Is the national Affordable Care Act in jeopardy because the Obama administration is putting off for a year the employer mandate requiring companies with more than 50 workers either to offer insurance or pay penalties of $2,000 to $3,000 per uncovered individual?
From the hue and cry raised not only by Republicans (predictably) but also by some supporters of health care reform, you'd think so. But you'd be mistaken.
The ACA (also known as Obamacare, especially to opponents) is the most complicated piece of domestic legislation since the Medicare and Medicaid programs were signed into law by LBJ in mid-1965. Those landmark laws, as well as the Social Security Act passed in 1935 during FDR's first term, had rough and bumpy launches.
So it smacks of blatant partisanship for Republicans in Congress to plan an investigation into the reasons behind the employer-mandate postponement to Jan. 1, 2015. And the reaction by some liberals has been just as knee-jerk.
A reminder that we fortunate residents of Massachusetts are sideline observers of all this, since most elements of this state's health insurance reform of 2006 remain in place. About 97 percent of Bay State citizens are insured (compared to 85 percent nationally) and middle-income earners (up to $70,656 for a family of four, before taxes) continue to benefit from Commonwealth Care subsidies.
But the fate of the national plan is crucial.
The Republican suggestion that the delay is politically motivated to help Democrats in the mid-term elections next year is bogus since, if anything, it's the Democrats who may be hurt if voters misperceive the circumstances.
It's laugh-out-loud funny to see some Republicans blast Democrats as the party cozying up to big business by giving companies some extra time. At the behest of their large corporate backers, House Republicans have tried and failed 37 times to repeal the ACA, arguing that the law is a train wreck waiting to happen.
But one advocate, health law and policy professor Sara Rosenbaum at George Washington University, has told national reporters: "I'm utterly astounded. It boggles the mind. This step could significantly reduce the number of uninsured people who will gain coverage in 2014." White House attorneys beg to differ.
It's important to remember that 94 percent of larger employers with more than 50 full-time workers already provide insurance and are thus complying with the mandate ahead of time. It's the red tape involved in filing forms with Washington detailing their coverage plans that had some companies flummoxed.
Regrettably, some firms have been cutting their workers' hours to below 30 (the threshold for full-time employment) or laying off full-timers to avoid the mandate. Furthermore, despite the new law, the 96 percent of U.S. businesses with fewer than 50 full-timers are not required to provide insurance, though many choose to do so.
The linchpin of the ACA -- the federal and state computerized health marketplace exchanges that will help many of the 49 million currently uninsured find affordable coverage -- is still on target for an Oct. 1 launch so policies for individuals can take effect this coming Jan. 1. Families of four with gross incomes below $88,000 a year will be eligible for federal tax credits to help pay for coverage.
Many benefits of the law already are in place. While it would be foolhardy to underestimate the challenges facing Washington before the final rollout of the health insurance act, it is needlessly destructive to proclaim that the ACA is in peril. The law upends our broken health insurance system in what's likely to turn out as a healing, significant step forward once the hurdles are cleared.
The ultimate solution, of course, remains elusive: A single-payer system similar to those that prevail in most advanced Western nations.
Clarence Fanto can be reached at firstname.lastname@example.org.