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Affordable Care Act: Difference between revisions
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A 2017 study found that the ACA reduced socioeconomic disparities in health care access.<ref>{{Cite journal |last1=Griffith |first1=Kevin |last2=Evans |first2=Leigh |last3=Bor |first3=Jacob |date=August 1, 2017 |title=The Affordable Care Act Reduced Socioeconomic Disparities In Health Care Access |journal=Health Affairs |volume=36 |issue=8 |pages=1503–1510 |doi=10.1377/hlthaff.2017.0083 |pmid=28747321 |pmc=8087201 |publisher=Project HOPE |oclc=07760874 |issn=0278-2715}}</ref> | A 2017 study found that the ACA reduced socioeconomic disparities in health care access.<ref>{{Cite journal |last1=Griffith |first1=Kevin |last2=Evans |first2=Leigh |last3=Bor |first3=Jacob |date=August 1, 2017 |title=The Affordable Care Act Reduced Socioeconomic Disparities In Health Care Access |journal=Health Affairs |volume=36 |issue=8 |pages=1503–1510 |doi=10.1377/hlthaff.2017.0083 |pmid=28747321 |pmc=8087201 |publisher=Project HOPE |oclc=07760874 |issn=0278-2715}}</ref> | ||
The Affordable Care Act reduced the percent of Americans between 18 and 64 who were uninsured from 22.3 percent in 2010 to 12.4 percent in 2016. About 21 million more people have coverage ten years after the enactment of the ACA.<ref>{{cite news |last1=Slavitt |first1=Andy |title=Affordable Care Act at 10: Amid coronavirus, never more popular, threatened or necessary |url=https://eu.usatoday.com/story/opinion/2020/03/23/obamacare-10th-anniversary-amid-coronavirus-column/2888511001/ |access-date=March 31, 2020 |work= | The Affordable Care Act reduced the percent of Americans between 18 and 64 who were uninsured from 22.3 percent in 2010 to 12.4 percent in 2016. About 21 million more people have coverage ten years after the enactment of the ACA.<ref>{{cite news |last1=Slavitt |first1=Andy |title=Affordable Care Act at 10: Amid coronavirus, never more popular, threatened or necessary |url=https://eu.usatoday.com/story/opinion/2020/03/23/obamacare-10th-anniversary-amid-coronavirus-column/2888511001/ |access-date=March 31, 2020 |work=USA Today|date=March 23, 2020 |archive-url=https://web.archive.org/web/20200331233236/https://www.usatoday.com/story/opinion/2020/03/23/obamacare-10th-anniversary-amid-coronavirus-column/2888511001/ |archive-date=March 31, 2020}}</ref><ref name=NYT20200323GoodnoughAbelsonetAl>{{cite news |author=Goodnough, Abby |author2=Abelson, Reed |author3=Sanger-Katz, Margot |author4=Kliff, Sarah |title=Obamacare Turns 10. Here's a Look at What Works and Doesn't. |url=https://www.nytimes.com/2020/03/23/health/obamacare-aca-coverage-cost-history.html |access-date=March 31, 2020 |date=March 23, 2020 |archive-url=https://web.archive.org/web/20200330105840/https://www.nytimes.com/2020/03/23/health/obamacare-aca-coverage-cost-history.html |archive-date=March 30, 2020 |issn=0362-4331 |oclc=1645522 |newspaper=The New York Times}}</ref> Ten years after its enactment studies showed that the ACA also had a positive effect on health and caused a reduction in mortality.<ref name=NYT20200323GoodnoughAbelsonetAl /> | ||
===Taxes=== | ===Taxes=== | ||
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===Hospitals=== | ===Hospitals=== | ||
From the start of 2010 to November 2014, 43 hospitals in [[Rural area#United States|rural areas]] closed. Critics claimed the new law had caused these closures. Many rural hospitals were built using funds from the 1946 [[Hill–Burton Act]]. Some of these hospitals reopened as other medical facilities, but only a small number operated [[Emergency department|emergency rooms]] (ER) or [[urgent care]] centers.<ref>{{cite news |last1=O'Donnell |first1=Jayne |last2=Ungar |first2=Laura |last3=Hoyer |first3=Meghan |date=November 12, 2014 |title=Rural hospitals in critical condition |url=https://www.usatoday.com/longform/news/nation/2014/11/12/rural-hospital-closings-federal-reimbursement-medicaid-aca/18532471/ |newspaper= | From the start of 2010 to November 2014, 43 hospitals in [[Rural area#United States|rural areas]] closed. Critics claimed the new law had caused these closures. Many rural hospitals were built using funds from the 1946 [[Hill–Burton Act]]. Some of these hospitals reopened as other medical facilities, but only a small number operated [[Emergency department|emergency rooms]] (ER) or [[urgent care]] centers.<ref>{{cite news |last1=O'Donnell |first1=Jayne |last2=Ungar |first2=Laura |last3=Hoyer |first3=Meghan |date=November 12, 2014 |title=Rural hospitals in critical condition |url=https://www.usatoday.com/longform/news/nation/2014/11/12/rural-hospital-closings-federal-reimbursement-medicaid-aca/18532471/ |newspaper=USA Today |access-date=January 28, 2015 |archive-date=September 16, 2015 |archive-url=https://web.archive.org/web/20150916011235/http://www.usatoday.com/longform/news/nation/2014/11/12/rural-hospital-closings-federal-reimbursement-medicaid-aca/18532471/ |url-status=live }}<br />{{cite news |last=Hamada |first=Omar L. |date=November 18, 2014 |title=Obamacare has detrimental effect on rural hospitals |url=http://www.tennessean.com/story/opinion/contributors/2014/11/19/obamacare-detrimental-effect-rural-hospitals/19087985/ |newspaper=The Tennessean |access-date=January 28, 2015 |archive-date=July 1, 2024 |archive-url=https://web.archive.org/web/20240701042654/https://www.tennessean.com/story/opinion/contributors/2014/11/19/obamacare-detrimental-effect-rural-hospitals/19087985/ |url-status=live }}</ref> | ||
Between January 2010 and 2015, a quarter of ER doctors said they had seen a major surge in patients, while nearly half had seen a smaller increase. Seven in ten ER doctors claimed they lacked the resources to deal with large increases in the number of patients. The biggest factor in the increased number of ER patients was insufficient primary care providers to handle the larger number of insured.<ref>{{cite news |url=http://www.washingtontimes.com/news/2015/may/4/er-visits-under-obamacare-doctors-say/#ixzz3ZH4xpm5H |title=ER visits up under Obamacare despite promises, doctors' poll finds |first=Tom Jr. |last=Howell |work=The Washington Times |date=May 4, 2015 |access-date=May 6, 2015 |archive-date=March 3, 2021 |archive-url=https://web.archive.org/web/20210303221345/https://www.washingtontimes.com/news/2015/may/4/er-visits-under-obamacare-doctors-say/#ixzz3ZH4xpm5H |url-status=live }}</ref> Michael Lee Jr. and [[Michael Monuteaux|Michael C. Monuteaux]] at Boston Children's Hospital analyzed national emergency department visits among children aged 0 to 17 from 2009 to 2016 using the American Community Survey (ACS) and Nationwide Emergency Department Sample (NEDS). They found no immediate change in pediatric emergency department visit rates the year after the ACA took full effect in 2014, but the rate of change from 2014 to 2016 was significantly higher than previous rate trends, almost 10%.<ref>{{cite journal |last1=Lee |first1=Michael |last2=Monuteaux |first2=Michael C. |title=Trends in pediatric emergency department use after the Affordable Care Act |journal=Pediatrics |date=2019 |volume=143 |issue=6 |doi=10.1542/peds.2018-3542 |pmid=31118219 |publisher=American Academy of Pediatrics |location=Itasca, IL |s2cid=162182158 |issn=1098-4275 |quote=ED visit rates increased by 1.1% per year pre-2014 and 9.8% from 2014 to 2016 (incidence rate ratio 1.09, 95% confidence interval 1.03-1.15, P = .005)|doi-access=free }}</ref> | Between January 2010 and 2015, a quarter of ER doctors said they had seen a major surge in patients, while nearly half had seen a smaller increase. Seven in ten ER doctors claimed they lacked the resources to deal with large increases in the number of patients. The biggest factor in the increased number of ER patients was insufficient primary care providers to handle the larger number of insured.<ref>{{cite news |url=http://www.washingtontimes.com/news/2015/may/4/er-visits-under-obamacare-doctors-say/#ixzz3ZH4xpm5H |title=ER visits up under Obamacare despite promises, doctors' poll finds |first=Tom Jr. |last=Howell |work=The Washington Times |date=May 4, 2015 |access-date=May 6, 2015 |archive-date=March 3, 2021 |archive-url=https://web.archive.org/web/20210303221345/https://www.washingtontimes.com/news/2015/may/4/er-visits-under-obamacare-doctors-say/#ixzz3ZH4xpm5H |url-status=live }}</ref> Michael Lee Jr. and [[Michael Monuteaux|Michael C. Monuteaux]] at Boston Children's Hospital analyzed national emergency department visits among children aged 0 to 17 from 2009 to 2016 using the American Community Survey (ACS) and Nationwide Emergency Department Sample (NEDS). They found no immediate change in pediatric emergency department visit rates the year after the ACA took full effect in 2014, but the rate of change from 2014 to 2016 was significantly higher than previous rate trends, almost 10%.<ref>{{cite journal |last1=Lee |first1=Michael |last2=Monuteaux |first2=Michael C. |title=Trends in pediatric emergency department use after the Affordable Care Act |journal=Pediatrics |date=2019 |volume=143 |issue=6 |doi=10.1542/peds.2018-3542 |pmid=31118219 |publisher=American Academy of Pediatrics |location=Itasca, IL |s2cid=162182158 |issn=1098-4275 |quote=ED visit rates increased by 1.1% per year pre-2014 and 9.8% from 2014 to 2016 (incidence rate ratio 1.09, 95% confidence interval 1.03-1.15, P = .005)|doi-access=free }}</ref> | ||
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In February 2014, American [[Pulitzer Prize]]-winning syndicated columnist, political commentator and physician [[Charles Krauthammer]] described the buyer's remorse Americans are having over the ACA, saying it is having a "wide, broad effect". Because so many people are being negatively impacted by the law, he said, "the bleeding is happening among Independents and also among Democrats".<ref>{{cite news |url=http://www.foxnews.com/on-air/on-the-record/2014/02/28/krauthammer-buyers-remorse-obama-comes-obamacare-having-wide-broad-effect-bleeding-happen |title=Krauthammer: Buyer's remorse on Obama comes from ObamaCare having 'this wide, broad effect ... the bleeding is happening among Independents and Democrats' |publisher=[[Fox News]] |date=February 27, 2014}}</ref> --> | In February 2014, American [[Pulitzer Prize]]-winning syndicated columnist, political commentator and physician [[Charles Krauthammer]] described the buyer's remorse Americans are having over the ACA, saying it is having a "wide, broad effect". Because so many people are being negatively impacted by the law, he said, "the bleeding is happening among Independents and also among Democrats".<ref>{{cite news |url=http://www.foxnews.com/on-air/on-the-record/2014/02/28/krauthammer-buyers-remorse-obama-comes-obamacare-having-wide-broad-effect-bleeding-happen |title=Krauthammer: Buyer's remorse on Obama comes from ObamaCare having 'this wide, broad effect ... the bleeding is happening among Independents and Democrats' |publisher=[[Fox News]] |date=February 27, 2014}}</ref> --> | ||
As of October 2013, approximately 40% were in favor while 51% were against.<ref>{{cite web |url=http://www.realclearpolitics.com/epolls/other/obama_and_democrats_health_care_plan-1130.html#polls |title=Obama and Democrats' Health Care Plan |website=RealClearPolitics |date=October 13, 2013 |access-date=March 26, 2014 |archive-date=March 16, 2021 |archive-url=https://web.archive.org/web/20210316053944/http://www.realclearpolitics.com/epolls/other/obama_and_democrats_health_care_plan-1130.html#polls |url-status=live }}</ref><ref>{{cite news |last=Swanson |first=Emily |date=July 30, 2009 |url=http://www.huffingtonpost.com/2009/07/30/healthplan_n_725503.html |title=Health Care Plan: Favor/Oppose |work=Pollster.com |access-date=July 14, 2011 |archive-date=October 1, 2018 |archive-url=https://web.archive.org/web/20181001170205/http://www.huffingtonpost.com/2009/07/30/healthplan_n_725503.html |url-status=live }}</ref> About 29% of [[Non-Hispanic whites|whites]] approved of the law, compared with 61% of [[Hispanic and Latino Americans|Hispanics]] and 91% of [[African American]]s.<ref>{{cite web |url=http://www.people-press.org/files/legacy-pdf/9-16-13%20Health%20Care%20Release.pdf |title=As Health Care Law Proceeds, Opposition and Uncertainty Persist |date=September 16, 2013 |publisher=Pew Research Center |access-date=December 18, 2013 |archive-date=April 24, 2018 |archive-url=https://web.archive.org/web/20180424151816/http://www.people-press.org/files/legacy-pdf/9-16-13%20Health%20Care%20Release.pdf |url-status=live }}</ref> A solid majority of seniors opposed the idea and a solid majority of those under forty were in favor.<ref>{{cite news |url=https://www.usatoday.com/news/washington/2010-03-23-health-poll-favorable_N.htm |title=Poll: Health care plan gains favor |last=Page |first=Susan |date=March 24, 2010 |work= | As of October 2013, approximately 40% were in favor while 51% were against.<ref>{{cite web |url=http://www.realclearpolitics.com/epolls/other/obama_and_democrats_health_care_plan-1130.html#polls |title=Obama and Democrats' Health Care Plan |website=RealClearPolitics |date=October 13, 2013 |access-date=March 26, 2014 |archive-date=March 16, 2021 |archive-url=https://web.archive.org/web/20210316053944/http://www.realclearpolitics.com/epolls/other/obama_and_democrats_health_care_plan-1130.html#polls |url-status=live }}</ref><ref>{{cite news |last=Swanson |first=Emily |date=July 30, 2009 |url=http://www.huffingtonpost.com/2009/07/30/healthplan_n_725503.html |title=Health Care Plan: Favor/Oppose |work=Pollster.com |access-date=July 14, 2011 |archive-date=October 1, 2018 |archive-url=https://web.archive.org/web/20181001170205/http://www.huffingtonpost.com/2009/07/30/healthplan_n_725503.html |url-status=live }}</ref> About 29% of [[Non-Hispanic whites|whites]] approved of the law, compared with 61% of [[Hispanic and Latino Americans|Hispanics]] and 91% of [[African American]]s.<ref>{{cite web |url=http://www.people-press.org/files/legacy-pdf/9-16-13%20Health%20Care%20Release.pdf |title=As Health Care Law Proceeds, Opposition and Uncertainty Persist |date=September 16, 2013 |publisher=Pew Research Center |access-date=December 18, 2013 |archive-date=April 24, 2018 |archive-url=https://web.archive.org/web/20180424151816/http://www.people-press.org/files/legacy-pdf/9-16-13%20Health%20Care%20Release.pdf |url-status=live }}</ref> A solid majority of seniors opposed the idea and a solid majority of those under forty were in favor.<ref>{{cite news |url=https://www.usatoday.com/news/washington/2010-03-23-health-poll-favorable_N.htm |title=Poll: Health care plan gains favor |last=Page |first=Susan |date=March 24, 2010 |work=USA Today |access-date=March 24, 2010 |archive-date=June 20, 2012 |archive-url=https://web.archive.org/web/20120620184320/http://www.usatoday.com/news/washington/2010-03-23-health-poll-favorable_N.htm |url-status=live }}</ref> | ||
A 2014 poll reported that 26% of Americans support ACA.<ref>{{cite news |url=http://bigstory.ap.org/article/poll-obama-health-law-fails-gain-support |title=AP-GfK Poll: Obama's health care fails to gain support |date=March 28, 2014 |access-date=March 30, 2014 |publisher=Associated Press |archive-date=April 1, 2014 |archive-url=https://web.archive.org/web/20140401024529/http://bigstory.ap.org/article/poll-obama-health-law-fails-gain-support |url-status=dead}}</ref> A later 2014 poll reported that 48.9% of respondents had an unfavorable view of ACA versus 38.3% who had a favorable view (of more than 5,500 individuals).<ref>{{cite web |url=https://www.rand.org/health/projects/health-reform-opinion.html |title=RAND Health Reform Opinion Study |date=May 1, 2014 |publisher=RAND Health |access-date=May 10, 2014 |archive-date=November 29, 2018 |archive-url=https://web.archive.org/web/20181129194516/https://www.rand.org/health/projects/health-reform-opinion.html |url-status=live }}</ref> Another held that 8% of respondents agreed the Affordable Care Act "is working well the way it is".<ref>{{cite web |archive-url=https://web.archive.org/web/20140503034720/https://online.wsj.com/news/articles/SB10001424052702303678404579533362696579096 |archive-date=May 3, 2014 |url=https://online.wsj.com/news/articles/SB10001424052702303678404579533362696579096 |title=The ObamaCare 8% |newspaper=The Wall Street Journal |publisher=News Corp |oclc=781541372 |issn= 1042-9840 |date=April 30, 2014 |access-date=May 1, 2014}}</ref> In late 2014, a [[Rasmussen Reports|Rasmussen]] poll reported Repeal: 30%, Leave as is: 13%, Improve: 52%.<ref>[[Alan Colmes]], "[http://www.alan.com/2014/12/01/poll-voters-no-longer-want-to-repeal-obamacare/ Poll: Voters No Longer Want To Repeal Obamacare] {{Webarchive |url=https://web.archive.org/web/20171023012206/http://www.alan.com/2014/12/01/poll-voters-no-longer-want-to-repeal-obamacare/ |date=October 23, 2017 }}", ''Liberaland'', December 1, 2014.</ref> | A 2014 poll reported that 26% of Americans support ACA.<ref>{{cite news |url=http://bigstory.ap.org/article/poll-obama-health-law-fails-gain-support |title=AP-GfK Poll: Obama's health care fails to gain support |date=March 28, 2014 |access-date=March 30, 2014 |publisher=Associated Press |archive-date=April 1, 2014 |archive-url=https://web.archive.org/web/20140401024529/http://bigstory.ap.org/article/poll-obama-health-law-fails-gain-support |url-status=dead}}</ref> A later 2014 poll reported that 48.9% of respondents had an unfavorable view of ACA versus 38.3% who had a favorable view (of more than 5,500 individuals).<ref>{{cite web |url=https://www.rand.org/health/projects/health-reform-opinion.html |title=RAND Health Reform Opinion Study |date=May 1, 2014 |publisher=RAND Health |access-date=May 10, 2014 |archive-date=November 29, 2018 |archive-url=https://web.archive.org/web/20181129194516/https://www.rand.org/health/projects/health-reform-opinion.html |url-status=live }}</ref> Another held that 8% of respondents agreed the Affordable Care Act "is working well the way it is".<ref>{{cite web |archive-url=https://web.archive.org/web/20140503034720/https://online.wsj.com/news/articles/SB10001424052702303678404579533362696579096 |archive-date=May 3, 2014 |url=https://online.wsj.com/news/articles/SB10001424052702303678404579533362696579096 |title=The ObamaCare 8% |newspaper=The Wall Street Journal |publisher=News Corp |oclc=781541372 |issn= 1042-9840 |date=April 30, 2014 |access-date=May 1, 2014}}</ref> In late 2014, a [[Rasmussen Reports|Rasmussen]] poll reported Repeal: 30%, Leave as is: 13%, Improve: 52%.<ref>[[Alan Colmes]], "[http://www.alan.com/2014/12/01/poll-voters-no-longer-want-to-repeal-obamacare/ Poll: Voters No Longer Want To Repeal Obamacare] {{Webarchive |url=https://web.archive.org/web/20171023012206/http://www.alan.com/2014/12/01/poll-voters-no-longer-want-to-repeal-obamacare/ |date=October 23, 2017 }}", ''Liberaland'', December 1, 2014.</ref> | ||
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In 2010 small business tax credits took effect.<ref name="hist">{{cite web |url=https://resources.ehealthinsurance.com/affordable-care-act/history-timeline-affordable-care-act-aca |title=History of the Affordable Care Act (ACA) |date=October 22, 2014}}</ref> Then [[Pre-existing Condition Insurance Plan|Pre-Existing Condition Insurance Plan]] (PCIP) took effect to offer insurance to those who had been denied coverage by private insurance companies because of a preexisting condition.<ref name="hist" /> By 2011, insurers had stopped marketing child-only policies in 17 states, as they sought to escape this requirement.<ref>{{Cite web |url=http://www.help.senate.gov/imo/media/doc/Child-Only%20Health%20Insurance%20Report%20Aug%202,%202011.pdf |title=Health Care Reforrm Law's Impact on Child-Only Health Insurance Policies |last=Enzi |first=Michael B. |date=August 2, 2011 |website=United States Senate |access-date=August 10, 2016}}</ref> In ''[[National Federation of Independent Business v. Sebelius]]'' the Supreme Court allowed states to opt out of the Medicaid expansion.<ref>{{cite web |last=Liptak |first=Adam |date=September 30, 2012 |location=Pittsburgh |url=http://www.post-gazette.com/stories/news/us/supreme-court-justices-face-important-rulings-in-upcoming-term-655566/ |title=Supreme Court justices face important rulings in upcoming term September |website=post-gazette.com |agency=The New York Times |access-date=September 30, 2012}}</ref><ref>{{Cite web |url=http://kff.org/health-reform/state-indicator/state-activity-around-expanding-medicaid-under-the-affordable-care-act/ |title=Status of State Action on the Medicaid Expansion Decision |publisher=[[Kaiser Family Foundation]] |access-date=August 12, 2016}}</ref><ref>{{cite web |last1=Walton |first1=Alice G. |title=How To Explain The Obamacare Ruling To A Five-Year-Old |url=https://www.forbes.com/sites/alicegwalton/2012/07/02/how-to-explain-the-obamacare-ruling-to-a-five-year-old/#23e103e723e1 |website=[[Forbes]]|access-date=May 5, 2017}}</ref> | In 2010 small business tax credits took effect.<ref name="hist">{{cite web |url=https://resources.ehealthinsurance.com/affordable-care-act/history-timeline-affordable-care-act-aca |title=History of the Affordable Care Act (ACA) |date=October 22, 2014}}</ref> Then [[Pre-existing Condition Insurance Plan|Pre-Existing Condition Insurance Plan]] (PCIP) took effect to offer insurance to those who had been denied coverage by private insurance companies because of a preexisting condition.<ref name="hist" /> By 2011, insurers had stopped marketing child-only policies in 17 states, as they sought to escape this requirement.<ref>{{Cite web |url=http://www.help.senate.gov/imo/media/doc/Child-Only%20Health%20Insurance%20Report%20Aug%202,%202011.pdf |title=Health Care Reforrm Law's Impact on Child-Only Health Insurance Policies |last=Enzi |first=Michael B. |date=August 2, 2011 |website=United States Senate |access-date=August 10, 2016}}</ref> In ''[[National Federation of Independent Business v. Sebelius]]'' the Supreme Court allowed states to opt out of the Medicaid expansion.<ref>{{cite web |last=Liptak |first=Adam |date=September 30, 2012 |location=Pittsburgh |url=http://www.post-gazette.com/stories/news/us/supreme-court-justices-face-important-rulings-in-upcoming-term-655566/ |title=Supreme Court justices face important rulings in upcoming term September |website=post-gazette.com |agency=The New York Times |access-date=September 30, 2012}}</ref><ref>{{Cite web |url=http://kff.org/health-reform/state-indicator/state-activity-around-expanding-medicaid-under-the-affordable-care-act/ |title=Status of State Action on the Medicaid Expansion Decision |publisher=[[Kaiser Family Foundation]] |access-date=August 12, 2016}}</ref><ref>{{cite web |last1=Walton |first1=Alice G. |title=How To Explain The Obamacare Ruling To A Five-Year-Old |url=https://www.forbes.com/sites/alicegwalton/2012/07/02/how-to-explain-the-obamacare-ruling-to-a-five-year-old/#23e103e723e1 |website=[[Forbes]]|access-date=May 5, 2017}}</ref> | ||
In 2013, the [[Internal Revenue Service]] ruled that the cost of covering only the individual employee would be considered in determining whether the cost of coverage exceeded 9.5% of income. Family plans would not be considered even if the cost was above the 9.5% income threshold.<ref>{{cite news |author=The Editorial Board |date=February 2, 2013 |title=A Cruel Blow to American Families |url=https://www.nytimes.com/2013/02/03/opinion/sunday/a-cruel-blow-to-american-families.html |archive-url=https://web.archive.org/web/20130207214914/https://www.nytimes.com/2013/02/03/opinion/sunday/a-cruel-blow-to-american-families.html |archive-date=February 7, 2013 |issn=0362-4331 |oclc=1645522 |work=The New York Times}}</ref><ref>{{cite news |url=https://newrepublic.com/article/112327/obamacare-not-universal-you-thought |title=Not-So-Universal Health Care |last=Cohn |first=Jonathan |date=February 5, 2013 |magazine=[[The New Republic]]}}</ref> On July{{nbsp}}2 Obama delayed the employer mandate until 2015.<ref name="CohnDelay" /><ref name="treasurystatement" /><ref name="REG-138006-12" /> The launch for both the state and federal exchanges was beset by management and technical failings. [[HealthCare.gov]], the website that offers insurance through the exchanges operated by the federal government, crashed on opening and suffered many problems.<ref>{{cite news |last=Kennedy |first=Kelly |date=December 1, 2013 |newspaper= | In 2013, the [[Internal Revenue Service]] ruled that the cost of covering only the individual employee would be considered in determining whether the cost of coverage exceeded 9.5% of income. Family plans would not be considered even if the cost was above the 9.5% income threshold.<ref>{{cite news |author=The Editorial Board |date=February 2, 2013 |title=A Cruel Blow to American Families |url=https://www.nytimes.com/2013/02/03/opinion/sunday/a-cruel-blow-to-american-families.html |archive-url=https://web.archive.org/web/20130207214914/https://www.nytimes.com/2013/02/03/opinion/sunday/a-cruel-blow-to-american-families.html |archive-date=February 7, 2013 |issn=0362-4331 |oclc=1645522 |work=The New York Times}}</ref><ref>{{cite news |url=https://newrepublic.com/article/112327/obamacare-not-universal-you-thought |title=Not-So-Universal Health Care |last=Cohn |first=Jonathan |date=February 5, 2013 |magazine=[[The New Republic]]}}</ref> On July{{nbsp}}2 Obama delayed the employer mandate until 2015.<ref name="CohnDelay" /><ref name="treasurystatement" /><ref name="REG-138006-12" /> The launch for both the state and federal exchanges was beset by management and technical failings. [[HealthCare.gov]], the website that offers insurance through the exchanges operated by the federal government, crashed on opening and suffered many problems.<ref>{{cite news |last=Kennedy |first=Kelly |date=December 1, 2013 |newspaper=USA Today |url=https://www.usatoday.com/story/news/politics/2013/12/01/federalexchangmeetsgoal/3795523/ |title=White House claims success on HealthCare.gov repairs |access-date=December 1, 2013}}</ref> Operations stabilized in 2014, although not all planned features were complete.<ref>{{cite news |url=http://www.cnn.com/2013/10/22/politics/obamacare-website-four-reasons |title=Rough Obamacare rollout: 4 reasons why |last=Cohen |first=Tom |date=October 23, 2013 |publisher=CNN|access-date=November 5, 2013}}</ref><ref>{{cite news |url=http://www.csmonitor.com/USA/Latest-News-Wires/2013/1106/Senate-Democrats-frustrated-with-botched-rollout-of-Obamacare |title=Senate Democrats frustrated with botched rollout of Obamacare |last1=Holland |first1=Steve |date=November 6, 2013 |newspaper=The Christian Science Monitor |last2=Rampton |first2=Roberta |agency=Reuters |access-date=November 19, 2013}}</ref> | ||
The [[Government Accountability Office]] released a non-partisan study in 2014 that concluded the administration had not provided "effective planning or oversight practices" in developing the exchanges.<ref name="AP-20140731" /> In ''[[Burwell v. Hobby Lobby]]'' the Supreme Court exempted closely held corporations with religious convictions from the contraception rule.<ref name=":2" /> At the beginning of the 2015, 11.7 million had signed up (ex-Medicaid).<ref>{{Cite news |url=https://www.bloomberg.com/news/articles/2015-06-02/obamacare-dropouts-lead-to-enrollment-decline-of-1-5-million |title=Obamacare Sign-Ups Decline to 10.2 Million as Some Don't Pay |last=Tracer |first=Zachary |website=Bloomberg.com |date=June 2, 2015 |access-date=August 21, 2016}}</ref> By the end of the year about 8.8 million consumers had stayed in the program.<ref>{{Cite web |url=https://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2016-Fact-sheets-items/2016-03-11.html |title=December 31, 2015 Effectuated Enrollment Snapshot |date=March 11, 2016 |access-date=June 18, 2022 |archive-date=April 11, 2016 |archive-url=https://web.archive.org/web/20160411120015/https://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2016-Fact-sheets-items/2016-03-11.html |location=Baltimore, MD |publisher=Health and Human Services |website=cms.gov}}</ref> Congress repeatedly delayed the onset of the "[[Cadillac tax]]" on expensive insurance plans first until 2020<ref>{{Cite web |url=http://www.politico.com/story/2015/12/white-house-obamacare-cadillac-tax-216881 |title=How the White House lost on the Cadillac Tax |last=COOK |first=NANCY |date=December 16, 2015 |publisher=[[Politico]]|access-date=August 21, 2016}}</ref> and later until 2022 and repealed it in late 2019.<ref name="auto1"/> | The [[Government Accountability Office]] released a non-partisan study in 2014 that concluded the administration had not provided "effective planning or oversight practices" in developing the exchanges.<ref name="AP-20140731" /> In ''[[Burwell v. Hobby Lobby]]'' the Supreme Court exempted closely held corporations with religious convictions from the contraception rule.<ref name=":2" /> At the beginning of the 2015, 11.7 million had signed up (ex-Medicaid).<ref>{{Cite news |url=https://www.bloomberg.com/news/articles/2015-06-02/obamacare-dropouts-lead-to-enrollment-decline-of-1-5-million |title=Obamacare Sign-Ups Decline to 10.2 Million as Some Don't Pay |last=Tracer |first=Zachary |website=Bloomberg.com |date=June 2, 2015 |access-date=August 21, 2016}}</ref> By the end of the year about 8.8 million consumers had stayed in the program.<ref>{{Cite web |url=https://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2016-Fact-sheets-items/2016-03-11.html |title=December 31, 2015 Effectuated Enrollment Snapshot |date=March 11, 2016 |access-date=June 18, 2022 |archive-date=April 11, 2016 |archive-url=https://web.archive.org/web/20160411120015/https://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2016-Fact-sheets-items/2016-03-11.html |location=Baltimore, MD |publisher=Health and Human Services |website=cms.gov}}</ref> Congress repeatedly delayed the onset of the "[[Cadillac tax]]" on expensive insurance plans first until 2020<ref>{{Cite web |url=http://www.politico.com/story/2015/12/white-house-obamacare-cadillac-tax-216881 |title=How the White House lost on the Cadillac Tax |last=COOK |first=NANCY |date=December 16, 2015 |publisher=[[Politico]]|access-date=August 21, 2016}}</ref> and later until 2022 and repealed it in late 2019.<ref name="auto1"/> | ||