Betsy McCaughey
The central parts of ObamaCare don’t roll out until 2014, but the wheels are already falling off this clunker. The latest news from four federal agencies is that 1) insurance will be a lot less affordable than Americans were led to expect, 2) fewer people than promised will get insurance and 3) millions of people who have coverage through a job now will lose it, thanks to the president’s “reforms.” Oh, and children are the biggest victims.
The Affordable Care Act is looking less and less affordable.
Start with the IRS’s new estimate for what the cheapest family plan will cost by 2016: $20,000 a year to cover two adults and three kids. And that will only cover 60 percent of medical bills, so add hefty out-of-pocket costs, too.
The next surprise is for parents who thought their kids would be covered by an employer. Sloppy wording in the law left that unclear until last week, when the IRS ruled that kids won’t be covered.
Starting in 2014, the law will require employers with 50 or more full-time employees to offer coverage or pay a penalty. “Affordable” coverage, that is — meaning the employee can’t be told to contribute more than 9.5 percent of his salary. For example, a worker earning $40,000 a year cannot be required to pay more than $3.800.
But the law doesn’t specifically mandate family coverage — and now the administration says that won’t be required.
You can see why: If the lowest-cost family plan (again, two adults and three kids) is to run a whopping $20,000, and if the employee’s contribution is limited to $3,800, the employer’s tab would be $16,200 — adding about $7.40 an hour to the cost of that employee. Wisely, the IRS announced on Jan. 30 that employers won’t have to pay for dependents.
But the Congressional Budget Office’s much-cited prediction that ObamaCare would leave only 30 million people uninsured by 2016 was based on the assumption that kids would be covered by employers. At the very least, employers insuring their workers for the first time to avoid the penalty are unlikely to do that.
So how will the kids be covered? They won’t. The IRS shocked the law’s advocates by announcing that the insurance exchanges won’t provide subsidies for a child whose parent is covered at work.
Nor will these parents be penalized for not insuring their children — the IRS will kindly consider the kids exempt from the mandate.
Also exempt are millions of people who’ll stay uninsured because their state is wisely choosing not to loosen Medicaid eligibility.
Some background: Despite President Obama’s promises to help solve the problem of the uninsured by making private health plans more affordable, the law expands coverage mainly by forcing states to loosen their Medicaid eligibility rules. But the Supreme Court ruled that the feds can’t command states in this way.
At first, the CBO said that ruling would only prevent 4 million people from gaining coverage — but more states than it expected are refusing to go along; it could well be 8 million more without coverage.
Oh, and the CBO last week also doubled its previous estimate on how many people will lose the health coverage they now get through work, upping the figure to 8 million by 2016 and 12 million by 2019. Several top consulting firms put the figures even higher.
Yet the biggest setback is that most states are refusing to set up insurance exchanges. The exchanges are supposed to sell the government-mandated plans and hand out taxpayer-funded subsidies to most enrollees.
Here’s the glitch. The law says that in states that refuse, the federal government can set up an exchange. But the law empowers only state exchanges, not federal ones, to hand out subsidies. The Obama administration says it will disregard the law and offer subsidies in all 50 states anyway, but the case will likely go to the Supreme Court.
If the courts uphold the clear language of the law, then some 8 million people in the affected states won’t be eligible for subsidies to cover that $20,000 (or more) insurance bill. That’s another 8 million without coverage.
All in all, at least 40 million people could be uninsured in 2016, only 9 million fewer than before the law was passed.
Expect the momentum for repealing this law to grow as its flaws, perverse incentives and faulty predictions come to light.
Betsy McCaughey is the author of “Beating ObamaCare.”
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Wheels coming off
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