1. People losing coverage: About 14 million people will lose their employer coverage by 2019, as smaller employers terminate their plans and workers who currently have employer coverage enroll in Medicaid. Half of all seniors on Medicare Advantage could lose their coverage and the extra benefits the plans offer.It's so bad that a vast majority of the states have introduced legislation that nullifies the basic tenets of the federal law. For once, Florida is leading the charge,
2. Huge fines for companies: Businesses will pay $87 billion in penalties in the first five years after the fines trigger in 2014, partly because they can’t afford to offer expensive, government-mandated coverage and partly because some of their employees will apply for taxpayer-subsidized insurance.
3. Higher costs for consumers: Tens of billions of dollars in new fees and excise taxes will be “passed through to health consumers in the form of higher drug and devices prices and higher premiums,” according to Foster. A separate report shows small businesses will be hit hardest.
4. A program created to fail: The new “CLASS Act” long-term-care insurance program will face “a significant risk of failure,” according to Foster. Indeed, he finds, “there is a very serious risk that the problem of adverse selection will make the CLASS program unsustainable.”
5. Spending increases: Under the new law, national health spending will increase by $311 billion over the coming decade. And instead of bending the federal spending curve down, it will move it upward “by a net total of $251 billion” over the next decade.
6. “Free-riders”: An estimated 23 million people will remain uninsured in 2019, roughly 5 million of whom would be undocumented aliens; the remainder would be the 18 million who decline to get coverage and who will pay the penalty.
7. Spending reductions are fiction: Estimated reductions in the growth rate of health spending “may not be fully achievable” because “Medicare productivity adjustments could become unsustainable even within the next ten years, and over time the reductions in the scope of employer-sponsored health insurance could also become an issue.”
8. You can’t keep your doctor: Fifteen percent of all hospitals, nursing homes, and other providers treating Medicare patients could be operating at a loss by 2019, which will “possibly jeopardize access to care for beneficiaries.” Doctors are threatening to drop out of Medicare because cuts in Medicare reimbursement rates mean they can’t even cover their costs.
9. Coverage but no care: A significant portion of those newly eligible for Medicaid will have trouble finding physicians who will see them, and the increased demand for Medicaid services could be difficult to meet.
The Florida legislature voted Thursday to place a state constitutional amendment on the ballot that would ban any laws that compel someone to “participate in any health care system.” It requires a 60 percent vote to succeed. The legislation is modeled after the American Legislative Exchange Council’s Freedom of Choice in Health Care Act, which has been introduced or announced in 42 states.