At his end-of-the-year news conference, President Barack Obama called the botched rollout of the Affordable Care Act his single biggest mistake of 2013. That’s putting it mildly. Supporters of Obamacare can’t wait to put this year behind them: From dropped insurance coverage for millions of Americans to the delay of the law’s employer mandate and the problems with HealthCare.gov, 2013 has been nothing short of a disaster.
There are two things that are important to recognize about Obamacare’s difficulties this year. First, people shouldn’t have been surprised that the law was so hard to implement and spawned so much bad press — in fact, it was designed so that the law’s more politically unpopular provisions would take effect only after the 2012 elections.
Second, as bad as 2013 has been for Obamacare, the year ahead doesn’t look much better. In fact, 2014 has the potential to be even worse — for the law, the Obama administration and congressional Democrats.
The drafters of Obamacare recognized that many elements of the law would be unpopular, while other provisions — allowing people up to the age of 25 to remain on their parents’ plans, ending co-payments for preventive care or closing the “doughnut hole” in Medicare prescription drug coverage — would be immensely popular with the voting public. These provisions all took effect shortly after the law was signed in 2010.
So, what was left for 2013 and beyond, after Obama had been re-elected president, were a series of provisions that Democrats knew would cause more political and policy trouble. Millions of Americans in the individual market being dropped from their existing plans is directly related to Obamacare’s essential health benefits requirement, which mandates coverage across 10 categories and goes into effect in 2014. And the one-year delay in the effective date of the employer mandate, which now starts in 2015, was an attempt to delay some of the law’s negative labor market effects — cuts in wages, hours and employment — until after the midterm elections in November 2014.