House Speaker Nancy Pelosi was widely mocked when she said of Obamacare, “We have to pass the bill so that you can find out what is in it.” At the time, March 2010, Pelosi's words accurately described the Democrats' just-get-it-done approach to passing a national health care bill. But now it turns out Pelosi was wrong. In fact, we have to implement Obamacare so that you can find out what is in it.
Amid the other momentous events coming in 2013 -- bitter fights over federal spending, debt, entitlements and immigration -- the biggest story of the year, and of 2014 as well, will be the arrival of Obamacare in the lives of every American.
For millions of people, Obamacare will mean, alone or in some combination: higher insurance bills, unwanted changes in status at work, higher taxes, loss of employer-based health insurance and a bewildering bureaucracy that will make today's already complex insurance maze seem downright simple.
Whether Obamacare's benefits will outweigh the chaos it produces could decide the future of the program.
Start with higher insurance bills. “The big unwritten story is that for people who already have insurance through the individual market, or small companies that are buying products in the state-regulated small group market -- those current policies are going to see premium increases on the order of 25 percent to 30 percent come Jan. 1, 2014,” says James Capretta, a health care expert and close student of Obamacare at the conservative Ethics and Public Policy Center. “They are going to have a rate shock like you wouldn't believe.”
The reason is that those people are generally younger and healthier and are able to get lower rates. Under Obamacare, they will be combined with older and less healthy people who cost more to insure. Capretta says about 30 million people will see a steep increase -- a population big enough to make a lot of political noise.
Then there is the change in work status. Under Obamacare, companies don't have to insure, or pay fines for not insuring, employees who work less than 30 hours a week. So it's no surprise that many companies are going to make sure their part-time workers, and some current full-time workers, stay below the 30-hour limit. That will mean less work and less pay for those employees.
Then there are the unexpected costs. This week, the Department of Health and Human Services revealed it will charge employer and individual plans a $63 “fee” for every person they cover. The Obama administration says the fee will be temporary, but it could touch about 190 million Americans at least for the next few years.