Today marks the deadline when Americans without insurance need to sign up for coverage under the Affordable Care Act (ACA) in order to be insured by January 1. Under the program popularly known as Obamacare, people who are not insured through their employer or a government program such as Medicare or Medicaid must obtain coverage or pay a penalty.
President Obama indicated Friday that 1 million Americans had been enrolled through the federal and state exchanges set up under the ACA through the third week of December. The numbers mark an increase over the 365,000 who had enrolled through November 30 after the problem-plagued rollout of the federal HealthCare.gov web site, but still fall far short of the 3.3 million the administration had hoped to reach by this date.
In advance of today’s deadline, the White House made a change Thursday allowing people who had recently had their insurance coverage cancelled because it did not meet ACA specifications to qualify for a “hardship exemption” in order to avoid a penalty next year for not having insurance. Contrary to Obama’s repeated claims that “If you like your plan, you can keep your plan,” it is estimated that 500,000 people have seen their insurance canceled because their policies did not include the basic benefits mandated by the ACA.
Health and Human Services Secretary Kathleen Sebelius announced that anyone who has had their prior coverage canceled, and who believes that the plans offered on the Obamacare exchanges “are unaffordable,” can be exempt from the “individual mandate” to obtain qualified coverage.
This exemption is but the latest twist and turn in the implementation of the health care legislation. The most significant change was a one-year waiver granted to businesses with more than 50 employees, who will not be required to provide their full-time employees with insurance until January 2015. These changes have demonstrated that the health care overhaul has nothing to do with providing access to affordable, quality health care for ordinary Americans, but is geared towards cutting costs for employers and the government, while rationing medical care for working people.
The insurance industry was not pleased with the latest Obamacare exemption, which will allow individuals whose insurance has been canceled to purchase bare-bones “catastrophic” coverage on insurance exchanges or go without coverage altogether. The main component of the “individual mandate” requires people to purchase coverage on the exchanges from private insurers, who are banking on making a handsome profit from the new influx of cash-paying customers.
The insurance companies fear that exempting this group of people from penalties for not being insured will keep healthier—i.e., cheaper to insure—people out of the exchanges, leaving the pool of insured less healthy and more costly to insure, cutting into profits. Karen Ignani, president of Americas Health Insurance Plans (AHIP), commented that this latest exemption “could cause significant instability in the marketplace and lead to further confusion and disruption for consumers.”
At a White House press conference on Friday, the president was asked what he thought had been his biggest mistake of the past year. He responded that the health care rollout—specifically, the technical problems at HealthCare.gov—had been his biggest mistake. He stated that it had been his responsibility to see that “consumers had a good experience, an easy experience in getting the information they need, and knowing what choices and options were there for them to be able to get high-quality, affordable health care.” He added, “Since I’m in charge, obviously we screwed up.”
The media has generally accepted this line of argument. If only the web site had not floundered, the path would have been cleared for millions of uninsured people to gain access to affordable, quality health care. The reality is that the cheapest plans offered through Obamacare come not only with far more costly premiums than in the individual market, but large out-of-pocket costs, including deductibles averaging more than $5,000 annually, as well as restricted networks of hospitals and doctors and reduced access to many prescription drugs.
At Friday’s press conference, Obama continued to advance the lie that his health care legislation was a genuine progressive reform. “The bottom line,” he said, “is that we’ve got several million people who are going to have health care that works.” He said that criticisms of the health care rollout “don’t go to the core of the law.” He claimed that “a year from now or two years from now, when we look back, we’re going to be able to say that even more people have health insurance who didn’t have it before.”
In one of the few questions at the press conference that actually got to the substance of the new exemption being offered to people whose coverage had been canceled, NBC News’ Chuck Todd said to the president: “But with 72 hours to go, you make this change where people are buying the junk—frankly, a junk-type policy that you… were trying to get people away from.”
Todd was pointing to the fact that under the Affordable Care Act, potentially a half million people will now be allowed to purchase “catastrophic” coverage that provides bare-bones coverage. These same people will also be allowed to opt out altogether if they believe that the insurance options on the exchange are “unaffordable.” In other words, they will have shoddy coverage, or none at all.
From his holiday in Hawaii on Sunday, the president continued his public relations campaign for Obamacare. “The law is working,” he said in a statement.