The Affordable Care Act never would have been passed had Congress known how it would develop
Obamacare barely passed Congress in 2010. If people had known how it would develop, the health-care act would likely never have become law.
Under Obamacare, the number of uninsured was supposed to decline from 50 million to 22 million in 2016... Instead, there are still 31 million uninsured.
Back in 2009, when the law was proposed, and in 2010, when it was signed, the Affordable Care Act’s (ACA) proponents were giddy with optimism. Proponents proclaimed the many promises of Obamacare. Millions of people would be enrolled by 2016. The number of uninsured would decline dramatically. Health-care costs and premiums would drop. Everyone would have coverage. The federal deficit would decrease. Of course, as President Obama promised, everyone would be able to keep their plans and their doctors.
The truth has turned out to be very different. That’s why all Republican candidates say they want to repeal the program. Here are seven things about Obamacare that turned out to be very bad.
1. Low enrollment. Many people would not have jumped on the Obamacare bandwagon if they had known the relatively small number of Americans who would actually be enrolled on the exchanges by 2016. 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. Under Obamacare, the number of uninsured was supposed to decline from 50 million to 22 million in 2016 and remain at that level. Instead, there are still 31 million uninsured, and the number is never projected to go below 29 million, according to CBO.
The Kaiser Family Foundation (February 2016) says that around 10% of the population (32.3 million of 316 million Americans) lacks health-insurance coverage. If the goal of health-care reform is to extend insurance coverage to more Americans, there are surely more effective — and less costly — ways to achieve this goal.
3. Lost doctors. In a presidential weekly address on July 18, 2009, President Obama said: “Michelle and I don’t want anyone telling us who our family’s doctor should be — and no one should decide that for you either. Under our proposals, if you like your doctor, you keep your doctor.”
Various sources note that a common (and popular) way to reduce premium costs has been to reduce the number of doctors in the insurer’s network, which leads to a much greater likelihood of people losing their doctors than without the ACA.
Initially the ACA required only 20% of “essential community providers” to be included in networks, but the number went up to 30% after there was a backlash from hospitals. According to a NIH study, 15% of plans offered on the exchanges exclude doctors from at least one kind of specialty.
4. Lost plans. Speaking in the Rose Garden, on July 21, 2009, President Obama said: “If you like your current plan, you will be able to keep it. Let me repeat that: If you like your plan, you’ll be able to keep it.” But it wasn’t true. Many plans disappeared because they did not comply with the ACA regulations.
Sen. Ben Sasse, a Republican from Nebraska, recently released a report about 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 hasdropped 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. President Obama claimed that the Affordable Care Act would reduce annual insurance premiums by $2,500 for a typical family. Yet a report by 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.
Many members of Congress voted for Obamacare to... put America’s health-care system on a sounder foundation. For most Americans, the opposite has happened.
6. Higher deductibles. Practically no one forecast that even after spending additional thousands of dollars a year for health insurance, families would have to spend thousands of dollars more on medical care before being able to take advantage of insurance for more than annual check-ups. Many people get sticker shock. The New York Times, long a cheerleader for Obamacare, reported that many people can’t afford to use the health insurance that 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 Obamacare will result in an additional $274 billion in administrative costs alone over the period of 2014 through 2022. The most recent CBO analysis concludes that repealing Obamacare would result in macroeconomic effects that would decrease the deficit by over $216 billion over the 2016-2025 period.
Legislative options that would repeal and replace Obamacare, such as the Restoring Americans’ Healthcare Freedom Reconciliation Act — passed on Jan. 6, 2016, and vetoed by President Obama on Jan. 8, 2016 — are projected to save taxpayers even more: $474 billion over the 2016-2025 period, the Congressional Budget Office notes.
Many members of Congress voted for Obamacare to help the American public and put America’s health-care system on a sounder foundation. For most Americans, the opposite has happened. Health-care expenses for many individuals and families are higher, their insurance costs are higher, their choice of doctors and insurance is diminished, and the total costs of the program are burdening a weak economy. Had members of Congress known then what they know now, they would never have passed Obamacare.
This piece originally appeared in WSJ's MarketWatch