Obamacare Survives--Now What? by David Nather. Politico.com November 7, 2012.
With the reelection of President Barack Obama, any prospect of repeal of the Affordable Care Act or Obamacare can now be discarded. This article provides a summary of key implementation issues for the law moving forward. This articles addresses the following issues:
(1) How the opponents of the law will continue to fight the law thru lawsuits about contraceptive coverage and the availability of subsidies through the insurance exchanges.
(2) Some states are moving toward implementing their own insurance exchanges, others are opting for exchanges conducted in partnership with the federal government. Other states are going to leave the responsibility to the feds.
(3) In addressing the so-called "fiscal cliff" there will be pressure to cut subsidies for individuals who buy insurance in the exchanges and meet low income benchmarks.
(4) There is a question of whether the exchanges will attract a mixture of sick and well individuals in order to balance costs.
(5) The individual mandate for purchase of insurance will present challenges of implementation and acceptance
(6) Will cost control mechanisms in the law work?
(7) Some employers may drop coverage and force employees to get coverage in the exchanges. However some employers have faced adverse publicity when they have attempted to do this.
(8) How will states implement the encouraged, but not required, expansion of Medicaid?
(9) How will reductions in reimbursements to Medicare providers and to Medicare Part D impact the availability of treatment for Medicare patients?
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