I had my reservations about the ACA (a.k.a. Obamacare) when it passed and I still have my doubts that it will be a success. (It’s going to need some major tweaks.) Charlie Pierce calls out attention to one of its shortcomings – quoting his post here in its entirety:
Whoops, here’s another part of the Affordable Care Act that has to go back into the shop because it’s starting to leave gears, and bolts, and piston rods all over the road.
Unable to meet tight deadlines in the new health care law, the Obama administration is delaying parts of a program intended to provide affordable health insurance to small businesses and their employees – a major selling point for the health care legislation. The law calls for a new insurance marketplace specifically for small businesses, starting next year. But in most states, employers will not be able to get what Congress intended: the option to provide workers with a choice of health plans. They will instead be limited to a single plan. This choice option, already available to many big businesses, was supposed to become available to small employers in January. But administration officials said they would delay it to 2015 in the 33 states where the federal government will be running insurance markets known as exchanges. And they will delay the requirement for other states as well.
There are several reasons why the ACA came out of Congress as a jerry-rigged, inherently self-sabotaging beast of a bill. One of these reasons was that “compromise,” and its idiot stepbrother, “bipartisanship,” combined to make simply getting a deal done the reason for passing the thing. And the problem with the deal that finally got done was that it insisted on keeping health-insurance companies in charge of health-care coverage in this country. This necessitated the creation of a bill that had to be both sufficiently progressive and sufficiently deferential to major corporate interests. So we get a push-me-pull-you out of the deal. If all of the elements of this ever come fully on-line, I’ll be amazed.
Bottom line: Requiring people to buy overpriced health coverage – which seems a likely outcome so long as large entrenched companies are allowed to run the show – is a mixed blessing. Yes, many more people get coverage but they’re forced to overpay and that overpayment could presumably be put towards something else they would rather have spent it on. A public option would have gone a long way towards cost control. C’est la vie. (See also Paul Krugman on the public option that didn’t make it into the ACA.)
FWIW, a few weeks ago I was reading an interview with Senate candidate Stephen Lynch. Interestingly, in terms of pros and cons, he and I perceived pretty much the same issues with the ACA. He voted against it. If I had his job I would have voted for it. (Reasonable people can disagree.) I’m a likely Markey supporter but I think more of Lynch now after learning a bit more about him than I did when he entered the race. (I like Mike Capuano more than Lynch and Markey combined but unfortunately he decided not to run.)