10 unanswered questions about Obamacare

Since Obamacare’s March 31, 2014 deadline, the Administration has gone on a victory tour to tout the law and HealthCare.gov’s eight million so-called “new” enrollees.  But, are there really eight million new enrollees? Of the 8 million, who has paid their premiums? Were they uninsured prior to obtaining insurance? Or, was their insurance previously cancelled?  What else is the President not telling the American people?

Below are 10 issues the President has yet to address.

1.  The President has ignored or arbitrarily waived the law on nearly 40 separate occasions.

2.  Despite spending $600 million, the Administration has yet to finish key pieces of the federal exchange,[1] such that it is difficult to know who of the 8 million enrollees has actually paid their first and second month premium.

3.  Healthcare.Gov is still unable to transfer Medicaid applications to state Medicaid systems. As a result, hundreds of thousands of Medicaid applications are still waiting for approval by states. The Administration proposes to deal with this backlog by cutting off or limiting administrative Medicaid funding.[2]

4.  Premiums are going up. Carriers must file FY 2015 rate requests without the benefit of knowing the health status and cost of their newly enrolled members.  Wellpoint, the biggest insurer on HealthCare.gov, indicated that consumers can expect double digit rate [premium] hikes.[3]

5.  State exchanges are less competitive than those individual markets in place prior to Obamacare. According to Forbes, there is 29 percent less insurer competition on the state exchanges now relative to individual markets in place prior to Obamacare.[4]

6.  There is even less competition among insurers at the county level.  In one out of every six counties (17 percent) nationwide, the state exchange offers only one insurer. In an additional 35 percent of the counties, only two insurers offer coverage. In another 25 percent, only three insurers are selling coverage.  Thus, in at least half the counties of America, less than two carriers are competing for business. In three fourths the counties of America, less than three carriers are competing.[5]

7.  There is a lack of choice with respect to benefits.  The essential health benefit package standardizes the benefits insurers can offer – significantly limiting choice and preference. In fact, the only difference between plans is cost sharing and provider networks.[6]

8.  In a recent small business survey, forty five percent of those polled said they had curbed hiring plans because of the healthcare law. An additional third (29 percent) of small businesses surveyed said they had to make staff cuts.[7]

9.  In the latest ABC/Post poll, support for Obamacare is down from 49 percent last month to 44 percent.  “More than half Americans also think implementation is worse than expected.”[8]

10.  In the same poll, 58 percent say the new law is causing higher costs overall and 47 percent say it will make the health care system worse.[9]

[1] Glenn Kessler, How much did HealthCare.gov cost? (Part 2), Washington Post (November 19, 2013).
[2] Angela Boothe, Administrative Cuts to Medicaid Will Not Solve HHS Problem, American Action Forum (April 28, 2014).
[3] Jay Hancock, Affordable Care Act Plans Pose Actuarial and Rate Challenges for Insurers, Washington Post (April 26, 2014).
[4] Edmund F. Haislmaier, Health Insurers’ Decisions on Exchange Participation: Obamacare’s Leading Indicators, Heritage Foundation (November 12, 2013).
[5] Aylene Senger, If You Like Choice, Competition And Entrepreneurship, Obamacare Is Not For You, Forbes (April 25, 2014).
[6] See id
[7] See http://www.usbankconnect.com/article/2014-annual-small-business-survey-results
[8] James Freeman, ObamaCare Less Popular, The Wall Street Journal (April 29, 2014).
[9] See id.