Affordable Care Act Problems Multiply Part I: Logistical Concerns

By: Tony Glosson

With only 69 days until the Affordable Care Act (ACA) exchanges open for enrollment, Obama administration officials face major logistical and structural challenges. This two-part blog series details some of the major issues with ACA implementation.

This post, Part I of the series, highlights various logistical problems, while Part II will focus more specifically on fraud and consumer privacy-related concerns.

Delayed Enforcement of the Employer Mandate

The Obama Administration acknowledged July 3rd the necessity to delay a major component of the ACA, the “employer mandate,” until 2015. The provision requires employers with more than 50 workers to provide their employees with government-approved health insurance or face tax penalties. Many larger businesses, which had actively opposed the employer mandate, expressed relief at the decision to delay the provision.

Legal scholars have characterized the administration’s one-year delay as an illegal move, citing the lack of statutory authority in the ACA for the IRS to change the effective date of the law. Further complicating the administration’s situation is the revelation that the White House had known for months of the issues cited as necessitating the delay but continued insisting that the rollout would move forward as scheduled until recently. Other critics are questioning the fairness of giving businesses reprieve from ACA insurance requirements while still forcing individual workers and their families to comply. Even some allies of the administration supported a recent bill delaying the individual mandate.

Yearlong Computer Glitch

On July 9th, it was revealed that a programming error has left insurance companies unable to charge older smokers the full lawful penalties under the ACA without simultaneously charging younger smokers higher rates. Alternatively, insurers may simply give the older smokers a pass—and make the rest of their customers foot the bill in the form of increased premiums. For reasons unexplained, officials anticipate this glitch will take one full year to resolve.

Two-tiered Medicaid System

Under the ACA, states receiving federal funds to expand Medicaid must offer certain preventative care services to newly-eligible Medicaid enrollees. According to a recently-released study by George Washington University, existing enrollees may not have access to the same preventative care services. While the federal government provided monetary incentives to extend these additional services to existing Medicaid enrollees, states are under no obligation to accept those incentives, and some have already chosen not to do so. In effect, this could result in a two-tiered Medicaid system in which new enrollees get special treatment, while existing ones get only second-rate coverage.

Be sure to check back later for Part II of the series detailing fraud and consumer privacy concerns.