Since it was signed into law in 2010, the Patient Protection and Affordable Care Act (ACA) has survived a constitutional challenge before the
Even if the agencies involved clear the initial hurdle of enrollment, a host of other problems loom. Fundamentally, the ACA could fall short of its goal of providing better and more affordable healthcare for most Americans. And at the same time that the new plan provides insurance for millions of uninsured Americans, for many others its implementation could spell trouble: slashed work hours, a proliferation of burdensome insurance plans with expensive deductibles, and the dissolution of the multi-employer health plans that provide stable insurance to many union members.
Obstacles to Obamacare's successful launch stem from five sources: how
Holes in the safety net
The effort to string together a healthcare program around existing insurance coverage has resulted in a safety net full of gaping holes. The ACA could have provided much better insurance if it had included a public option, as progressives advocated. Even so, many of the glitches in the law could be fixed under normal political circumstances, but today Democrats do not dare introduce revisions when most Republicans would seize any opportunity to kill the ACA.
Consider how the law deals with affordability.
The ACA requires businesses with 50 or more employees to offer "affordable" insurance to anyone working 30 or more hours per week - which must cost no more than 9.5 percent of the worker's household income. In addition, businesses must also provide insurance for dependents, though potentially at an additional cost to the employee.
Employers who fail to provide any insurance will have to pay a fine of
The problem is the definition of "affordable." A median middle-class family of four with private insurance earns about