Obamacare- What To Expect in 2011

It’s a new year and a new phase of Obamacare. The Republicans took the majority in the House of Representatives last November with a 63 seat gain, which is the largest gain since 1948  ( when the Democrats picked up 75 seats).   Two of the main reasons cited for the Republican victory: 1) The high unemployement rate and 2) Obamacare.

In 2011, there are a number of things brewing with Obamacare that could make this year very contentious.  They are listed below as follows:

1. The Individual Mandate–  On December 13, 2010,  Judge Henry Hudson ruled the federal mandate of the health care law unconstitutional.   Judge Hudson also said the individual mandate  “exceeds the constitutional boundaries of executive power.” For more about this case ( which is almost certain to be decided by the Supreme Court some time in 2012), click here: 
2. Obamacare and The General Welfare Clause– When Sen. Ben Nelson negotiated a $100 Million expemption of future Medicaid costs with  “The Cornhusker Kickback” prior to the passage of Obamacare, it appears that this negotiating tactic may have violated the General Welfare Clause in the Constitution. This is because laws are supposed to benefit the general welfare of all citizens. If this provision had been implemented, then 49 states would have had to pay for the Medicaid costs of Nebraska’s citizens. This is great for Nebraska—but the other states get nothing in return. For more on Obamacare and the General Welfare Clause, click here:
3. House of Representatives Will Pass the Obamacare Repeal– Many Republicans campaigned on a repeal of Obamacare. So, while the House is expected to pass their repeal bill, it is not likely to pass the Senate. Even if it passed the Senate, President Obama would surely veto any legislation that repeals his landmark legislative accomplishment. Nevertheless, over 20 Democratic Senators are up for re-election in 2012. If they come from moderate states ( i.e. Sen. Ben Nelson of Nebraska, Sen. Claire McCaskill of Missouri), they will be very reluctant to vote up or down on whether to keep or repeal Obamacare. This issue should be a major issue right up to the 2012 election ( for Pres. Obama as well).
4.  New Mandated Provisions Take Affect- The new 2011 coverage mandates (two are the requirements that all insurance carriers offer coverage to adult children up to age 26 and no charges or copays for routine preventive care) become effective for clients that have insurance renewals on or after September 23, 2010. These mandates have already caused many of our clients to face higher than average rate increases ( our client’s average rate increase has been from 10% to 26%).
5. Shortage of Doctors- Of the estimated 32 Million more Americans that will reportedly be insured by Obamacare, it is estimated that approximately 50%  ( 16 Million ) will access care through Medicaid. This arrangement is better for the federal government because Medicaid is reimbursed at an extremely lower level already ( lower than Medicare ) and also because Medicaid is funded by both the states and at the federal level. However, at a time when we are insuring 32 Million more people, Congress may reduce doctor reimbursements even further. And, this is at a time when 77 Million Baby Boomers ( 10,000 Boomers turn 65 each day)  begin to retire and need more medical care. The number of seniors who need more medical care is expected to increase to 72 Million by 2020 ( from approximately 36 Million today).
6. Those Without Health Insurance Options Stand To Benefit– The individuals who stand to benefit the most are those individuals ( not generally applicable to groups) who are children with pre-existing conditions and any others that may now be eligible for their state’s high-risk pool ( and were unable to get insurance before).
7. All In the Health Insurance Industry Will Be Affected– Doctors, Hospitals, Health Insurers, Brokers, and any others dealing with the health insurance industry will have to adjust to many parts of this legislation.
8. The Unknown– Health Insurance is a very personal decision. And, if the Obama Administration says “ if you want to keep your current plan/doctor, you can keep your plan/doctor”,  we will have to see how many insured Americans are able to do so. Those that lose their plan and doctor will be upset at having to make a change. And, I’ve learned that there are a few very personal things in life: Love and Religion—and Health Insurance can fall into this category as well.

So, get ready for gridlock, because I don’t see any solution between Democrats and Republicans until 2012. And, the longer this issue drags on, the more it may hurt the Democrats ( unless the Republicans don’t have a sufficient replacement plan). Over the half the states ( 27 ) now want Obamacare declared unconstitutional. Stay tuned….