Democrats, Republicans prepare for new round of battles over health-care law

The first enrollment period for the Affordable Care Act ends at midnight Monday, closing one chapter on President Obamas landmark health-care law and paving the way for a new round of confrontations that could ultimately determine the laws long-term prospects.

Supporters face an array of political, financial and legal challenges in the coming months. Democrats and insurance industry officials are already seeking ways to blunt what may be the next big controversy: an expected increase in monthly insurance premiums next year for the health plans sold through the federal and state marketplaces.

Republicans, meanwhile, continue to use the law to attack vulnerable Democratic incumbents in the midterm elections, which will decide whether the GOP wins control of the Senate.

Combatants on both sides debated the administrations report last week that 6 million people had signed up for private plans. The laws working, White House senior adviser David Plouffe said on ABCs This Week. He added: And this was a seminal achievement.

But Republican Sen. John Barrasso (Wyo.) expressed skepticism about the figure. They are cooking the books on this, he told Fox News Sunday.

In the months and years ahead, other questions will loom: How will Americans react when they get fined next year for not having insurance? Will more states expand Medicaid under the law? And will the federal courts make future changes to the law, including barring the use of government subsidies to help pay for coverage in the federal marketplace?

The unresolved issues mean it is far too soon to know how President Obamas signature domestic achievement and one of the most polarizing pieces of U.S. social policy will turn out. So far, the action has been a warm-up act for what lies ahead, said Larry Levitt, senior vice president of the nonprofit Kaiser Family Foundation.

Heres a road map of what comes next:

Premiums trend

Monthly insurance premiums almost always go up, because costs typically rise. So the big questions are: How much will premiums increase for next year, how widespread will the increases be, and how will consumers be affected?

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Democrats, Republicans prepare for new round of battles over health-care law

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