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After the Election: Obamacare

Sunday, November 11th, 2012

At first glance, the 2012 general election doesn’t seem to have changed much. President Obama was re-elected. Democrats will retain control of Congress, and Republicans will retain control of the House.  What might we expect to happen in Washington in the next two years?

For one thing, this election insures that the Affordable Care Act (ACA), or Obamacare, will go fully into effect in 2014. Even if a majority of the House wants it to go away, a Democratic majority in the Senate would never pass a repeal bill. And even if they did, President Obama would never sign it.

A number of Republican governors now find themselves in a pickle. The ACA calls for establishing statewide insurance exchanges, which will be insurance marketplaces one can access online. Individuals and small businesses can use the exchanges to find affordable health insurance policies.

If you have ever had to purchase an individual health insurance policy, you will appreciate the exchanges. It can be difficult just to find out what is available in your state, and if you do online searches much of the “hits” you get will be scams.

With the exchanges, you will be able to find every legitimate health insurance policy offered in your state in one place, and you will be able to compare them easily. The policies offered through the exchanges must meet certain federal guidelines to protect consumers from buying the ripoff insurance that somehow never covers whatever medical problem you have. It is hoped the exchanges will drive competition among insurance companies so consumers can get better deals.

The exchanges are being set up to help people comply with the individual mandate requirement. Beginning in 2014, most citizens will be required to have health insurance or pay a penalty. This will make it possible to require insurance companies to accept customers even if they have a preexisting condition. In 2014, no matter what condition your health is in — even if you have a life-threatening disease such as mesothelioma — the insurance companies cannot refuse to sell a policy to you.

How are the Republican governors in a pickle? The ACA requests that states set up their own exchanges. If they fail to do that, the federal government will step in and do it for them.

Several governors, mostly Republicans, have refused to even think about the exchanges. They weren’t going to comply with federal demands, period. Several of their states even filed lawsuits against the ACA to have it declared unconstitutional, but last summer the Supreme Court upheld the health care law.

Then, they believed President Obama would be defeated in the general election, and that Republicans would take back the Senate, and then Obamacare would be repealed. (He wasn’t, they didn’t, and it won’t be. )

On November 7, the day after the election, governors looked at their calendars and saw a deadline looming — November 16, 2012, the due date for state plans for the new insurance exchanges. The governors who thumped their chests and dared the federal government to make them comply now knew that if they didn’t submit a plan, the federal government would do it for them.

Then the governors got a reprieve. On Friday, the Obama Administration announced that states could take until December 14 to file their plans. And if they want to run exchanges “in partnership” with the federal government, they have until February 15. But one way or another, the exchanges will be in business beginning January 1, 2014.