Period of Readjustment

Sweeping legislative changes almost never work so well that they don’t require some amendments pretty soon after initial passage. So it was with Social Security (passed in 1935 and amended in 1939), Medicare (passed in 1965, amended in 1967 and 1972) and even Ronald Reagan’s 1986 immigration reform (amended in 1988). It’s just the way the system works… or rather… used to work.

Even the Obama Administration and the powerhouses in the Democratic Party know that the Affordable Care Act (Obamacare), passed in 2010, needs adjustment. But a commitment from the GOP to oppose anything to do with that statute, short of total repeal, means that such adjustments simply cannot take place. Democrats fear that even broaching the possibility of amendment will open the door for Republicans to dismantle the entire statute.

Many GOP-controlled states have taken advantage of the Supreme Court’s decision allowing them to opt out of the Medicare expansion offered in that statute, with pretty dire consequences for many in the lowest socio-economic strata: “The refusal by about half the states to expand Medicaid will leave millions of poor people ineligible for government-subsidized health insurance under President Obama’s health care law even as many others with higher incomes receive federal subsidies to buy insurance. Starting next month, the administration and its allies will conduct a nationwide campaign encouraging Americans to take advantage of new high-quality affordable insurance options. But those options will be unavailable to some of the neediest people in states like Texas, Florida, Kansas, Alabama, Louisiana, Mississippi and Georgia, which are refusing to expand Medicaid. More than half of all people without health insurance live in states that are not planning to expand Medicaid.” LevineBreakingNews.com, May 25^th.

Lots of companies have cut back hours of fulltime workers, to less than 30 hours a week, to side-step the cost of a required offering of healthcare (or pay a fine) to their employees. Many employers want change (which you’d think the GOP would back): “[They say the] law’s definition of a full-time worker has to be raised from someone working 30 hours a week… noting that restaurants, retailers and other businesses are already looking at cutting many employees’ hours to 29 to avoid having to offer the health care coverage mandated by the law. The group wants the definition raised to 40 hours. They also say that the definition of a large employer — with all that entails for the requirements for health insurance — needs to rise from 50 full-time employees or ‘full-time equivalents,’ which could be a combination of several part-time workers.

“They would also like a grace period into 2014 to comply with the law before penalties are assessed for not offering insurance that comports with the law’s mandates. And they want Congress to drop a provision requiring the automatic enrollment of new employees into a health care plan for any company with more than 200 full-time workers… ‘Key definitions in the law must be changed,’ Marshall L. Conrad, chairman of Libby Hill Seafood Restaurants in Greensboro, N.C., pleaded at a recent Congressional hearing.

“Health insurers are focused on another goal: repealing a new tax on insurance companies that takes effect next year. The tax is expected to raise more than $100 billion over 10 years. Insurers say the cost will be passed on to consumers and businesses in the form of higher premiums…  Concerns over the law’s fine print are shared even among some of its architects. As the Affordable Care Act neared completion, the Obama administration and some Democrats in Congress drafted a proposed compromise to resolve differences between the House and Senate versions and smooth rough edges. Under that version, the marketplaces that people would be able to use next year to buy insurance, often at subsidized rates, were going to be national in scope, not state by state.” New York Times, May 26^th.

There are lots of additional technical issues that need addressing, from looking at total family income versus individual income to ascertain qualifications to setting up “navigators” to help those with difficulty accessing this very complex body of rules and regulations. But from antipathy to a fear of a Pandora ’s Box or outright hatred, our do-nothing, blockade-everything-the-administration-wants Congress is likely to leave a law that can be fixed to wallow in “little failures” to increase a national appetite favoring the GOP cause, even if it hurts their own constituents. Repeal or nothing… and “nothing” seems to be the current agenda.

I’m Peter Dekom, and compromise has left the building, departed the city and fled the country, leaving dysfunction to rule our great nation!