Author Topic: Any remaining challenges to the Affordable Care Act?  (Read 4178 times)

Trudie

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Any remaining challenges to the Affordable Care Act?
« on: August 20, 2015, 11:41:28 AM »
Now that the Supreme Court has put the Constitutional challenge to the Affordable Care Act to bed does anyone think there are any avenues left to derail it completely or significantly alter it?

A few people I know in the insurance business (who sell lots of ACA policies) and public accounting fields say "no."  Given that we are on the cusp of another Presidential election much will be said to stir up the masses, but I want to push political rhetoric aside and look at things more objectively.

So, weigh in good people.

dandarc

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Re: Any remaining challenges to the Affordable Care Act?
« Reply #1 on: August 20, 2015, 11:53:44 AM »
In the very short-term no.  Obviously if congress collectively wants to change the law, and the president either agrees or faces a veto-proof vote, then anything can happen.

I personally think the penalty for not having insurance may need to be strengthened - it needs to be a very dumb move to not have insurance for the ACA to work as intended.

forummm

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Re: Any remaining challenges to the Affordable Care Act?
« Reply #2 on: August 20, 2015, 12:00:41 PM »
I personally think the penalty for not having insurance may need to be strengthened - it needs to be a very dumb move to not have insurance for the ACA to work as intended.

Next year it goes up to the greater of $695 per adult (plus half that per kid) or 2.5% of the household income over the filing threshold. Do you think it should be higher than that? I think it could be good to have it be higher. But they aren't really even enforcing it that strongly right now.

KittyCat

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Re: Any remaining challenges to the Affordable Care Act?
« Reply #3 on: August 20, 2015, 12:06:37 PM »
I personally think the penalty for not having insurance may need to be strengthened - it needs to be a very dumb move to not have insurance for the ACA to work as intended.
As forummm has stated, it's going up next year, and it has been increasing every year (although, I know next to nothing about its enforcement or lack thereof).

dandarc

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Re: Any remaining challenges to the Affordable Care Act?
« Reply #4 on: August 20, 2015, 12:16:38 PM »
Next year it goes up to the greater of $695 per adult (plus half that per kid) or 2.5% of the household income over the filing threshold. Do you think it should be higher than that? I think it could be good to have it be higher. But they aren't really even enforcing it that strongly right now.
The not enforcing it is the bigger problem.  Suppose we'll know in the next couple years - if the "number of people who are assessed the penalty" drops precipitously, then the penalty is adequate.  If not, the penalty is not high enough.  Maybe make the penalty the same as the premium for the cheapest exchange plan available for that household?  If there is a high likelihood of not actually having to pay the penalty, then it doesn't really matter what it is, so the Greek-style enforcement mechanism needs to go.

Eric

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Re: Any remaining challenges to the Affordable Care Act?
« Reply #5 on: August 20, 2015, 12:18:59 PM »
There could still be challenges to the ACA in it's current form.  However, it doesn't seem like it will ever be repealed and leave us with nothing.  All current ACA bashing is punctuated by "repeal and replace" talk.  What that replacement would be is obviously unknown, however I'm willing to bet that the most important issues that the ACA covers, like being able to get insurance that covers a pre-existing condition, will still be left in tact.
« Last Edit: August 20, 2015, 01:35:38 PM by Eric »

monstermonster

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Re: Any remaining challenges to the Affordable Care Act?
« Reply #6 on: August 20, 2015, 04:45:56 PM »
What that replacement would be is obviously unknown, however I'm willing to bet that the most important issues that the ACA covers, like being able to get insurance that covers a pre-existing condition, will still be left in tact.

I suspect some parts might be dismantled but very few (though I secretly hope every state will now have to get Medicaid expansion.)

If the pre-existing coverage restriction is lifted, I'll have to discontinue my medication and care I can't afford out of pocket. I'm terrified that will happen, and if so, I might have to move abroad.

Eric

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Re: Any remaining challenges to the Affordable Care Act?
« Reply #7 on: August 20, 2015, 07:36:46 PM »
What that replacement would be is obviously unknown, however I'm willing to bet that the most important issues that the ACA covers, like being able to get insurance that covers a pre-existing condition, will still be left in tact.

I suspect some parts might be dismantled but very few (though I secretly hope every state will now have to get Medicaid expansion.)

If the pre-existing coverage restriction is lifted, I'll have to discontinue my medication and care I can't afford out of pocket. I'm terrified that will happen, and if so, I might have to move abroad.

Anything is possible of course, but I would be pretty shocked if this changed.  People like this function.  Even people who think they are against the ACA like this function.  There was that polling awhile back that showed that most people didn't like the ACA, and at the same time, those same people did like each individual provision of the ACA.  Essentially, everyone likes what the ACA does, but some can't like the ACA because POLITICS!

forummm

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Re: Any remaining challenges to the Affordable Care Act?
« Reply #8 on: August 20, 2015, 07:45:36 PM »
What that replacement would be is obviously unknown, however I'm willing to bet that the most important issues that the ACA covers, like being able to get insurance that covers a pre-existing condition, will still be left in tact.

I suspect some parts might be dismantled but very few (though I secretly hope every state will now have to get Medicaid expansion.)

If the pre-existing coverage restriction is lifted, I'll have to discontinue my medication and care I can't afford out of pocket. I'm terrified that will happen, and if so, I might have to move abroad.

Anything is possible of course, but I would be pretty shocked if this changed.  People like this function.  Even people who think they are against the ACA like this function.  There was that polling awhile back that showed that most people didn't like the ACA, and at the same time, those same people did like each individual provision of the ACA.  Essentially, everyone likes what the ACA does, but some can't like the ACA because POLITICS!

Or when polled, people were something like 20% more favorable to the "Affordable Care Act" than "Obamacare".

sol

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Re: Any remaining challenges to the Affordable Care Act?
« Reply #9 on: August 20, 2015, 07:56:55 PM »
I thought this was going to be a thread about ways to change and improve the law (of which I think there are many), but a thread about ways to get it overturned (of which I think there are few that are likely to succeed).

But in the spirit of the OP, I suspect the easiest way to scrap the whole thing is for republicans to sweep the 2016 election.  With the presidency and 60% of congress they could do any damn thing they please, including shooting immigrants on sight, dismantling every federal agency, and ending all social service programs including the ACA.

Trudie

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Re: Any remaining challenges to the Affordable Care Act?
« Reply #10 on: August 21, 2015, 08:18:43 AM »
I thought this was going to be a thread about ways to change and improve the law (of which I think there are many), but a thread about ways to get it overturned (of which I think there are few that are likely to succeed).

But in the spirit of the OP, I suspect the easiest way to scrap the whole thing is for republicans to sweep the 2016 election.  With the presidency and 60% of congress they could do any damn thing they please, including shooting immigrants on sight, dismantling every federal agency, and ending all social service programs including the ACA.

Just to be clear - I don't want it to be overturned as I think it is long overdue and much needed.  I will rely on it and it's my #1 political issue in the next election.  I laughed at your tongue-in-cheek response (although I fear the world you describe) but I just wanted this thread to be a substantive discussion about particular political tactics or holes that might be punched into the program to weaken it.  I don't want to get derailed by how much people love or loathe certain political figures (although that material is quite rich) or get into namecalling of politicians.  I do plenty of that outside of this blog.

forummm

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Re: Any remaining challenges to the Affordable Care Act?
« Reply #11 on: August 21, 2015, 09:06:44 AM »
The biggest challenges to the ACA remain the same as they have from the beginning: 1) Obama asked for it (but let Congress figure out the details) and signed it, and 2) People don't know what it does but they've been told it's terrible ad nauseum.

If a Republican wins the presidency and are able to, they will probably repeal it (so they can say they repealed it) and then replace it with something largely similar. There will be differences introduced for the purpose of making it different from the ACA (so that it can be said to be different), to put more burden on the poor and reduce the burden on the wealthy, to lower standards for coverage, and to reduce the number of people ostensibly getting government coverage (even if the government is just buying private insurance for people--like what most Medicaid does today).

I'm a red panda

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Re: Any remaining challenges to the Affordable Care Act?
« Reply #12 on: August 21, 2015, 09:10:59 AM »

Or when polled, people were something like 20% more favorable to the "Affordable Care Act" than "Obamacare".

People love the Affordable Care Act.  They hate Obamacare.

Recently, the same thing was found about Common Core.  Common Core polls terribly!  But things like the Iowa Core, or Sunshine State Standards or the various things states are calling CC poll just great. They are basically identical sets of standards.

ShoulderThingThatGoesUp

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Re: Any remaining challenges to the Affordable Care Act?
« Reply #13 on: August 21, 2015, 09:15:22 AM »
Much of its enforcement has been pulled out of HHS's butt. Mandates are delayed, waivers are granted, etc. If the Republican Party weren't run by chimpanzees, they would win the presidency and enforce the law in a completely different way. But most likely all of the papering-over that the Obama administration did will stay in place.

That said, there's lots of strong signs that it's not working out fiscally. So if the government is run by competent people at any point over the next 20 years it will probably change. But that seems unlikely.