Obamacare: Is the program already in trouble?

We always knew the Affordable Care Act would be a disaster, said The Wall Street Journal in an editorial, but with six months before most of it even takes effect, President Obama’s signature accomplishment is already becoming “a fiasco for the ages.” In a clear attempt to bury bad news, the White House waited until the eve of the July 4th holiday to announce a one-year delay in the ACA’s “employer mandate”—requiring businesses with more than 50 full-time employees to provide workers with health insurance. The White House and its defenders are downplaying the significance of this tactical retreat, said Yuval Levin in NationalReview.com. But given the political embarrassment it inevitably caused, it’s a sign that Obamacare is in serious trouble. For three years, the administration has smugly denied Republican criticism that the giant health-care bureaucracy at the heart of Obamacare is unworkable. Now that implementation draws near, “the wheels are coming off the bus,” and even the administration has been forced to admit it.

Don’t be fooled by “the Obamacare Train Wreck Doomsaying chorus,” said Jonathan Chait in NYMag.com.The employer mandate is not a central aspect of the new system, and the administration delayed it until 2015 only to mollify companies who complained that proving their compliance was too burdensome. The vast majority of employers already do offer health insurance, so this delay means little, and will affect only about 1 percent of the U.S. workforce. “Introducing a program this big was always going to be bumpy,” said USA Today. When the Bush administration expanded Medicare to include prescription drug coverage, the program got off to a very rough start and had to be fixed. Obamacare’s central reform remains on track for 2014—providing affordable health insurance through exchanges to the 50 million uninsured Americans. Those rooting for an Obamacare collapse would sentence these Americans to a life without regular health care.

Delaying the employer mandate was “the right thing to do,” said Ezra Klein in WashingtonPost.com, but it should be scrapped entirely. Since the mandate applies only to companies with more than 50 full-time employees, it provides a perverse incentive for companies close to that 50-worker threshold not to hire anyone else, or to fire full-time workers and replace them with multiple part-timers. In a saner, less polarized political era, the White House and Congress would work together to fix the ACA as problems arose. But Republicans refuse to “pass any legislation that makes the law work better,” because they want it to fail altogether. So the White House had no choice but to act unilaterally.

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Still, the admission that Obamacare still isn’t “ready for prime time” will shake public confidence, said the Chicago Tribune. Many Americans have real doubts that the federal government can reliably manage something as complex and massive as the health-care system, and “a tough sell just got tougher.” The real test is only a few months away, said Ruth Marcus in WashingtonPost.com. In October, the insurance exchanges are supposed to start making policies available to the currently uninsured. Will the exchanges be ready, and offer policies uninsured people want and can afford? Will Americans in their 20s—“the young invincibles” who think they don’t need health care—enroll in sufficient numbers to bring the insurers’ costs and premiums down? “Of all the headaches facing Obamacare,” in other words, “the employer mandate isn’t close to the most throbbing.”