ObamaCare Dying

Democrats’ over-the-top assault on the GOP replacement for ObamaCare conveniently ignores the elephant in the room: ObamaCare is falling apart on its own.

Aetna announced last week that it’s pulling out of the last two states (down from 15) where it offered ObamaCare policies — following Humana, Cigna and UnitedHealth Group in giving up.

More and more states have just one insurer offering exchange policies, when competition between companies was key to the program’s design. Iowa is at risk of having no one offering ObamaCare coverage in 94 of its 99 counties next year — and other states aren’t far behind.

A “reform” that aimed at universal coverage is heading toward offering no coverage in the individual market in state after state.

The big knock against an early version of the House Republican bill was the Congressional Budget Office projection that it would wind up with 24 million fewer Americans insured than letting ObamaCare continue to work — but that assumed that ObamaCare would continue to work.

The problem is simple. For all the tens of billions in federal subsidies, insurers lose money: Aetna’s pre-tax losses from exchange policies were $100 million in 2014, $130 million in 2015, $450 million in 2016.

Companies that don’t exit still have to raise premiums, which leads ever more young, healthy people to go uninsured. The people left in the pool are older and/or less healthy — which drives further losses for insurers, and the cycle downward begins again. And it’s all meant chaos for consumers. Mary Katharine Ham recently described her experience in The Federalist: “Two years ago, I was a seven months-pregnant widow with one toddler who got a letter two weeks after my husband died, informing me I’d lost my third or fourth health insurance plan since the Affordable Care Act passed. If you’ll remember, the promise was that I could keep my plan if I liked it. I could not.”

Something like 8 million Americans lost their old insurance when the ObamaCare law banned them — and many, like Ham, have since lost their policies time and again.

Not that her coverage is great: She calls it “much more expensive” and “less effective” than her pre-Obama policy. Most plans also severely restrict your choice of doctors, hospitals and so on. “You can keep your doctor” was another lie.

And that’s before insurers do another round of rate hikes in the next cycle of the “death spiral.”

Then there’s Medicaid — the expansion of which accounts for nearly the entire net gain in health coverage under ObamaCare.

But the law, even with all its tens of billions in tax hikes and raiding of Medicare, didn’t fund that expansion permanently.

After the first few years, states will have to pick up much of the added cost. That could require massive tax hikes — which is why many states declined the “free money.”

From the start, critics suggested that ObamaCare was designed to fail — and be replaced by “single payer,” a national health-care system like Britain’s or Canada’s. The Bernie Sanders crowd still thinks that’s the way to go.

But those systems have major problems, too. The British press is full of NHS horror stories, scarily similar to the US Veterans Administration scandals. And, as Kevin Williamson noted recently at National Review, “There is a reason New York City’s hospitals are full of rich Canadians who cannot afford the free health care at home.”

With the Senate looking to start from scratch, the GOP health-care bill is a work very much in progress. But it’s work that has to be done — because ObamaCare is dying from its own design flaws.