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What Would Happen if Obamacare is Not repealed, Part 2

The New York Analysis of Policy and Government concludes its two-part review of what would occur if Obamacare is not repealed.

It is, perhaps, a pointless intellectual exercise to speculate on Obamacare’s impact if it’s not repealed, largely because, regardless of what Congress does, it is collapsing on its own.

Tyler Durden, writing for Zero Hedge, explains that “If Obamacare enrollments continue their current trend and insurers continue to hike premiums at alarming rates then Republicans may not have to worry about ‘repealing and replacing Obamacare’ as it might just work itself out “naturally”.

The House Ways and Means Committee  found that “Since the Obamacare exchanges opened for business on October 1, 2013, they have struggled to deliver quality, affordable health insurance options to Americans… Here’s a closer look at how Obamacare is failing across America:

  • PREMIUM SPIKES: Premium rates for the 2017 individual health insurance market may increase by an average of 24 percent, forcing many Americans to pay hundreds more a month to keep their coverage.

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Wall Street Journal: “The danger for insurers and supporters of the law now is that high prices and limited choices further deter low-risk people from signing up, and that the increases continue and become irreversible.” — Rate Increases for Health Plans Pose Serious Test for Obama’s Signature Law, October 18, 2016

Philadelphia Inquirer: “In a bid to keep at least one insurer on the exchange in every county, ‘the department allowed insurers to adjust their rate filings …’ regulators said in a filing approving an average rate increase of 28.4 percent for individual plans.” — Without Aetna and United Healthcare, Philly Area Faces Hefty Increases for Affordable Care Act Rates, October 17, 2016

Omaha World-Herald: “About 82,000 Nebraskans will pay more than expected for individual health insurance next year because Blue Cross won’t offer policies on the Affordable Care Act’s exchange.” — With Blue Cross’ Exit, Nebraskans Can Expect Even Higher Health Premiums through Obamacare, October 14, 2016

Associated Press: “Minnesota’s Democratic governor said Wednesday that the Affordable Care Act is ‘no longer affordable’ … while addressing questions about Minnesota’s fragile health insurance market, where individual plans are facing double-digit increases after all insurers threatened to exit the market entirely in 2017.” — Democrat Dayton: Health Law ‘No Longer Affordable’ for Many, October 12, 2016

Bloomberg: “Minnesota will let the health insurers in its Obamacare market raise rates by at least 50 percent next year, after the individual market there came to the brink of collapse.” — Near ‘Collapse,’ Minnesota to Raise Obamacare Rates by Half, September 30, 2016  

The Denver Post: “Residents who buy their health insurance themselves will pay 20 percent more on average next year … In some parts of rural Colorado, premium increases will top 40 percent.” — Colorado Health-Insurance Rates to Jump 20 Percent on Average for Individual Buyers in 2017, September 20, 2016

The Boston Globe: “Thousands of people who buy subsidized health insurance will face substantial premium increases — an average of 21 percent — if they want to keep the only plan that gives them access to certain prestigious Boston hospitals.” — Premiums Soar 21 Percent for Popular Health Plan, September 9, 2016

  • CO-OP CLOSURES: 74 percent (17 out of 23) of Obamacare co-ops have collapsed, wasting billions of taxpayer dollars and kicking hundreds of thousands of Americans off of their insurance.

The Washington Post: “17 co-ops have either collapsed or been ordered to close by state regulators because of their financial fragility, leaving hundreds of thousands of people to scramble for new coverage.” — Maryland’s ACA Health Co-Op Will Switch to For-Profit to Save Itself, October 3, 2016

The Record: “Health Republic Insurance of New Jersey will shut down for next year, forcing 35,000 people to find new insurance by Jan. 1 … The shutdown leaves just two companies doing business on HealthCare.gov, the Affordable Care Act marketplace for New Jersey.” — Health Republic Insurance of New Jersey’s Demise Exposes Flaws of Obamacare, October 2, 2016

Bloomberg: “Most of the original 23 co-ops have failed, dumping more than 800,000 members back onto the ACA markets over the last two years … With more of the nonprofits on the brink of folding, the situation for the remaining providers looks dire.” — Shaky Obamacare Market Adds to ‘Death Spiral’ Fears, September 23, 2016

FoxNews.com: “Health Republic Insurance of New Jersey is folding after the state’s insurance commissioner put the Obamacare co-op in ‘rehabilitation’ due to its hazardous financial condition.” — Another ObamaCare Co-Op Folds, Leaving Only 6 Remaining, September 13, 2016

  • FEWER, IF ANY, CHOICES: More Americans are finding themselves with fewer health care options as insurers exit the Obamacare exchanges.

Bloomberg: “A growing number of people in Obamacare are finding out their health insurance plans will disappear from the program next year, forcing them to find new coverage even as options shrink and prices rise.” — More Than 1 Million to Lose Obamacare Plans as Insurers Quit, October 14, 2016

Washington Post: “More than 250,000 people in North Carolina are losing the health plans they bought under the Affordable Care Act because two of the three insurers are dropping out — a stark example of the disruption roiling marketplaces in many parts of the country.” — In North Carolina, ACA Insurer Defections Leave Little Choice for Many Consumers, October 14, 2016

Washington Examiner: “Blue Cross’s exit [from Tennessee] is part of a nationwide trend of insurers pulling back from the Affordable Care Act marketplaces after experiencing heavy financial losses. Independent analysts have said one-third of the country may have just one Obamacare insurer next year.” — Obamacare Customers Lose Access to Top Tennessee Hospital, October 13, 2016

Forbes: “The exit of other major insurers means that 85% of North Carolinians needing Obamacare coverage will have only 1 insurance company to choose from in 2017.” — Mixed News For Obamacare In North Carolina As Blues Plan Opts To Remain In Obamacare Exchange, September 25, 2016

Alaska Public Media: “Alaskans shopping for individual health insurance on the federal exchange will only be able to choose from one insurer when open enrollment starts on November 1st.” — Alaskans Endure Rising Insurance Costs, September 21, 2016

Star-Telegram: “After three years of growth, which culminated in six health insurers offering 63 plans last year, the Affordable Care Act marketplace likely will fall to just one insurer for Tarrant County residents in 2017 … Having just one insurance company to choose on the exchange will limit medical options.” — Local Consumers Left with Few Options on Obamacare Exchange, September 16, 2016”

Allowing Obamacare to die a natural death, without any repealer by Congress, might be a viable political strategy.  But the damages left to the American health care system by this failed concept would leave substantial hardships in its wake.

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Media Misleads on Obamacare Repeal

Media coverage of the ongoing debate over how to repeal and replace Obamacare has been exceptionally inept.  It has ignored the deceptive manner in which the former President’s failed legislation was enacted, the depth of nationwide opposition to it, and the failures that require its elimination.

One of the key architects of the “affordable Care Act,” Jonathon Gruber, has boasted about the misstatements and coverups that were employed to gain passage. Notably, he has stated that “lack of transparency is a huge political advantage, and basically, call it the stupidity of the American voter.”

Obamacare was enacted in a Democrat-only, party line vote, in which even the elected officials voting on the measure has only a limited knowledge of what was in the bill. The American people knew even less, as demonstrated by then-speaker Pelosi’s infamous comment: “But we have to pass the…bill so that you can find out what’s in it….”

The Washington Post reports that “…there are now seven Gruber [Jonathon Gruber has been termed Obamacare’s “architect”] videos, in which he mocks the “stupidity” of American voters and boasts of the Obama administration’s ability to take advantage of it…”

The Americans for Prosperity (AFP)  organization has listed the most notable deceptions.

  • “If you like your healthcare plan, you will be able to keep your healthcare plan.”
  • “If you like your doctor, you will be able to keep your doctor.”
  • “We’re going to lower your premiums by up to $2500 per family per year.”
  • “No family making less than $250,000 a year will see their taxes increase.”
  • “I will not sign a plan that adds one dime to our deficits, now or in the future.”
  • “I will sign a universal healthcare bill into law…that covers every American.”

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Marketwatch notes that “Obamacare barely passed Congress in 2010. If people had known how it would develop, the health-care act would likely never have become law.”

Among the many failings of the measure noted by Marketwatch:

  1. Low enrollment. The Department of Health and Human Services estimates that between 9.4 million and 11.4 million signed up in 2016…In contrast, in March 2010, the Congressional Budget Office estimated that 21 million people would be enrolled on the exchanges.
  2. High numbers of uninsured. There are still 31 million uninsured, and the number is never projected to go below 29 million, according to CBO.
  3. Lost doctors. Varioussources note that a common (and popular) way to reduce premium costs has been to reduce the number of doctors in the insurer’s network.
  4. Lost plans.Sen. Ben Sasse released a reportabout Obamacare’s effects on competition among insurers, concluding that outcomes have worsened for most Americans, in terms of choice of insurers and plans. Over the past year, the number of insurers offering plans in exchanges has dropped by nearly 6%.Many states have lost more than 80% of their insurers: Alabama went from 23 to 3, Arkansas went from 24 to 4, and Wyoming from 21 to 1, just to name a few. Only New York did not lose over half of its insurers, going from 28 to 15 insurers, a 46% decline.
  5. Higher premiums.A reportby the Kaiser Family Foundation and the Health Research & Educational Trust found that, since 2008, average employer family premiums have climbed a total of $4,865. From 2015 to 2016 the most popular exchange family plan, Family Silver, saw a 10% average increase in its premiums. In some states, premiums rose by nearly 40%.In 2015 the average annual family premium was $17,545 per year, and the average premium for a single policy was $6,251. Young men were particularly hard-hit. Average premiums rose by 49% from 2013 to 2014, the year Obamacare was supposed to go into effect.
  6. Higher deductibles. The New York Times, long a cheerleader for Obamacare, reported that many people can’t afford to use the health insurancethat they have purchased because of the deductibles.New York Times reporter Robert Pear wrote that the median deductible in Miami was $5,000 in 2015. It was $5,500 in Jackson, Miss., and $4,000 in Phoenix. One Chicago family of four paid $1,200 monthly for coverage yet had an annual deductible of $12,700.
  7. High costs.The Office of the Actuary of the Center for Medicare and Medicaid Services has projected that Obamacarewill result in an additional $274 billion in administrative costs alone over the period of 2014 through 2022.

AFP  noted that “The promise to repeal Obamacare is what drove Americans to overwhelmingly cast their ballots for Obamacare’s opponents in three out of the last four elections.” The anger over the measure, in addition to its deceptions and failures, ran roughshod over individual rights. WND  worries that “The…Affordable Health Care Act…has forced nuns to pay for abortions, demanded that Christians violate their doctrines of faith…and much more.”

Much has been written about the fact that, just two months into his term, President Trump and Congress have not yet replaced the failed legislation.  However, a more open and vigorous debate about the replacement attempt is a good thing.  Rather than a secretive, deceptive, and ill-conceived measure such as Obama’s bill, a more fact-based and strenuous process centered on a vigorous exchange of ideas has a far better chance to produce an end product that actually improves, rather than harms, health care.  

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Obamacare’s Demise, and its Replacement Part 2

In addition to the ideological goal of nationalizing one-sixth of the American economy, Obamacare’s Progressive advocates support for the legislation was a reflection of their political alliance with lobbying interests from pharmaceutical corporations, the Trial Lawyers Association, and insurance companies, all of which had vested interests in opposing more viable reforms which would have truly and effectively reduced the cost of healthcare.

President-elect Trump, who made opposition to Obamacare a key part of his campaign, has proposed an alternative approach  to the failed concept:

“the House and Senate must:

  1. “Completely repeal Obamacare. Our elected representatives must eliminate the individual mandate. No person should be required to buy insurance unless he or she wants to.
  2. “Modify existing law that inhibits the sale of health insurance across state lines. As long as the plan purchased complies with state requirements, any vendor ought to be able to offer insurance in any state. By allowing full competition in this market, insurance costs will go down and consumer satisfaction will go up.
  3. “Allow individuals to fully deduct health insurance premium payments from their tax returns under the current tax system. Businesses are allowed to take these deductions so why wouldn’t Congress allow individuals the same exemptions? As we allow the free market to provide insurance coverage opportunities to companies and individuals, we must also make sure that no one slips through the cracks simply because they cannot afford insurance. We must review basic options for Medicaid and work with states to ensure that those who want healthcare coverage can have it.

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  4. “Allow individuals to use Health Savings Accounts (HSAs). Contributions into HSAs should be tax-free and should be allowed to accumulate. These accounts would become part of the estate of the individual and could be passed on to heirs without fear of any death penalty. These plans should be particularly attractive to young people who are healthy and can afford high-deductible insurance plans. These funds can be used by any member of a family without penalty. The flexibility and security provided by HSAs will be of great benefit to all who participate.
  5. “Require price transparency from all healthcare providers, especially doctors and healthcare organizations like clinics and hospitals. Individuals should be able to shop to find the best prices for procedures, exams or any other medical-related procedure.
  6. “Block-grant Medicaid to the states. Nearly every state already offers benefits beyond what is required in the current Medicaid structure. The state governments know their people best and can manage the administration of Medicaid far better without federal overhead. States will have the incentives to seek out and eliminate fraud, waste and abuse to preserve our precious resources.
  7. “Remove barriers to entry into free markets for drug providers that offer safe, reliable and cheaper products. Congress will need the courage to step away from the special interests and do what is right for America. Though the pharmaceutical industry is in the private sector, drug companies provide a public service. Allowing consumers access to imported, safe and dependable drugs from overseas will bring more options to consumers.

“The reforms outlined above will lower healthcare costs for all Americans. They are simply a place to start. There are other reforms that might be considered if they serve to lower costs, remove uncertainty and provide financial security for all Americans. And we must also take actions in other policy areas to lower healthcare costs and burdens. Enforcing immigration laws, eliminating fraud and waste and energizing our economy will relieve the economic pressures felt by every American. It is the moral responsibility of a nation’s government to do what is best for the people and what is in the interest of securing the future of the nation. Providing healthcare to illegal immigrants costs us some $11 billion annually. If we were to simply enforce the current immigration laws and restrict the unbridled granting of visas to this country, we could relieve healthcare cost pressures on state and local governments.”

An American Action Forum (AAF)  study proposes tort reform as an additional means to lower health care costs.  “ AAF found multiple state medical liability reforms reduced total healthcare premiums by 2.6 percent,  Employer healthcare costs also declined by 3.5 percent, [and]  If these results were replicated on a national level, the nation’s insured could save more than $15 billion in premiums…Tort reform has taken several forms and gained prominence in the 1990s as a way to curb high jury awards. For example, legislators can cap damages, reform how damages are paid, and amend joint and several liability (allowing the plaintiff to collect money from anyone found liable, regardless of their degree of liability).”