Five years after it was first introduced, Obamacare remains a highly partisan issue.
President Obama used the five-year anniversary of the Affordable Care Act to attack the proposed House GOP budget and call on the act’s critics who are largely Republicans to “embrace reality.” Said the president, “Instead of trying yet again to repeal the Affordable Care Act and allowing special interests to write their own rules, we should work together to keep improving our healthcare system for everybody.”
Obama called the law a success, referencing the 16 million people who now, according to administration figures, have health insurance as a result of its passage. He also praised the program for improving the overall quality of health care, crediting it as the main reason that there were “50,000 fewer preventable patient deaths in hospitals over the last three years of data.”
Obama also railed against the perception that Obamacare is detrimental to the economy and the job market with the argument that in the last year the growth in healthcare premium costs for businesses was at parity with the lowest year on record. Without the Affordable Care Act, he said, “the average family premium would be $1,800 higher than it is today.” He also pointed out that reducing healthcare costs is the most important driver of reducing the federal deficit.
Obamacare continues to remain a highly polarizing issue. It has divided the country in a manner that we have not seen before with other government programs. When Social Security was implemented in 1935, 89% of the country favored the notion of pensions for individuals in need in their sunset years. The same climate prevailed when Medicare was passed in 1965 with 60% of those surveyed at the time approving of “a compulsory medical insurance program covering hospital and nursing home care for the elderly.” Obamacare has largely been perceived as less attractive than Social Security or Medicare because, unlike these programs which ultimately benefit all Americans, Obamacare just provides subsidies to lower-income Americans.
Opponents of Obamacare continue to be particularly critical of the plan’s individual and employer mandates. The individual mandate, which requires individuals to carry health insurance, was initially criticized on principle. But now, it has caught attention for its substantial penalties for non-compliance. The penalty for not adhering to individual mandate is currently $325, up from $95 in 2014. In 2016, it will skyrocket to $695.
The penalty for not adhering to the employer mandate for organizations with 50 or more full-time employees is currently $2000 per employee (after the first 30 employees). In some instances, the penalty can go as high as $3000 per employee. Furthermore, the outcome of the King. vs. Burwell litigation which went to trial in March will have a major impact on the individual mandate. The plaintiffs in King are questioning the federal government’s authority to offer subsidies to the people in the 37 states who purchased their coverage through the federally operated healthcare.gov. This all came about because of the specific verbiage in the Affordable Care Act that states that the federal government can only offer subsidies “through an exchange established by the State.” So if the ruling goes with the verbatim interpretation of the document, individual subscribers will see their healthcare tax bills increase to $5000. However, the Affordable Care Act also states that if your healthcare costs exceed 8% of your income, the individual mandate no longer applies. Consequently with a $5000 sticker price, there will be a lot of low income individuals who are no longer required to adhere to the individual mandate.
Republicans have responded to Obamacare with their own plan, The Patient Choice, Affordability, Responsibility and Empowerment (CARE) Act. Introduced by Republican Senator Orrin Hatch (Utah), Senator Richard Burr (N.C.) and Representative Fred Upton (Mich,), CARE reportedly promises to offer relief from the most burdensome aspects of Obamacare. States will have the option of opting out of the individual and corporate mandates. The plan provides greater price transparency and allows individuals to buy healthcare across state lines. The plan also includes tax credits to small businesses, caps Medicaid allotments so that states have more flexibility and more predictable funding streams, and institutes additional medical malpractice reforms.
Yet Democrats continue to embrace Obamacare as a key component of their platform. In anticipation of the anniversary, the Democrats produced a number of placards promoting the success of Obamacare and calling for an ongoing public commitment to the program, “Commit to protecting Obamacare,”” Say thanks for Obamacare,” “Stand with Obamacare.” Even 2016 Democratic presidential candidate front runner Hillary Clinton said prior to her email debacle that if she had run in 2014, she would have run on Obamacare.
So where do we go from here? We still have Republicans and Democrats standing on opposite sides of the fence with the Democrats making a commitment to “protect Obamacare” and Republicans making a commitment to repeal Obamacare.