4) Will enough healthy people sign up?
In the end, bros may hold the key to Obamacare’s success. The law needs lots of young, healthy people to sign up for health insurance to counterbalance older enrollees and those with chronic conditions. (This is because insurers make make money on healthy people and lose money on sick people. Pre-Obamacare, insurance companies dealt with this by simply refusing to insure the sickest people. The ACA said they must take all comers.)
The problem? Young people don’t seem eager to sign up for insurance. A Harvard Institute of Politics poll from a few months ago showed that 30 percent of 18-29 year olds don’t plan to sign up for coverage, and 40 percent are on the fence.
If insurers can’t reach this balance, the market may tumble into what’s known as a “death spiral”: Insurers raise premiums to make up the losses from all their sick customers, which causes more healthy people to drop out, which causes them to raise rates again, and so on.
Some people are extremely worried about this possibility. But others aren’t, because the federal government has created a bunch of failsafes to help insurance companies through the rocky next few years. And we all keep our fingers crossed that, because the penalty for lacking health insurance gets steeper every year, eventually the bros will listen to their moms and sign up for a plan. And get a haircut while they’re at it.
5) Will the website start working on a reasonable way?
After Healthcare.gov’s abysmal debut, the site began working marginally better over the last few months of 2013. But as the dust settles from the December 24 deadline to get coverage by January 1, it’s clear that not all the bugs have been worked out.
More than 100,000 people who signed up for Medicaid or the Children’s Health Insurance Program weren’t actually enrolled, because of a glitch. There’s still no easy way to update your profile if you’ve had a baby or have experienced some other life-altering event. When I attended a Dallas enrollment event recently, I was told that some enrollees weren’t able to pay for their plans through the site and instead had to call the insurance company directly.
6) What’s to become of the birth control mandate?
The Supreme Court has agreed to hear a case brought by Hobby Lobby, a Christian-owned, Oklahoma-based crafts purveyor and by Conestoga Wood Specialties, a cabinet-making company in Pennsylvania, which object to the law’s requirements that companies cover contraceptive pills on their insurance plans.
Hobby Lobby CEO David Green has said he specifically opposes some of the drugs that would be covered, such as Plan B, which he says prevents human embryos from being implanted in a woman's womb and amounts to abortion.
If the companies win, not only could it impact female employees of other religious organizations, some fear it could be the start of business owners using the religious exemption to opt out of a host of other laws.
"If the court strikes down the contraception mandate, the implications could be broad,” Adam Winkler, a liberal law professor at UCLA, told Talking Points Memo. “It could give businesses the right to seek exemptions from any number of generally applicable laws, including laws protecting against discrimination on the basis of sexual orientation."