Kate Pickert highlights one:
Hundreds of thousands—if not millions—of people who purchase coverage independently are now receiving letters from insurers canceling policies that do not comply with new Affordable Care Act (ACA) regulations. In cancelling such plans, some insurers are telling customers they will be automatically enrolled in alternative ACA-compliant coverage unless they object.
This could be a major snag in the ACA’s plan to subsidize insurance purchased on the individual market. New tax credits, available to individuals earning less than 400 percent of the federal poverty level, or about $46,000 per year, can only be accessed through new ACA insurance marketplaces. Those who purchase coverage outside the exchanges cannot claim subsidies, even if they qualify for them, according to the Centers for Medicare and Medicaid Services, the agency overseeing implementation of the ACA. Automatic enrollment directly through an insurer would avoid the exchanges, and the subsidies, entirely.
Scott Gottlieb identifies another potential problem with the ACA:
The potential woes stem from an oversight made by the architects of Obamacare.
Under the law, insurers who offer policies inside the Obamacare exchanges are required to treat their enrollees inside and outside the exchange as a single risk pool. Among other things, this provision was meant to reduce the chance that insurers would steer healthier patients into plans sold outside the exchanges.
But the law doesn’t prevent insurers from offering plans exclusively outside the exchange. If they are entirely outside the exchange, they get to create their own risk pool, and aren’t subject to the same pricing that burdens plans inside the exchange. (See this Commonwealth Fund Brief for a fuller explanation)
As the pool inside the exchange becomes older, sicker, and costlier, more plans will have an economic incentive to get out of the Obamacare market altogether.
Once outside, they are free to price their products to match a better risk pool.
Other provisions will further encourage plans to drop out.
Obviously we need to make some fixes to the law. But how can we when the House will only vote to repeal it? I remain gobsmacked that the president did not meticulously prepare his core domestic policy initiative. I know the broader project makes sense, but is he really trying to prove that in practice, technocratic government is an oxymoron?
The Dish 