NYT: Obamacare 'Ambiguity' Could Make Health Care Too Costly for Millions

The New York Times reports that an “ambiguity” in President Obama’s signature health care law may make the Affordable Care Act unaffordable for millions of American workers and their families.

Ironically, the glitch is Clintonesque in nature, over the meaning of the word “affordable.” The definition of the word could have enormous practical repercussions in decisions about who obtains government assistance for health insurance.

Under rules proposed by the Internal Revenue Service, which will carry out some of the primary provisions of Obamacare, some working class families would be unable to afford employer-sponsored family coverage health care benefits and yet would also not qualify for subsidies granted in Obamacare. In other words, these workers and their families will fall between the cracks of the language of the legislation.

For a family whose annual income is $35,000 and who pays $4,130 -- or 12% of income -- for family health care coverage sponsored by an employer, the costs would be considered “affordable” under IRS rules. Under Obamacare, however, employer-sponsored health insurance is considered “unaffordable” if a worker pays a premium of more than 9.5% of the worker’s household income. The IRS argues that this calculation should be based only on the cost of individual coverage for the employee, not coverage for a spouse or children. Thus, the family would not be eligible for government subsidies to buy private health insurance in the states’ exchanges.

An additional ambiguity in Obamacare is whether employers have obligations to provide coverage to employees’ dependents. While the law states that an employer with 50 or more full-time employees may be subject to a tax penalty if it fails to offer health care coverage to “its full-time employees (and their dependents),” the employer’s obligation to dependents remains unclear.

The debate over the definition of the word “affordable” has made rivals of the Obama administration and some Democrats in Congress, as well as advocates for low-income families. A letter sent to the administration, by some of the very lawmakers who pushed the bill through to passage, states, “The effect of this wrong interpretation of the law will be that many families remain or potentially become uninsured.”

This is an interesting dilemma for the Obama administration. If the rules are changed to allow more people to qualify for subsidies, the cost of the law will increase even beyond its current price tag. If the administration issues a requirement that all employers provide “affordable” coverage to dependents as well as workers, costs would increase for many employers.

Wasn’t Obamacare supposed to be utopia because “everyone” would finally be insured?


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