Curmudgeon's Corner

PPACA...The Morning After

Posted by Al Campbell on June 29, 2012

U.S., Healthcare, Political, Quality of Life, Taxes

PPACA…The Morning After:

Political posturing is running rampant, as everyone would’ve expected.  The Dems have suddenly developed affection for Supreme Court Chief Justice Roberts that was not apparent a couple of days ago.  Similarly, the Republicans are reeling in wonder at what they thought was a foregone conclusion about Chief Justice Roberts’ likely course of action.  I suspect members of the Court may also be wondering about that.

The next few months will see Presidential politics at fever pitch.  Romney has already stated his intent to ‘repeal’ ObamaCare (PPACA) if he is elected.  Repeal does not seem to be a simple process and likely would require at least sixty Republicans in the Senate and a solid majority in the House as well as Romney in the Whitehouse.  Executive orders might be issued, but that doesn’t seem a foolproof ‘solution’ to this situation.

The Republicans will tout ObamaCare as a huge tax increase since ‘tax’ was the rationale applied to the majority opinion.  That may or may not play to public opinion since many appear to believe this law will only be beneficial and that it will not have any ugly hidden portions not yet known.

If possible, I expect the implementation of ObamaCare will be speeded; although it has been progressing at quite a high speed for some time already.  The more pieces that can be implemented, the tougher the job will be to ‘repeal’.  The term ‘repeal’ is being used when that may not be the true intent, but is meant to convey the elimination of the law in some manner.

Those who think ObamaCare is wonderful are being heard loudly and clearly as they trumpet their support of the decision announced yesterday.

Employers will once again turn their attention to what the law means to them.  I suspect there will be moves to keep employee counts under 50 since that has some benefit as ObamaCare is currently constituted.  Employers in that category can be fined for not providing health care coverage, but that is limited to the employees #31 through #50, and amounts to only $2,000 per employee per year.  That is great incentive to those employers since they’re spending a lot more than the fine amount if they now provide coverage.  This will drive individuals into the ‘exchanges’ seeking coverage, and that was always the intent of ObamaCare since it was enacted.

The Cadillac plan taxes do not hit until 2018, and that was intended since many of the labor health plans would likely qualify as Cadillac plans.  Family health plan premiums of $27,000 and higher will qualify as Cadillac plans, for example, and that number will not be hard to reach by 2018.  Some plans already reach that amount today.

Many other requirements exist and are implemented during 2013 and 2014 for the most part.  Most have high-sounding names implying that they are beneficial.  Most of those beneficial things carry price tags or some other implication that make them less than beneficial to other parties.

Dependents to age 26 remain coverable under parents’ plans.  There can be no refusal of coverage due to pre-existing conditions.  Rate bands must not be greater for the oldest person then three times the cost for the youngest person.  There is currently no real penalty for people who decide to avoid buying insurance until they need it; the penalty is miniscule compared to the premiums they avoid and they can get coverage no matter their condition when they want it.

As ObamaCare is implemented fully and as we have the opportunity to observe it over time, we will see the flaws that people were warned about becoming very significant cost issues.  Those issues will also be manifested by limitations on treatment given age of patient, likelihood of favorable or unfavorable outcomes, etc.  The world of healthcare as we have known it will be altered dramatically.  Treatment ‘go/no go’ decisions will begin to enter the picture.  Doctors will be told how to treat and to what degree to treat certain patients/conditions.  The waiting times for appointments and to schedule treatments will grow longer and longer.

As with anything our Congress does, there will be winners and there will be losers.  The real problem is that now this ‘rule’ is being applied to our health care with full knowledge by our Congress.  Malice aforethought comes to mind.