Now that January 1, 2014 has passed one would hope it would be clear sailing for Obamacare but that is not the case. Confusion is the rule of the 
day. What actually became law on January 1st 2014? The employee mandate has been delayed for one year (January 1, 2015). The due date for individuals has been moved back several weeks. The millions of people who had private insurance canceled have been told they can keep their unqualified plans (if the insurance companies allow it). Catastrophic insurance which was deemed unqualified by the President is now allowed. So the real question is what happens now?
Individuals that do not have insurance from their employer or did not have an individual plan before now must sign up on the exchanges. These are the main people affected by the new law at this time. It is said that over two million people have signed up in the exchanges but how many have actually paid. Surveys show it is less than 10%. We will have to see how many actually pay the premium. The other problem is surveys show that the people signing up are older and in poor health. The young and healthy which are badly needed to offset the old and sick are so far staying away. Without the young and healthy signing up, the system cannot sustain itself financially.
The next area is Medicaid. Several million people have been added to Medicaid in the 25 states that accepted its expansion. The question is what will happen to them. More and more Doctor’s are refusing new medicaid patients and many are not taking any medicaid patients. More patients with fewer Doctors mean longer waits, shorter visits and lower quality care. We will have to wait and see what happens in this area but it does not look good.
Even those that are signing up in the exchanges have much smaller Doctor and hospital networks to serve them (and higher deductibles). Does this mean longer waits, shorter visits and lower quality care? Logic would suggest this is true, but we will again have to wait and see. How will the larger deductibles affect people seeking a Doctor? Will they now have the money to pay for the visits or stay away and be sick? History has showed us they will stay away until it becomes an emergency. Will this behavior suddenly change? Do emergency rooms still take people that can’t pay but have insurance? These are questions that will be answered for us in the near future.
Now there are several lawsuits pending to add to the confusion. It has just been ruled that Catholics in certain groups do not have to add certain pregnancy prevention medicines or devices to their insurance. If this stands many other religious groups will join in. There is also a large lawsuit claiming the entire law is illegal because all tax bills (remember the Supreme Court already ruled these are taxes not penalties) have to originate in the House of Representatives and it did not. We do not know the final outcome of these cases, but they will add to the confusion.
I have always said that Obamacare was not designed to work; it was designed to pass (the House and Senate). With the total disarray of the role out, high prices, high deductibles and the young and healthy staying away, can Obamacare work? If it doesn’t work what happens? Many ranking democrats like Harry Reid and Nancy Pelosi are calling for a single payer system. Was this the plan all along? I do not believe Obamacare in its present form can work in America but is the answer even more Government control? I think that would only make matters worse. The answer for now is confusion, and we will have to wait and see what happens. I just hope it can be fixed before it destroys the greatest medical system in the world.
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