There is no way to spin the White House’s retreat on the employer mandate as a good omen for the Affordable Care Act.
The mandate – a requirement that companies offer health benefits if they employ 50 or more full-time workers – was supposed to be one of the easier parts of health care reform. It was just a matter of the Treasury Department and Department of Health and Human Services writing regulations and companies providing payroll information.
But employers have been complaining loudly about confusion and costs – and threatening to turn full-time workers into part-time workers to stay below the 50-employee trigger point.
Like much of Obamacare, it was supposed to take effect at the beginning of 2014. But the administration has just moved that deadline back a year, promising to help the affected companies make a smooth transition by 2015.
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Cynics are saying the delay is designed to push the issue beyond next year’s congressional elections. But it’s hard to see how Democrats will profit politically.
The mandate actually affects a small subset of American employers. Most middle-size and large companies – 95 percent, according to the Kaiser Family Foundation – already provide their employees with health care insurance. Those that don’t may account for as little as 1 percent of the American work force.
But that means fear of the impact is likely to be worse than the impact itself. The postponement will keep at least some fear in play as ballots are cast in November 2014.
This is a sideshow compared to other components of the Affordable Care Act.
The individual mandate – a requirement that uninsured people either carry coverage or pay a fine – will be much harder to manage and much more unpopular. Yet it’s a key source of the system’s funding. If the employer mandate can be delayed, what’s the case for not delaying the individual mandate?
Also essential are public health care exchanges, which will allow individuals and small businesses to shop for medical policies. Setting them up has been a daunting bureaucratic challenge. The employer mandate was supposed to be a snap by comparison.
Washington state offers a cautionary tale for the Obama administration. The Legislature approved a massive health reform here in 1993, replete with employer and individual mandates, and the equivalent of a health care exchange.
But a backlash from employers and the public derailed the mandates in 1994, and lawmakers gutted the new system in 1995.
Defenders of the Affordable Care Act had better be girding for political battle. And someone had better be cracking the whip at Treasury, and Health and Human Services.
These departments have had more than three years to get ready for the 2014 rollout; the delay of one of the law’s simpler provisions is discouraging. The expansion of health care is likely to go down as President Obama’s signature achievement – if it survives – and it demands his full administrative attention.