The calm in the eye of the ObamaCare storm

After the defeat of the candidate who would repeal the President's health care law, we have entered a "period of relative calm," as the bureaucrats ready the rollout later this year.  But the political storm may be renewed in its "full fury" as January 1, 2014 approaches.

At least that is the opinion of Henry J. Aaron, writing for the Brookings Institution.  Aaron compares the ObamaCare life cycle to that of a hurricane, with "a deceptive and short-lived calm" now upon us.

Keeping in mind that Brookings is a generally a left-leaning think tank, and that Aaron is a proponent of centralized health care, Aaron's first caution flag illustrates the "complexity of the law":

"People will be eligible for coverage" under Medicaid for income up to either "138 percent of the federal poverty level (FPL)" or "100 percent of the FPL," through a "basic health" plan for income "between the Medicaid level and 200 percent of the FPL," or through "ordinary insurance," with subsidies through the exchanges for incomes up to "400 percent of the FPL."

Confusing to read, Byzantine to implement.

Aaron further notes that family members can have differing coverage and subsidies, and even differing exchange rules if they work in adjacent states. 

Not to mention such esoterica as repayment of excess subsidies for changing incomes, instant access to earnings data, and lack of an "effective enforcement mechanism," along with multiple active lawsuits.

As Mr. Aaron says, "Nothing approaching the complexity of this 'roll out' has ever taken place in U.S. peacetime history," with the startup challenges "vastly more complicated" than Social Security or Medicare ever were.  

"Businesses are hiring battalions of lawyers to decipher the bureaucratese," Grace-Marie Turner observes in Forbes, and health insurers "have hundreds of other critical questions."

With less than nine months before October 1, 2013, when "millions of people will start applying for coverage" under the new regime, the exchanges are behind schedule, thousands of pages of rules are yet unwritten, and small businesses, the engine of our economy, are struggling to cope with the law and avoid financial harm.

The Heritage Foundation cites Congressional Budget Office studies and other studies predicting 20 million or more Americans will lose their employer coverage under ObamaCare.

A Nevada restaurant owner quoted in a Heartland Institute article says "we can't pay for this...I don't know what secret [the politicians] know, where they just assume we can write them a check."

Heartland also quotes health policy experts who estimate that restrictions on grandfathering health plans, combined with "skyrocketing premium costs," will result in two-thirds of workers in small businesses losing their current coverage.

"Administrative overload" and the potential failure of critical links will only add to the turmoil already present on the ground, as Americans line up in 2014 and 2015 for disrupted coverage, exploding costs and rationed care, amid a system in chaos and confusion.

Aaron predicts the political storm will "gather force" again this October, reaching its "full fury" on January 1, 2014, and carrying over into the 2016 presidential campaign:

Those who said that the presidential election would settle the fate of heath reform will be proven mostly right. But it will become clear that they had the date wrong: the key election will turn out to have been not 2012, but 2016.

Facing a Democratic candidate committed to locking down ObamaCare, it will behoove Mr. Rubio, Mr. Ryan and other potential 2016 Republican candidates to seize the mantle of leadership and present a compelling case for the conservative alternative to a dysfunctional nationalized health care.

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