But as the White House and its allies declare victory, major hurdles remain. And it will take years to determine whether the law will accomplish its mission of creating stable insurance markets that can help a significant number of America’s nearly 50 million uninsured gain health coverage, experts say.
Republicans are counting on that uncertainty to play into their strategy for the midterm congressional elections in November. Their plan: Draw on public dissatisfaction with the Patient Protection and Affordable Care Act to help the GOP win control of the U.S. Senate and retain the party’s dominance in the House of Representatives.
“We’re not really going to know whether it worked or not until the third or fourth year. And of course, that’s two elections down the road,” said Timothy Jost, a professor at the Washington and Lee University School of Law in Lexington, Virginia.
“What I worry about is that we won’t be able to figure out whether it’s worked or not until it’s too late,” he said.
Even before the first enrollment period comes to a close, Republicans and some Democrats have separately proposed election year changes that could appeal to voter concerns — and would leave the law substantially altered.
Republican proposals would undermine Obamacare by making health insurance optional and returning sick people to high-risk pools. A handful of Senate Democrats last week also proposed some Republican-sounding ideas that would allow insurance to be sold across state lines, discontinue the employer mandate for many small businesses and allow low-premium, high-deductible plans to be sold in the marketplaces.
Families USA, an administration ally on healthcare reform, plans to make its own public recommendations this week on how the enrollment drive for 2015 might be improved. “Our recommendations will build‎ on the laudatory success of the first enrollment period,” said Ron Pollack, the group’s executive director.