The Affordable Care Act is getting closer to implementation, less than half a year. But there are a great many questions still lingering and no clear road map from the Obama administration as the clock ticks.
U.S. Sen. Max Baucus, D-Mont., one of the moving forces behind the health care reform law passed in 2010, said that given the federal government’s efforts so far to communicate the law with Americans, the act could be headed for a “huge train wreck.”
So far, the White House has been tightlipped about its plans to roll out promotional information on the act, which has some Democratic Party lawmakers nervous. With enrollment in health coverage plans set to start Oct. 1, there is some worry that whatever plan the administration has for starting its push this summer may be too little too late. Beginning on that date, health care coverage markets called exchanges will begin offering federally subsidized private individual and family coverage to those with low to moderate incomes.
The act is expected to expand coverage to about 15 million Americans in the coming federal fiscal year, with millions more expected to join in the seven years after that.
Meanwhile, surveys show that Americans have little idea about how the health insurance exchanges set to be created by the act will be set up and operated. They also suggest that younger Americans — those who will be needed to offset the expected influx of older individuals who have more health issues — will not be persuaded to buy coverage just because of the penalties — $95 in the first year — that will be imposed for not purchasing coverage.
The participation of younger, healthier individuals who are less likely to need expensive health care is needed to keep the costs of the coverage down.
Plus, only just over a third of the states are building their own exchanges. The other 33 — including Georgia — will be covered with exchanges built by the Obama administration.
What it boils down to is there is a great deal of work to be done in a scant five months. President Barack Obama has said he expected there will be “bumps” in the road.
For an individual, a “bump” on the federal level in the cost of a premium or coverage can be a mountain on a personal level. And that has some Democratic lawmakers worried about their own political health.
Baucus doesn’t have to worry. Last month, he became the sixth Democratic senator to announce that he was retiring from the Senate. A bumpy start to Obama’s signature legislation, especially if premiums on the exchanges are seen as too expensive, could be retaliation at the ballot box, leading some to speculate that Democrats, which now have 53 Senate seats (two independents caucus with them), could lose control of that body.
If Republicans were to take a majority in the Senate in 2016, the Affordable Care Act might have an unintended side effect. Those on the Left who bemoan the “outdated” filibuster might well find a renewed appreciation for it.