This Week in Health Care Reform: January 25th, 2013


With his second-term underway, the President and his most significant legislative achievement face a new frontier; meanwhile, opponents regroup and reload along well-worn battle lines; and, the looming changes to health insurance products and rates come closer to reality.

The New World: Having survived a seemingly endless array of challenges to its affordability, efficacy, and constitutionality, the Affordable Care Act must now stand on its own merits as implementation moves forward.  On the heels of a new poll underscoring a weary public’s sour outlook for Washington’s ability to get anything done, the federal government continues its work on the expansion of private health insurance brought about by the sweeping health care law.  With the majority of the law scheduled to go live by the beginning of next year – including exchanges (which are slated to open for enrollment in less than nine months) – entire systems for handling as-yet-to-be-developed processes, are still being developed.  And, as the success or failure of the Affordable Care Act now rests in the hands of state legislators, agency bureaucrats, and innumerable stakeholders, there’s no telling when we’ll know just what our new world looks like.  

Lines of Attack: Even with an arguably clearer path towards implementation ahead of it, that’s not to say the health care law is without its detractors.  As budget negotiations continue to bounce around the halls of Congress, lawmakers will undoubtedly be tempted to look for spending cuts wherever they can find them.  Despite its promise of new savings and additional revenues, the Affordable Care Act is also projected to bring as much as $1.7 trillion in new spending over the next decade, a not insignificant sum, and one that hasn’t gone unnoticed.  With little legislative appetite remaining to go down already blocked dead ends, some feel it’s time for opponents to explore the health care law for new exposure points.

Sticker Shock: In a new report released earlier this month, it was estimated that at least one large segment of the population can expect their premiums to go up, despite the Affordable Care Act’s proponents’ assertions to the contrary.  Published in the latest issue of the American Academy of Actuaries’ bimonthly magazine, the analysis focuses on a specific piece of the health care law, namely, age rating, which requires young people to pay substantially more for their insurance in order to partially subsidize the cost for older consumers.  The report’s authors estimate that 80 percent of Americans younger than 30 in the individual market will face higher premiums.  Others fear that this is just the tip of the sticker shock iceberg and that some markets could see premiums as much as double.  And, while debate continues as to what accounts for these increases, brokers have already been busy spreading the word.

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