NRL News

Several Provisions of Obama Health Law Take Effect, Worst Yet to Come

by | Aug 7, 2012

By Jennifer Popik, JD
Robert Powell Center for Medical Ethics

Jennifer Popik, J.D. Robert Powell Center for Medical Ethics

This summer, the Obama Health Care Law (“ObamaCare”) has generated a renewed wave of controversy. In June, the Supreme Court narrowly upheld most of the law’s key provisions, and only last week, several provisions took effect. 

In an attempt to swing public opinion in favor of the unpopular law, several of the law’s most well-liked provisions have already taken effect, including allowing adult children to stay on a parent’s policy until age 26.  With respect to rationing, however, the most dangerous, and sure-to-be-unpopular, provisions will take hold gradually over the next several months and years unless the bill is repealed.

While the most dangerous provisions are many months from taking effect, last week, one innocent-sounding provision relating to “medical loss ratios” took effect.  Generally speaking, a medical loss ratio is the ratio between what the company actually pays out in claims or medical services and what it has left over to cover sales, marketing, underwriting, taxes, and other administrative expenses and profits. The provision, by and large, requires insurers to spend at least 85 percent of premium money on medical care, rather than on administrative costs or profits. 

This would occur at the same time as other provisions in the health care bill impose significant additional administrative expenses on insurers involving reporting on quality and efficiency as well as managing care to achieve greater “value” for the funds expended.

With a narrower margin for administrative expenses, this restriction could lead to the inability of insurers to operate in the black and have the effect of driving many of them out of the market.  This medical loss ratio provision is designed to work with other provisions of the Obama Health Law that have an eye on preventing Americans from spending what bureaucrats deem to be “too much” on their health care and that of their family.

Despite the continuous scrutiny the Obama Health Law received, few Americans realize that under ObamaCare, private citizens’ right to spend their own money to save the lives of their own families will be subject to drastic restriction.  There are several egregious provisions aimed at reducing what people can spend on their healthcare, including the Independent Payment Advisory Board as well as the state exchanges. These are described at

The major provision by which ObamaCare will work to reduce care is one that will give federal bureaucrats the power to impose so-called “quality” measures on all health care providers, so that treatment that a doctor and patient deem needed to save that patient’s life or preserve the patient’s health but which runs afoul of the imposed standards will be denied, even if the patient is willing and able to pay for it. In 2015 and thereafter, an 18-member “Independent Payment Advisory Board” is directed to inform the federal Department of Health and Human Services how to use those imposed standards to limit what private citizens are permitted to spend on their own families’ health care to below the rate of medical inflation.

While the House of Representatives has now voted multiple times to repeal the anti-life health law, action has stalled in the Democratic-controlled Senate, and President Obama has threatened to veto any repeal effort.  According to National Right to Life President Carol Tobias, “If President Obama wins re-election, it will mean massive abortion subsidies and it will put the lives of millions at risk through systematic government-imposed rationing of lifesaving medical care.”

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Categories: ObamaCare