ObamaCare throws 460,000 children under the bus
The problem arises from murky language in the law. It says a worker cannot get taxpayer-subsidized coverage on the new health insurance exchanges, starting in 2014, unless the cost of employer-based health coverage for that worker exceeds 9.5 percent of the worker’s household income.
Both the I.R.S. and the Congressional Joint Committee on Taxation have interpreted the law to consider only the cost of covering the individual employee in calculating the 9.5 percent, not the much higher cost for a family plan.
Although some analysts had offered persuasive legal and social arguments for adopting a more expansive and generous interpretation of what the law requires, the strict interpretation prevailed in a final rule issued by the I.R.S. last week.
There is no doubt that this pinched approach will put a significant number of workers and their dependents in a bind. A Kaiser Family Foundation survey found that in 2012, employees’ annual share of insurance premiums averaged $951 for individual coverage and $4,316 for family coverage. Under the I.R.S. rule, such costs would be considered affordable for an employee with a household income of $35,000 a year — making the employee’s spouse and children ineligible for a public subsidy on a health exchange, even though that family would have to spend 12 percent of its income for the employer’s family plan.
Estimates made in 2011 by respected research organizations suggested that some 2 million to 3.9 million non-working spouses and dependents would be harmed by the strict ruling. Looking only at children who were uninsured but supposed to gain coverage under health care reform, the Government Accountability Office estimated last June that 460,000 might remain uninsured because of the affordability definition, and that 1.9 million might stay uninsured if an existing children’s health insurance program is phased out as currently planned. This outcome is exactly the opposite of what health care reform is supposed to achieve.
If you think that ObamaCare was about "health care" reform, yes, it is the opposite. Otherwise, even granting good intent from the administration*, outcomes like this are inevitable, Murphy's Law-type outcomes for a classification and financing system as rickety and complicated as ObamaCare. Single payer would have been a lot simpler.
NOTE * Which I don't. I think the administration's electoral technique of constructing a majority with demographicallly targeted "concrete material benefits" for small slices of support shades over into public policy. It's not about getting everybody into the lifeboats, it's about getting as few people as possible into as few lifeboats as possible, and those people being "deserving" and part of the Democrats electoral coalition (which is, of course, more or less the same thing). I don't think even the health care lobbyists who wrote the bill for Obama deliberately targeted poor and working class children for slaughter, but "mistakes" like that are going to happen with any system that operates on Obama's minimalist lines. And don't get me started on throwing the smokers under the bus.