Although the Affordable Care Act (ACA) was enacted 5 years ago, 2014 was the first year of implementation for most of the health law’s major provisions. In fact, it turned out to be a glitch machine. Defying the expectations of even the law’s most ardent critics, Obamacare’s rollout of the federal online health exchange was a disaster, combined with the cancellation of millions of private health insurance policies (if you “liked” your plan, too bad), a delay in reporting requirements of the employer mandate, and new administrative exemptions from the individual mandate penalty.

Nonetheless, the Obama administration’s allies insist that the law is “working” and that it will even become popular with the majority of Americans with the passage of time. The law’s congressional supporters, they hope, will reap political benefits rather than political retribution.

King vs. Burwell is on the horizon. If the plaintiffs are successful, so goes the theory, subsidies end in 37 exchanges operated by the Department of Health and Human Services and serviced by HealthCare.gov. Coverage gets more expensive, and people won’t be able to afford their policies.

But, this outcome was foretold all the way back in the Senate mark-up of the proposed ACA legislation. Purposely requiring subsidies in state-run exchanges remains the incentive for states to set them up. The administration did not expect so many states elected not to set up their own exchanges, and it is now a big problem. As was noted in 2009 by critics of the bill, if states don’t hand out subsidies, people won’t be able to afford to buy coverage.

In the health savings account industry, the problem is compounded. The ACA law also created a perpetual rule change engine. For example, every year HHS issues what’s called the Letter to Issuers letter to Federal-facilitated Marketplaces (FFMs), in which it discusses all of the fixes that need to be made to exchange operations. This year, HHS has proclaimed that we would all be better off if out-of-pocket maximums (OOPM) for “other than self-only coverage” were restricted to the OOPM for individuals or $6,850 for 2016.

My son Benjamin has a serious growth hormone deficiency. He’ll be 13 years old in May but could easily pass for a boy of 8 or 9. In fact, many 8- and 9-year-olds are taller than him. He’s a full head shorter than all of his pals in seventh grade.

Although his mother and I don’t have medical degrees, we medical degrees, we had Benjamin’s diagnosis pegged when he was 3 years old and still wearing clothing for an 18-month-old.

Several trips to his pediatrician along with a couple simple tests to assess Benjamin’s bone age confirmed with data what we could see with our own eyes. Our boy wasn’t just in the bottom percentile in average height for kids his age – he was in the sub-basement

Doctors in the United States appear as bitterly divided over the Affordable Care Act as the general public.

The Affordable Care Act (ACA), also called Obamacare, has been a lightning rod since it was signed into law in 2010.

Five years after its enactment, the healthcare reform legislation still divides the American public. In a Gallup poll taken in early April, 50 percent of people surveyed said they disapprove of the act while 44 percent said they approve.

So, perhaps it’s no surprise that America’s 1 million doctors appear to be as split on Obamacare as the general public.

The Physicians Foundation released a survey last fall in which 20,000 doctors responded by email to an array of questions.

Of the respondents, 46 percent gave Obamacare a D or F grade, while 25 percent gave it an A or B grade.

In addition, two-thirds of those responding said they did not accept health insurance plans offered through the Affordable Care Act’s online insurance exchanges.

Those who oppose Obamacare say the survey is an accurate reflection of the country’s medical profession.

Those who support the law are quick to point out the survey was not a scientific poll. They say people who respond to email queries tend to be more critical than the general population.

House Committee on the Education and the Workforce
Subcommittee on Health, Employment, Labor, and Pensions
Hearing on
“Five Years of Broken Promises:
How the President’s Health Care Law is Affecting America’s Workplaces”
Tuesday, April 14, 2015
Mr. Chairman, Mr. Ranking Member, Members of the Committee,
My name is Tevi Troy, and I am the President of the American Health Policy Institute, adjunct fellow at Hudson Institute, and a former Deputy Secretary of the U.S. Department of Health and Human Services, as well as a former senior White House Domestic Policy Aide. The American Health Policy Institute is a 501(c)3 think tank dedicated to studying the issue of employer sponsored health insurance and highlighting the challenges employers face in offering care to their employees and their dependents. In addition to publishing a variety of studies on employer sponsored health insurance, the Institute also examines employer responses to these challenges and shares best practices from the most successful of these responses. These roles give the Institute a unique perspective on developments in employer sponsored health insurance, and enable it to make recommendations to both policymakers and business leaders regarding

Repealing the ACA’s individual mandate would result in 7 million fewer insured Americans in 2025 but would reduce federal spending on financial assistance by $191 billion, American Action Forum President Douglas Holtz-Eakin, who backs axing the mandate, told the House Ways and Means health subcommittee Tuesday.

About 14 million Americans have gained health coverage since Obamacare’s insurance expansion began in 2014 — but those new enrollees haven’t swamped the nation’s doctors’ offices, new research shows.

When the health-care law started, there was concern that an influx of new patients could overwhelm doctors. It’s already hard enough to get an appointment with a primary care provider — wouldn’t millions of newly insured Americans just exacerbate the problem?

New data from 16,000 providers across the country, pulled by the medical records firm AthenaHealth, shows that requests for new appointments just barely edged upward in 2014. The proportion of new patient visits to primary care doctors increased from 22.6 percent in 2013 to 22.9 percent in 2014.

The Affordable Care Act, signed by President Obama five years ago this week, sparked a host of changes. For some workers, the law’s legacy amounts to fewer hours of paid work.

The law’s requirement that larger employers provide affordable insurance to workers putting in 30-plus hour weeks has led some companies to cap the number of hours employees can log. A new survey out Tuesday from the Society for Human Resource Management finds that 14% of employers have cut back on hours for part-time employees, and an additional 6% plan to do so. The survey, which included more than 740 human resources professionals, found that a small subset of companies were considering reducing hours for full-time employees too.

Firms are playing around with how they classify and schedule workers, but the strategy comes with risk. James Napoli, a partner with Seyfarth Shaw LLP who helps employers comply with the ACA, says he’s seen an uptick in audits focused on compliance with the health care law by the Department of Labor and the Internal Revenue Service. The audits, which began about three years ago, are starting to become broader, more frequent and more serious, he said.

ObamaCare is celebrating its fifth anniversary, but few Americas are cheering.

The Real Clear Politics average of the latest major opinion polls about the health law shows that 52.5% oppose it and only 42% approve. The 10.5% spread is identical to the average of polls taken when the law was signed five years ago. Approval numbers never have topped disapproval numbers since the law was enacted. It is not getting more popular and it is not settled law, as President Obama claims.

President Obama is touting the increased number of people who have health insurance as a result of the law. According to Gallup, the uninsured rate among U.S. adults averaged 12.9% in the fourth quarter of last year. The uninsured rate was 14.4% the year before the health law passed, also according to Gallup.

So our health sector has been thrown into turmoil, millions of people have lost their private health plans, $1 trillion in new and higher taxes have been imposed on individuals and businesses – and the uninsured rate has dropped a net of 1.5%.

Complying with the health care law is costing small businesses thousands of dollars that they didn’t have to spend before the new regulations went into effect.

Brad Mete estimates his staffing company, Affinity Resources, will spend $100,000 this year on record-keeping and filing documents with the government. He’s hired two extra staffers and is spending more on services from its human resources provider.

The Affordable Care Act, which as of next Jan. 1 applies to all companies with 50 or more workers, requires owners to track staffers’ hours, absences and how much they spend on health insurance. Many small businesses don’t have the human resources departments or computer systems that large companies have, making it harder to handle the paperwork. On average, complying with the law costs small businesses more than $15,000 a year, according to a survey released a year ago by the National Small Business Association.

“It’s a horrible hassle,” says Mete, managing partner of the Miami-based company.