Law Blog

Should You Opt Into Obamacare?

The House of Representatives recently voted to repeal Obamacare for the 40th time. At this point, the Patient Protection and Affordability Act (Obamacare) will survive any attempt to be repealed. That doesn’t mean Obamacare is untouchable. Some political groups have found more creative approaches to protest the law. FreedomWorks, for example, chose symbolic burning of Obamacare “draft cards.”

In addition to its grassroots efforts, conservative groups such as FreedomWorks also lobby Congress directly. FreedomWorks encourages GOP senators to vote against healthcare funding by pressuring senators at town hall meetings and by keeping a list of which Republicans vote for Obamacare funding and which Republicans vote against it. Even though Obamacare was signed by the President and declared constitutional by the courts, Congress can still refuse to pay for it.

If Congress won’t pay for the Obamacare, why should consumers follow the program? First, the individual mandate will still take effect in 2014. If the choice is between paying for health insurance and paying for nothing, the former sounds like a better deal. Second, Congressional defunding of Obamacare would not actually stop Obamacare from being implemented. State insurance exchange markets, for instance, will be funded by states, not Congress. Funding for federal insurance exchange market and the individual mandate have already been set aside, so the revenue streams for those programs will last longer than Obamacare opponents expect them to.

Congress might cut funding for Obamacare in the coming months, but this should not stop consumers from making an informed decision about their health insurance in 2014. Below, we examine three reasons why some Americans are skipping out on buying health insurance.

1. Obamacare Will Force Me to Change Doctors

Opposition: Obamacare will limit which doctors a patient can choose from by either forcing people to choose from doctors approved by government bureaucrats or forcing private doctors out of practice.

Facts: People who already have health insurance before Obamacare goes into effect can keep the insurance they already have.

For people who do not have insurance when the individual mandate goes into effect in 2014, website “exchange markets” will be created by states and the federal government. These “exchange markets” will allow consumers to choose from insurance companies which have bid for the right to be on the exchange market. The markets are not mandatory, although buying health insurance is.

The actual selection of doctors is based on agreements between the doctors and the insurance companies. The doctors have to accept payment from the insurance company while the insurance company has to agree to pay the doctor. This is a feature of the American healthcare system that has existed before Obamacare and will continue even after the new law goes into effect.

2. Congress is On a Different Healthcare System than Everyone Else

Opposition: One of the talking points during the debate over Obamacare passage was whether or not Congress itself would use Obamacare. The rational was that “if it’s good enough for the American people, it should be good enough for Congress.”

Facts: Congress and its staff are currently using the Federal Employees Health Benefits Plan (FEHBP), the same insurance plan all federal employees use. As of 2013, Senator Majority Leader Harry Reid has the same healthcare insurance plan as Postal Service Mail Carriers.


3. Obamacare Will Create Longer Lines and Waiting Times for Doctors
Obamacare requires that Congress and its staff be taken off the FEHBP and use the exchange markets instead. However, the markets were mainly intended for small businesses. With 535 Congressional members plus staff, Congress is not small. Congressional members and staff are set to receive subsidies which would allow them to buy the same benefits they had on the FEHBP, even while they are on the newly created exchange markets. The subsidies are taken from money left over from the FEHBP.

Opposition: Obamacare creates more demand for medical services but does nothing to expand supply. This will lead to longer lines and waiting times for doctors. The result is a two-tier system where people pay to see the doctor first and everyone else waits for their turn.

Facts: Obamacare expanded Medicare coverage and eliminated many reasons insurance groups could reject patients. Patients cannot be denied coverage because of disability, pre-existing conditions, or medical history. Obamacare also expands the benefits insurance groups are required to provide, such as birth control.

Although new medical schools are opening and existing schools are expanding admissions, medical training may be cut in next year’s federal budget. President Obama’s 2014 budget proposal offers to cut $780 million devoted to hospital training. Provisions of Obamacare itself could save hospitals money, but there is no requirement that the savings must be invested in future doctors.