Obamacare problem death by thousand cuts

Watching Obamacare unfold has been like taking a dizzying carnival ride. With every twist and turn, the health care direction is altered and its riders are confronted with unexpected consequences.

The Affordable Care Act got off to a wobbly start with an ill-prepared website. Health exchange signups lagged behind expectations, prompting a deadline extension to get people on board. As employers struggled to implement the complex law, the Obama administration extended the compliance deadline for some and delayed tax penalties for others.

With a general election looming, the rules were tweaked again in May to allow the administration to use taxpayers’ money to help cover insurers’ shortfalls. It could cost taxpayers billions of dollars. Critics call it a bailout of Big Medicine.

Some employers who already provided health insurance thought a solution to escalating costs would be to discontinue coverage and give employees extra pay they could use to buy insurance on the exchanges. That didn’t work out well because pay is taxable while health benefits are not. That bumps some employees into a higher tax bracket and makes some ineligible for federal subsidies.

Everyone, including the members of Congress who voted for the law — not one Republican voted for it — expected some adjustments in the implementation of the sweeping reform, but the magnitude of its impact on health care consumers and employers is staggering.

The mounting problems are becoming death by a thousand cuts. So before the patient dies, the administration and Congress need to sort this out, fix what’s not working and clarify the rules.

— Albuquerque Journal