Waiting for 'Obamacare'

Published in La Presse
(Canada) on 4 July 2013
by Ariane Krol (link to originallink to original)
Translated from by Teresa Sorbera. Edited by Phillip Shannon.
American companies will have another year to meet the new requirements set out by the health care reform. This delay will most likely not be the last.

The news of the extension, which took a lot of people by surprise, was discretely announced to the public on the White House’s blog at 6 p.m. on Tuesday. Companies employing more than 50 full-time employees must offer health insurance coverage. This measure will be phased in starting Jan. 1, 2014 and will become mandatory on Jan. 1, 2015.

Republicans, who dream about the failure of President Obama’s flagship law, have had a field day thanks to the delay. Indeed, this is a major concession for Democrats — Obama has to concede to the reality that companies are reluctant or unwilling to implement the new measure. The majority of big companies already offer health insurance coverage to their employees; it is mostly small and medium-sized companies that have been in the line of fire. Apparently, some companies were even ready to bend over backward in order not to pass the critical threshold of employing more than 50 full-time employees: Not only are companies no longer recruiting, but they are also reducing work hours and laying off employees. These are highly unwanted consequences, as much for the U.S. economy as for “unimportant workers,” which "Obamacare" is supposed to help.

The Obama administration says that it wishes to give companies more time to comply with the law. The risk is that the situation will be the same in a year’s time, with employers that are just as opposed to paying their employees’ insurance premiums as they are to paying fines ($2,000 per employee), which they will be required to pay if they do not offer this social benefit.

In the meantime, thousands of employees who should have been covered will swell the ranks of Americans who are not insured and must purchase a health insurance policy themselves. Starting Jan. 1, 2014, every American will be subject to an individual health insurance mandate. Each state must create a sort of online public market by Oct. 1, 2013, but there is every reason to believe that some states will not be ready by then or not in a position to carry out all the necessary procedures. Between the people who have become disheartened with taking out an insurance policy and those who do not even try, the Internal Revenue Service will have its plate full next year.

This is without taking into account people who have fallen through the cracks. The Affordable Care Act, like its name indicates, it supposed to render treatment more accessible. However, studies have shown that policyholders could see the cost of their insurance premiums rise. In addition, it seems that that number of insurers willing to take part in public markets is lower than predicted in some regions.

There is no doubt that every American citizen should be covered by an acceptable health insurance policy, but there is a long and bumpy road ahead before this is implemented. The opposition is so strong that many people wonder whether "Obamacare" will one day be considered a landmark in social progress or merely a thorn in America’s side and a reason for disagreement.


Les entreprises américaines auront un an de plus pour répondre aux nouvelles exigences de la loi sur l'assurance-santé. Et ce retard ne sera sans doute pas le seul.

Annoncée en douce sur le blogue de la Maison-Blanche à 18h mardi, la nouvelle a pris bien du monde par surprise. Les entreprises de plus de 50 employés à temps plein, qui devaient offrir une couverture d'assurance-maladie à compter du 1er janvier prochain, auront jusqu'en 2015 pour le faire.

Les républicains, qui fantasment sur l'échec de la loi phare du président Obama, en ont évidemment fait leurs choux gras. De fait, il s'agit d'une concession majeure, mais une concession à la réalité. La plupart des grandes entreprises offrant déjà une assurance-santé, c'étaient surtout des PME qui étaient dans la ligne de mire. Et apparemment, certaines étaient prêtes à bien des contorsions pour ne pas franchir le seuil critique de 50 employés à temps plein: arrêter d'embaucher, mais aussi réduire les horaires et faire des mises à pied. Des effets hautement indésirables, autant pour l'économie américaine que pour les petits travailleurs, dont l'Obamacare est pourtant censé améliorer le sort.

L'administration Obama dit vouloir donner plus de temps aux entreprises pour se conformer à la loi. Elle risque toutefois de se retrouver au même point dans un an, devant des employeurs aussi opposés aux primes d'assurance qu'aux pénalités (2000$ par salarié) auxquelles elles s'exposent si elles refusent d'offrir cet avantage social.

En attendant, des milliers de travailleurs qui auraient dû être couverts viendront grossir les rangs des citoyens qui n'ont pas de police et doivent s'en magasiner une. L'obligation individuelle d'être assuré le 1er janvier 2014, en effet, tient toujours. Une sorte de marché public doit être mis en ligne dans chaque État le 1er octobre, mais tout porte à croire que certains de ces systèmes ne seront pas prêts, ou pas en mesure de réaliser toutes les opérations requises. Entre les individus qui se décourageront de s'inscrire et tous ceux qui n'essaieront même pas de le faire, l'agence fédérale du revenu (IRS) en aura plein les bras l'an prochain.

Et c'est sans compter les inconnues. L'Affordable Care Act, comme son nom l'indique, est censé rendre les soins plus accessibles. Cependant, des analyses montrent que des assurés pourraient voir leurs primes augmenter. De plus, les assureurs désireux de participer aux marchés publics s'annoncent moins nombreux que prévu dans certaines régions.

***

La nécessité de doter chaque citoyen américain d'une couverture médicale décente ne fait pas de doute, mais son déploiement s'annonce pour le moins cahoteux. Les résistances sont telles qu'il y a lieu de se demander si l'Obamacare sera un jour considéré comme un progrès, ou si cette réforme demeurera un irritant et un motif de discorde.
This post appeared on the front page as a direct link to the original article with the above link .

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