage should be expected to even out once the changes become known quantities. As new provisions emerge and compromises are reached, however, those adjustments have to continue. The ongoing uncertainty may become more costly than the adjustment itself, which is how opponents of the law intend to kill it off.
