Blair Horner: Obama Administration Weakens Federal Health Care Reform

In a few short months, Americans who need health insurance will be able to obtain it.  They will either get it from the government – through programs like Medicare or Medicaid, from their employers, or purchase it themselves from health marketplaces, known as health benefit exchanges.

In New York State, over 2 million of the 19 million residents lack health insurance.  Most of the individuals without insurance, work and are not offered coverage by their employer.   Under the federal health care law, those individuals would be required to have health insurance coverage.  Most Americans will be required to have that insurance by January 1, 2014, or they will be subject to tax penalties.

In New York, some of those lower income individuals and their families will be covered through an expanded Medicaid program.  But the rest have to hope that their employer will offer coverage or that they will have to buy the coverage themselves.  As mentioned earlier, these individuals will be able to purchase it through health marketplaces – the health exchanges.

Under the federal health care law, there are government subsidies for families with incomes under $90,000 to purchase their insurance through these health marketplaces.  The lower the income, the larger the subsidy.

However, the law also penalizes employers who fail to offer health insurance to their employees.  The federal law requires employers with more than 50 full-time workers to offer affordable health insurance starting next year or face fines.  And last week, the Obama Administration delayed implementation of that provision of the federal law.

Under the provision to set up state-based marketplaces, subsidies are supposed to be available to many lower- and middle-income people who do not have access to coverage from employers or other sources.  It may be difficult, however, for state officials running the exchanges to know who is entitled to subsidies if employers do not report information on the coverage they provide to workers.

And it was the reporting requirements placed on employers that led the Obama Administration to delay the implementation of the employer mandate.  Reportedly, the White House had been facing increasing criticisms from businesses about the reporting requirements — especially the Treasury Department, which has responsibility, given its oversight of the tax reporting system.

Employer groups applauded the delay and other opponents used the opportunity to urge for repeal of the law.

The Administration argued that the delay will allow it to consider ways to simplify the new reporting requirements and it will provide time to adapt health coverage and reporting systems.  Within the next week, the Administration promised it will issue official guidance to insurers, self-insuring employers and other parties that provide health coverage.  As that process moves forward, the Administration will encourage employers to comply with the law’s reporting provisions in 2014.

But will this “encouragement” work?  It hasn’t in the past.

But we know one outcome:  Some Americans will lose access to affordable health care offered by their employer.  And as a result, they will be required to individually purchase health insurance through the health exchange or pay a penalty to the government.

Knuckling under to pressure from the law’s opponents may help ease political problems for the Obama Administration, but it will hurt some Americans.  In New York, whether that decision will result in some New Yorkers losing access to affordable health care will hinge on how well the Cuomo Administration’s health exchange performs.

Here’s hoping that the Cuomo Administration’s meets the latest obstacle thrown in its path by the decision of the Obama team.

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