An Unhappy Third Birthday for ObamaCare


Photo credit: Aih. / Foter.com / CC BY

Three years ago this week, ObamaCare was signed into law. The president's health care overhaul has already had a rough life. Since passage, it's survived a Supreme Court challenge, more than two dozen repeal votes in Congress, and host of implementation hurdles and political controversies. And that's just the beginning: The law's major coverage provisions — a Medicaid expansion and private health insurance subsidies administered through state-based health exchanges — won't kick in until later this year. 

With that in mind, here's a three-year check-up on the law — where it stands, and what it faces going forward.

Premiums are already going up. States such as Florida, Ohio, and California have already seen insurers request double digit rate hikes. ObamaCare's insurance mandates have contributed to the rise, and the law's requirement that insurers spend 80 percent of premium revenue on health care or rebate the difference to customers — the so-called 80/20 rule — creates further incentives for insurers to charge high up front premiums.

Insurers are warning of even bigger premium hikes when the law's major provisions kick in next year. Privately, other insurers have issued similar warnings of large rate hikes on the way. Aetna CEO Mark Bertolinin told the company's investors last December that some individuals could see hikes of up to 100 percent. Privately, insurers are also warning brokers are large rate hikes to come. Even state insurance officials in ObamaCare-friendly states have cautioned that "rate and market disruption" is on the way.

The public still doesn't support the law. The law has always struggled in the court of public opinion, and there's little reason to believe that that's about to change. After a brief jump in public approval coinciding with last year's election, public opinion regarding the law has started to sink once again. The law has even lost favor amongst voters in the president's own party in recent months, with a recent Kaiser Foundation poll showing Democratic support for the law dropping from 72 percent in November 2012 to 57 percent in February of this year.

The law is still the subject of heated political controversy. Given the continued lack of public support, it's hardly surprising that legislators would oppose the law as well. But that's had big consequences for ObamaCare, which was expected to rely heavily on states for implementation. Instead, more than half of the states have exercised their right to opt out of the exchange-creation process, letting the federal government do it instead. Additionally, a number of states have announced that they won't pursue the law's Medicaid expansion either.

There are more legal challenges in the works. The text of the law says unambiguously that only only exchanges run by states shall be allowed to administer the law's insurance subsidies, and that only employers in those states shall be subject to its employer fines. But the Internal Revenue Service decided to ignore the clear text of the law; its regulations say that employers are subject to fines even in states with federally run exchanges, and that the subsidies are available in those exchanges too. Oklahoma's attorney general has already filed suit against the rule.

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36 responses to “An Unhappy Third Birthday for ObamaCare

  1. The thing’s a toddler and it’s already harder to kill than Rasputin.

    1. It is fucking Damian.

    2. It was impossible to kill before it was born. It’s Charlie Kelly.

  2. Cake is, and always will be, better than pie.

    1. Liar. Why do you lie?

      1. Because the cake is a lie.

        1. Which is why pie is always better than cake.

      2. If you say you don’t like cake, you’re either stupid or a liar.

        1. Did I say I don’t like cake?

          1. If you think pie is better it’s only because you don’t like cake. You find cake thoroughly disgusting. And it’s only because you’ve never eaten good cake.

            1. YOU TAKE THAT BACK!

    2. You sir, are worse than Hitler…a cake eating Hitler.

      1. I bet he thinks ‘deep dish’ is pizza, too.

      2. Some cake would be good right now…

        1. Pie would be better, though.

      3. Hitler loved pie. True story.

        1. And SparkY loved cake. They cancel out.

    3. heathen

    4. Damn you all. Now I want both cake and pie. After eating some tasty, tasty pizza.

    5. Sparky might go into berzerker mode; come at you like a whirling dervish, all fists and elbows. You might be screaming “No, no, no” and all he hears is “Who wants cake?”

    6. Cake Boss!

  3. http://news.investors.com/0321…..src=IBDDAE

    Yeah it is a complete cluster fuck just like anyone with any brains knew it would be. Fuck everyone who ever supported this pile of shit. I know some knew it was fucked up and want it to fail to get single payer so they can do real damage. But most of the supporters, including nearly all those in the media, were just stupid and need to be called out mercilessly on this issue.

  4. A little jog down memory lane. All of this happened when it was past.

    1) Ezra Klein is confidently predicting that it will save hundreds of thousands of lives.
    2) Nick Kristoff expects miraculous improvement in our national life expectancy.
    3) Michael Moore thinks this will stop people from getting thrown out of their homes in a Medical bankruptcy.
    4) At least one of you must be willing to claim massive improvements in infant mortality, after you’ve cited those statistics to me over and over.


    1. How do you call them out on something that they will always believe to be true?

      1)Can you prove to Ezra Klein that the bill won’t save those lives.
      2)Can you prove to Kristoff that life expectancy is going up for reasons other than Obamacare?
      3)Can you even talk to Michael Moore without throwing up in your mouth a little?


      1. 3)Can you even talk to Michael Moore without throwing up in your mouth a little?

        I can’t even talk about Michael Moore without throwing up in my mouth a little. The biggest laugh line in Team America, for me, was after Gary went back to the base after Michael Moore had suicide bombed it and INTELLIGENCE told him “We were suicide bombed by a fat socialist weasel.” I laughed so hard I was worried that I’d be asked to leave the movie theater.

  5. The text of the law says unambiguously that only only exchanges run by states shall be allowed to administer the law’s insurance subsidies, and that only employers in those states shall be subject to its employer fines.

    This is just going to drive an even larger chasm between the red states and the blue states. (If SCOTUS rules the correct way). Red states won’t create their own exchanges because then businesses in those states will be able to ignore the health law entirely. Businesses in blue states will be on state exchanges and will see themselves as propping up the federal exchanges in red states. Hilarity will ensue.

    1. If SCOTUS rules the correct way

      Don’t worry, the Nazgul will find a way to show deference to the intentions of congress and allow the IRS to have its way.

      1. I don’t know. They might be getting tired of the vilification they are getting from normal people. Every now and then they like to throw us a bone to shut us up.

        1. They sure like ripping the EPA new ones.

    2. I’ve looked at those provisions of the law, and sadly I can’t say they are completely unambiguous.

      The crazed complexity of this law, and the incompetent drafting means that it is hard to say anything is unambiguous. In all seriousness, the law lacks a definition of “health insurance exchange”, and is inconsistent in referring to state v federal v generic exchanges.

      Its a frickin’ mess.

      1. True. It was obvious the penalty was a fine, not a tax. Anything is possible.

      2. Bad statutory writing is just a license for regulators to make the regulations say whatever they want them to.

        1. Everything is proceeding as I have foreseen it.

        2. Feature, not bug. The whole fucking thing was just an enabling act to put the Dept. of Health and Humman Services in charge fo regulating the entire health insurance market. Once that fails, they’ll move on to single payer, with HHS in charge of that too.

            – Yoda

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