Republicans’ response to the Department of Treasury’s announcement that it would delay enactment of the Affordable Care Act’s employer responsibility provision has put the party in the awkward position of attacking the administration for considering the objections and concerns of the business community and not proceeding with implementation quickly enough. This comes after years of Congressional maneuvers to defund the law and repeal it.
While administration officials argue that they’re postponing the provision — which requires employers with more than 50 employees to pay a fine if they don’t offer affordable quality coverage — to allow businesses more time to comply with the law and promise to “convene employers, insurers, and experts to propose a smarter system” for 2015, Republicans caution that the decision spells disaster.
“This further confirms that even the proponents of ObamaCare know it will hurt jobs, decrease economic growth and make it harder for families to have access to quality and affordable health care,” House Majority Leader Eric Cantor (R-VA) said in a statement. “Delaying the employer mandate is a clear admission…that the health care law is unaffordable, unworkable and unpopular,” Sen. John Barrasso (R-WY) agreed.
Objecting to a voluntary slowdown is unusual sentiment from men who accuse the administration of raming through a one-size-fits-all law before anyone has had a chance to read it — and it ignores the government’s past experiences with implementing complex legislation.
Consider the Bush administration’s performance in implementing the 2003 Medicare Modernization Act, the law which established the Medicare Part D prescription drug program. Republicans not only rammed the legislation through Congress, they ignored warnings about the complexities of the new system and installed the law without adequately educating seniors or pharmacists. What resulted was the very “train wreck” that the GOP is now predicting for Obamacare: tens of thousands of low-income seniors discovered that medications they had been taking for years were no longer covered, many went without needed prescriptions or paid high out-of pocket fees, and 36 states were forced to “provide emergency payments to frail citizens.
Here is just a sampling of newspaper clips from that period:
— “Low-income Medicare beneficiaries around the country were often overcharged, and some were turned away from pharmacies without getting their medications, in the first week of Medicare’s new drug benefit…[T]he Vermont Legislature passed a bill declaring, “There is a public health emergency due to the federal implementation of Medicare Part D, which has resulted in serious operational problems, causing Vermonters to be turned away at the pharmacy without the drugs they need.” [NYT, 1/8/2006]
— “When it began, some pharmacists and beneficiaries experienced hourlong waits on telephone lines to get help or verify information from Medicare or individual health plans offering the benefit. Many senior citizens and disabled residents were unable to get their prescriptions filled because pharmacists couldn’t verify insurance coverage.” [Boston Globe, 3/10/2006]
— “The problems are legion — inadequate coverage, computer glitches, inadequate training of pharmacists, long delays — and they fall most heavily on the poor and the mentally ill.” [Gotham Gazette, 1/26/2013]
— “The Bush Medicare prescription-drug program, now three weeks old, has turned out so far to be a lobbyist’s dream and an aging American’s nightmare.” [Christian Science Monitor, 1/26/2006]
Delaying a provision that will affect a small number of employers — only about 10,000 employers with more than 50 employees don’t provide coverage or have inadequate insurance — but could, if improperly implemented, lead to confusion and loss of insurance, seems like smart policy in the context of Bush’s experiences.
The House Energy and Commerce Committee has launched an investigation into the delay and is seeking information about the conversations the Department has had with businesses: “As the Treasury Department statement makes clear, the administration has been ‘engaging in a dialogue with businesses’ and is pursuing changes in the law’s implementation and requirements based on their feedback. We note that these communications and the decision-making process related to the delay of certain aspects of the law have not been disclosed publicly. The acknowledgement that a delay in the law’s implementation is needed is completely at odds with previous statements made by administration officials.”