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President Barack Obama announced last week that people who had their health insurance canceled can now purchase a bare bones plan that only covers major medical expenses without facing the threat of a fine.
It’s a significant change for some, and one of several ways the administration has altered some provisions of the law.
How much tinkering has gone on?
Fox political commentator George Will offered this analysis on Fox News Sunday.
"At this point, it’s very hard to quantify, (but) perhaps most of the law has already in some sense been waived or otherwise suspended," Will said. "The president said this week that the suspensions of the employer mandate, the individual mandate, etc., etc., etc., do not go to the core of the law. If not that, what is the core of the law?"
For this fact-check, we will take a stab at quantifying the steps the law set out to do so we can determine if, as Will said, most of the law has been waived or suspended.
Delays and modifications
There have been a number of modest administrative changes, including giving people an extra week to sign-up for coverage to begin in January and giving insurance companies an extra month at the end of next year to set premiums.
There have also been some significant alterations.
This summer, Obama delayed by a year a requirement that all companies with 50 or more employees provide their workers health care coverage.
And in the fall, when a wave of cancellation notices appeared in the mailboxes of Americans who bought coverage directly from insurance companies, Obama gave states the option to let people stay on those plans through next year -- even though the plans did not meet the standards of the Affordable Care Act.
In some ways, the move this week was a way to supplement that relief for people who wanted more options.
Comparing head counts
Of all the changes, the most recent one seems likely to touch the most lives. Obama said his staff estimated that about 500,000 people might want a high-deductible, catastrophic plan. We have seen credible estimates that about 4 million people saw their plans canceled but some have now found replacement coverage. In reality, we won’t know the full scope of this policy shift for several months.
The next-biggest impact stems from the delay in the employer mandate. Analysts with the RAND Corporation, a respected, independent research group, recently estimated that about 300,000 fewer people would have coverage as a result.
While these figures are only estimates, they show that the changes -- while perhaps significant -- affect only a small portion of people in the health insurance market.
About 365,000 people purchased insurance through the federal marketplace through November and another 800,000 were found eligible for Medicaid, according to the Department of Health and Human Services. Obama said another 500,000 people had signed up for health insurance in December.
Other parts of the law are affecting many more Americans.
The law added about 3.1 million young adults to their parent’s health care plans. A requirement that insurance companies spend at least 80 percent of every premium dollar on actual health care affected the health care policies of about 77 million people in 2012, according to government figures. That resulted in about $3.4 billion in rebates, coverage adjustments or policy enhancements.
Starting in 2011, the Medicare Part D prescription drug benefit became more generous. More than 35 million people participate in that program.
Looking at the individual mandate, the Urban Institute, a Washington academic policy group, estimated that it would hit about 18 million people. That dwarfs the 500,000 the administration believes will take advantage of the catastrophic coverage option.
With all the talk about problems with the health care law, it’s easy to forget just how many corners of health insurance policy the law affects.
Will seemed guilty of that on Fox News Sunday when he said most of the law has been waived or suspended. Obama has made at least two major course corrections in the law. He delayed the employer mandate by one year and allowed individuals dealing with canceled plans to buy insurance that fails to meet minimum standards under the law.
One way to put these changes into context is to look at the number of people they affect. While precise data are missing, the combined impact could be in the range of 1 million Americans.
On the other side of the ledger, 3.1 million young adults have gained access to coverage through the law, another 18 million people are subject to the individual mandate and millions more have benefited from requirements that health insurance companies spend premiums on care.
We rate the claim Mostly False.
Fox News, Fox News Sunday, Dec. 22, 2013
Commonwealth Fund, Major provisions of the Affordable Care Act, 2010
Urban Institute, The individual mandate in perspective, March 2012
RAND Corporation, Delaying the Employer Mandate: Small Change in the Short Term, Big Cost in the Long Run, 2013
Health Affairs, Progress Report: The Affordable Care Act’s Extended Dependent Coverage Provision, Dec. 16, 2013
Kaiser Family Foundation, The Medicare prescription drug benefit fact sheet, Nov. 19, 2013
Health and Human Services Department, Health insurance marketplace: December enrollment report, Dec. 3, 2013
Health and Human Services Department, Good news in Medicaid in states that are expanding, Dec. 3, 2013
Centers for Medicare and Medicaid, 80/20 rule delivers more value to consumers in 2012
New York Times, October Medicaid Applications Far Outpace Enrollment Through Exchanges, Dec. 3, 2013
The Hill, Obama: 500K healthcare signups in December, Dec. 20, 2013
ABC News, White House allows mandate exemption over cancelled plans, Dec. 20, 2013
Kaiser Health News, Health Insurers Scramble Toward Jan. 1 Coverage Deadlines, Dec. 20, 2013
Kaiser Family Foundation, Beyond Rebates: How Much Are Consumers Saving from the ACA’s Medical Loss Ratio Provision?, June 6, 2013
Associated Press, Feds Try To Smooth Bumpy Health Care Transition, Dec. 12, 2013
Washington Post, Obamacare’s online SHOP enrollment delayed by one year, Nov. 27, 2013
Bloomberg, Insurers To Get Extra Month To Set 2015 Obamacare Rates, Nov. 22, 2013
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