Is Obamacare Headed for Even More Trouble?
The decision of President Barack Obama's administration to delay a crucial component of its health-care reform law, first reported today by Bloomberg News, raises two immediate questions. First, can the White House protect other components of the law from renewed attack? Second, what does this say about the broader problems facing implementation?
Administration officials said enforcement of the employer mandate, which requires businesses with more than 50 employees to provide a certain level of health insurance, will be delayed to 2015. The administration argues that this change reflects its desire "to implement the ACA in a careful, thoughtful manner."
But it's almost inconceivable that business groups will be satisfied with just this change. The National Retail Federation wants the employer mandate to apply only to businesses with 100 or more full-time employees, not 50. By announcing that it's willing to budge on timing, the administration weakens its ability to resist more substantial changes, such as reducing the mandate's scope. This change could make the politics worse, not better.
Nor is it just the employer mandate that's affected. Opponents of other elements of the law -- the individual mandate, Medicare payment cuts, exchange subsidies, to name a few -- will no longer buy the line that we're too far along to change now. Trade associations, whose members may have started questioning the return on investment of their Obamacare lobbying campaigns, now have a new mandate of their own: Increase their efforts.
The Advanced Medical Technology Association never liked the excise tax on medical devices. America's Health Insurance Plans never liked the law's tax on health insurers. Precedent is a mighty thing.
Perhaps the most interesting part of today's news is what it says about the challenges the administration perceives in putting this law into place. The White House has been operating under a siege mentality in the lead-up to implementation, as anybody who's tried to get a call returned by the U.S. Centers for Medicare and Medicaid Services can tell you. Making a change of this magnitude, at this late date, suggests some genuine concern about the law.
Does today's news mean that Obamacare itself is in danger? Not really. At least not yet. But coming as it does after the Supreme Court made the Medicaid expansion optional, and after so many states have refused to build exchanges, this latest concession raises the question of what will be the next thing to go -- and how many more battles the administration can afford to lose before the law is in real trouble.
(Christopher Flavelle is a member of the Bloomberg View editorial board. Follow him on Twitter.)