Why does health overhaul drama continue?

  • Monday, March 9, 2015 11:34pm
  • Opinion

WASHINGTON (AP) — President Barack Obama’s health overhaul remains an all-consuming drama for many, even though millions of people are gaining insurance coverage through a law that’s now 5 years old.

Political opposition

Unyielding opposition from conservative voters has made it practically impossible for Republican lawmakers to take a pragmatic approach to a program with obvious flaws, but also popular aspects.

Few in the United States want to go back to the days when insurance companies could deny coverage to people with pre-existing health conditions. But Republicans have followed a political game plan that requires them to first repeal Obama’s law before trying to replace it with legislation of their own, presumably to accomplish similar goals.

Administration stumbles

The president who once said you could keep your health plan if you liked it was caught flat-footed by a wave of insurance cancellations blamed on health law requirements taking effect in 2014. The HealthCare.gov website, talked up as the equivalent of Amazon and Travelocity, broke down the day it was launched in 2013, and took months to patch up. That same year, the administration announced the delay of a major requirement affecting employers on an obscure government blog just days before the Fourth of July. This year, HealthCare.gov sent the wrong tax information to about 800,000 people, and an online insurance market geared to small businesses has disappointed. The administration keeps resupplying the law’s critics with ammunition.

Costs of care

Although premiums are heavily subsidized, people who buy private coverage through the law’s new insurance markets may still struggle with costs.

Out-of-pocket expenses, including the annual deductible and required copayments, can be as high as $6,600 for an individual and $13,200 for a family.

Faced with a serious illness, a family making $60,000 a year might have to shell out more than 20 percent of its income.

Average monthly premiums rose by 8 percent this year in the states served by HealthCare.gov, according to preliminary administration data. After subsidies, the average monthly premium that consumers pay directly rose by $23 a month.

IT’S DARN COMPLICATED

Obama’s law joined two of the most complicated areas for consumers: health insurance and taxes.

Even now, in the second year of coverage, enrollment counselors say many consumers get overwhelmed trying to understand what plan is best for them. It can be hard to figure out which doctors are in what plans, and what is the patient’s share of the cost for a particular medication.

This tax filing season will reveal the connections between the law and the tax system, which is used to deliver carrots and sticks.

Premiums subsidies are packaged as tax credits and consumers will have to account to the IRS that they got the right amount. People who remained uninsured will see fines deducted from their tax refunds, if they’re deemed able to afford coverage.

If the last five years are a guide, look for more surprises as the saga continues.

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