Eight rea­sons to still hate Oba­macare

The Washington Times Weekly - - Editorials - By Stephen Moore

Re­mem­ber Oba­macare? The fight is far from over on the fu­ture of the Obama-era health in­sur­ance over­haul. Repub­li­cans are mak­ing a list-ditch ef­fort this year to turn the pro­gram and the money over to the state. This isn’t full Oba­macare re­peal, but would make a world of sense be­cause states would be free to ex­per­i­ment and find ways to re­duce costs and pro­vide bet­ter ser­vices.

Democrats are adopt­ing a new po­lit­i­cal spin, which is that every­thing is fine with Oba­macare. They claim that the only rea­son pre­mium and de­ductible costs keep ex­plod­ing is be­cause Pres­i­dent Trump re­pealed the in­di­vid­ual man­date tax — which was noth­ing more than an un­fair penalty on low-in­come fam­i­lies that can’t af­ford the high cost of the health law’s man­dates. But if Mr. Trump is to blame, why were the costs sky­rock­et­ing two years be­fore Mr. Trump even en­tered the Oval Of­fice?

The clear-eyed re­al­ity is that things aren’t go­ing well with Oba­macare. The pre­dicted death spi­ral in the in­sur­ance mar­ket — higher costs cause more healthy peo­ple to drop cov­er­age, which raises prices even more, and the cy­cle con­tin­ues — is now ir­refutably upon us. This law should re­ally be re­named the UCA: the Un­af­ford­able Care Act. Here are eight rea­sons Oba­macare needs to be re­pealed now, more than ever.

1. Health in­sur­ance is more ex­pen­sive than ever. Re­mem­ber the prom­ise that the av­er­age fam­ily would save $2,500 a year on health in­sur­ance? For­get about it. In May 2017 the Depart­ment of Health and Hu­man Ser­vices re­ported that av­er­age health in­sur­ance pre­mi­ums dou­bled since 2013. How many fam­i­lies’ in­comes dou­bled over that same pe­riod? In 2018 costs have risen by an­other 19 per­cent for high-cost plans and 32 per­cent for the cheap­est plans, ac­cord­ing to a study by the Ur­ban In­sti­tute. Over­all in­fla­tion for all other goods and ser­vices are run­ning at 2 per­cent.

2. En­ti­tle­ment spend­ing has ex­ploded. Oba­macare has driven en­ti­tle­ment spend­ing up much faster than ex­pected. The pro­jected bud­getary cost of Oba­macare sub­si­dies and Medicaid ex­pan­sions from 2018 to 2027 now to­tals $4.8 tril­lion. The Con­gres­sional Bud­get Of­fice es­ti­mates that Oba­macare and its Medicaid ex­pan­sion are re­spon­si­ble for 44 per­cent of the pro­jected fu­ture in­creases in en­ti­tle­ment spend­ing.

3. Oba­macare has not stopped the stam­pede of ris­ing health care costs. In­stead of “bend­ing the cost curve down,” na­tional ex­pen­di­tures on health care con­tinue to rise. The year be­fore Oba­macare was fully im­ple­mented, health care amounted to 17.2 per­cent of U.S. gross do­mes­tic prod­uct (GDP). Last year that tab grew to 18.3 per­cent — an in­crease of al­most $200 bil­lion in health spend­ing. The lat­est fore­cast for 2025 is that med­i­cal ex­penses will reach al­most 20 per­cent of GDP.

4. Amer­i­cans are pay­ing more money for less health cov­er­age. Ac­cord­ing to Kaiser, the av­er­age de­ductible for peo­ple with em­ployer-pro­vided health cov­er­age last year was $1,221 com­pared to $303 in 2006. Usu­ally, you pay higher de­ductibles for lower pre­mi­ums. Un­der Oba­macare, you pay more when you get your hospi­tal bill.

5. Fewer in­sur­ance choices. Ac­cord­ing to fed­eral and state data of in­surer ex­change op­tions per county, more than 50 per­cent of our na­tion’s coun­ties have only one in­surer in 2018. Over 30 per­cent of coun­ties are lim­ited to two in­sur­ers. This means roughly 4 of 5 coun­ties will have ei­ther just one or two Oba­macare ex­change in­sur­ers to choose from.

6. Medicaid en­roll­ment is ex­plod­ing. The vast ma­jor­ity of Amer­i­cans who have re­ceived in­sur­ance un­der the Oba­macare law have en­rolled in Medicaid. Medicaid en­roll­ment has soared from 55 mil­lion to 74 mil­lion since 2013. Yet many physi­cians, health clin­ics and hos­pi­tals don’t ac­cept Medicaid. This means tens of mil­lions of Amer­i­cans of­ten can’t choose the doctor, hospi­tal or treat­ment of their choice. Medicaid users in ma­jor cities ex­pe­ri­ence an av­er­age de­nial rate of 47 per­cent. Mid-sized city Medicaid users have an av­er­age de­nial rate of 40 per­cent.

7. Nearly 30 mil­lion Amer­i­cans still unin­sured. On April 1, 2014, stand­ing in the rose gar­den at the White House, Pres­i­dent Obama claimed that the Affordable Care Act meant “ev­ery­body” would have health in­sur­ance. To­day, some 30 mil­lion Amer­i­cans re­main unin­sured to this day. Why? Fam­i­lies can’t af­ford the in­sur­ance. In 2012, the Con­gres­sional Bud­get Of­fice es­ti­mated that Oba­macare ex­change en­roll­ment would in­crease by 9 mil­lion by 2016. In­stead, an un­der­whelm­ing 400,000 in­crease oc­curred, which is a stag­ger­ing 96 per­cent re­duc­tion in the an­tic­i­pated growth of net-ACA ex­change en­roll­ment.

8. Oba­macare con­tin­ues to ig­nore ob­vi­ous cost-sav­ing al­ter­na­tives. Oba­macare does not al­low pa­tients to buy in­sur­ance across state lines, which would dra­mat­i­cally in­crease com­pe­ti­tion and lower costs. It does not al­low small­busi­ness-as­so­ci­ated health plans. It lim­its low-cost health sav­ings ac­counts op­tions. It has no pro­vi­sions for cap­ping med­i­cal mal­prac­tice costs — be­cause Democrats were bought off by the trial lawyers.

Let’s sum­ma­rize what we have got­ten for our money un­der Oba­macare. We have spent hun­dreds of bil­lions of dol­lars al­ready; we have mas­sively in­creased the size of the fed­eral bud­get; we have sub­si­dized in­sur­ance plans to get Amer­i­cans to sign up for Oba­macare; we have pe­nal­ized peo­ple if they don’t buy Oba­macare (un­til that law was re­pealed); but we still have al­most 1 in 11 Amer­i­cans without in­sur­ance. Has there ever been a big­ger pub­lic pol­icy flop?

I re­cently de­bated a high-rank­ing Obama White House econ­o­mist and asked him: What was the great­est ac­com­plish­ment of Pres­i­dent Obama in eight years in of­fice? He replied: the Affordable Care Act. Re­ally? If this is Mr. Obama’s grand suc­cess, imag­ine how bad the fail­ures were. Stephen Moore is a se­nior fel­low at the Her­itage Foun­da­tion and an eco­nomic con­sul­tant with Free­dom Works.

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