- The Washington Times - Monday, July 6, 2015

President Obama says it’s time to move on, but challenges abound for Obamacare, even if it’s on a firmer legal ground.

Insurers have requested sharp premium hikes as they take stock of who’s entering the market and who’s not, and it’s unclear if a weightier penalty for lacking insurance will drive young and healthy people to the exchanges in 2016.

“The biggest challenge ahead is getting more people enrolled,” said Larry Levitt, senior vice president of the Kaiser Family Foundation, a nonpartisan health policy organization.

Some states are struggling to keep their insurance exchanges afloat, meanwhile, and Obamacare’s insurance mandates on businesses are phasing in through next year, posing an administrative and financial headache for large and midsize firms.

According to Mr. Obama, the Supreme Court’s decision last month to uphold the law’s subsidies in 34 states on the federal exchange should put an end to the partisan fights around the Affordable Care Act.



“I’m hoping that what we can do is now focus on how we can make it even better,” he told a Nashville audience last week.

But congressional Republicans remain ready to highlight the overhaul’s faults for the foreseeable future, even as they struggle to formulate a unified strategy to repeal and replace the law and turn the 2016 election into a referendum on health care reform.

In the meantime, the law is marching toward its third enrollment period this fall and will rise or fall on its merits.

For now, state regulators are scrutinizing some major insurers’ requests for double-digit rate hikes in 2016. Claims data from Obamacare’s first year of coverage, and the phasing out of payments under the so-called “risk corridor” and reinsurance programs — which soften the financial blow of taking on too many sick customers — factored into the requests, according to analysts.

They say increases in more popular plans are modest compared to the market at large. On average, insurers are seeking a less-than-5 percent increase in the second-lowest-cost silver, or “benchmark,” plan by which subsidies are calculated, according to a Kaiser foundation study of 11 major cities.

Mr. Obama is banking on state regulators to keep rates in check, citing the experience from Obamacare’s first two years.

“When all the dust settled and the commissioners who were empowered to review these rates forced insurance companies to justify what they were seeking, what you discovered was that the rates actually didn’t go up as much as people thought,” he said in Tennessee last week.

Congressional budget scorekeepers have estimated that 20 million Americans will hold insurance through Obamacare’s exchanges in 2016 — nearly double the 10.2 million paying customers the administration counts now.

Larger enrollment will be key to keeping premiums down, as healthier persons balance out the risk that insurers absorb from sicker patients who cannot be denied coverage, and Obamacare’s rising individual mandate tax may or may not spur more people into the marketplace.

People who could afford insurance but didn’t acquire it and didn’t qualify for an exemption were taxed $95 or 1 percent of income over the filing threshold in 2014, a penalty that rose to $325 or 2 percent of income in 2015, and ups to $695 or 2.5 percent of income in 2016.

“The ramping up of the mandate is the big wild card for 2016,” Mr. Levitt said. “The mandate is pretty soft by design in the first two years.”

Even if interest spikes, some states are grappling with faulty or unsustainable web exchanges. With HealthCare.gov and its subsidies intact, Republicans in Minnesota and Vermont have urged their states to switch over to the federal portal instead of throwing more resources at their state websites.

Meanwhile, a series of deadlines is approaching as the 2016 campaign heats up. The twice-delayed employer mandate will require companies of 100 or more workers to insure 95 percent of their full-time workers next year instead of just 70 percent, while employers with 50 to 100 workers will be subject to the mandate for the first time.

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