Obamacare has been delayed. And delayed and delayed and delayed.
Different components of the Affordable Care Act, commonly known as Obamacare, have been pushed back by the White House in the past and most recently this last week -- with the possibility of more delays coming in the future. Here's how these multiple delays could affect you and those you know.
In April, the Obama administration announced that the Small Business Health Options Program, or SHOP, national online insurance marketplace for small employers wouldn't make the original Oct. 1 start-up date for full operations. Officials said this delay resulted from "operational challenges."
What does this delay mean to you? If you work for an organization with 50 or fewer employees in one of the 36 states not operating their own exchange, this announcement meant that your employer could use the SHOP exchange to offer health insurance -- but only one insurance plan would be available instead of a wide variety of plans as originally intended. Think Henry Ford and his comment in the early days of the automobile industry that customers could have a car in any color -- "as long as it is black."
The delay announced this week by the White House right before Thanksgiving, though, supersedes the previous delay. More about this latest pushback a little later, but first, back to the past.
September brought another delay. Federal officials intended for the HealthCare.gov website to include all information and directions in Spanish by Oct. 1. However, with the rush to launch the site on time, the Spanish version was pushed to the side.
On Nov. 22, the Obama administration announced more delays. If you're shopping for individual health insurance and need it to be effective on Jan. 1, you now have until Dec. 23 to enroll. Before the massive problems experienced with HealthCare.gov, the enrollment cutoff date for a start-of-the-year effective date was Dec. 15.
At the same time, the White House pushed back the start of open enrollment for next year. Rather than begin on Oct. 15, 2014, open enrollment will crank up on Nov. 15. The end date for open enrollment period also will be pushed back from Dec. 7, 2014, to Jan. 7, 2015.
The administration said these delays will give insurers more time to evaluate their experience from the first year of operations under the health-reform legislation. Obamacare critics suggested the delays stemmed from a desire to keep customers from seeing how much their insurance prices will increase until after the November Congressional elections.
That April delay of the SHOP exchanges turned into something much more significant this week. The White House quietly announced that the small-employer marketplace won't be ready for use until a year from now. Officials said that getting the individual insurance functionality of HealthCare.gov working was more important at this point.
If you're employed by an organization with 50 or fewer employees in one of the states not operating an exchange, you won't go to the Obamacare website to buy health insurance. That doesn't mean that you can't purchase insurance, though.
Small businesses will need to go directly to insurers, agents, or brokers -- as they have done in the past. Once an employer has completed the process for offering health insurance, its employees can enroll in whatever method supported by the insurer.
If you work in one of the 14 states (plus the District of Columbia) that operate their own exchange, this latest delay doesn't apply to you. If you work for a small business opting to use the state-run exchange, you should be able to purchase health insurance through the website for the exchange.
Could there be more delays with Obamacare? Possibly. The odds of further extensions depend largely on how well the HealthCare.gov website performs in the coming weeks -- and whether insurers can process the applications received from the site and get paid what they're owed.
As for processing the applications, insurers haven't had a warm-and-fuzzy feeling about the quality of data received so far. Aetna (NYSE:AET) CEO Mark Bertolini stated that there was "so much wrong, you just don't know what's broken until you get a lot more of it fixed." Bertolini speculated that it could be three years before the problems are fully addressed.
Further delays could lead to chaos in the insurance markets. The recent proclamation by President Obama that insurers could continue to sell plans that had been canceled because of Obamacare's minimum benefits requirements at least for another year produced a backlash from the insurance industry. An extension of the individual mandate would probably make that criticism look mild by comparison.
Some insurers might not put up as much of a fuss. Aetna, for example, receives only 3% of its revenue from individual and small group insurance. UnitedHealth Group (NYSE:UNH), the nation's largest health insurer, has taken a cautious approach to participation in the Obamacare exchanges and likely wouldn't be affected too much.
Likewise, Cigna (NYSE:CI) probably wouldn't be greatly affected by more delays. The insurer participates in only five state exchanges. Cigna's management stated that the start of Obamacare wasn't a "watershed moment" for the company.
However, the predicted chaos could affect you. Some industry insiders say that even higher premiums could be a direct result of changing the rules at the last minute.