The New York Analysis of Policy and Government presents a two-part examination of what would happen if Obamacare isn’t replaced.

There has been a great deal of discussion about the impact of replacing Obamacare. Perhaps more attention should be paid to what would happen if Obamacare is NOT replaced.

A Washington Free Beacon report quotes Aetna CEO Mark Bertoline, noting that “Obamacare Will Continue to Deteriorate If Nothing Happens…” Aetna has announced that it will leave Obamacare exchanges in Iowa and Virgina. Bertoline also stressed that “a reinsurance pool would be a better solution for really sick individuals…When you talk to a lot of constituents who have $6,000 deductibles, live in the five eastern counties of Colorado where there isn’t a doctor, a $6,000 deductible is not helpful.”

Writing for the Journal of American Physicians and Surgeons, Dr. Lawrence R. Huntoon, M.D.states:

“ObamaCare is designed to cheat both patients and physicians. It destroys patient choice and often disrupts continuing long-term patient-physician relationships. By implementing extremely high deductibles, co-pays, and out-of-pocket maximums, ObamaCare creates the illusion of coverage at the cost of unacceptably high premiums…In order to survive, physicians who depend on third-party payment will need to take appropriate legal measures to limit financial losses caused by ObamaCare. Many will likely reassess their plan participation as financial losses and bureaucratic impediments to care increase. Third-party-free practice models will become more attractive to many physicians. And, unfortunately, physicians who opt for hospital-subsidized employment in an attempt to escape the adversities of ObamaCare will only exacerbate the loss of choice for patients and the rationing of care by the so-called Accountable Care Organizations. Patients will also come to recognize that they are paying a very high price for the illusion of coverage under ObamaCare. As patients increasingly realize that, for the most part, they will be spending their own money for medical care during any given year, they will begin to look for better value in their medical care. Third-party-free physicians, who are able to provide timely access to care, and more face-to-face time with patients at an affordable cost, will become more attractive to many patients. Likewise, as high deductibles, high co-pays, and unlimited out-of-pocket costs are a reality under ObamaCare, health savings accounts will become more attractive to more patients. If one is going to spend one’s own money, one might as well spend tax-free money as opposed to after-tax money. “

A major concern about Obamacare has been its detrimental impact on full-time employment, a problem that would continue if the law remains in effect. Writing for Forbes last September, Michael C. Cannon noted: “Four percent of large employers are reducing hiring because of the cost of providing health benefits to them… ObamaCare will depress wages for high-skilled workers by 1.3 percent and for low-income workers by 3 percent.”

The harsh economic impact of Obamacare doesn’t receive adequate attention. Casey B. Mulligan writes in Side Effects and Complications: The Economic Consequences of Health-Care Reform that the economy, and particularly employment, are detrimentally affected.

Edward Morrissey, writing for the Fiscal Times, concurs. He cites a Goldman Sachs study that demonstrates that employers have reduced full-time positions in favor of part-time ones that don’t require them to provide health insurance. That trend will continue if Obamacare is not repealed.

The continued existence of Obamacare-related taxes also would serve as an ongoing drag on the economy. Americans for Tax Reform’s John Kartch lists the $1 trillion in taxes that would be repealed if the legislation were overturned:

Obamacare Individual Mandate Tax

Obamacare Employer Mandate Tax

Obamacare’s Medicine Cabinet Tax
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Obamacare’s Flexible Spending Account tax

Obamacare’s Chronic Care Tax

Obamacare’s HSA withdrawal tax.

Obamacare’s 10% excise tax on small businesses with indoor tanning services.

Obamacare health insurance tax.

Obamacare 3.8% surtax on investment income.

Obamacare medical device tax.

Obamacare tax on prescription medicine.

Obamacare tax on retiree prescription drug coverage.

The Report concludes tomorrow.

Quick Analysis

Putin’s Saber Rattling

Earlier this week, President Biden reversed his 2022 decision, authorizing the provision of antipersonnel land mines to the Ukrainian government. It follows an earlier Administration authorization to allow the use of an advanced American missile system capable of striking as deep as 100 miles inside Russian territory. The US election season may be ending, but both Russia and the West show no indication of stepping down the conflict. Russian propaganda continues to swell as the Kremlin increases its threats to use nuclear weapons against the West. Last week Andrey Sushentsov, program director of the pro-Kremlin think tank Valdai Discussion Club (VDC), published an article on growing nuclear tensions in the region. Official Russian language in the last few years has been threatening. Since the US election, rhetoric like that in the Sushentsov article, has approached the level of nuclear blackmail. The VDC article’s main theme centers on Russia’s intent to directly confront the West militarily if the North Atlantic Treaty Organization (NATO) becomes involved in Russia’s conflict with Ukraine. “On the one hand, these threats are intended to frighten the West, but on the other, Russian propagandists themselves are starting to believe in the inevitability of escalation,” according to Ksenia Kirillova of the Jamestown Foundation. On November 11, Sushentsov wrote that “The conflict will reach a completely new level, with unpredictable consequences for Europe and the entire world.” Kirillova points out that Putin’s distorted image of the world is divorced from reality and is causing the Kremlin to issue demands that are impossible to fulfill. Financial and other Russian resources needed to support Putin’s war are growing scarcer at the same time. This week the Kremlin announced a reduction of payments to its soldiers. Recently North Korea acknowledged it was sending soldiers to fight in Ukraine as Putin is running out of bodies to use as cannon fire. The war is not going well for Russia. One question floating around the Washington intelligence community is whether Putin will act out of desperation before President-elect Trump assumes office. In recent months the Russian propaganda machine is spewing out materials from fairly reputable analytical platforms inside the country. Kirillova says that “Kremlin ‘experts’ do not conceal that such threats are only intended to break the West psychologically, as they themselves are not prepared for full-scale nuclear war.” Despite Russia’s lack of preparation for an all-out war with the West, the expanding nuclear rhetoric carries with it an increase in the threat of a full-scale war in multiple theaters of operation. In June 2023 a founder of the Russian Council on Foreign and Defense Policy, Sergey Karaganov, called for “delivering a pre-emptive strike of retaliation” on Poland to force the West to surrender. In the previous month, Dmitry Suslov, a direct of research programs at the policy center proposed organizing “a demonstration nuclear explosion” aimed at intimidating the West. In September, President Putin announced a reappraisal of Russian nuclear doctrine after speaking earlier in the year at the plenary session of the St. Petersburg International Economic Forum and jokingly calling Suslov a “scary person.” Pavel Baev, writing in the European Daily Monitor, says “Putin intends his announcement to mark an escalation of nuclear brinkmanship and influence the proceedings of future Ukrainian peace efforts.” Putin is expanding the list of environmental conditions that are acceptable for using a nuclear weapon and incorporating it into Russian military doctrine. Baev adds that “The ups and downs of Russian brinkmanship are disconnected from the kinetic battles of the war, correlating instead with Ukrainian peace offensives, such as Ukrainian President Volodymyr Zelenskyy’s first peace summit in Bürgenstock, Switzerland.” Despite the increase in vitriolic language, in a You Tube video published a week before the US presidential election, Karaganov openly assured the West the primary goal of the escalation is to break the American spirit and that of the West, not outright nuclear war. By Election Day in the US, with political prognosticators predicting a win for former president Trump, Karaganov changed his tune and called for an increased role in nuclear deterrence. Kirillova points out that Western concessions to Russia are unlikely to reduce the risk of nuclear escalation. The distorted reality inside the Kremlin continues to push that President-elect Trump is an adherent of “world government,” that Ukraine will create a nuclear weapon, and Russia must prepare for a nuclear conflagration to achieve its ambitions for a new world order. President-elect Trump has indicated he will not agree to concessions that destabilize Europe, the Middle East or other regions. Going forward a strong US foreign policy may be the most stabilizing course the West can count on to restrain Putin and his intent to rebuild the Russian empire. Daria Novak served in the U.S. State Dept. Illustration: Pixabay

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