By Phil Riske
Managing Editor, Rose Law Group Reporter
Implementation of major provisions of the Affordable Care Act now shift to the states with the reelection of President Obama.
Now comes the big hurdle: making it work. “Given the massive amount of work that needs to be done to get the state insurance exchanges up and running, I would expect to see some flexibility with the upcoming deadlines in both the short and long term,” said David Weissman, RLG human resources and employment law attorney. “That said, this train has definitely left the station, and it is important for both companies and individuals to understand their compliance obligations under the law, as those requirements will be upon us before we know it.”
A number of Republican governors, including those in Arizona, Idaho, New Jersey, Virginia and Tennessee, have said they would decide what to do after the election, giving themselves only a 10-day window before the deadline.
The deadline for state implementation is only eight days away.
Update: U.S. Extends a Deadline for States on Coverage
After nearly three years of legal and political threats that kept President Obama’s health care law in a constant state of uncertainty, his reelection on Tuesday all but guarantees that the historic legislation will survive. Speaker John Boehner, nevertheless, tweeted repeal of Obama Care is still on the table for the House.
Much depends on the states as they decide in the coming weeks and months whether to build online marketplaces known as insurance exchanges, where individuals and small businesses can shop for health plans, and whether to expand their Medicaid programs to reach many more low-income people.
Arizona was among 26 states that sued the federal government to block the Affordable Care Act, arguing its Medicaid expansion was “unduly coercive” because it required states to expand or lose all their federal Medicaid funding in its sharing of costs with the federal government.
A court ruling solved that problem by making the expansion voluntary, so states that decide to maintain the status quo would not be penalized with losing existing Medicaid funds.
Although there is no deadline for states to indicate whether they will expand Medicaid, hospitals and other stakeholders are already lobbying the states to do so. Hospitals will see reimbursement rates trimmed under the health care law, and expanding Medicaid would bring new paying customers to help cover their losses.
To help balance budget deficits, Brewer and the Legislature took more than 200,000 children and adults from the Arizona Health Care Cost Containment System, the state’s Medicaid program
Health-care advocates say the costs of not extending Medicaid to more low-income families would be greater than the state’s share of expanded coverage.
Even if Brewer and lawmakers agree to expand Medicaid, they say, it wouldn’t take effect until Jan. 1, 2014. Meanwhile, the next 18 months will bring additional hardship.
There’s bound to be epic negotiations between Obama and Congress over federal spending and taxes, where the administration will inevitably face pressure to scale back some of the costliest provisions of the law.
“Mr. Obama faces crucial choices about strategy that could determine the success of the health care overhaul: Will the administration, for example, try to address the concerns of insurers, employers and some consumer groups who worry that the law’s requirements could increase premiums? Or will it insist on the stringent standards favored by liberal policy advocates inside and outside the government?” asks The New York Times
Many supporters feel one of Mr. Obama’s most important tasks will be to step up efforts to promote and explain the law to a public that remains sharply divided and confused about it. In exit polls on Tuesday, nearly half of voters said the law should be either partly or fully repealed.
Speaker ‘Confident’ of Deal With White House on Immigration/The New York Times
