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Today, the Obama administration delayed the enrollment deadline for
insurance through healthcare.gov 24 hours without any fanfare, extending
the sign-up period to one minute before midnight on Christmas Eve,
according to the Washington Post.
This latest holiday surprise is unlikely to shock anyone as the
entire rollout process has been peppered with false starts, fake
deadlines and rule changes. One of the most significant changes happened
Friday when the Department of Health and Human Services announced that
consumers whose plans had been canceled as a result of the health care
overhaul could purchase catastrophic health insurance plans or opt out
of the process entirely. Critics say this particular policy twist could
ultimately sabotage the law.
HHS Secretary Kathleen Sebelius's decision last week to expand the
number of people who would be released from fines for not complying with
the individual mandate was a direct response to a request from Sen.
Mark Warner, D-Va. Warner and five other senators asked for
clarification regarding the definition of "hardship exemptions" in a
letter dated Dec. 18. The senators argued that individuals whose health
plans were canceled because of Obamacare and whose new health plan
options were unaffordable deserved "transition relief." These
individuals should be granted "hardship exemptions" and the option of
purchasing a lower-cost catastrophic plan, regardless of their age,
wrote Warner.
Sebelius thanked the senators for their suggestions and agreed to both revisions. (See both letters here).
The result is that a broader swath of the population would now be
legally exempt from fines if they did not comply with the individual
mandate by enrolling in and paying for new health plans.
To many critics, Friday's announcement was a direct reversal of
Obama's previous stance. In an editorial, The Wall Street Journal
declared Obama Repeals Obamacare:
What an incredible political turnabout. Mr. Obama and HHS used to insist that the new plans are better and less expensive after subsidies than the old "substandard" insurance. Now they're conceding that at least some people should be free to choose less costly plans if they prefer—or no plan—and Obamacare's all-you-can-eat benefits rules aren't necessary for quality health coverage after all.
The Journal noted the decision to expand the exemptions even
marginally invites a "blanket hardship amnesty for everyone," an idea it
urged Republicans to attempt. The editorial also forecast price spikes
next summer, as insurance providers brace for more government revisions
to policy.
The latest policy shifts are one of many. In July, Obama announced he would delay the mandate that employers must offer insurance to employees
until 2015, according to Politico. The deadline for enrollment in
individual health plans that would begin on New Year's Day was delayed
from Dec. 15 to Dec. 23, but is now extended another day. The deadline
for complying with the health care law without receiving a fine was also
delayed as was the deadline for paying the first month's premiums to insurance providers.
In a press conference Friday afternoon, President Barack Obama
addressed this latest shift in policy concerning exemptions saying it
was meant to provide "an additional net in case people might have
slipped through the cracks."
Juliette Forstenzer Espinoza, executive director of the Health Care
Rights Initiative, ,said, "This waiver addresses a real practical
concern for real individuals on the ground who were not adequately
prepared for the cancellations." She believes the decision was fair and
ethically motivated. Espinoza concedes however that a better idea might
have been to create a specialized navigation system for this particular
group of consumers so that they might also meet the policy goal of
getting insurance coverage.
"Most people who had plan cancellations in the 2013 non-group market
will be able to buy relatively low cost plans in the marketplace that
will provide better coverage than what they currently have, she added.
"Allowing these individuals to purchase catastrophic coverage provides
another choice for consumers to consider as they make this transition.
The extent to which this affects insurance markets depends on how many
people select this option and how their use of health services compares
with others in the catastrophic pool."
Avrik Roy,
a senior fellow at the Manhattan Institute and the incoming Opinion
editor at Forbes, said this latest announcement has generated "utter
chaos." Roy argued that the price differences between catastrophic
plans and the lowest tier, so-called bronze plans available from the
insurance exchanges being established under Obamacare, is insignificant
enough that people who find exchange plans too costly will find
catastrophic plans equally unaffordable and opt for an exemption rather
than buying into any plan.
By offering more people the chance to buy catastrophic health plans
or opt out entirely, President Obama has shrunk the insurance pool of
those available to purchase new plans. That could upset the delicate
balance of healthy versus ill patients needed to make Obamacare
economically viable, said Roy.
But Katherine Hempstead, senior program officer of the research and
evaluation unit at the Robert Wood Johnson Foundation, says that
allowing individuals to purchase catastrophic coverage offers another
option that will allow them to ultimately transition into the
marketplace. "The extent to which this affects insurance markets
depends on how many people select this option and how their use of
health services compares with others in the catastrophic pool,"
Hempstead said.
Insurers initially set prices for their plans based on expectations
of how much health spending would accrue across a population. "This new
"hardship exemption" will encourage healthier individuals, whose
expected spending would be low, to drop out of the pool. As a result,
average spending per enrollee on the exchanges is likely to be
substantially higher than the insurers had planned for, forcing them to
lose money on their policies," said Roy.
These last-minute changes could also confuse individuals who were
having difficulty navigating the new health care system, and could
prevent some individuals from realizing they are obligated to get
coverage, said one Washington Post
editorial. "The threat is that, in seeing to the concerns of those who
might have to pay more in 2014 or in future years or some other group
that feels put upon at some time, politicians will poke so many holes
and add so many exceptions that the law is seriously undermined," said
the Saturday editorial.
Espinoza, an advocate of Obamacare, says the greatest problem with
all of these changes is that public education among the people who are
most in need of accurate information has been severely lacking. "If they
didn't have a clear understanding of what the problem was, how could
they have an understanding of what the fix is?"
The latest moves come on the same day a poll
was released showing that the public believes both that Obamacare is
the president's greatest achievement -- and his greatest failure.
