Twenty-Seven Obamacare Changes
Yesterday’s update was hardly surprising, given how much the law has already been distorted.

President Obama proposes more changes to the Affordable Care Act, November 14, 2013.


President Obama’s announcement Thursday of another illegal change to his health-care law continues a long pattern of trying to fix his fatally flawed signature legislation by administrative fiat.

By our count at the Galen Institute, more than 27 significant changes already have been made to Obamacare: at least 10 that President Obama has made unilaterally, 15 that Congress has passed and the president has signed, and 2 by the Supreme Court. But even this large number of changes hasn’t stopped the cascade of failures we are seeing today.

His administrative order Thursday will allow some people who had some plans in effect as of October 1 to keep them under some circumstances. But this was at least partly to get ahead of measures that are gaining bipartisan support in Congress to help the millions of people who are losing their health insurance.

The Keep Your Health Plan Act, sponsored by Representative Fred Upton (R., Mich.), chairman of the Energy and Commerce Committee, will be considered in the House today. A companion measure is being offered in the Senate by Senator Ron Johnson (R., Wis.). Senator Mary Landrieu (D., La.) is offering the Keeping the Affordable Care Act Promise Act, which takes a different approach but has a similar goal.

Here is the list of changes that have already been made to the law. It shows those made by the Obama administration before the president’s most recent announcement; those made by the 111th Congress (with Democratic control of the House) and signed by President Obama; changes made by the 112th and 113th Congresses (with Republican control of the House) and signed by the president; and those made by the U.S. Supreme Court.

Changes by administrative action

1. Congressional opt-out: The administration decided to offer employer contributions to members of Congress and their staffs when they purchase insurance on the exchanges created by the ACA, a subsidy the law doesn’t provide. (September 30, 2013)

2. Delaying the individual mandate: The administration changed the deadline for the individual mandate, by declaring that customers who have purchased insurance by March 31 will avoid the tax penalty. Previously, they would have had to purchase a plan by mid February. (October 23, 2013)

3. Employer-mandate delay: By an administrative action that’s contrary to statutory language in the ACA, the reporting requirements for employers were delayed by one year. (July 2, 2013)

4. Self-attestation: Because of the difficulty of verifying income after the employer-reporting requirement was delayed, the administration decided it would allow “self-attestation” of income by applicants for health insurance in the exchanges. This was later partially retracted after congressional and public outcry over the likelihood of fraud. (July 15, 2013)

5. Small businesses on hold: The administration has said that the federal exchanges for small businesses will not be ready by the 2014 statutory deadline, and has instead delayed the implementation of the SHOP (Small-Employer Health Option Program) exchanges until 2015. (March 11, 2013)

6. Closing the high-risk pool: The administration decided to halt enrollment in transitional federal high-risk pools created by the law, blocking coverage for an estimated 40,000 new applicants, citing a lack of funds. The administration had money from a fund under Secretary Sebelius’s control to extend the pools, but instead used the money to pay for advertising for Obamacare enrollment. (February 15, 2013)