Throughout the presidential campaign, there’s been a lot of talk about either keeping or repealing Obamacare — but the fact is, no matter who wins today’s election, the implementation of some pieces of President Obama’s health care reform law will have to move forward.
The Obama administration — which has been steadily issuing final “rules” for implementing Obamacare components as the different pieces of the health law take effect — will likely unleash a flood of new regulations after tonight’s election results. If President Obama wins a second term, that process could extend into 2014. But if Mitt Romney wins, the regulations will be issued at a much faster pace in an effort to get as many Obamacare rules finalized before a Romney administration would have the chance to potentially undo them. This means that HHS would have to finalize those rules before November 22nd, 60 days before Romney’s inauguration.
Regardless of who wins the presidency, HHS is almost guaranteed to issue new rules on these three core Obamacare elements in the coming month or so:
1) Statewide health insurance exchanges. States have until November 16th to decide if they plan to establish their own exchange, an exchange created in partnership with the federal government, or an exchange created entirely by the federal government. Although HHS has some guidelines for the basic structure of the exchanges, it still has to finalize the details on how it will partner with states to create “federally-facilitated” exchanges without confusing Americans.
2) Essential health benefits. After setting up the rules for how the health exchanges will function, HHS will have to specify which insurance policies will be covered under them. Insurance plans under the exchanges will have to meet federal standards across ten “essential benefit” categories, including preventive care, emergency services, maternity care, and prescription drugs. But states have leeway to decide what benefits should fall under those categories, and the federal government may have to provide states with more guidance about the minimum coverage they need to be offering to their residents.
3) Part-time workers and employer-provided health benefits. Obamacare requires large employers to offer full-time employees a minimum level of health benefits or pay a fine — but some companies have been toying with the idea of shifting more workers to part-time status in order to avoid the extra coverage costs. This would be a devastating labor practice for the low-wage workers who cannot afford private insurance but are not poor enough to qualify for Medicaid — and often work nearly as many hours as their full-time co-workers. HHS will likely issue rules to either prevent this kind of benefit-dodging or encourage large employers to insure part-time workers.
These are only some of the rules that HHS will have to consider very soon — others include instructions for states’ Medicaid expansions and contraception requirements for religious institutions. No matter who reaches 270 electoral votes tonight, states and health care providers across the country still need more details from HHS to effectively implement the health reform law’s various moving parts.