What happens in November will play a major role in shaping President Obama’s final two years in office.
After the disastrous rollout of the president’s signature domestic initiative in 2013, the administration needs to avoid the problems that diminished public confidence in the most significant overhaul to the health care system since the creation of Medicare.
The White House believes the technical problems that crashed healthcare.gov will become a distant memory. However, team Obama must worry about much more than just a website.
Here are the top five potential Obamacare headaches looming in November:
1. Price increases
Whether Obamacare absorbs the blame or not, the cost of health insurance is expected to rise next year.
A new analysis by the Health Research Institute at PricewaterhouseCoopers this week estimated premiums on the Obamacare health insurance exchanges would increase by an average of 7.5 percent next year.
Another survey released Wednesday by the National Business Group on Health found that health care costs at large companies would jump by 6.5 percent in 2015. And to account for higher costs, employers are planning to shift more of the burden to their employees.
Such a development wouldn’t necessarily constitute the so-called sticker shock that critics of Obamacare predicted. Still, the White House would be forced to explain why health care costs are increasing despite presidential promises to the contrary.
Some Americans could become disillusioned with higher medical bills, even as the uninsured population is shrinking nationally.
2. Low polling numbers
Obamacare is working — that’s what you’ll hear from the White House repeatedly between now and November.
But the public isn’t buying it.
A Kaiser Family Foundation tracking poll released earlier this month found that 53 percent of Americans have an unfavorable view of Obamacare — a record high in the survey’s history and an eight-percentage-point spike from just the month before.
The poll also showed that fewer people are undecided in how they perceive Obamacare. In other words, it is now infinitely harder for the Obama administration to find new converts — last year was its best chance to change opinions on the hot-button issue.
Such findings are why Republicans are using Obamacare as a central issue in their attempt to win control of the Senate in November. And the second enrollment period will start following elections in which negative Obamacare advertising will significantly eclipse positive spots.
3. Re-enrollment issues
Millions of Americans have enrolled in new Obamacare plans, even if it took longer than they anticipated.
Now the administration faces the challenge of trying to keep all 8 million of them, while seeking new customers.
But those plans could look a lot different in 2015.
Some consumers will automatically re-enroll in their existing plans and others will have to sign up for an extension or choose another option.
What some people might not realize is that their premiums might increase even if they simply stay in their plan for another year. To avoid such additional costs, certain consumers will need to shop for different coverage, something they might not realize until they receive their bill.
Just because a health plan is the cheapest available this year doesn’t make it so for 2015. The White House will ask people to return to healthcare.gov to make sure their insurance payments are acceptable — a request unlikely to be well-received.
4. November is about the worst month to start open enrollment
The Obama administration will ask Americans to focus on choosing a health plan just as the holiday season begins — a time generally viewed as the most financially stressful period of the year, even though it is the traditional period for open enrollment.
Sure, open enrollment is slated to last until mid-February. But if the White House wants a quick uptick in Obamacare signups — which didn’t happen last year — November is hardly conducive to achieving that.
Some have called for the administration to extend open enrollment closer to April, when more low-income Americans get their tax returns and have additional income. Barring an extension of the enrollment dates, which the White House implemented in the wake of technical glitches the first time, health insurance could be overlooked by those with pressing financial obligations.
5. Subsidy eligibility
Two questions at the center of the Obamacare debate have proven difficult to answer: Who is eligible for coverage and how much financial help should they receive?
Just this week, the Obama administration announced that 310,000 enrollees would have to verify their citizenship or legal status or lose their coverage.
The administration also will have to work through any data discrepancies, such as income, birthday or address, which put millions of Obamacare recipients at risk in recent months.
And two federal appeals courts last month issued conflicting rulings over federal subsidies awarded through the federal Obamacare health exchange, opening the possibility that the Supreme Court will rule on the issue.
If the federal subsidies are considered illegal, it would deal the most crippling blow to Obamacare since its inception, as millions of Americans rely on the aid to pay for their health plans.