Those adamantly opposed to The Affordable Care Act (ACA), once derisively referred to as Obamacare but which has since lost its pejorative appellation, still rally around any bill to appeal the law or to somehow defund it. Many of these individuals see the health care law as an infringement on their personal liberty especially the mandate that everyone purchase healthcare or face a penalty that surprisingly survived a Supreme Court challenge. Other concerns revolve around the cost to businesses, its affect on hiring, worker status and whether it will ultimately reduce the number or uninsured in this country while cutting the cost of healthcare.
Cost of Coverage
A common argument against the law is that it will increase the cost of coverage since some people will only buy coverage once they become sick or injured, since there is no longer any provision for preexisting illnesses or other conditions, thus raising coverage for everyone else.
Privacy concerns seem to nag at mostly those on the Right since any government involvement, in their worldview, would compromise an individual’s right to privacy, at least when it comes to medical records. They feel that individuals shopping for coverage will have their health records shared among federal agencies who could distribute them to private companies. Federal officials have said that there is no database where health records are stored and potentially accessible to outsiders.
Navigators or counselors who assist people in choosing a suitable plan may have access to your Social Security number, tax and immigration status to determine eligibility for benefits and some are concerned about the potential for abuse. Navigators are required to undergo training, pass an exam and be subject to criminal penalties for privacy violations or fraud. Although not required, many states now require counselors to undergo criminal background checks.
Cost to Small Businesses
Businesses with fewer than 50 employees are exempt from any penalties imposed by the ACA for failing to offer health insurance coverage to employees. Certain businesses with low income wage earners are eligible for a tax credit including those with 25 employees or less who have average salaries of $50,000 or less or who contribute at least 50 percent of premiums to a health exchange plan.
Large employers face annual penalties of $2,000 per full-time employee, minus the first 30 employees, who receives a subsidy if the company fails to offer coverage. Should a full-time employee receive subsidized coverage in the Exchange due to unaffordable or inadequate coverage, the employer is subject to a penalty of $3000 for each subsidized employee, minus the first 30 workers.
Some companies are fearful of the ACA’s penalties and are reportedly holding off from hiring new employees or terminating some. According to some polls, some businesses are considering dropping coverage while others are reducing the hours of employees to part-time.
Counterarguments to this concern is that the ACA offers tax credits for some businesses that contribute to employee health insurance costs, which could cover up to 35 percent of the company’s premium contribution for employees.
Labor unions have expressed their concerns over The Affordable Care Act contending that the law gives nonunion contractors an unfair advantage over union shops. They feel that the law imposes significantly higher costs of multi-employer funds and unions members while allowing nonunion members to shift their costs to taxpayers. The ACA purportedly encourages nonunion contractors to buy their plans from the new health exchanges while union members have to pay for their own coverage under their respective collective bargaining agreements.
Delays and a Wait-and-See Approach
The penalty on employers who fail to provide coverage, however, has been postponed from its implementation date of January 1, 2014. Also, the Obama administration will be changing the enrollment procedures for some who sign up for taxpayer subsidized coverage.
Even with these delays, which many Republican lawmakers and policy pundits are crowing as evidence of the ACA’s shortcomings and unpopularity, others are urging patience while encouraging the Obama administration to be more proactive in educating the public about the law’s benefits and ultimate savings. As with many historic legislative acts, whether the ACA becomes acceptable to most people and achieves its goal of cost savings and universal coverage remains to be seen.