What To Expect In 2014: Obamacare, Immigration Reform, Budget Battles & More

Obamacare, Medicaid & Medicare

In 2014, an expansion of Medicaid, with an increased cost burden for taxpayers, is expected. This is according to the Kaiser Family Foundation which has also projected Obamacare adding another 20 millionnew Medicaid dependents. It is estimated this expansion will add an average of 13% in costs to state budgets in 2014 alone.

The health insurance premium “sticker shock” will continue in 2014 as the reality of higher premiums really hits home. Most Americans, but especially the young and healthy, will have to come to grips with health insurance premium increases anywhere between 50% and 150%. And, to make matters worse, employers will continue to cut full-time workers back to part-time by reducing employees’ hours per week from 40 to 29 or less. This is being done to minimize the number of employees qualifying for the expensive Obamacare-compliant coverage.

Because businesses must pay more to purchase Obamacare-compliant plans, remaining employer-based health insurance policies will have higher out-of-pocket costs for employees, including higher co-pays and deductibles.

While Medicaid expands, Medicare will be gutted. In 2014, Medicare patients will be forced to deal with several unwanted changes:

  • Increased premiums for supplemental policies
  • Fewer types of Medicare supplement policies to choose from
  • More cutbacks in Medicare-covered services
  • Longer delays to see physicians, due to many physicians closing their doors to Medicare patients because of the cuts in reimbursements
  • Fewer cancer care specialists accepting Medicare patients
  • Higher costs for hospital-based cancer treatments–private offices with lower costs will increasingly be closed due to reimbursement cutbacks
  • Approval of fewer hospital-based surgeries because Obamacare rules incentivize hospitals (are paid more by Medicare) to do fewer surgeries and procedures.
  • Medicare patients who sign the Advance Beneficiary Notice (ABN), which obligates them to pay for services Medicare does not cover, will now have higher out-of-pocket costs when paying for these non-covered services.
  • Patients over 80 are already finding reduced approvals for certain procedures and medicines and this age-based rationing is expected to continue as the Medicare cuts increase over the next decade.

As of January 1, 2014, the Individual Mandate to purchase Obamacare-compliant health insurance is in effect. Along with the mandate will come some of Obamacare’s most serious issues: longer waits to see a doctor, higher payments for fewer treatment options and the deterioration of quality healthcare as doctors and hospitals go out of business. In the health care sector, we’ll see government advance as the quality and efficiency of the free market recedes.

But, it is not just the Obamacare minimum coverage mandates that have caused health insurance premiums to soar. The new year will also bring with it a flurry of new taxes–with a $1 trillion price tag. Not surprisingly, these will be passed on to consumers. From the New York Post:

“Most insurers aren’t advertising the ObamaCare taxes that are added on to premiums, opting instead to discretely pass them on to customers while quietly lobbying lawmakers for a break.

But one insurance company, Blue Cross Blue Shield of Alabama, laid bare the taxes on its bills with a separate line item for ‘Affordable Care Act Fees and Taxes.’

The new taxes on one customer’s bill added up to $23.14 a month, or $277.68 annually, according to Kaiser Health News. It boosted the monthly premium from $322.26 to $345.40 for that individual.”

And, the following is a list of the new Obamacare taxes that Americans will be forced to pay through their health insurance premiums (via United Liberty):

  • A 2 percent levy on every health plan
  • A $2 fee per policy that goes into a new medical-research trust fund called the Patient Centered Outcomes Research Institute.
  • Insurers pay a 3.5 percent user fee to sell medical plans on the HealthCare.Gov website.
  • Americans also will pay hidden taxes, such as the 2.3 percent medical-device tax that will in turn inflate the cost of items such as pacemakers, stents and prosthetic limbs.
  • Those with high out-of-pocket medical expenses should also anticipate receiving smaller income-tax deductions.
  • Though, currently Americans can deduct expenses that exceed 7.5 percent of their annual income, that threshold will jump to 10 percent under ObamaCare.
  • A new Medicare tax is on the horizon. Under ObamaCare, individual tax filers earning more than $200,000 and families earning more than $250,000 will pay an added 0.9 percent Medicare surtax on top of the existing 1.45 percent Medicare payroll tax. They’ll also pay an extra 3.8 percent Medicare tax on unearned income, such as investment dividends, rental income and capital gains.

Battles Over Extension of Unemployment Benefits, Minimum Wage, Debt Ceiling & Farm Bill

One of the first matters Congress will tackle in the new year is the extension of benefits for the long term unemployed. These benefits expired on December 28th and Senate Majority Leader Harry Reid has indicated he wants a vote on the bill first thing when the Senate gets back. He also advocates an increase in the minimum wage but its destiny in the House is uncertain. John Boehner is reportedly willing to extend unemployment insurance but is asking for some spending reduction in return.

The farm bill is still pending resolution on how much in the way of cuts to make to food stamps.

The debt ceiling confrontation will occur most likely in March, but potentially as late as early June or as early as February and word has it that Republicans won’t budge on not raising the ceiling without some concessions from Democrats. Obama, however, has insisted he will not negotiate on the debt ceiling.

Immigration Reform

Harry Reid believes John Boehner will negotiate on comprehensive immigration reform, despite Boehner’s declarations to the contrary.

Reid has said that Boehner’s antagonism against Tea Party groups has bolstered his confidence that he will not have to break up the Senate immigration bill and negotiate a series of piecemeal reforms with the House. The Senate bill consists of more than 1,200 pages and the most controversial element of it is a provision granting a pathway to citizenship for millions of illegal immigrants.

Additionally, Rep. Steve King (R-IA) has organized a group of conservatives who pledge to vote against any immigration reform bill. Even Sen. Marco Rubio (R-FL), a co-sponsor of the Senate bill, has backed away from calls to go to conference with the comprehensive measure. “At this point, the most realistic way to make progress on immigration would be through a series of individual bills,” Rubio spokesman Alex Conant said in October.

Elections 2014 & 16

The GOP needs pick up six seats to gain control of the upper chamber. According to The Hill:

“That’s a tall order, but history and the map in 2014 is on the GOP’s side. It’s likely that most Democrats in red states, most notably Sen. Mark Pryor (Ark.), will distance themselves from Obama in 2014. Still, the most closely watched race will be Senate Minority Leader Mitch McConnell’s (R-Ky.) effort to win a sixth term.

Democrats in the House say they can win back the lower chamber, but that is unlikely. They need to win 17 seats, meaning there will have to be a Democratic wave come November. The wave might begun to form during the government shutdown, but it hit a wall with the botched ObamaCare implementation.”

Also, Democrats will need to gain 17 House seats in order to retake that chamber, a prospect that is fraught with obstacles. Due to redistricting, there are far fewer swing seats than in past years and then there’s the liability of Obamacare.

In 2016, Clinton is expected to run and is also expected to be the prohibitive favorite to win the 2016 Democratic nomination. The Republican field is likely to be crowded and may include senators such as Sens. Ted Cruz (TX), Rand Paul(KY), Marco Rubio (FL), Rob Portman (OH) John Thune (SD) and Kelly Ayotte (NH). Chris Christie and Scott Walker are two other possible candidates.


Two competing bills to revamp the NSA and the continuing updates coming from Edward Snowden are helping Rep. James Sensenbrenner (R-WI) and Senate Judiciary Committee Chairman Patrick Leahy (D-VT) attract co-sponsors for their expansive legislation. However, Rep. Mike Rogers (R-MI) and Sen. Dianne Feinstein (D-CA), who head the House and Senate Intelligence panels, have argued that the threat of terrorism is on the rise and necessitates NSA intelligence activities and should not be dismantled.


The tentative, yet controversial, deal Obama and Secretary of State John Kerry brokered has been criticized by both Republicans and Democrats. Some lawmakers, such as Sen. Charles Schumer (D-NY), want to pass additional Iran sanctions, but the White House has vowed to veto such a bill. Also, representatives from Iran and the P5+1 group of world powers have chosen January 20 to begin implementing the Geneva deal on Tehran’s nuclear program.


The Hill reports: “Obama has repeatedly said that U.S. troops will leave Afghanistan by the end of 2014, but it remains to be seen what the U.S. presence will be there beyond that. The U.S. has had an uneasy relationship with Afghan President Hamid Karzai, and a security deal for 2015 still has not been signed.”

Incandescent Light Bulb Ban

Lastly, as of the first day of the new year the manufacture and import of 60- and 40-watt incandescent light bulbs will be illegal in the U.S. The Energy Independence and Security Act of 2007 (EISA) was one of the first matters Democrats took up on retaking the House in the 2006 elections and was signed into law by President George W. Bush in 2007.

The EISA mandated a elimination of the Edison bulb, to be replaced by the more costly, but ostensibly more energy-efficient, compact fluorescent bulbs (CFL). Consumers complaints regarding CFLs include bulbs lacking brightness no matter what the rating, a warm up time in order to reach full brilliance and the breakage and cleanup issues created by the presence of mercury in CFLs. For instance, the Times of London reported that, “large numbers of Chinese workers have been poisoned by mercury” as many CFLs are manufactured in China.

The mercury in one bulb, for example, is enough to contaminate up to 6,000 gallons of water beyond safe drinking levels. According to a British study, CFLs are “a fire hazard that could burn down your home.”

And, as Daniel Sobiesky, in a Business Insider editorial points out, “as the new bulbs were so beneficial consumers had to be forced to use them.”

Welcome to 2014.