Eight Things That Could Go Wrong with ObamaCare

September 26, 2013

In less than a week, ObamaCare's health insurance exchanges will be open for enrollment. Three months after that, the law's major coverage provisions officially go into effect. It's the biggest expansion of the entitlement state in decades and a massive bureaucratic undertaking. Even the law's biggest supporters don't expect it to go off without a hitch: President Obama warned earlier this year that the law will likely come with some "glitches and bumps." Here are eight things that could go awry with the law when it opens for business, and in the years beyond, says Peter Suderman, a senior editor at Reason Magazine.

  • When more people have health insurance, it could be harder to see primary care physicians. There's already a shortage of primary care physicians relative to national demand. Increasing the number of people who have health insurance tends to increase the demand for physicians' services.
  • Health insurers will limit doctor networks in order to keep prices down.
  • Employers will cut hours for workers to avoid potential requirements under ObamaCare.
  • ObamaCare navigators and other enrollment aides could violate the privacy of exchange users.
  • The online exchange technology won't be ready -- or won't work as well as it is supposed to.
  • Employers could move many more workers than expected onto the exchanges, and increase the price of the law as a result.
  • The exchanges will grant subsidies that are wrong, or need to be repaid. One study last year estimated that roughly 2.6 percent of exchange applicants "judged eligible for subsidies would receive advance payments on those subsidies that were too high by $208 per year, on average."
  • Individuals whose income hovers near the Medicaid eligibility line could be forced on and off the program. A 2011 study by health professors at Harvard and George Washington University found that over six months, "More than 35 percent of all adults with family incomes below 200 percent of the federal poverty level will experience a shift in eligibility from Medicaid to an insurance exchange, or the reverse."

Source: Peter Suderman, "Eight Things that Could Go Wrong with ObamaCare," Reason Magazine, September 19, 2013.

 

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