WASHINGTON, August 7, 2013 — Time is running out for opponents of President Obama’s healthcare law who want it repealed, defunded or killed. There is an October 1 deadline for states to have exchanges set up in time for the Affordable Care Act, or Obamacare, to start January 1, 2014. As that deadline approaches, concerns about implementation, costs, and jobs are growing, not going away.
Is Obamacare a step on the way to single-payer health insurance, a total government takeover of the American health insurance market? Does it merely subsidize insurance for millions of Americans without threatening the insurance arrangements of millions of others? Uncertainty about the law’s effects on jobs and access to affordable healthcare keeps those questions alive for patients, doctors and employers. If they expected lawmakers to give them solutions, they are finding that every answer comes with two more questions.
In response to questions about managing costs and protecting privacy, the House passed a bill sponsored by Rep. Tom Price, R-GA, to get the IRS out of Obamacare. The vote was 232-185, with 228 Republicans and four Democrats supporting and 185 Democrats opposed. The Senate has yet to vote on the measure.
Sweeping regulations issued by unelected bureaucracies such as the “Independent Payment Advisory Board” — sometimes described as a death panel — are part of the unknown consequences we face as we enter the system. Others questions have to do with privacy; who will control and have access to the vast store of personal information and patient data that are required by Obamacare? Can a government whose intelligence agencies have given us massive phone and internet data collection without probable cause or warrant be trusted with these data? Can an agency that engaged in partisan political rigging of the electoral landscape last year be trusted to oversee their collection?
Yet another set of questions has to do with doctor-patient relationships. We were promised that no one with an insurance plan and a physician would be required to give up either, yet in the last month the government has admitted that the promise will not hold for everyone. How will Obamacare change doctor-patient relationships?
The Doctors Company Market Research reports that 60 percent of physicians believe that the law will negatively effect overall patient care. One nonsurgical specialist from California was quoted in the survey as describing Obamacare as “too much interference with patient care.” Another from Kentucky said, “Physicians have no input/control in providing patient care.” Think of the restrictions administrators place on medical care and the ability of physicians and patients to make decisions in HMOs and in Medicare-funded nursing homes, then imagine those spread across the entire health industry. These physicians clearly have.
Access to physicians and the number of doctors still able to practice medicine under the law are decreasing as physicians are taking fewer patients. American physicians familiar with the deficiencies of bureaucratized healthcare management are more apt to support a repeal to Obamacare than to approve of it.
Employer concerns caused the White House to propose delaying the employer mandate until 2015. Some of these issues include difficulties business owners are facing while preparing for compliance verification rules associated with this mandate in the Affordable Care Act. Probably more worrying to the White House was growing evidence of the negative impact Obamacare would have on employment decisions, convincing the administration that this was a bridge best crossed after the midterm elections.
While the delay could allow compromise and give everyone time to do some problem-solving to smooth the transition into full implementation of Obamacare, it is more likely to only postpone higher costs and a negative job impact. Those who want to stop Obamacare are therefor concerned that these delays will only harm, not help workers, employers, and the healthcare system.
Part of that evidence of negative job impact has to do with employers cutting back worker hours to avoid the need to provide insurance uner the expensive administrative burden imposed by Obamacare. Businesses with 50 or more employees are required by ACA to provide health insurance to all of their full-time employees whether they can afford it or not.
Job creation so far this year has been close to a million, but an astonishing 77 percent of those jobs are part-time. By holding off hiring more full-time employees and instead offering only part-time or temporary positions, employers can protect their businesses from the insurance, tax and administrative costs imposed by Obamacare. The U.S. Chamber of Commerce reports that the employer mandate threatens job growth more now than ever because more hires could mean triggering expensive penalties for businesses that do not offer coverage.
If businesses do not provide health insurance, they will have to pay $2,000 per employee after the first 30 employees. The incentive to hire new workers drops if employers have to pay an additional $2,000 tax per new hire on top of the health coverage penalty taxes for current employees. And because hiring a full-time worker involves long-term costs that create incentives for a long-term commitment, the impact should start showing up now, which seems to be born out by the employment numbers.
Costs of the healthcare law are adding up as unmanageable for employers in both time and money. The increased financial burden limits companies in ways that employers need to manage growth to continue offering products and services that Americans want.
Lawmakers contemplating political and policy issues surrounding Obamacare must push their case quickly. If many ACA opponents are correct, they really do have only six weeks to sell their case to the American people; the law’s supporters have that long to stop them. If opponents are convinced of the law’s destructive impact, they should ignore the political fallout of killing Obamacare in any way they can, even if that means a government shutdown.
We elect our senators and representatives to make hard choices for the good of the country, not simply to position themselves for reelection. If ACA opponents and proponents alike take their duty seriously, they will lay out their cases carefully and thoughtfully. If instead they choose to demagogue the issue, America has a bigger problem than Obamacare.
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