CHICAGO: President Barack Obama may have defeated opponents of his landmark health care law in the courts and at the ballot box, but the sweeping reforms still face a rocky road ahead.
Advocates are concerned that the funding needed to help expand coverage to 30 million uninsured Americans could take a hit in budget negotiations as Obama battles his Republican rivals over the so-called fiscal cliff tax and austerity crisis.
The implementation process is also expected to get messy as responsibility passes to the governors and health departments of the nation’s 50 states, many of which are led by Republicans who have stridently sought to repeal the measure widely dubbed “Obamacare.”
Republicans say the reforms, signed into law in March 2010, will increase costs, cause insurance premiums to rise and hurt the quality of health care.
They have especially taken issue with a key underpinning of the overhaul, an “individual mandate” requiring almost every US citizen to take out health insurance or be subject to a fine beginning January 1, 2014.
States have until December 14 to decide whether they want to set up health care exchanges that form one of the backbones of the Affordable Care Act - or if they want the federal government to handle the matter.
These exchanges are meant to help those who will be required to purchase health insurance to choose between available plans and obtain information about subsidies.
If run properly, the exchanges can help lower costs for everyone by spreading the insurance risk and reducing the number of uninsured who end up racking up unpaid bills at hospital emergency rooms. They also help insurance companies recover the cost of new rules - also set to kick in on January 1, 2014 - that will prevent them from denying coverage for pre-existing conditions, increasing rates due to gender or health status, or placing annual caps on coverage.AFP
